The Synergetic Effect of Periodontal Therapy and TNF‐α Inhibitor for the Treatment of Comorbid Periodontitis and Psoriasis

Abstract

AimTo assess the adjunctive effect of periodontal therapy on psoriasis‐related outcomes in a combined experimental model of ligature‐induced periodontitis and Imiquimod (IMQ)‐induced psoriasis. Also, this experiment aimed to study the impact of TNF‐α inhibitors on the periodontium.MethodsFifty‐six C57/BL6J mice were randomly allocated to seven experimental groups: (a) control group (P–Pso–) with no treatment; (b) periodontitis (P+Pso–) with periodontal therapy; (c) periodontitis (P+Pso–) with TNF‐α inhibitor; (d) psoriasis (P–Pso+) with TNF‐α inhibitor; (e) periodontitis and psoriasis (P+Pso+) with periodontal therapy; (f) P+Pso+ with TNF‐α inhibitor; and (g) P+Pso+ with both periodontal therapy and TNF‐α inhibitor. Samples (maxilla, dorsal skin and blood) were harvested immediately after death. Measures of periodontitis distance between the cemento‐enamel junction and alveolar bone crest (CEJ–ABC) and number of osteoclasts and psoriasis (epidermal thickness and infiltrate cells (per 0.03mm2)) severity, as well as systemic inflammation (IL‐6, IL‐17A and TNF‐α) were collected.ResultsIn the P+Pso+ group, a significant adjunctive effect of periodontal therapy to TNF‐α inhibitors was found in the reduction of epidermal thickening and inflammatory infiltrate of the dorsal skin (p < 0.05). Similarly, treatment with TNF‐α inhibitor resulted in a significant adjunctive effect to periodontal therapy in the reduction of alveolar bone loss (p < 0.05). These changes were accompanied by a significant decrease in the circulating levels of IL‐6 and IL‐17A when both periodontal therapy and TNF‐α inhibitor were administered.ConclusionsThe combination of periodontal therapy and TNF‐α inhibitor showed a positive synergetic effect in the treatment of comorbid experimental ligature‐induced periodontitis and IMQ‐induced psoriasis via the reduction of systemic inflammation.