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

Abstract

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.

Keywords: dental caries; periapical periodontitis; psoriasis.

FIGURE 1

Flow chart for subject selection.