Bidirectional Relationship Between Periodontal Disease and Reproductive Disorders: Focus on Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder characterized by hyperandrogenism, irregular ovulation, and polycystic ovarian morphology. The severity of periodontal inflammation in PCOS may be linked to elevated levels of inflammatory mediators, like interleukins (IL-6, IL-17), and matrix metalloproteinase-8 (MMP-8), found in both serum and saliva samples. This systematic review aims to assess the presence, nature, and variations in salivary inflammatory biomarkers in individuals with PCOS and their potential connection to periodontal disease (PD). Materials and Methods: Selected databases were PubMed, Scopus, Google Scholar, and Web of Science. The search strategy included the following terms: “oral inflammatory biomarkers”, “Salivary mediators,” “metabolic indicators,” “periodontal diseases,” “periodontitis,” “polycystic ovary syndrome,” “PCOS,” and “ovulatory dysfunction.” Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Results: Several salivary inflammatory biomarkers are present in women with PCOS, including cytokines, C-reactive protein (CRP), reactive oxygen species (ROS), MMPs, and microbial diversity alterations. Additionally, the reviewed studies suggest a correlation between PCOS and PD, as patients with PCOS exhibit greater periodontal alterations compared to healthy women. The heightened periodontal response in PCOS appears to be associated with a systemic inflammatory state, probably increasing the susceptibility to PD. Conclusions: Salivary inflammatory biomarkers in PCOS patients are a useful diagnostic tool for evaluating the heightened risk of periodontal disease. Further research with stricter protocols is necessary to better define the diagnostic potential of these biomarkers for PCOS patients and determine their role in the early detection of periodontal disease.