22 May 2019

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Periodontitis and psoriasis: is there an association?

Giulia Palandrani

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Periodontitis is a chronic inflammatory disease resulting from an opportunistic infection of endogenous plaque biofilm. Periodontitis affects more than 50% of adults worldwide, and 5–10% present a severe form of the disease leading to the loss of teeth.  
Psoriasis is a chronic inflammatory multisystemic disease that occurs mainly on the dermis and epidermis, affecting between 1 and 3% of the population It has been suggested that bacteria may have an important role in its immunopathogenesis.  
In this sense, these two diseases present similar immunopathogenic process and common risk factors. Several studies show greater bone loss in patients with psoriasis and at the same time an increased risk for psoriasis in periodontal patients. 
The specific objective of this case‐control study was to evaluate a possible association between psoriasis and periodontitis   

MATERIAL AND METHODS  
In this Case-control study 397 individuals with psoriasis (cases) and 359 individuals without psoriasis (controls) were examined. All individuals underwent a complete periodontal examination, different parameters were evaluated: probing depth (PD); clinical attachment level (CAL); bleeding on probing (BOP) and the plaque index (PI). Moreover the following data of interest were recorded: gender, age, family income, education levels, dental flossing, frequency of tooth brushing, BMI, diabetes, use of anti‐anxiety and anti‐depressants drugs, smoking habits, and alcohol consumption.    

RESULTS     
With respect to the variables of interest, individuals with psoriasis showed significantly higher BMI (p < 0.001), diabetes (p = 0.002), use of anxiolytics (p = 0.002) and antidepressants (p = 0.006), and smoking (p = 0.022).  A higher prevalence of periodontitis was observed in the case group (46.1%) when compared to controls (33.1%). Additionally, the prevalence of periodontitis significantly increased according to the severity of psoriasis forms [mild (44.4%), moderate (46.3%), and advanced (47.1%)] showing a relationship between these diseases. On the contrary the present study does not confirm an association between severity of periodontitis and higher occurrence of psoriasis.  

CONCLUSIONS  
This study show an association between psoriasis and periodontitis. However these results can be considered a starting point, further studies are needed to consolidate these data.    

For additional informations:
Periodontitis as another comorbidity associated with psoriasis: A case‐control study.