Soheila Mirzaei,1,*Reyhaneh Shoorgashti,2
1. Islamic Azad university of Medical Sciences, Tehran, Iran 2. Islamic Azad university of Medical Sciences, Tehran, Iran
Introduction: Endometriosis affects 6-10% of reproductive-age women. The immunobiology of endometriosis represents a paradigm shift in theories of the pathogenesis of endometriosis. Periodontal disease is a chronic inflammatory disorder as well. Since both endometriosis and periodontal disease are chronic, inflammatory processes, the aim of this review was to investigate whether an association exists between endometriosis and periodontal disease.
Methods: This review has been conducted based on analysis of available literature indexed in PubMed database between 2015 and 2022. Specific keywords including “endometriosis”, “periodontal disease” and “inflammation” have been used. Experimental and review articles on the mentioned theme were included.
Results: Higher proportion of severe periodontitis among women with endometriosis has been reported. There was a commonality of altered levels of immune modulators in patients with endometriosis and periodontal disease. Increased levels of cytokines and interleukin-1beta, IL-6, IL-8 and tumor necrosis factor-alpha have been demonstrated in patients with endometriosis. In addition, chronic periodontitis is linked to a chronic systemic inflammatory burden secondary to the systemic dissemination of periodontal pathogenic bacteria, their products (e.g., lipopolysaccharides), and locally produced inflammatory mediators (i.e., IL-1β, IL-6, TNF-α).
Conclusion: The immune dysregulation seen in periodontal disease can be the reason for the local immune deficiency propagating endometriosis, and oxidative stress of the periodontal disease may enhance the stress for endometriosis. However, further studies among larger cohorts of endometriosis may provide more evidence about the association.