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Current Oral Health Reports

, Volume 6, Issue 1, pp 22–30 | Cite as

Is Human Papilloma Virus Infection Linked to Periodontitis? A Narrative Review

  • Ana P. OrtizEmail author
  • Jeslie M. Ramos-Cartagena
  • Sandra I. García-Camacho
  • Oelisoa M. Andriankaja
  • Cynthia M. Pérez
Systemic Diseases (N Buduneli, Section Editor)
  • 31 Downloads
Part of the following topical collections:
  1. Topical Collection on Systemic Diseases

Abstract

Purpose of Review

Research suggests that periodontal tissue might serve as a reservoir for oral human papillomavirus (HPV) infection, while another hypothesis is that chronic inflammation of the tissue might perpetuate an infection with oral HPV infection. In this narrative review, we summarize the evidence related to a potential association between oral HPV infection and periodontitis.

Recent Findings

Twelve articles were identified, and their key findings summarized. Studies vary in sample size, study population, study design, and methods for assessment of oral HPV and periodontitis. Although results are conflicting and still inconclusive, various studies have found an association between oral HPV infection and periodontitis, which is supported by biological plausibility.

Summary

Future longitudinal studies should further evaluate this association, using clinical definitions of oral HPV infection and periodontitis, and focusing on high-risk populations for oral HPV infection. Studying this association is important since periodontitis might help identify at-risk individuals for oral HPV infection and potentially HPV-related oropharyngeal cancers.

Keywords

Periodontitis Gingivitis Oral human papillomavirus Oral cancer 

Notes

Acknowledgements

This work was supported by the National Institutes of Health [1R21DE024850-01A1, NIDCR] and [1R21DE027226-01A1, NIDCR].

