Association between periodontal disease and polycystic ovary syndrome: a systematic review

Abstract

The purpose of the present study was to review systematically the association between periodontal diseases (PDs) and polycystic ovary syndrome (PCOS). To address the focused question, 'Is there a relationship between PD and PCOS?' indexed databases were searched up to October 2016 without time or language restrictions using different combinations of the following key words: PCOS, ovarian cysts, PD, periodontitis, gingival diseases and gingivitis. Letters to the Editor, commentaries, historic reviews, case-report, unpublished articles and animal/experimental studies were excluded. Seven case-control studies were included. The number of study participants ranged between 52 and 196 females aged between 15 and 45 years. In three and three studies, proinflammatory cytokines were assessed in gingival crevicular fluid and saliva samples, respectively. In one study, salivary microbes were investigated. All studies reported that a positive association exists between PD and PCOS. In conclusion, there is a positive association between PD and PCOS; however, further well-designed longitudinal controlled clinical trials are needed in this regard. It is recommended that physicians should refer patients with PCOS to oral health-care providers for comprehensive oral evaluation and treatment.

Evaluation of periodontal status in different phenotypes of polycystic ovary syndrome in untreated patients of early reproductive age: A case–control study

“…Our study, unlike other studies, revealed that PD, one of the periodontal health parameters, started to differentiate even though the cases were of early reproductive age, where periodontal diseases were rarely detected. Besides, as cases in the early reproductive stage were exposed to the hyperandrogenic and inflammatory environment of PCOS for a shorter period of time, deterioration in all periodontal findings may not have begun completely yet . Also, our study consisted of women who were recently diagnosed and had not received any hormonal or infertility treatment previously.…”

“…Recently, the association of periodontal diseases with PCOS has been under the spotlight in reproductive endocrinology and periodontology due to its association with inflammation and long‐term metabolic consequences . Previous studies claimed the increased risk of periodontal disease in PCOS . Although the underlying biological causes are unclear, hyperandrogenic environment induced by chronic anovulation in PCOS causes structural changes in the gingiva, increasing the risk of periodontal diseases by enabling bacteria to colonize more readily in the gum tissue .…”

“…Although the underlying biological causes are unclear, hyperandrogenic environment induced by chronic anovulation in PCOS causes structural changes in the gingiva, increasing the risk of periodontal diseases by enabling bacteria to colonize more readily in the gum tissue . Moreover, data suggest that low‐grade systemic inflammation in PCOS patients might exacerbate the periodontal condition . But the effect of different phenotypes of PCOS on periodontal parameters is unknown since the studies did not include phenotypic classification.…”

“…6 It is thought that pro-inflammatory mediators in patients with periodontal disease act on the pathophysiological mechanisms involved in the development of many diseases such as diabetes mellitus, cardiovascular diseases, obesity and pregnancy preterm delivery and preeclampsia. [7][8][9] Recently, the association of periodontal diseases with PCOS has been under the spotlight in reproductive endocrinology and periodontology 10,11 due to its association with inflammation and longterm metabolic consequences. 12 Previous studies claimed the increased risk of periodontal disease in PCOS.…”

“…12 Previous studies claimed the increased risk of periodontal disease in PCOS. 10,11 Although the underlying biological causes are unclear, hyperandrogenic environment induced by chronic anovulation in PCOS causes structural changes in the gingiva, increasing the risk of periodontal diseases by enabling bacteria to colonize more readily in the gum tissue. 13 Moreover, data suggest that low-grade systemic inflammation in PCOS patients might exacerbate the periodontal condition.…”