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Marruganti C, Romandini M, Gaeta C, Trovato E, Cinotti E, Rubegni P, D'Aiuto F, Grandini S. Treatment of periodontitis ameliorates the severity and extent of psoriasis-A randomized clinical trial. J Periodontal Res 2024. [PMID: 38899599 DOI: 10.1111/jre.13314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
AIM To assess the impact of non-surgical periodontitis treatment over conventional dermatological treatment on the severity and extent of psoriasis in patients affected by comorbid psoriasis and periodontitis. METHODS Seventy-four patients affected by both psoriasis and Stages I-IV periodontitis were randomized to receive either Steps 1-2 (non-surgical) of periodontal therapy (test group; n = 37) or no treatment (control group; n = 37). The two groups were balanced in terms of psoriasis medications, with the majority of the included patients undergoing biologics (74.0%) as monotherapy, while minor proportions were under systemic medications (13.7%) or none/topical/phototherapy (12.3%). The psoriasis area severity index (PASI) was regarded as the primary outcome. The Body Surface Area (BSA) and the Dermatology Life Quality Index (DLQI) were additionally considered as dermatological outcomes. Probing pocket depth, recession depth, clinical attachment level, periodontal inflamed surface area, and full-mouth plaque and bleeding scores were also measured. [Correction added on July 5, 2024, after first online publication: The preceding sentence has been revised]. RESULTS Periodontal therapy in the test group led to statistically significant lower PASI scores at 10 weeks (mean = 3.15; standard deviation [SD] = 3.78) compared to the control group (mean = 7.11; SD = 6.09) (mean difference [MD] = -4.0; 95% confidence interval [CI]: -6.3, -1.6; p = .001). The test group also showed improvements in BSA (MD = -4.3) and periodontal parameters compared to the control group. DLQI only showed a non-statistically significant tendency (MD = -2.0). CONCLUSION Steps 1-2 of periodontal therapy showed an additional effect over conventional dermatological treatment in reducing the severity and extent of psoriasis (Clinicaltrials.gov: NCT05311501).
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Affiliation(s)
- Crystal Marruganti
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Unit of Periodontology, UCL Eastman Dental Institute, London, UK
| | - Mario Romandini
- Department of Periodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Carlo Gaeta
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Emanuele Trovato
- Unit of Dermatology, Department of Medical, Surgical and Neurological Science, University of Siena, Siena, Italy
| | - Elisa Cinotti
- Unit of Dermatology, Department of Medical, Surgical and Neurological Science, University of Siena, Siena, Italy
| | - Pietro Rubegni
- Unit of Dermatology, Department of Medical, Surgical and Neurological Science, University of Siena, Siena, Italy
| | | | - Simone Grandini
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
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Kwak EJ, Choi YJ, Kim HN, Kim KE, Jeon J, Baek YS. Increased dental comorbidities in patients with psoriasis: a nationwide population-based cohort study in Korea. Clin Exp Dermatol 2023; 48:1347-1353. [PMID: 37624999 DOI: 10.1093/ced/llad286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Limited data are available regarding the association between psoriasis and common dental conditions. OBJECTIVES To investigate the risk of potential dental comorbidities in patients with psoriasis. METHODS We conducted a nationwide population-based cohort study to analyse the claims data of patients with psoriasis (n = 15 165) and age- and sex-matched controls (n = 75 825). The incidence risk of the following potential dental conditions was analysed: dental caries, pulp and periapical disease, periodontal disease, gingival changes and tooth loss. RESULTS After adjusting for potential cofactors, the adjusted hazard ratios (aHRs) of dental caries [1.105; 95% confidence interval (CI) 1.078-1.132], pulp and periapical disease (1.07; 95% CI 1.044-1.096) and periodontal disease (1.108; 95% CI 1.088-1.129) were significantly higher than those in the control cohort (P < 0.001). However, among the subset of patients with psoriasis who received systemic antipsoriatic treatment (n = 4275), the aHR risk of all potential dental comorbidities was not significantly higher from that of the control cohort. CONCLUSIONS Patients with psoriasis have an increased risk of dental comorbidities, and systemic antipsoriatic treatment may help mitigate this increased risk.
