Presentation (CTI)

OBJECTIVES: Hyperuricemia is associated with systemic inflammation, oxidative stress, and cardiometabolic comorbidities, while periodontitis is a chronic inflammatory disease characterized by progressive destruction of periodontal supporting tissues. Given overlapping inflammatory and metabolic pathways, this targeted literature review (TLR) evaluated PubMed-indexed evidence on the association between serum uric acid abnormalities, including hyperuricemia and hypouricemia, and periodontitis in adults.
METHODS: A targeted PubMed search was conducted to identify studies evaluating serum uric acid levels or clinically defined hyperuricemia/hypouricemia in relation to periodontitis. Eligible studies included adult populations with biochemical assessment of serum uric acid and periodontal outcomes assessed using clinical periodontal measures, diagnostic classifications, or periodontal indices. Data were summarized narratively by study design, population, serum uric acid exposure definition, periodontal outcome, and reported association.
RESULTS: Of 152 PubMed records screened, 9 studies met eligibility criteria. Included studies represented diverse populations from the USA, Korea, China, Taiwan, Cameroon, and Slovenia, and included large national datasets such as NHANES, KNHANES, and KoGES, alongside smaller clinical or community-based cohorts. Most studies were cross-sectional, with one cohort-based analysis. Periodontitis definitions varied across studies and included CDC/AAP criteria, CPI-based definitions, EFP/AAP staging, PISA, clinical attachment loss, and probing pocket depth. Findings were heterogeneous. Some studies reported higher odds of periodontitis or severe periodontitis with elevated serum uric acid or hyperuricemia, while others found no significant association or suggested an inverse/protective association. One Korean national survey identified hypouricemia, rather than hyperuricemia, as associated with increased periodontitis risk.
CONCLUSIONS: Current evidence suggests a biologically plausible but inconsistent association between serum uric acid dysregulation and periodontitis. Differences in population characteristics, periodontal definitions, uric acid thresholds, metabolic comorbidities, and confounder adjustment likely contribute to heterogeneity. Further longitudinal and well-controlled studies are required to clarify the role of SUA as a potential risk marker or modifier of periodontal disease.