Abstract
Aim: The aim of the current study was to investigate the possible relationship between periodontal status indices and the risk for psoriasis development in a Greek adult population. Subjects and Methods: The study sample comprised 337 psoriasis patients-cases and 337 healthy individuals-controls between 40 to 69 years of age who referred by three dermatology and one dental private practice. Cases and controls completed a health medical and dental questionnaire and underwent an examination of their periodontal status that included the following parameters: Probing Pocket Depth (PPD), Clinical Attachment Loss (CAL), frequency of a regular/irregular annual dental follow-up, and number of missing teeth. Odds ratios (OR’s) and 95% Confidence Intervals (95% CI’s) were assessed using logistic regression model adjusted for possible confounders. Results: The multivariate regression analysis model showed that a higher BMI (p=0.009, OR= 3.154, 95% CI= 1.532-4.028), alcohol overconsumption (p= 0.012, OR= 2.024, 95% CI=1.445-3.435), moderate /severe CAL (p=0.047, 95% CI=2.112, 1.156-3.249), and a number of missing teeth more than four (p=0.027, OR=2.817, 95% CI= 1.267-3.872 and p= 0.016, OR=3.510, 95% CI= 1.350-4.145) were statistically significantly associated with risk for psoriasis development. Conclusion: Individuals with a higher BMI, excessive alcohol consumption, moderate/severe attachment loss and a number of missing teeth more than four were at significantly higher risk for developing psoriasis. Keywords: Periodontal disease; Psoriasis; Number of missing teeth; Risk factor.
Highlights
Psoriasis is a chronic inflammatory skin disease affecting 1-3% of the population [1], whereas its prevalence ranges from 2 to 4% in the general population [2]
Periodontal Disease (PD) is associated with a systemic inflammatory response, increasing levels of inflammatory cytokines, chemokines and Symbiosis Group *Corresponding author email: nikolaos_c@hotmail.com, nchrysant@med.uoa.gr other inflammatory mediators such as C-reactive protein (Crp), Interleukin-1(IL-1) and IL-6 [29], that are responsible for periodontal tissues damage [31]
Individuals who had less than 20 natural teeth, those who were treated for PD, conservatively or surgically, within the previous six months and those who had received a prescription of systemic antibiotics or anti-inflammatory or other systemic drugs, such as glucocorticoids the previous six weeks were not enrolled in the study protocol as those conditions could influence [50] the oral tissues condition, and could lead to biased secondary associations
Summary
Psoriasis is a chronic inflammatory skin disease affecting 1-3% of the population [1], whereas its prevalence ranges from 2 to 4% in the general population [2]. Previous reports have been most extensively investigated the mentioned association in Rheumatoid Arthritis (RA), and found that the odds of having RA among those with periodontitis was 2 to 8 times higher than those without periodontitis [3741]. Both diseases, psoriasis and PD implicate an exaggerated immune response in epithelial surfaces and an abnormality in the regulation of the host inflammatory response [11,42,43]. Patients with periodontitis may have a higher risk of psoriasis, the data on this association are limited The aim of this retrospective case-control study was to further analyze the possible association between periodontitis and psoriasis
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