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Affiliation(s)
- Eun-Jung Kwak
- National Dental Care Center for People with Special Needs, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Yun Jin Choi
- Biomedical Research Institute, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Han-Na Kim
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ko Eun Kim
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jiehyun Jeon
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yoo Sang Baek
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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Baek YS, Kwak EJ, Kim YC, Kim KE, Song HJ, Jeon J. Periodontal disease does not increase the risk of subsequent psoriasis. Sci Rep 2023; 13:5942. [PMID: 37046012 PMCID: PMC10097622 DOI: 10.1038/s41598-023-32907-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
Previous studies suggested that chronic periodontitis may be a risk factor for psoriasis. However, no study has confirmed this relationship for all stages of periodontal disease (gingivitis and periodontitis). This nationwide population-based retrospective cohort study aimed to investigate whether periodontal disease is an independent risk factor for the development of subsequent psoriasis. Patients aged ≥ 20 years who underwent both medical and oral checkups from the National Health Screening Program between 2002 and 2007 were selected from a customized database provided by the National Health Insurance Service (NHIS). Then, patients with periodontal disease (n = 3,682,468) and without periodontal disease (control, n = 3,637,128) according to oral examination results were identified. We tracked each patient for subsequent psoriasis diagnosis until the end of 2018 using NHIS database. The incidence rates of psoriasis per 1000 person-years were 0.36 and 0.34 in the periodontal disease group and control groups, respectively. After adjusting for potential cofactors, no significant increase in risk (adjusted hazard ratio, 0.994; 95% confidence interval, 0.974-1.015) was observed. Similar results were observed when analyzing the risk of psoriasis in patients who required scaling or periodontal surgery. In conclusion, periodontal disease is not an independent risk factor of psoriasis.
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Affiliation(s)
- Yoo Sang Baek
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Eun-Jung Kwak
- National Dental Care Center for Person with Special Needs, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Young Chan Kim
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Ko Eun Kim
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Hae Jun Song
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Jiehyun Jeon
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea.
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Hussein M, Farag YMK, Sonis S. Psoriasis and oral health in adult United States population: a cross-sectional study. BMC Oral Health 2023; 23:66. [PMID: 36732740 PMCID: PMC9896729 DOI: 10.1186/s12903-022-02689-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/22/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To detect the association between psoriasis as an exposure and oral health conditions as outcomes represented by periodontal and dentition status. This was addressed by analysis of a large number of adults in the United States. METHODS By using The National Health and Nutrition Examination Survey datasets from 2009 to 2014, we performed a cross-sectional analysis of 11,726 participants included in our study population. For participants aged ≥ 30 years, the psoriasis status was assessed from the medical questionnaire. We used data from periodontal and oral examinations to assess the oral conditions of our participants. We examined the association between psoriasis as exposure and moderate/severe periodontitis and non-functional dentition as outcomes. RESULTS The weighted prevalence of psoriasis was 3%, 44% for moderate/severe periodontitis, and 20.5% for non-functional dentition. The fully adjusted model showed no significant association between psoriasis and moderate/severe periodontitis (Prevalence Ratio 1.02, 95% CI 0.9-1.2, p = 0.8). There was no statistically significant association between psoriasis and non-functional dentition except in the fully adjusted model it became statistically significant (Prevalence Ratio 0.8, 95% CI 0.7-0.9, p = 0.04). CONCLUSION Our results showed no association between psoriasis and periodontal or dentition status except in a fully adjusted model for non-functional dentition.
