Periodontal Involvement in Autoimmune Blistering Diseases: A Narrative Review

Area of Science:

• Oral Medicine
• Periodontology
• Dermatology

Background:

• Autoimmune blistering diseases (AIBDs) like pemphigus vulgaris (PV) and mucous membrane pemphigoid (MMP) can cause painful gingival inflammation (desquamative gingivitis).
• This gingival involvement may impair oral hygiene and lead to secondary inflammatory conditions.
• There is increasing interest in the periodontal health and oral microbiome of AIBD patients.

Purpose of the Study:

• To review and synthesize existing literature on the periodontal status of patients diagnosed with AIBDs.
• To explore the association between AIBDs, gingival involvement, and periodontal parameters.
• To examine available microbiological data in AIBD patients with periodontal conditions.

Main Methods:

• A narrative review of studies identified through PubMed and Scopus databases.
• Inclusion of primary studies assessing periodontal status in AIBD patients.
• Evaluation of periodontal conditions using clinical parameters (probing depth, clinical attachment loss) and hygiene indices.

Main Results:

• Ten studies met the inclusion criteria, with most indicating worse periodontal status in AIBD patients compared to controls.
• In MMP, disease activity, duration, and gingival involvement correlated with poorer periodontal parameters.
• Adjusting for oral hygiene suggested potential confounding, and evidence for an independent link to periodontitis remains insufficient. Microbiological data indicated the presence of periodontal pathogens.

Conclusions:

• AIBD patients may exhibit poorer periodontal health, potentially due to pain-related hygiene issues and dysbiotic biofilms.
• These microbial factors might exacerbate inflammation and tissue damage, though microbial profiles are influenced by disease activity and treatment.
• Understanding the link between AIBDs and periodontal status is crucial for timely diagnosis and integrated patient management.