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Med Oral Patol Oral Cir Bucal. 2024 Nov 1;29(6):e866-e875. doi: 10.4317/medoral.26831.
Today, idiopathic infertility is becoming more frequent, affecting more than 186 million people in the world. The presence of comorbidities makes patient management complex, requiring individualized infertility treatment. Periodontal diseases could contribute negatively to the management of infertility, increasing inflammation, oxidative stress and insulin resistance, and contributing negatively to the development and progression of comorbidities associated with these two entities. The aim of this systematic review is to explore whether there is an association between periodontal diseases and male and female infertility and deepen into the possible mechanisms underlying this association.
The studies analyzed in this research included a total of 4871 patients (732 men and 4139 women), were original studies with high quality, mostly with a control group. Authors who have investigated idiopathic infertility suggest that infertility is associated with diseases that present low-grade chronic inflammation, oxidative stress and insulin resistance (such as obesity, type 2 diabetes and polycystic ovary syndrome), which are in turn related to periodontal diseases.
A higher prevalence of periodontal disease was found in patients with infertility compared with controls. Periodontal diseases could initially be mediated by a local and systemic proinflammatory environment, which favors a pro-oxidant state, leading to oxidative stress and, finally, irreversible destruction of the periodontal tissue. Insulin resistance, oxidative stress and inflammation are present in the pathologies associated with an increase in the prevalence and severity of periodontal diseases (such as obesity, type 2 diabetes and polycystic ovary syndrome). Therefore, IR, low-grade chronic inflammation and the oxidative stress could be the pathophysiological mechanisms linking idiopathic infertility and periodontal diseases.
Studies suggest an association between infertility and periodontitis. Future researches are necessary to find causality factors. Studying the patient in a global and multidisciplinary way could help in the management and treatment of idiopathic infertility.
如今，特发性不孕越来越常见，影响了全球超过 1.86 亿人。合并症的存在使患者的管理变得复杂，需要对不孕进行个体化治疗。牙周病可能对不孕的管理产生负面影响，增加炎症、氧化应激和胰岛素抵抗，并对与这两种疾病相关的合并症的发展和进展产生负面影响。本系统评价的目的是探讨牙周病与男性和女性不孕之间是否存在关联，并深入探讨这种关联的潜在机制。
本研究分析的研究共包括 4871 名患者（732 名男性和 4139 名女性），均为高质量的原始研究，大多数有对照组。研究特发性不孕的作者认为，不孕与存在低水平慢性炎症、氧化应激和胰岛素抵抗的疾病有关（如肥胖、2 型糖尿病和多囊卵巢综合征），而这些疾病又与牙周病有关。
与对照组相比，不孕患者的牙周病患病率较高。牙周病最初可能通过局部和全身促炎环境介导，有利于促氧化状态，导致氧化应激，最终导致牙周组织不可逆转的破坏。胰岛素抵抗、氧化应激和炎症存在于与牙周病患病率和严重程度增加相关的病理中（如肥胖、2 型糖尿病和多囊卵巢综合征）。因此，IR、低水平慢性炎症和氧化应激可能是将特发性不孕与牙周病联系起来的病理生理机制。
研究表明不孕与牙周炎之间存在关联。需要进一步的研究来寻找因果因素。以全球和多学科的方式研究患者可以帮助管理和治疗特发性不孕。