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Affiliation(s)
- Mai Hussein
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. .,Ministry of Health and Population, Cairo, Egypt.
| | - Youssef M. K. Farag
- grid.38142.3c000000041936754XHarvard Medical School, 25 Shattuck Street, Boston, MA 02115 USA ,grid.21107.350000 0001 2171 9311Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Stephen Sonis
- Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital/Dana Farber Cancer Institute, Boston, MA USA ,grid.38142.3c000000041936754XDepartment of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA USA ,Primary Endpoint Solutions, LLC, Waltham, MA USA
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Polineni S, Gopinath H, Ramani JR, Yadav S, Aravindakshan R, Yerragudi N, Prabhakaran N, Sreenivas KD, Abraham VT. The association of psoriasis and psoriatic arthritis with periodontitis: A hospital-based case-control study. Indian J Dermatol Venereol Leprol 2023:1-5. [PMID: 37067142 DOI: 10.25259/ijdvl_331_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 10/01/2022] [Indexed: 02/05/2023]
Abstract
Background
Periodontitis can trigger and perpetuate inflammation in several chronic inflammatory diseases. The association of periodontitis with psoriasis has been investigated earlier, but data are incomplete and the influence of confounders has not been fully evaluated.
We examined the relationship of dental and periodontal health parameters in patients with psoriasis and/or psoriatic arthritis.
Methods
This hospital-based cross-sectional analytical study was conducted in patients with chronic plaque psoriasis, psoriatic arthritis or both, and compared with controls. Dental and periodontal health parameters were assessed based on the WHO oral health assessment method. Multivariate logistic regression was done on variables with significant or near-significant values to find the association between periodontitis and psoriasis and/or psoriatic arthritis after adjusting for confounders.
Results
Psoriasis and/or psoriatic arthritis were independently and significantly associated with periodontal pockets ≥4 mm in depth.
Limitations
Causality and temporal relationship cannot be established as this was a cross-sectional study. As in all observational studies, the possibility of unmeasured or unknown confounders exists. Psoriatic arthritis was present only in a small subset of patients.
Conclusion
Patients with psoriasis and/or psoriatic arthritis have significant periodontal inflammation. This needs to be addressed by dental examination and intervention.
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Affiliation(s)
| | - Hima Gopinath
- Department of Dermatology, All India Institute of Medical Sciences, Mangalagiri, Guntur District, Andhra Pradesh, India
| | - Jami Rupa Ramani
- Department of Dermatology, All India Institute of Medical Sciences, Mangalagiri, Guntur District, Andhra Pradesh, India
| | | | - Rajeev Aravindakshan
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Mangalagiri, Guntur District, Andhra Pradesh, India
| | | | - Nagendran Prabhakaran
- Department of Dermatology, All India Institute of Medical Sciences, Mangalagiri, Guntur District, Andhra Pradesh, India
| | - Kalyan Deepak Sreenivas
- Department of Orthopaedics, All India Institute of Medical Sciences, Mangalagiri, Guntur District, Andhra Pradesh, India
| | - Vineet Thomas Abraham
- Department of Orthopaedics, All India Institute of Medical Sciences, Mangalagiri, Guntur District, Andhra Pradesh, India
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Nijakowski K, Gruszczyński D, Kolasińska J, Kopała D, Surdacka A. Periodontal Disease in Patients with Psoriasis: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811302. [PMID: 36141573 PMCID: PMC9516998 DOI: 10.3390/ijerph191811302] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 05/05/2023]
Abstract
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.
