Association of uric acid in oral health, periodontal disease, and systemic disorders: A systematic review

Background: The relationship between periodontitis or periodontal disease (PD) with uric acid (UA) is controversial. Furthermore, a rise in UA levels in common systemic disorders documented to be liked to PD must be understood. Objectives: The objective is to determine the association of UA levels with periodontal health and disease states by a systematic review of evidence from observational studies. Furthermore, we aimed to group secondary research papers which showed systemic diseases linked to periodontitis (SDLP) for the changes in UA levels in serum and discuss the consequences. Materials and Methods: A systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. The literature search was followed by qualitative assessment using the Newcastle–Ottawa scale when evaluating PD with UA associations. A similar strategic search system was used for identifying secondary studies (systematic reviews with meta-analyses or [SRMA]) for identifying UA levels in common SDLP. Results: Out of 212 selected studies, 40 underwent full-text analysis; 6 were eligible for systematic review. The current review summarizes that overall PD cases have significantly more UA levels than healthy individuals or controls from data from three observational studies. In the case of SDLP, around 8 SRMA (conducted on = 164 observational studies) revealed a significant association (P < 0.05 in all instances) with serum hyperuricemia; cancer incidence and progression were more in women with raised UA than in men. Conclusion: The review showed that UA levels were significantly altered in PD compared to healthy individuals. However, the available evidence is inadequate to establish whether UA is diminished or elevated in periodontal disease. The SDLP all showed a significant association with raised serum UA levels with cancers affecting more women than men with high UA levels.