Oral health status and dental treatment needs of psoriatic patients with different therapy regimes

Association between apical periodontitis and psoriasis vulgaris: A cross-sectional study

AIM

To evaluate the prevalence of apical periodontitis (AP) and caries in subjects with psoriasis vulgaris.

METHODOLOGY

In total, 152 patients with psoriasis vulgaris were included in the study. The severity and extent of psoriasis were assessed according to the Psoriasis Area Severity Index (PASI), the Body Surface Area (BSA) and the Physician's Global Assessment Scale (PGA). Periapical status was assessed through dental examination and periapical radiographs. Data regarding the Periapical Index (PAI), caries experience expressed as the Decayed, Missing, Filled Teeth Index (DMFT) and psoriasis medications were recorded. A predictive logistic regression model for the presence of AP and a linear regression model were then built to relate the severity and extent of AP to the type of drug therapy taken for psoriasis and to the severity and extent of the skin disease.

RESULTS

Subjects with severe/moderate psoriasis showed a significantly higher prevalence of AP (p = .002) and a higher PAI score (p = .0035) than subjects with mild psoriasis. No significant correlation was found between AP and caries experience (p = .76). The logistic regression model showed that moderate/severe psoriasis increased the odds of having AP [odds ratio (OR) = 1.30 ± 1.088, 1.55]. A negative linear relationship between biological drug intake and PAI score value was observed (coefficient = -.54; p = .04).

CONCLUSIONS

The degree of severity of psoriasis is significantly associated with AP, suggesting that psoriasis may play a role in the pathogenesis of AP. However, no significant correlation was observed for caries experience. Furthermore, the immune-modulating drugs taken by these patients did not seem to have different effects on the prevalence of AP.

Periodontal Disease in Patients with Psoriasis: A Systematic Review

Psoriasis is a chronic, inflammatory, and recurrent skin disease. As with periodontitis, the development and progression of lesions depend on immunological, genetic, and environmental factors. This systematic review was designed to answer the question: "Is there a relationship between psoriasis and periodontal disease?". Following the inclusion and exclusion criteria, sixteen studies were included in this systematic review (according to PRISMA statement guidelines). Based on the meta-analysis, psoriasis patients showed a more than two-fold increase in the odds of periodontal disease. Almost one-third of these patients suffered from periodontitis of varying severity. Despite the heterogeneity of the included studies, psoriasis is associated with a higher risk of periodontitis, and especially with advanced progression.