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Affiliation(s)
- Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
- Correspondence:
| | - Dawid Gruszczyński
- Student’s Scientific Group in Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Julia Kolasińska
- Student’s Scientific Group in Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Dariusz Kopała
- Student’s Scientific Group in Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
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Paksoy T, Ustaoğlu G, Yaman D, Arıöz Ö, Demirci M, Ünlü Ö, Avcı E, Polat M. The link between total antioxidant status, total oxidant status, arylesterase activity, and subgingival microbiota in psoriasis patients. Int J Dermatol 2022; 61:1487-1496. [PMID: 35906956 DOI: 10.1111/ijd.16353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 06/15/2022] [Accepted: 06/24/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Studies focusing on the relationship between periodontitis and systemic diseases have suggested a possible association between these two chronic and inflammatory disorders. We aimed to comparatively investigate the salivary oxidative status, biomarker levels, clinical findings, and the microbial load on subgingival biofilm samples in psoriasis patients and controls. METHODS Forty participants were allocated into four groups as follows: (1) systemically and periodontally healthy (C group); (2) systemically healthy with periodontitis (P group); (3) psoriasis (Ps) and periodontally healthy (Ps-C group); and (4) Ps with periodontitis (Ps-P group). Subgingival biofilm samples were obtained to detect the periodontopathogenic agents by Real-time PCR (qPCR). The total antioxidant status (TAS) (mmol/l), total oxidant status (TOS) (μmol/l), and arylesterase (ARE) activity (U/L) were analyzed using saliva samples. RESULTS The level of TOS and oxidative stress index (OSI) were significantly higher in patients with Ps-P and P compared to controls (P = 0.001, and P ˂ 0.001, respectively). ARE levels were higher in controls compared to Ps and P (P ˂ 0.001). The prevalences of bacteria detected in subgingival biofilm samples were similar between all groups (P > 0.05). CONCLUSIONS This study reported that psoriasis may amplify TOS and OSI, and the co-existence of psoriasis and periodontitis may aggravate oxidative stress.
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Affiliation(s)
- Tuğçe Paksoy
- Istanbul Atlas University, Faculty of Dentistry, Department of Periodontology, Istanbul, Turkey
| | - Gülbahar Ustaoğlu
- Bolu Abant Izzet Baysal University, Faculty of Dentistry, Department of Periodontology, Bolu, Turkey
| | - Deniz Yaman
- Bolu Abant Izzet Baysal University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Bolu, Turkey
| | - Özkan Arıöz
- Bolu Abant Izzet Baysal University, Faculty of Dentistry, Department of Periodontology, Bolu, Turkey
| | - Mehmet Demirci
- Kırklareli University, Faculty of Medicine, Department of Medical Microbiology, Kırklareli, Turkey
| | - Özge Ünlü
- İstanbul Atlas University, Faculty of Medicine, Department of Medical Microbiology, İstanbul, Turkey
| | - Emre Avcı
- Health Sciences University, Gülhane Pharmacy Faculty, Basic Pharmaceutical Sciences Department, Department of Biochemistry, İstanbul, Turkey
| | - Mualla Polat
- Bolu Abant Izzet Baysal University, Faculty of Medicine, Department of Dermatology and Venerology, Bolu, Turkey
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Altemir A, Melé-Ninot G, Lázaro-Simó A, Iglesias-Sancho M, Quintana-Codina M, Arandes J, Carrera-Morodo M, Salleras-Redonnet M. Manifestaciones orales en pacientes con psoriasis. Prevalencia y asociación con sus características clínicas y epidemiológicas. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:459-466. [DOI: 10.1016/j.ad.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 12/20/2021] [Accepted: 01/07/2022] [Indexed: 10/19/2022] Open
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[Translated article] Oral Lesions in Patients With Psoriasis: Prevalence and Association With Its Clinical and Epidemiological Characteristics. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.01.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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10
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Olejnik M, Adamski Z, Osmola-Mankowska A, Nijakowski K, Dorocka-Bobkowska B. Oral health status and dental treatment needs of psoriatic patients with different therapy regimes. Aust Dent J 2021; 66 Suppl 1:S42-S47. [PMID: 33891315 DOI: 10.1111/adj.12847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/08/2021] [Indexed: 11/28/2022]
Abstract
The aim of the study was to investigate the dental treatment requirements and oral health status of psoriatic patients with different severities of the disease, managed by different methods, including biological therapies. METHODS One hundred and twenty-seven patients diagnosed with psoriasis were enrolled in this study. All subjects completed a general medical history and a Dermatology Life Quality Index (DLQI) questionnaire. The severity of the disease was assessed using the Psoriasis Area and Severity Index (PASI) scale and a DLQI questionnaire. In order to evaluate the oral health status, the following techniques were used: Approximal Plaque Index (API), the Community Periodontal Index (CPI) and the Decayed, Missing and Filled Teeth (DMFT) index. RESULTS Patients treated with biologicals presented a significantly lower mean CPI index and required no surgical interventions. Subjects managed with topical therapy had significantly more decayed teeth and higher treatment needs. Only 11.3% of patients did not require dental intervention. CONCLUSIONS The study revealed a high need for dental interventions in patients with psoriasis. The type of treatment used may affect the oral health status of patients. However, further investigations are required to explain the significantly lower CPI value in the group treated with biologicals.
