Prevalence of Apical Periodontitis in Patients with Autoimmune Diseases - a Retrospective Study

Abstract

Abstract Aim: The purpose of this case-control study was to investigate the prevalence of apical periodontitis (AP) in patients affected by autoimmune (AI) disorders [inflammatory bowel disease (IBD), rheumatoid arthritis (RA), and psoriasis (Ps)]. Both patients under no medication and patients under biologic and conventional medications were investigated. Methodology: The controls included 89 patients (2329 teeth) with no systemic diseases, and 89 patients (2145 teeth) with AI were investigated. Full dental panoramic tomograms were used to determine the periapical status of the teeth. Additional variables were collected, including patient's socio-demographic characteristics, medications taken by AI patients, the decayed, missing, and filled teeth (DMFT) index, periapical index (PAI) and size of the apical radiolucency. Chi-square test and logistic regression analysis were utilised to evaluate the correlation between AI and AP. P- values lower than 0.05 were considered to be statistically significant. Results: The prevalence of AP in AI patients was 89.9%, and 74.2% in control subjects (odds ratio [OR]= 4.40, p=0.004). Patients with RA had the highest risk of developing AP, whereas those with IBD had the lowest risk. Multiple binary logistic regression analysis indicated that teeth of AI patients who were not taking any medication or were treated with biologic disease modifying anti-rheumatic drugs (bDMARDs) had a higher risk of developing AP than teeth of control subjects (OR=1.76 and OR=2.76 respectively; p=0.001). Teeth of patients taking conventional DMARDs (cDMARDs) were less affected by AP compared to those of patients taking bDMARDs. Conclusions: Patients with autoimmune disease have higher prevalence of apical periodontitis. The use of biologic medications did not affect the prevalence of apical periodontitis.