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any new studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, Xiao W, Kim E, et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol. 2011;29(32):4294–301.CrossRefGoogle Scholar
  2. 2.
    National Cancer Institute. Oral Cavity and Pharynx Cancer - Cancer Stat Facts [Internet]. 2017 [cited 2018 Nov 12]. Available from: https://seer.cancer.gov/statfacts/html/oralcav.html
  3. 3.
    Viens LJ, Henley SJ, Watson M, Markowitz LE, Thomas CC, Thompson TD, et al. Human papillomavirus–associated cancers — United States, 2008–2012. MMWR Morb Mortal Wkly Rep. 2016;65(26):661–6.CrossRefGoogle Scholar
  4. 4.
    Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2014 [Internet]. Atlanta:US; 2015 [cited 2018 Nov 12]. Available from: http://www.cdc.gov/std/program/pupestd.htm
  5. 5.
    Centers for Disease Control and Prevention. Prevalence of HPV in adults aged 18-69: United States, 2011–2014 [Internet]. 2017 [cited 2018 Nov 12]. Available from: https://www.cdc.gov/nchs/products/databriefs/db280.htm
  6. 6.
    •• Ortiz AP, González D, Vivaldi-Oliver J, Castañeda M, Rivera V, Díaz E, et al. Periodontitis and oral human papillomavirus infection among Hispanic adults. Papillomavirus Res. 2018:128–33 This manuscript is important because it evidence an association between oral HPV infection and severe periodontitis.Google Scholar
  7. 7.
    Chung CH, Bagheri A, D’Souza G. Epidemiology of oral human papillomavirus infection. Oral Oncol. 2014;50(5):364–9.CrossRefGoogle Scholar
  8. 8.
    de Moraes RC, Dias FL, Figueredo CM da S, Fischer RG. Association between chronic periodontitis and oral/oropharyngeal cancer. Braz Dent J. 2016;27(3):261–6.CrossRefGoogle Scholar
  9. 9.
    Galvão-Moreira LV, da Cruz MCFN. Oral microbiome, periodontitis and risk of head and neck cancer. Oral Oncol. 2016;53:17–9.CrossRefGoogle Scholar
  10. 10.
    Moergel M, Kämmerer P, Kasaj A, Armouti E, Alshihri A, Weyer V, et al. Chronic periodontitis and its possible association with oral squamous cell carcinoma – a retrospective case control study. Head Face Med. 2013;9(1):39.CrossRefGoogle Scholar
  11. 11.
    Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nat Rev Dis Primers. 2017;3:17038.Google Scholar
  12. 12.
    Eke PI, Dye BA, Wei L, Slade GD, Thornton-Evans GO, Borgnakke WS, et al. Update on prevalence of periodontitis in adults in the United States: NHANES 2009 to 2012. J Periodontol. 2015;86(5):611–22.CrossRefGoogle Scholar
  13. 13.
    Nazir MA. Prevalence of periodontal disease, its association with systemic diseases and prevention. Int J Health Sci (Qassim). 2017;11(2):72–80.Google Scholar
  14. 14.
    Casanova L, Hughes FJ, Preshaw PM. Diabetes and periodontal disease: a two-way relationship. Br Dent J. 2014;217(8):433–7.CrossRefGoogle Scholar
  15. 15.
    Chávarry NGM, Vettore MV, Sansone C, Sheiham A. The relationship between diabetes mellitus and destructive periodontal disease: a meta-analysis. Oral Health Prev Dent. 2009;7(2):107–27.PubMedGoogle Scholar
  16. 16.
    Blaizot A, Vergnes J-N, Nuwwareh S, Amar J, Sixou M. Periodontal diseases and cardiovascular events: meta-analysis of observational studies. Int Dent J. 2009;59(4):197–209.PubMedGoogle Scholar
  17. 17.
    Humphrey LL, Fu R, Buckley DI, Freeman M, Helfand M. Periodontal disease and coronary heart disease incidence: a systematic review and meta-analysis. J Gen Intern Med. 2008;23(12):2079–86.CrossRefGoogle Scholar
  18. 18.
    Ide M, Papapanou PN. Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes – systematic review. J Periodontol. 2013;84(4–s):S181–94.PubMedGoogle Scholar
  19. 19.
    Daalderop LA, Wieland BV, Tomsin K, Reyes L, Kramer BW, Vanterpool SF, et al. Periodontal disease and pregnancy outcomes: overview of systematic reviews. JDR Clin Trans Res. 2018;3(1):10–27.Google Scholar
  20. 20.
    Hajishengallis G. Periodontitis: from microbial immune subversion to systemic inflammation. Nat Rev Immunol. 2015;15(1):30–44.CrossRefGoogle Scholar
  21. 21.
    Van Dyke TE, Sheilesh D. Risk factors for periodontitis. J Int Acad Periodontol. 2005;7(1):3–7.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Ling L-J, Ho C-C, Wu C-Y, Chen Y-T, Hung S-L. Association between human herpesviruses and the severity of periodontitis. J Periodontol. 2004;75(11):1479–85.CrossRefGoogle Scholar
  23. 23.
    Kamma JJ, Contreras A, Slots J. Herpes viruses and periodontopathic bacteria in early-onset periodontitis. J Clin Periodontol. 2001;28(9):879–85.CrossRefGoogle Scholar
  24. 24.
    Contreras A, Umeda M, Chen C, Bakker I, Morrison JL, Slots J. Relationship between herpesviruses and adult periodontitis and periodontopathic bacteria. J Periodontol. 1999;70(5):478–84.CrossRefGoogle Scholar
  25. 25.
    Yapar M, Saygun I, Ozdemir A, Kubar A, Sahin S. Prevalence of human herpesviruses in patients with aggressive periodontitis. J Periodontol. 2003;74(11):1634–40.CrossRefGoogle Scholar
  26. 26.
    Contreras A, Slots J. Active cytomegalovirus infection in human periodontitis. Oral Microbiol Immunol. 1998;13(4):225–30.CrossRefGoogle Scholar
  27. 27.
    Horewicz VV, Feres M, Rapp GE, Yasuda V, Cury PR. Human papillomavirus-16 prevalence in gingival tissue and its association with periodontal destruction: a case-control study. J Periodontol. 2010;81(4):562–8.CrossRefGoogle Scholar
  28. 28.
    Liederbach E, Kyrillos A, Wang C-H, Liu JC, Sturgis EM, Bhayani MK. The national landscape of human papillomavirus-associated oropharynx squamous cell carcinoma. Int J Cancer. 2017;140(3):504–12.CrossRefGoogle Scholar
  29. 29.