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Affiliation(s)
- M Olejnik
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznań, Poland
| | - Z Adamski
- Department and Clinic of Dermatology, Poznan University of Medical Sciences, Poznań, Poland
| | - A Osmola-Mankowska
- Department and Clinic of Dermatology, Poznan University of Medical Sciences, Poznań, Poland
| | - K Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznań, Poland
| | - B Dorocka-Bobkowska
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznań, Poland
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Graetz C, Woeste S, Mrowietz U, Ehrenthal JC. The impact of psychological attachment on the relationship between periodontal health and dental fear in patients with versus without psoriasis: a questionnaire-based, cross-sectional study. BMC Oral Health 2021; 21:95. [PMID: 33663457 PMCID: PMC7934537 DOI: 10.1186/s12903-021-01457-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 02/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background While there is increasing evidence for the relevance of psychosocial variables such as dental fear or psychological attachment in dentistry, much less is known about the mechanisms that determine the strength of those associations. One potential moderator is the occurrence of a comorbid chronic disease such as psoriasis, which is linked to relevant disease parameters such as periodontal inflammation. The aim of the study was to test a moderation model of the relationship between dental fear, psychological attachment and psoriasis on periodontal health. Methods A total of 201 patients (100 with psoriasis, 101 without psoriasis) were included in a questionnaire-based, cross-sectional study. Dental status was measured with the Community Periodontal Index (CPI), dental fear was measured with the Hierarchical Anxiety Questionnaire (HAQ), and psychological attachment was measured with the Relationship Questionnaire (RQ). In addition to the examination of main effects, bootstrapping-based analyses were conducted to test the moderating influence of psychological attachment on the association between CPI and dental fear, gain moderated by group (with vs. without psoriasis). Results Controlling for several covariates, higher CPI scores were associated with higher levels of dental fear only in individuals without psoriasis under conditions of higher levels of psychological attachment anxiety and lower levels of attachment avoidance. Conclusion In individuals without psoriasis, psychological attachment can moderate the association between periodontal health and dental fear. This may provide a useful framework for reducing dental fear through interventions on the level of the dentist-patient relationship.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
| | - Sirka Woeste
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Ullrich Mrowietz
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Campus, Kiel, Germany
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Periodontitis and the impact of oral health on the quality of life of psoriatic individuals: a case-control study. Clin Oral Investig 2020; 25:2827-2836. [PMID: 32955692 DOI: 10.1007/s00784-020-03600-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/16/2020] [Indexed: 02/08/2023]
Abstract
AIM To evaluate the periodontal condition and the impact of oral health on the quality of life (OHRQL) among individuals with and without psoriasis. METHODS This case-control study comprised 295 individuals with psoriasis and 359 controls. A full mouth examination was performed for all periodontal clinical parameters. To evaluate OHRQL, the Oral Impact on Daily Performance (OIDP) questionnaire was applied. Data was analyzed using the chi-square, Fischer, Kruskal-Wallis, Mann-Whitney, and Bootstrap intervals tests to determine different profiles in relation to the OIDP. RESULTS Individuals with psoriasis had a 1.40 greater chance of having periodontitis than controls (OR = 1.40 95%CI: 1.01-1.93; p = 0.019). Individuals with psoriasis with periodontitis (+P) had greater impacts on OHRQL (13.76 ± 15.58), when compared with those without periodontitis (-P) (4.83 ± 8.25; p < 0.001). Additionally, psoriasis +P stage III/IV patients (13.94 ± 15.68) had worse indicators than controls -P (9.49 ± 22.54; p = 0.001). The final multivariate model demonstrated higher OIDP scores related to the following variables: diabetes, anxiolytics use, periodontitis, and psoriasis, showing worse OHRQoL. CONCLUSIONS This study demonstrated an important risk association between psoriasis and periodontitis, as both diseases demonstrated worse OHRQL indicators. Moreover, the severity of periodontitis and psoriasis significantly increased these negative impacts. CLINICAL RELEVANCE Practical implications: Multidisciplinary interaction is desirable to improve the impact of these diseases on the QoL of individuals with psoriasis and periodontitis.
