Psoriasis Severity Linked to Apical Periodontitis but Not to Dental Caries: Study

Researchers have found in a new study that a significant association between psoriasis severity and apical periodontitis (AP), suggesting a possible role of psoriasis in AP pathogenesis. However, no significant correlation was observed between psoriasis and dental caries. Additionally, immune-modulating drugs from psoriasis patients did not appear to affect apical periodontitis prevalence.

A study evaluated the prevalence of apical periodontitis (AP) and caries in subjects with psoriasis vulgaris. 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 apical periodontitis and a linear regression model were then built to relate the severity and extent of apical periodontitis 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 apical periodontitis and caries experience (p = .76). The logistic regression model showed that moderate/severe psoriasis increased the odds of having apical periodontitis [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).

The degree of severity of psoriasis is significantly associated with apical periodontitis, suggesting that psoriasis may play a role in the pathogenesis of apical periodontitis. 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 apical periodontitis.