Association of ankylosing spondylitis with radiographically and clinically diagnosed apical periodontitis: A cross-sectional study

Abstract

Background. There are no studies evaluating the possible association between ankylosing spondylitis (AS) and apical periodontitis (AP). Objectives. The aim of the present cross-sectional study was to investigate the possible association between AS and AP. Material and methods. Fifty patients diagnosed with AS, receiving treatment at the Rheumatology Clinic in Erzurum, Turkey, were included in the experimental group. Another 50 age-and gender-matched individuals without any history of systemic disease were included in the study as the control group. All patients were examined radiographically and clinically to diagnose the presence of AP. The following data was recorded for all patients: the smoking habit, the number of teeth present, the number of teeth with AP, the number of root canal-treated (RCT) teeth, and the number of RCT teeth with AP. Results. There were 1,283 teeth in the AS group and 1,305 in the control group. There was a significant association between teeth with AP and AS, as the prevalence of teeth with AP was significantly lower in the control group (1.3%) than in the AS group (2.9%) (OR (odds ratio) = 2.250; p = 0.005). There was no statistically significant difference between the groups in terms of the number of RCT teeth and RCT teeth with AP (p > 0.05). Conclusions. Ankylosing spondylitis is significantly associated with an increased prevalence of AP. It can be concluded that patients with AS can be more prone to develop AP. However, AS does not reduce the success rate of endodontic treatment, because there was no significant difference between the AS and control groups in terms of RCT teeth with AP.

Prevalence of Apical Periodontitis in Patients with Autoimmune Diseases under Immunomodulators: A Retrospective Cohort Study

“…In this retrospective cohort study, patients affected by autoimmune diseases (RA, Ps and IBD) showed a higher prevalence of apical periodontitis than the controls, even if they exhibited a similar dental health condition, as shown by the DMFT values. This result is in accordance with previous reports (22,23,30,31) and may be explained by the excessive production of pro-inflammatory cytokines (a common trait of all autoimmune diseases) (32,33), which is also associated with the development, progression and persistence of AP (34)(35). Moreover, the longer the time elapsed between the diagnosis of AD and the dental visit, the greater was the prevalence of AP in the study group, underlining the importance of monitoring oral health in diseased patients.…”

Pro-Inflammatory Oral Microbiota in Juvenile Spondyloarthritis: A Pilot Study

“…The mechanism by which oral inflammation may be linked to SpA is beyond the scope of the study. However, in light of findings showing involvement of the Th17 pathway in the setting of periodontitis [ 29 , 30 ] and findings from some [ 31 , 32 , 33 ] albeit not all [ 34 ] studies showing that patients with psoriasis or SpA had increased periodontal disease as compared to healthy controls, we suspect that local inflammation may generate an inflammatory response that extends systemically through cross-reactivity or other immunologic mechanisms. A recent review article has likewise reached the conclusion that periodontal inflammation can result in microbiota changes and SpA [ 35 ].…”

Occurrence of radiopaque and mixed lesions at periapical region in patients with rheumatoid arthritis and ankylosing spondylitis: a retrospective study

“…In the literature on RA, Jalali et al [ 20 ] found no differences between the RA and C groups in terms of the presence of apical lesions, while Karatas et al [ 18 ] reported that patients with RA might be prone to developing apical lesions. The only study evaluating the association of AS with apical lesion development found that patients with AS disease may be inclined to develop apical lesions [ 19 ]. In these studies, clinical symptoms and the presence of radiolucent lesions were evaluated as indicators of endodontic disease [ 18 – 20 ].…”

“…On the contrary, there is some evidence that anti-TNF treatments (TNF blockers) [ 6 ] and, similarly, IL-17 blockers [ 7 ] are more effective in the treatment of AS than RA. Another interesting finding comes from Karatas et al [ 19 ], who demonstrated that apical lesions healed faster in patients on anti-TNF-α than in their C group.…”