Prevalence of apical periodontitis in patients with autoimmune liver diseases under immune suppressants and immune modulators: a cross-sectional study.

Francesca Ideo, Sadia Niazi, Luchino Chessa, Michela Miglianti, Giulia Bardini, Francesco Mannocci, Elisabetta Cotti

Autoimmune liver diseases (ALDs) are chronic conditions generated by an immune-mediated auto-aggressive inflammatory reaction in genetically susceptible individuals. The purpose of this study was to evaluate the prevalence of AP in patients suffering from ALDs, in treatment with the immune-suppressants glucocorticoids, azathioprine, and/or ursodeoxycholic acid. The ALDs group included 46 patients (11 men and 35 women, average age: 57.9 ± 11.8 years) and 1186 teeth. The control (C) included 50 healthy patients (15 men and 35 women, average age: 58.6 ± 10.4 years) and 1251 teeth), under no medications. Demographic data, and medical, pharmacological, and dental history, were recorded. Dental and radiographic examinations were performed, presence of AP, periapical index score, DMFT, quality of restoration, and root canal treatment were evaluated. The influence of the medications assumed by the patients on the prevalence of AP was also tested. The prevalence of AP was significantly lower in ALDs than in C, at patient (p=.019), and tooth level (p=.005). (p=.015). Smoking and age were associated with a significant increase in AP in cases and controls (p=0.045, and p=0.001). In both groups, endodontically treated teeth showed a higher prevalence of AP. considering all the limitation due to the observational nature of the study, the patients affected by autoimmune liver diseases, and in treatment with immune-suppressors (often associated with immune-modulators), were found to exhibit lower prevalence of AP.