Gingival crevicular fluid tissue/blood vessel‐type plasminogen activator and plasminogen activator inhibitor‐2 levels in patients with rheumatoid arthritis: effects of nonsurgical periodontal therapy

Background and Objective The aim of this study was to evaluate the effect of nonsurgical periodontal therapy on clinical parameters and gingival crevicular fluid levels of tissue/blood vessel‐type plasminogen activator (t‐PA) and plasminogen activator inhibitor‐2 (PAI‐2) in patients with periodontitis, with or without rheumatoid arthritis (RA). Material and Methods Fifteen patients with RA and chronic periodontitis (RA‐P), 15 systemically healthy patients with chronic periodontitis (H‐P) and 15 periodontally and systemically healthy volunteers (C) were included in the study. Plaque index, gingival index, probing pocket depth, clinical attachment level, bleeding on probing, gingival crevicular fluid t‐PA and PAI‐2 levels, erythrocyte sedimentation rate, serum C‐reactive protein and disease activity score were evaluated at baseline and 3 mo after mechanical nonsurgical periodontal therapy. Results All periodontal clinical parameters were significantly higher in the RA‐P and H‐P groups compared with the C group (p < 0.001) and decreased significantly after treatment (p < 0.001). Pretreatment t‐PA levels were highest in the RA‐P group and significantly decreased post‐treatment (p = 0.047). Pre‐ and post‐treatment PAI‐2 levels were significantly lower in controls compared with both periodontitis groups (p < 0.05). Gingival crevicular fluid volume and the levels of t‐PA and PAI‐2 were significantly correlated. Conclusion In patients with periodontitis and RA, nonsurgical periodontal therapy reduced the pretreatment gingival crevicular fluid t‐PA levels, which were significantly correlated with gingival crevicular fluid PAI‐2 levels. The significantly higher t‐PA and PAI‐2 gingival crevicular fluid levels in periodontal patients, regardless of systemic status, suggest that the plasminogen activating system plays a role in the disease process of periodontitis.