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13
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Zhang X, Gu H, Xie S, Su Y. Periodontitis in patients with psoriasis: A systematic review and meta-analysis. Oral Dis 2020; 28:33-43. [PMID: 32852860 PMCID: PMC9290533 DOI: 10.1111/odi.13617] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 12/23/2022]
Abstract
Objective The present study aimed to summarize and update the evidence regarding the association between periodontitis and psoriasis. Methods The present systematic review was conducted under the guidelines of Transparent Reporting of Systematic Reviews and Meta‐Analyses (PRISMA) and was recorded in the PROSPERO database, under registration number CRD42017063799. Three databases (MEDLINE, Embase, and Cochrane Library) were searched up to March 2020. Case–control or cohort studies assessing the association between periodontitis and psoriasis were identified. Quantitative synthesis was conducted with meta‐analysis. Results A total of 13 studies (11 case–control and two cohort studies) assessing the association between periodontitis and psoriasis were included. Of these 13 articles, 9 showed the prevalence of periodontitis or psoriasis. Therefore, meta‐analyses were conducted with data retrieved from the nine studies included. Pooled effect estimate for nine studies showed that patients with periodontitis associated with a higher risk of psoriasis with a pooled OR of 2.87 (95% CI, 1.75–4.69). Conclusions This systematic review demonstrated a positive association between periodontitis and psoriasis; however, a causal relationship cannot be established. Due to the weak evidence, caution should be taken when interpreting the results regarding periodontal parameters. Well‐designed prospective studies are necessary to evaluate interactions between both diseases.
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Affiliation(s)
- Xinze Zhang
- Department of Stomatology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hongqiu Gu
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shang Xie
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yingying Su
- Department of Stomatology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Ehrenthal JC, Woeste S, Mrowietz U, Gerdes S, Graetz C. Profiles of psychosocial variables and dental status in patients with psoriasis. J Eur Acad Dermatol Venereol 2020; 34:e586-e587. [PMID: 32277503 DOI: 10.1111/jdv.16452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J C Ehrenthal
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | - S Woeste
- Clinic of Conservative Dentistry and Periodontology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - U Mrowietz
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - S Gerdes
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - C Graetz
- Clinic of Conservative Dentistry and Periodontology, University Medical Center Schleswig-Holstein, Kiel, Germany
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Belstrøm D, Eiberg JM, Enevold C, Grande MA, Jensen CAJ, Skov L, Hansen PR. Salivary microbiota and inflammation-related proteins in patients with psoriasis. Oral Dis 2020; 26:677-687. [PMID: 31916654 PMCID: PMC7188313 DOI: 10.1111/odi.13277] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/13/2019] [Accepted: 01/05/2020] [Indexed: 12/14/2022]
Abstract
Objective The purpose of the present study was to characterize the composition of the salivary microbiota and quantify salivary levels of inflammation‐related proteins (neutrophil gelatinase‐associated lipocalin [NGAL] and transferrin) in patients with psoriasis and compare data to those obtained in patients with periodontitis and orally healthy controls, respectively. Materials and methods Stimulated saliva samples from patients with psoriasis (n = 27), patients with periodontitis (n = 58), and orally healthy controls (n = 52) were characterized by means of next‐generation sequencing of the 16S rRNA gene. Salivary levels of NGAL and transferrin were quantified using immunoassays. Results Linear discriminant effect size analysis showed that 52 (22 psoriasis‐associated and 30 periodontitis‐associated) and 21 (8 psoriasis‐associated and 13 orally healthy control‐associated) bacterial taxa differentiated the salivary microbiota in patients with psoriasis from that of patients with periodontitis and orally healthy controls, respectively. Significantly lower mean salivary levels of NGAL (psoriasis: 996 [std. error 320], periodontitis: 2,072 [295], orally healthy controls: 2,551 [345] ng/ml, p < .0001) and transferrin (psoriasis: 4.37 [0.92], periodontitis: 7.25 [0.88], orally healthy controls: 10.02 [0.94] ng/ml, p < .0001) were identified in patients with psoriasis. Conclusions Psoriasis associates with characteristics of the salivary microbiota and salivary levels of inflammation‐related proteins, which are different from characteristics in patients with periodontitis and orally healthy controls, respectively.
