SYSTEMIC DISEASES (N BUDUNELI, SECTION EDITOR) Are Sex Steroid Hormones Influencing Periodontal Conditions? A Systematic Review Aliye Akcalı 1,2 & Zeynep Akcalı 3 & Fareeha Batool 4 & Catherine Petit 4,5 & Olivier Huck 4,5 # Springer International Publishing AG, part of Springer Nature 2018 Abstract Purpose of Review The pulsatile fashion of the release of sex steroid hormones has an impact on periodontium. The aim of this systematic review was to determine whether sex steroid hormones influence periodontal diseases or not. Recent Findings MEDLINE via OVID, EMBASE, and the Cochrane Database updated until July 2017 were searched and, particularly, the papers published over the past 5 years were reviewed. Summary The evidence is more supportive towards the effect of sex steroid hormone perturbations on an existing periodontal disease rather than the initiation of disease. Examination of potential diagnostics for preventive or therapeutic applications is needed in order to decrease the composite risks arising from the hormonal changes themselves. Also, further clinical trials comparing sex steroid hormone exposure on patients with similar baseline periodontal conditions are emerging in order to understand the causal mechanisms between the two, eventually, helping to make clearer clinical recommendations and guidelines for hormone-dominated periods in both men and women. Keywords Estrogens . Periodontal diseases . Periodontal indexes . Progesterone . Sex steroid hormones . Testosterone Introduction Periodontal diseases, including gingivitis and periodontitis, are among the most prevalent diseases worldwide [1, 2]. They are initiated by changes within biofilms and establishment of a dysbiotic flora that further drives the progression of the disease and associated inflammatory response [ 3]. These inflammatory diseases of infectious origin are characterized mainly by gingival bleeding for gingivitis and by clinical attachment loss for peri- odontitis, which may lead to increased tooth mobility and ulti- mately tooth loss inducing reduced masticatory function with a consequent impaired oral health-related quality of life [4]. Several risk factors have been identified including not only the acquired ones like local and environmental stressors (i.e., smoking, overhanging dental treatments) but also certain system- ic conditions such as diabetes mellitus, rheumatoid arthritis, or pregnancy which are closely related to periodontal diseases in a bidirectional manner [5, 6]. Substantive endocrine changes, such as transient, physiologic, or pathologic, may affect periodontal condition through modula- tion of the inflammatory response as well as through a direct action on periodontal pathogens. Therefore, a specific insight on the association between endocrine system and periodontal diseases has been established in the currently used classification system, emphasizing its importance in diagnosis and treatment [7]. Periodontal manifestations of sex steroid hormones are ex- hibited in relation to the substantive endocrine changes during puberty, menstrual cycle, pregnancy, and menopause controlled by both endocrine and reproductive systems [ 8]. The proposed This article is part of the Topical Collection on Systemic Diseases * Aliye Akcalı aliye.akcali@uni-wh.de; a.akcali@qmul.ac.uk 1 Department of Periodontology, School of Dentistry, University of Witten/Herdecke, Alfred-Herrhausen-Str. 44, 58455 Witten, Germany 2 Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK 3 Department of Internal Medicine, Havran Government Hospital, Balıkesir, Turkey 4 Department of Periodontology, Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France 5 INSERM 1260 Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France Current Oral Health Reports https://doi.org/10.1007/s40496-018-0168-0