Periapical and endodontic status of patients with inflammatory bowel disease: Age‐ and sex‐matched case–control study

• Published in: International endodontic journal Vol. 55; no. 7; pp. 748 - 757
• Main Authors: Segura‐Sampedro, Juan J., Jiménez‐Giménez, Carla, Jane‐Salas, Enric, Cabanillas‐Balsera, Daniel, Martín‐González, Jenifer, Segura‐Egea, Juan J., López‐López, José
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.07.2022; John Wiley and Sons Inc
• Subjects: apical periodontitis; Case-Control Studies; Clinical Research; Crohn Disease - complications; Crohn Disease - epidemiology; Crohn's disease; Gastrointestinal tract; Gum disease; Humans; Inflammatory bowel disease; Inflammatory bowel diseases; Inflammatory Bowel Diseases - complications; Intestine; Lesions; Original; Patients; Periapical Periodontitis - complications; Periapical Periodontitis - diagnostic imaging; Periapical Periodontitis - epidemiology; Periodontitis; Prevalence; Root Canal Therapy; root canal treatment; Root canals; Sex; Statistical analysis; Teeth; Ulcerative colitis; Crohn's disease; ulcerative colitis; apical periodontitis; inflammatory bowel disease; root canal treatment
• ISSN: 0143-2885; 1365-2591; 1365-2591
• DOI: 10.1111/iej.13747

Aim Crohn's disease (CD) and ulcerative colitis (UC) are two chronic recurrent inflammatory processes of the gastrointestinal tract, grouped under the name inflammatory bowel disease (IBD), causing clinical episodes of intestinal inflammation. The aim of this study was to investigate the possible association between IBD and the prevalence of apical periodontitis (AP) and root canal treatment. Methodology A case–control study design matched to age and sex was used. The study group (SG) included 28 patients with IBD (13 with CD, 15 with UC). Another 28 healthy subjects, without IBD and age‐ and sex‐matched, were included in the control group (CG). Radiographic records were analysed and AP was diagnosed as radiolucent periapical lesions (RPLs), using the periapical index score. Student's t‐test, χ2 test and multivariate logistic regression were used in the statistical analysis. Results In the CG, only 17 subjects (61%) had at least one tooth with AP, whilst in the SG group they were 23 patients (82%; OR = 2.98; 95% CI = 0.87–10.87; p = .08). The number of subjects with one or more root filled teeth (RFT) in the CG was 14 (50%), whilst in the SG they were 22 (79%; OR = 3.67; 95% CI = 1.14–11.79; p = .026). At least one RFT with AP was evident in three subjects (10.7%) in the CG, whilst in the SG 15 patients (53.6%) showed RFT with AP (OR = 9.60; 95% CI = 2.35–39.35; p = .001). In the multivariate logistic regression analysis, only endodontic status was found to be associated with IBD (OR = 1.86; 95% CI = 1.24–2.80; p = .003). Conclusion IBD, UC and Crohn’s disease are associated with higher prevalence of RFT and higher percentage of RFT with periapical lesions. Dentists should consider these findings when caring for IBD patients by monitoring the evolution of periapical lesions of endodontically treated teeth.