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Affiliation(s)
- Daniel Belstrøm
- Section for Periodontology and Microbiology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Josefine Maria Eiberg
- Section for Periodontology and Microbiology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Enevold
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Anastasia Grande
- Section for Periodontology and Microbiology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Lone Skov
- Department of Dermatology and Allergy, Faculty of Health and Medical Sciences, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Peter Riis Hansen
- Section for Periodontology and Microbiology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Herlev and Gentofte Hospital, Hellerup, Denmark
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Dalmády S, Kemény L, Antal M, Gyulai R. Periodontitis: a newly identified comorbidity in psoriasis and psoriatic arthritis. Expert Rev Clin Immunol 2019; 16:101-108. [PMID: 31825680 DOI: 10.1080/1744666x.2019.1700113] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Introduction: Psoriasis is a chronic autoimmune skin disease with strong genetic background and environmental triggers. Patients with psoriasis and psoriatic arthritis are at greater risk of developing other chronic and potentially severe comorbidities, such as psoriatic arthritis, hyperlipidemia, type 2 diabetes mellitus, obesity, metabolic syndrome, cardiovascular diseases or depression. Recently, accumulating epidemiologic, genetic and pathogenetic evidence indicates that psoriasis is also associated with periodontitis, a chronic progressive inflammatory disease, which may result in tooth loss without early and adequate therapy.Areas covered: In this review article we summarize and discuss in detail the available epidemiologic, genetic, microbiological and immunological links between psoriasis and periodontitis.Expert opinion: Periodontitis, via the immunomodulatory effect of the oral microbiota, may play both a direct and indirect role in the development or exacerbation of psoriasis, and may influence the efficacy of antipsoriatic therapy. These new findings indicate a need for increased awareness, early recognition and focus on prevention of periodontitis for patients with psoriasis.
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Affiliation(s)
- Szandra Dalmády
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Lajos Kemény
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary.,MTA-SZTE Dermatological Research Group, University of Szeged, Szeged, Hungary.,HCEMM-SZTE Skin Research Group, University of Szeged, Szeged, Hungary
| | - Márk Antal
- Department of Operative and Esthetic Dentistry, University of Szeged, Szeged, Hungary
| | - Rolland Gyulai
- Department of Dermatology, Venerology and Oncodermatology, University of Pécs, Faculty of Medicine, Pécs, Hungary
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Ingen-Housz-Oro S. Quoi de neuf en dermatologie clinique? Ann Dermatol Venereol 2019; 146:12S1-12S10. [DOI: 10.1016/s0151-9638(20)30100-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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Ucan Yarkac F, Ogrum A, Gokturk O. Effects of non-surgical periodontal therapy on inflammatory markers of psoriasis: A randomized controlled trial. J Clin Periodontol 2019; 47:193-201. [PMID: 31571243 DOI: 10.1111/jcpe.13205] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/19/2019] [Accepted: 09/26/2019] [Indexed: 12/31/2022]
Abstract
AIM The purpose of this randomized controlled clinical study was to evaluate the effect of non-surgical mechanical periodontal therapy on the inflammatory status and severity of psoriasis in subjects with psoriasis. MATERIAL AND METHODS The study population consisted of 92 periodontitis patients with psoriasis vulgaris suffering from an untreated periodontal disease. Two randomized groups were formed from these patients: immediate periodontal therapy (test group, n = 46) and delayed periodontal therapy (control group, n = 46). Periodontal clinical measures, on salivary interleukin 2, interleukin 6 and secretory immunoglobulin A levels and the Psoriasis Area and Severity Index (PASI) scores were evaluated at baseline and on the 8th week in control and test groups. RESULTS Eight weeks after completion of non-surgical periodontal therapy (test group) or initial examination (control group), a significant decrease was observed in interleukin 2, interleukin 6 level and in PASI score, whereas a significant increase was observed in secretory immunoglobulin A levels in the test group (p < .05). CONCLUSION Within the limits of this study, the results suggest that effective periodontal therapy improves the psoriasis condition in patients afflicted by both diseases.
