Periodontitis as a reservoir of human papillomavirus in the causation of oral squamous cell carcinoma: a review

Abstract

Human papillomavirus (HPV) is a DNA virus from Papillomavirus family, and is one of the most widely reported sexual infection, which is not only related to ano-genital malignancies, but also associated with head and neck cancers, with chronic periodontitis being one of the risk factor for the same. Chronic periodontitis leads to loss of tissue structures of and around periodontium and is clinically detectable in the form of periodontal pocket and loss of alveolar bone. A variety of other systemic diseases have also been found to be linked to chronic periodontitis, such as cardiovascular diseases, respiratory diseases, etc., and recent data show that it is also related to malignancies of oral cavity. Junctional epithelium of periodontal pocket helps HPV to survive by facilitating the cellular functions to grow and hence, acts as a reservoir for the virus. Porphyromonas gingivalis, a Gram-negative anaerobic bacteria and HPV interacts both directly and indirectly in a series of complex reactions and as a result of some inflammatory reactions, this association further leads to commencement and progression of head and neck squamous cell carcinoma or oral squamous cell carcinoma. This article reviews the pathophysiology of oral human papillomavirus infection and its role in head and neck cancers, with chronic periodontitis as one of the causative factors