Association between Periodontitis and Head and Neck Squamous Cell Carcinoma: a Systematic Review
Keywords:
periodontitis; head and neck neoplasms; squamous cell carcinoma; systematic reviewAbstract
Introduction: Periodontitis remains a global health challenge and has been implicated in the pathogenesis of various systemic diseases, including cancer. However, findings on its association with head and neck squamous cell carcinoma (HNSCC) remain inconsistent across observational studies.
Objective: To systematically review observational studies assessing the association between periodontitis and HNSCC, and explore potential biological mechanisms underlying this relationship.
Methods: A systematic review of observational studies published in Scopus, PubMed, ScienceDirect, and Web of Science until December 2025 was conducted following the PRISMA 2020 guidelines. Eligible studies evaluated the association between periodontitis and HNSCC. Risk of bias was assessed using the ROBINS-I tool.
Results: Fourteen observational studies involving 22,000 participants were included. Most reported a positive association between periodontitis and HNSCC; twelve studies reported odds ratios ranging from 1.09 to 10.9. Current evidence suggests that periodontal pathogens and chronic inflammation may contribute to HNSCC development through multiple mechanisms of carcinogenesis.
Conclusions: The available observational data support an association between periodontitis and HNSCC, but current evidence is insufficient to establish a causal relationship. Further high-quality prospective studies are needed to clarify whether this association is causal.
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