    • Hormia M, Willberg J, Ruokonen H, Syrjänen S. Marginal Periodontium as a Potential Reservoir of Human Papillomavirus in Oral Mucosa. J Periodontol. 2005;76(3):358–63 This manuscript was one of the first to evaluate the prevalence of oral HPV infection in gingival tissues and to propose that the marginal periodontium serves as a reservoir for HPV.Google Scholar
  30. 30.
    Fuster-Rossello L, Ribotta E, Cuffini C, Fuster-Juan M. Human papilloma virus in oral mucosa and its association with periodontal status of gynecologically infected women. Acta Odontol Latinoam [Internet]. 2014;27(2):82–8 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25523960.
  31. 31.
    Syrjänen S. Oral manifestations of human papillomavirus infections. Eur J Oral Sci. 2018;126(Suppl (Suppl Suppl 1)):49–66.CrossRefGoogle Scholar
  32. 32.
    • Madinier I, Doglio A, Cagnon L, Lefèbvre J-c, Monteil RA. Southern blot detection of human papillomaviruses ( HPVs ) DNA sequences in gingival tissues. J Periodontol. 1992;63(8):667–73 This manuscript was the first to evaluate the prevalence of oral HPV infection in gingival tissues.CrossRefGoogle Scholar
  33. 33.
    Tezal M, Sullivan Nasca M, Stoler DL, Melendy T, Hyland A, Smaldino PJ, et al. Chronic periodontitis−human papillomavirus synergy in base of tongue cancers. Arch Otolaryngol Neck Surg. 2009;135(4):391–6.CrossRefGoogle Scholar
  34. 34.
    Bui TC, Markham CM, Ross MW, Mullen PD. Examining the association between oral health and oral HPV infection. Cancer Prev Res (Phila). 2013;6(9):917–24 Available from: http://www.ncbi.nlm.nih.gov/pubmed/23966202.
  35. 35.
    Jacob A, Janam P, Babu Vijayamma JM. Prevalence of human papilloma virus in marginal periodontium and its association with periodontitis: a cross sectional study. J Indian Soc Periodontol. 2014;18(4):447–50.CrossRefGoogle Scholar
  36. 36.
    •• Wiener RC, Sambamoorthi U, Jurevic RJ. Association of periodontitis and human papillomavirus in oral rinse specimens: Results from the National Health and Nutrition Examination Survey 2009–2012. J Am Dent Assoc. 2015;146(6):382–9 Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC4450443 This manuscript is important because it uses a greater sample size and establishes no association between oral HPV infection and periodontitis.
  37. 37.
    Dayakar MM, Shipilova A, Gupta D. Periodontal pocket as a potential reservoir of high risk human papilloma virus: a pilot study. J Indian Soc Periodontol. 2016;20(2):136–40.PubMedPubMedCentralGoogle Scholar
  38. 38.
    Shipilova A, Dayakar MM, Gupta D. High risk human papillomavirus in the periodontium: A case control study. J Indian Soc Periodontol. 2017;21(5):380–5.Google Scholar
  39. 39.
    Sun CX, Bennett N, Tran P, Tang KD, Lim Y, Frazer I, et al. A pilot study into the association between oral health status and human papillomavirus-16 infection. Diagnostics (Basel) [Internet] 2017;7(1). Available from: www.mdpi.com/journal/diagnostics
  40. 40.
    WHO | Periodontal country profiles [Internet]. WHO. World Health Organization; 2010 [cited 2018 Nov 16]. Available from: http://www.who.int/oral_health/databases/niigata/en/
  41. 41.
    Wiebe CB, Putnins EE. The periodontal disease classification system of the American Academy of Periodontology--an update. J Can Dent Assoc. 2000;66(11):594–7.Google Scholar
  42. 42.
    Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999;4(1):1–6.CrossRefGoogle Scholar
  43. 43.
    Eke PI, Page RC, Wei L, Thornton-Evans G, Genco RJ. Update of the case definitions for population-based surveillance of periodontitis. J Periodontol. 2012;83(12):1449–54.CrossRefGoogle Scholar
  44. 44.
    Eke PI, Thornton-Evans G, Dye B, Genco R. Advances in surveillance of periodontitis: the Centers for Disease Control and Prevention periodontal disease surveillance project. J Periodontol. 2012;83(11):1337–42.CrossRefGoogle Scholar
  45. 45.
    Candotto V, Lauritano D, Nardone M, Baggi L, Arcuri C, Gatto R, et al. HPV infection in the oral cavity: epidemiology, clinical manifestations and relationship with oral cancer. Oral Implantol (Rome). 2017;10(3):209–20.Google Scholar
  46. 46.
    Heath EM, Morken NW, Campbell KA, Tkach D, Boyd EA, Strom DA. Use of buccal cells collected in mouthwash as a source of DNA for clinical testing. Arch Pathol Lab Med. 2001;125(1):127–33.PubMedGoogle Scholar
  47. 47.
    Thammaiah S, Venkobarao MC, Sathyavanthan H, Mirnalini AS. Quantitative polymerase chain reaction-based detection of HPV 16 E6 and E7 DNA in oral squamous cell carcinoma. J Oral Pathol Med. 2018;47(9):873–9.CrossRefGoogle Scholar
  48. 48.
    Chang F, Syrjanen S, Kellokoskp J, Syrjanen K. Human papillomavirus (HPV) infections and their associations with oral disease. J Oral Pathol Med. 1991;20(7):305–17.CrossRefGoogle Scholar
  49. 49.
    Tezal M. Interaction between chronic inflammation and Oral HPV infection in the etiology of head and neck cancers. Int J Otolaryngol. 2012;2012:1–9.CrossRefGoogle Scholar
  50. 50.
    Gillison ML, Broutian T, Pickard RKL, Tong Z, Xiao W, Kahle L, et al. Prevalence of oral HPV infection in the United States, 2009-2010. JAMA. 2012;307(7):693–703.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ana P. Ortiz
    • 1
    • 2
    Email author
  • Jeslie M. Ramos-Cartagena
    • 2
  • Sandra I. García-Camacho
    • 2
  • Oelisoa M. Andriankaja
    • 3
  • Cynthia M. Pérez
    • 1
  1. 1.Department of Biostatistics and Epidemiology, Graduate School of Public HealthUniversity of Puerto Rico Medical Sciences CampusSan JuanPuerto Rico
  2. 2.Cancer Control and Population Sciences DivisionUniversity of Puerto Rico Comprehensive Cancer CenterSan JuanPuerto Rico
  3. 3.Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto RicoMedical Sciences CampusSan JuanPuerto Rico

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