Interazione tra cavo orale e sistema riproduttivo femminile

Background Periodontal disease affects 90% of the population and in 10% of cases it expresses itself in its most severe form. Its multifactorial etiology, due to host susceptibility, environmental and behavioral factors, has an inflammatory basis. There are several diseases with which it is associated and there are numerous studies on the relationship between inflammation of the tooth's supporting tissue and many systemic diseases, but very few studies assess its relationship to female fertility. In a review resulting from research at the University of L'Aquila, an actual correlation between the two issues is highlighted. Infertility can depend on several factors. The scientific literature reports a clear association between endometriosis and infertility. The latter is a chronic inflammatory disease characterized by the ectopic presence of endometrial tissue outside the uterine cavity. Objective After confirming the correlation between periodontitis and infertility, it was necessary to evaluate the effects of endometriosis, one of the most important pathologies associated with female infertility, and its pharmacological therapy on alveolar bone tissue, whose resorption is an expression of strong inflammation. A mouse model is selected on which the gynecological pathology is induced, to carry out evaluations on female fertility, independently of male fertility. Methods and materials The first part of the study consists in the random separation of the samples into five different groups. The inoculation of uterine tissue in CD1 mice is the technique used for the non-surgical induction of endometriosis. The first group is the only one composed of healthy mice, the others are characterized by animals in which endometriosis is induced but to which a different treatment is applied: in one no pharmacological treatment was administered, in another D-Chiro-Inositol (DCI) was used, or Dienogest (DG) and finally DCI and DG were administered together. Two hemimandibles were isolated from each mouse and analyzed with the MicroCT Scanco Medical UCT40 Skyscan 1174. Alveolar bone loss (ABL) was defined as the area bounded by the cementoenamel junction (CEJ)and the alveolar bone crest at the lingual level of the first (M1) and second (M2) mandibular molar. Due to possible variability, the value was normalized considering the mesio-distal length of the tooth at the time of bone resorption. Student's t-test and ANOVA with multiple covariance were used for statistical analysis (P < 0.05). Results Evaluations were performed to confirm the development of the endometriosis, such as the identification of lesions and follicular count(7). ABL M1 always presents a statistically significantly lower value in healthy mice than in those affected by endometriosis, even when they have received pharmacological treatment. In the case of ABL M2, the bone tissue would be significantly reduced in mice treated with the combination of DCI and DG. Performing an evaluation with the t-student of ABL M2, the group of sick mice and without pharmacological treatment shows greater periodontal inflammation than the healthy ones. The result of normalized ABL of M1+M2 is superimposable to that of ABL M1. ABL is greater in individuals with endometriosis subjected to treatment with DCI or DCI in combination with DG, compared to those sick to which no pharmacological treatment was administered. Discussion and Conclusions Bone resorption in mice affected by endometriosis is statistically significantly higher than in healthy mice. This indicates a greater inflammation of the tooth-supporting tissue in individuals suffering from the gynecological problem, capable of causing active phases of periodontitis that leave objective outcomes. The loss of alveolar resorption is higher in M1 than M2. Treatment carried out with DCI or DCI+DG would seem to cause a side effect since even sick mice and without pharmacological treatment show a better bone situation