Is There Any Association Between Periodontitis and Prostatic Alterations? A Systematic Review.

The prostate plays a crucial role in male reproduction but is susceptible to diseases such as prostate cancer. Periodontitis, as an inflammatory disease, has the potential to modulate systemic conditions. This systematic review aimed to evaluate the association between periodontitis and prostatic alterations. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines and registered in the PROSPERO database (CRD42024614333). Observational studies comparing the presence of periodontitis in men with and without prostatic alterations were included. The search strategy was applied to databases such as PubMed, Scopus, Embase, Web of Science and Lilacs, as well as gray literature (OpenGrey and Google Scholar). The selection of studies and data extraction were carried out independently by two reviewers. Methodological quality was assessed using the tools of the Joanna Briggs Institute, and confounding factors were analyzed using multivariate models, where applicable. A total of 769 references were identified, and 14 studies were included. Most studies indicated a significant association between periodontitis and prostate cancer, with a higher risk in patients with periodontal disease. Associations with BPH and chronic prostatitis were also observed in fewer studies. However, methodological limitations, such as inadequate control of confounding factors (e.g. smoking, genetics and age), heterogeneity in diagnostic criteria and reliance on self-reported data, increased the risk of bias. Many studies did not adequately adjust for confounding factors, compromising the robustness of the evidence. Thus, the findings suggest a potential association between periodontitis and prostatic alterations, especially prostate cancer.