Patients of autoimmune liver disease treated with immune suppressants have lower prevalence of apical periodontitis: Study

Autoimmune liver diseases (ALDs) are chronic conditions generated by an immune-mediated auto-aggressive inflammatory reaction in genetically susceptible individuals. The purpose of this study was to evaluate the prevalence of apical periodontitis in patients suffering from ALDs, in treatment with the immune-suppressants glucocorticoids, azathioprine, and/or ursodeoxycholic acid. The Autoimmune liver diseases group included 46 patients (11 men and 35 women, average age: 57.9 ± 11.8 years) and 1186 teeth. The control (C) included 50 healthy patients (15 men and 35 women, average age: 58.6 ± 10.4 years) and 1251 teeth), under no medications. Demographic data, and medical, pharmacological, and dental history, were recorded. Dental and radiographic examinations were performed, presence of apical periodontitis, periapical index score, DMFT, quality of restoration, and root canal treatment were evaluated. The influence of the medications assumed by the patients on the prevalence of apical periodontitis was also tested.

Results: The prevalence of apical periodontitis was significantly lower in Autoimmune liver diseases than in C, at patient (p=.019), and tooth level (p=.005). (p=.015). Smoking and age were associated with a significant increase in apical periodontitis in cases and controls (p=0.045, and p=0.001). In both groups, endodontically treated teeth showed a higher prevalence of apical periodontitis. Considering all the limitation due to the observational nature of the study, the patients affected by autoimmune liver diseases, and in treatment with immune-suppressors (often associated with immune-modulators), were found to exhibit lower prevalence of apical periodontitis.

Reference:

Ideo F, Niazi S, Chessa L, Miglianti M, Bardini G, Mannocci F, CottiDDS E. Prevalence of apical periodontitis in patients with autoimmune liver diseases under immune suppressants and immune modulators: a cross-sectional study. J Endod. 2024 Mar 23:S0099-2399(24)00165-1. doi: 10.1016/j.joen.2024.02.026. Epub ahead of print. PMID: 38527610.

Keywords:

Patients, autoimmune, liver disease, immune suppressants, lower prevalence, apical periodontitis, study, Journal of Endodontics, Ideo F, Niazi S, Chessa L, Miglianti M, Bardini G, Mannocci F, CottiDDS E