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Affiliation(s)
- Fatma Ucan Yarkac
- Faculty of Dentistry, Periodontology, Necmettin Erbakan University, Konya, Turkey
| | - Atiye Ogrum
- Faculty of Medicine, Dermatology and Venereology, Gaziosmanpasa University, Tokat, Turkey
| | - Ozge Gokturk
- Faculty of Dentistry, Periodontology, Bolu Abant Izzet Baysal University, Bolu, Turkey
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Qiao P, Shi Q, Zhang R, E L, Wang P, Wang J, Liu H. Psoriasis Patients Suffer From Worse Periodontal Status-A Meta-Analysis. Front Med (Lausanne) 2019; 6:212. [PMID: 31632975 PMCID: PMC6779717 DOI: 10.3389/fmed.2019.00212] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/16/2019] [Indexed: 12/31/2022] Open
Abstract
Background and Objective: Patients with psoriasis have a significantly elevated risk of periodontitis compared with the nonpsoriasis controls. However, the data regarding the difference in the periodontal health status of the psoriasis patients and the nonpsoriasis controls are limited and inconsistent; hence, a specialized meta-analysis that quantitatively compared the periodontal status between the psoriasis and nonpsoriasis subjects by evaluating the related clinical periodontal indexes was needed. The aim of this meta-analysis was to quantitatively evaluate whether the periodontal status of psoriasis patients is worse than that of nonpsoriasis subjects. Methods: We searched PubMed and EMBASE for all eligible studies that compared the periodontal status between psoriasis patients and nonpsoriasis subjects. The studies were screened based on pre-established inclusion criteria. After extracting the available periodontal indexes from the included studies, the weighted mean difference (WMD) with 95% confidence intervals (CIs) was calculated by pooling the mean and standard deviations (SD) of each index. Results: In total, 8 studies, including 812 psoriasis patients and 772 nonpsoriasis subjects, were included in our meta-analysis, and the publication dates ranged from 2013 to 2019; eight periodontal indexes were analyzed. The WMD (95% CIs) for each index were: bleeding on probing (%), 9.188 (4.046–14.330, P < 0.001); probing depth (mm), 0.524 (0.183–0.865, P = 0.003); clinical attachment loss (mm), 0.408 (0.051–0.765, P = 0.025); plaque index, 0.186 (−0.170 to 0.543, P = 0.306); gingival index, 0.458 (−0.413 to 1.328, P = 0.303), remaining teeth, −1.709 (−2.106 to −1.312, P < 0.001); missing teeth, 1.130 (0.275–1.985, P = 0.010); the level of alveolar bone loss (mm), 0.400 (0.102–0.698, P = 0.008). Conclusion: In summary, our meta-analysis revealed that psoriasis patients suffer from worse periodontal health than do nonpsoriasis subjects, mainly characterized by worse gingival inflammation, more alveolar bone loss, fewer remaining teeth and more missing teeth. Considering the limitations of this meta-analysis, more high-quality and well-designed studies are needed to validate our conclusions in the future.
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Affiliation(s)
- Pengyan Qiao
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Quan Shi
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Rong Zhang
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Lingling E
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Peihuan Wang
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Juncheng Wang
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hongchen Liu
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
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