Odontogenic infections and leprosy reactions: A case –control study

Objective: To analyze the association between reactional episodes in leprosy and clinical and radiographic parameters relating to dental and gingival-periodontal structures of oral health. Methods: Observational case-control study unpaired with multibacillary leprosy patients evaluated between August 2012 and January 2014 from three endemic Brazilian municipalities; patients with first leprosy reaction (cases) were compared to patients without leprosy reaction (controls). The independent variables were grouped into: sociodemographic, disease clinical characteristics, behavior and lifestyle and dental and gingival-periodontal conditions. Two dentists were assigned to the fieldwork and the Kappa statistic was calculated. Logistic regression with 95% confidence interval was carried out. Results: The study included 57 individuals, including 23 reaction cases (40·4%) and 34 controls (59·6%). Chronic periodontal disease (CPD) (ORaj ¼ 4·3; p ¼ 0·033); the necessity for tooth extraction (ORaj ¼ 23·4; p ¼ 0·006), the presence of bone loss (ORaj ¼ 6·5; p ¼ 0·030), the presence of periodontal pockets (ORaj ¼ 3·4; p ¼ 0·045) and a visit to the dentist (ORaj ¼ 0·3; p ¼ 0·014) are associated with reactional episodes in leprosy. Conclusions: The dental and gingival-periodontal parameters shown to be associated with reactional episodes in leprosy were the presence of teeth that need to be extracted, CPD, and the presence of a periodontal pocket. Alveolar bone reabsorption was a radiographic parameter associated with reactional episodes in leprosy.