MD DMD University Erlangen-Nürnberg Erlangen, Bayern, Germany
Disclosure(s):
Nicole Neurath, MD DMD: No financial relationships to disclose
Introduction/Rationale: The prevalence of periodontitis is elevated in patients with inflammatory bowel disease (IBD). The neutralisation of antibodies against the cytokines TNF and interleukin-12/23 (IL-12/23) is a fundamental component of the clinical management of IBD. However, the extent to which such cytokine blockade in IBD influences the clinical picture of periodontitis remains to be elucidated.
Methods: In this exploratory study, 45 patients suffering from IBD who were undergoing biological therapy with cytokine blockers were examined for the presence of periodontitis. The prospective study identified three distinct groups: anti-TNF therapy (n = 15), anti-IL-12/IL-23 therapy (n = 15), no anti-TNF or anti-IL-23 therapy (control group; n = 15). The depth of the gum pockets in all sextants was determined using the Periodontal Screening Index (PSI). Furthermore, a comprehensive medical history pertaining to IBD and oral hygiene was obtained. IL-6 levels were determined by ELISA in gingival crevicular fluid (GCF).
Results: Of the 45 patients with IBD, 14 had known or evidence of previously unknown periodontitis. The investigation revealed that the mean PSI index in the anti-IL-12/IL-23 group was significantly lower than in the other groups. Within the anti-IL-12/IL-23 group, two individuals with a history of periodontitis exhibited a PSI index of 0, while no subjects demonstrated indications of latent periodontitis. In contrast, three individuals in the anti-TNF group and six individuals in the control group had previously been diagnosed with periodontitis, and two and three additional individuals from these groups exhibited signs of previously unknown periodontitis. IL-6 levels in GCF were significantly lower in the anti-IL-12/IL-23 group as compared to the control group.
Conclusion: This exploratory study suggested that anti-IL-12/IL-23 therapy in IBD may have protective effects against periodontitis. Possible links between biologic therapy and periodontitis should be investigated prospectively in larger cohorts.
