Dentist № 1 (44) – 2022, pp. 32-37                                                                                           SCIENTIFIC PUBLICATION

The study of the dental status of patients with psoriasis: results of the clinical study

A.A. Radkevicha, O.S. Zykovab, I.Yu. Karpukc

aVitebsk State Medical University, Vitebsk, Belarus
bMD, PhD, Associate Professor, Vitebsk State Medical University, Vitebsk, Belarus
cMD, PhD, DMSci, Professor, Vitebsk State Medical University, Vitebsk, Belarus

https://doi.org/10.32993/dentist.2022.1(44).5

ABSTRACT
The aim of the study. Psoriasis is associated with various somatic diseases. The objective of our study was the examination of the dental status of patients with psoriasis in comparison with non-psoriatic controls.
Objects and methods. 85 patients with a clinical diagnosis of psoriasis, who were on inpatient treatment, were enrolled to the main group. 39 healthy individuals without inflammatory skin diseases were registered to the control group. If the inclusion criteria were not met, patients were excluded from the study. The examination of the periodontal status was carried out by measurement of the depth of the periodontal pockets and the loss of clinical attachment, as well as by analyzing the loss of alveolar bone on dental X-rays.
Results and discussion. Patients with psoriasis had damage to the oral mucosa, more often than those without psoriasis (n = 42, 49,5% and n = 2, 4,1% accordingly, p < 0,001). Fissured tongue (n = 42, 61,9%) and desquamative glossitis (n = 13, 31%) were met more often among the patients with psoriasis. The value of the the caries-fillingremoved index was statistically significantly different in two groups (main 16.91 ± 8.55, control 8.21 ± 4.15, p = 0.037), as well as the number of missing teeth (7.03 ± 7.7/ 1.53 ± 1.25, p = 0.027). Sulcus bleeding index was 2,08 ± 0,9 in group with psoriatic patients and 1,09 ± 0,51, р = 0,035 in the group of controls. Clinical attachment loss in comparison study/control group was 2,17 ± 2,97/0,18 ± 0,21 accordingly, р = 0,028. Pocket depth was 1,95 ± 0,79 in the main group and 0,85 ± 0,63, р = 0,037 controls had; radiological periodontal bone loss index was 75,56 ± 9,37/ 86,25 ± 8,48, р = 0,026 correspondingly.
Conclusion. Patients with psoriasis have worse dental health, in particular due to worse gum condition, greater loss of alveolar bone, significant loss of dentoalveolar attachment and a greater number of extracted teeth. Considering the limitations of the study, further investigations of the existing problem are required, including risk factors and laboratory diagnostic data analysis for future confirmation of the findings.

Keywords: psoriasis, periodontitis, indices, oral health, systemic disease

References 

  1. Menter A., Gottlieb A., Feldman S.R. [et al.] Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J. Am. Acad. Dermatol., 2008, vol. 58, no. 5, pp. 826–850, doi: doi.org/10.1016/j.jaad.2008.02.039.
  2. Gudjonsson J.E., Elder J.T. Psoriasis: epidemiology. Clin Dermatol., 2007, vol. 25, pp. 535–546, doi: 10.1016/j.clindermatol.2007.08.007.
  3. Kim N., Thrash B., Menler A. Comorbidities in psoriasis patients. Semin. Cutan. Med. Surg., 2010, vol. 29, no. 1, pp. 10–15.
  4. Hart T.C., Atkinson J.C. Mendelian forms of periodontitis. Periodontology 2000, 2007, vol. 45, pp. 95–112, doi: doi.org/10.1111/j.1600-0757.2007.00233.x.
  5. Jotwani R., Palucka A.K., Al-Quotub M. [et al.] Mature dendritic cells infiltrate the T cell-rich region of oral mucosa in chronic periodontitis: in situ, in vivo, and in vitro studies. J Immunol., 2001, vol. 167, no. 8, pp. 4693–4700, doi: 10.4049/jimmunol.167.8.4693.
  6. Yeung H., Takeshita J., Mehta N.N. [et al.] Psoriasis severity and the prevalence of major medical comorbidity: a population-based study. JAMA Dermatol., 2013, vol. 149, no. 10, pp. 1173–1179, doi: 10.1001/jamadermatol.2013.5015.
  7. Sommer D. M., Jenisch S., Suchan M. [et al.] Increased prevalence of the metabolic syndrome in patients with moderate to severe psoriasis. Arch. Dermatol. Res., 2006, vol. 298, no. 7, pp. 321–328, doi: 10.1007/s00403-006-0703-z.
  8. Scannapieco F.A., Bush R.B., Paju S. Associations between periodontal disease and risk for atherosclerosis, cardiovascular disease, and stroke. A systematic review. Annals of periodontology, 2003, vol. 8, no. 1, pp. 38–53, doi: 10.1902/annals.2003.8.1.38.
  9. World Health Organization (WHO) Global Report on Psoriasis. Geneva: WHO, 2016.
  10. Rydén L., Buhlin K., Ekstrand E. [et al.] Periodontitis Increases the Risk of a First Myocardial Infarction: A Report From the PAROKRANK Study. Circulation, 2016, vol. 133, no. 6, pp. 576–583, doi: 10.1161/CIRCULATIONAHA.115.020324.
  11. Davidovici B.B., Sattar N., Prinz J. [et al.] Psoriasis and systemic inflammatory diseases: potential mechanistic links between skin disease and co-morbid conditions. The Journal of investigative dermatology, 2010, vol. 130, no. 7, pp. 1785–1796. doi: 10.1038/jid.2010.103.
  12. Wang Y., Chen J., Zhao Y. [et al.] () Psoriasis is associated with increased levels of serum leptin. The British journal of dermatology, 2008, vol. 158, no, 5. pp. 1134–1135, doi: 10.1111/j.1365-2133.2008.08456.x.
  13. Rácz E., Prens E.P. Molecular pathophysiology of psoriasis and molecular targets of antipsoriatic therapy. Expert reviews in molecular medicine, 2009, vol. 11, e38 p., doi: 10.1017/S146239940900129X.
  14. Gyurko R., Shoji H., Battaglino R. A. [et al.] Inducible nitric oxide synthase mediates bone development and P. gingivalis-induced alveolar bone loss. Bone, 2005, vol. 36, no. 3, pp. 472–479, doi: 10.1016/j.bone.2004.12.002.
  15. Sabat R., Philipp S., Höflich C. [et al.] Immunopathogenesis of psoriasis. Experimental dermatology, 2007, vol. 16, no. 10, pp. 779–798, doi: 10.1111/j.1600-0625.2007.00629.x.
  16. Naldi L. Psoriasis and smoking: links and risks. Psoriasis, 2016, vol. 6, pp. 65–71, doi: 10.2147/PTT.S85189.
  17. Picciani B.L., Domingos T.A., Teixeira-Souza T. [et al.] Geographic tongue and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation – a literature review. Anais brasileiros de dermatologia, 2016, vol. 91, no. 4, pp. 410–421, doi: 10.1590/abd1806-4841.20164288
  18. Kkilikan R., Villarroel-Dorrego M., Jiménez C. [et al.] Lesiones bucales en pacientes con psoriasis: estudio descriptivo de 200 pacientes. Ciencia Odontológica, 2011, vol. 8, no. 2, pp. 120–125.
  19. Costa S.C., Hirota S.K., Takahashi M.D. [et al.] Oral lesions in 166 patients with cutaneous psoriasis: a controlled study. Medicina oral, patologia oral y cirugia bucal, 2009, vol. 14, no. 8, pp. e371-e375.

Correspondence to:  Е-mail: aa.radkev@gmail.com