Impact of Non-surgical Periodontal Therapy in the Management of Plaque Psoriasis.

Impact of Non-surgical Periodontal Therapy in the Management of Plaque Psoriasis. A Randomised Controlled Trial.

Both periodontitis and plaque psoriasis are non communicable chronic inflammatory diseases. They share genetic polymorphysms (IL-1, IL-6 e TNFalfa) and risk factors (smoking, diabetes, obesity), as well as a great resemblance in terms of pathophysiological pathways. In fact, they are both characterized by an hyperactivation of the innate immune response which induces an excessive production of cytokines such as IL-17/TNFalfa. While non-surgical periodontal therapy consists in the mechanical removal of supra and subgingival calculus, psoriasis treatment involves the administration of either systemic or biologic drugs. Evidence is scarce regarding the effectiveness of non-surgical periodontal therapy in ameliorating the clinical outcomes of plaque psoriasis. The biological plausibility relies on the important reduction of systemic inflammation caused by periodontal treatment, which could ameliorate psoriasis phenotype.

Inclusion Criteria:

• diagnosis of plaque psoriasis;
• diagnosis of untreated periodontitis;
• presence of at least 20 teeth;
• age between 18 and 70 years;
• ability and willingness to give informed consent.

Exclusion Criteria:

• inability of unwillingness to give informed consent;
• patients undergoing periodontal treatment within the last 6 months;
• patients undergoing immunosuppressive treatments for other systemic diseases;
• pregnancy or lactation;
• pts undergoing antibiotic therapy.