THE DETRIMENTAL EFFECT OF CHRONIC PERIODONTAL DISEASE AND SYSTEMIC INFLAMMATION ON ENDOTHELIAL DYSFUNCTION IN UNTREATED HYPERTENSIVE PATIENTS

The association between periodontal disease and erectile dysfunction has not been sufficiently studied. However, recent studies have reported a possible link based on mutually shared risks factors between both pathologies, but the association is fundamentally attributed to endothelial dysfunction, phenomenon that is related to both diseases. It has been suggested that chronic periodontal disease can induce systemic inflammatory response that results in deterioration of the physiological and biochemical conditions of the endothelium causing endothelial dysfunction. On the other hand, erectile dysfunction is a multifactorial disease, but the vasculogenic factor is considered as the most frequent one, attributed to a vascular defect (en-dothelial dysfunction). So, the strongest link is the vascular function alteration, which undoubtedly demonstrates demonstrates a solid argument of association between both diseases. The objective of this literature review is to report the possible mechanisms of association between periodontal disease and erectile dysfunction, focusing mainly on endothelial dysfunction as the main existing link. KEYWORDS: PERIODONTAL DISEASES; PERIODONTITIS; ERECTILE DYSFUNCTION; VASCULAR ENDO-THELIUM.

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Endothelial Dysfunction, its Relationship with Chronic Periodontal Disease, and other Associated Risk Factors

The Open Dentistry Journal ◽

10.2174/1874210602115010377 ◽

2021 ◽

Vol 15 (1) ◽

pp. 377-383

Author(s):

Juliana Velosa-Porras ◽

Francina M. E. Arregoces ◽

Catalina L. Uriza ◽

Alvaro J Ruiz

Keyword(s):

Endothelial Dysfunction ◽

Periodontal Disease ◽

Clinical History ◽

Individual Characteristics ◽

Initial Flow ◽

Chronic Periodontal Disease ◽

Associated Risk Factors ◽

Flow Mediated Vasodilation ◽

Relationship Of ◽

The Relationship

Background: Chronic periodontitis is related to individual characteristics. However, it is precisely infectious in nature with the possibility of generating a chronic systemic inflammatory response that could favour its association with diseases, such as endothelial dysfunction, hypertension, CVD, and diabetes. Purpose: The aim of the study was to analyze the relationship of endothelial dysfunction measured by flow-mediated vasodilation in the brachial artery with periodontal disease and other possible factors. Methods: A case-control study was carried out in which those who had periodontitis were defined as cases, and those who were periodontally healthy or had gingivitis were defined as controls. A clinical history was obtained from all patients, and all patients underwent biofilm control and periodontal examinations. Blood tests were performed to determine CBC, glycaemia, total cholesterol, HDL-C, and LDL-C levels, and standardized procedures were used to measure flow-mediated dilation. Results: A total of 202 patients were included in this study: 101 controls [healthy/gingivitis] and 101 cases [periodontitis]. Regarding sex, glycaemia [p = 0.019] and triglycerides [p = 0.001] levels and initial flow-mediated vasodilation [p = 0.001] and final flow-mediated vasodilation [p = 0.001] values were higher in men, while HDL values were lower [p = 0.001. The average age was higher for those in the group that presented dysfunction than for those in the group without dysfunction [p = 0.014]. When analyzing the percentage of patients with endothelial dysfunction in each of the groups, there were very few positive results obtained [5 per group]. Conclusion: Initial and final arterial vasodilation was lower in women than in men. Likewise, there were more cases of endothelial dysfunction in women. In this study, patients with endothelial dysfunction were older. Periodontitis was not associated with endothelial dysfunction.

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