Relationship between Chronic Periodontitis and Erectile Dysfunction: A Narrative Review

Table 1

Characteristics of the 9 studies evaluating ED and CP.

Author, year	Objective	Study population	Patients included	Assessment of ED	Assessment of CP
Keller et al., 2012 [28]	Association between ED and CP; gingivectomy and periodontal flap surgery on ED	Taiwan’s National Health Insurance Research Database (NHIRD) of inpatient and outpatient medical benefit claims	32,856 ED cases; 164,280 age-matched controls; ≥18 y	Self-administered IIEF-5 questionnaire and ICD-9-CM code 607.84; 2 ED diagnoses with at least one by a urologist	ICD-9-CM code 523.4; ≥2 CP diagnoses prior to ED diagnosis
Matsumoto et al., 2014  [27]	Association between ED and CP	Asahikawa city, Japan	88 adult men; mean age: 50.9 y	Self-administered IIEF-5 questionnaire	CP self-check sheet
Oğuz et al., 2013 [31]	Association between ED and CP	Patient pool of the Department of Urology at İnönü University	80 ED cases; 82 controls; 30–40 y	Clinician administered IIEF questionnaire	Severe periodontal disease was defined as 15 tooth sites with 4 mm PD and BoP
Sharma et al., 2011 [26]	Association between ED and CP	Outpatient section of Ankur Healthcare (andrology clinics), Rajajinagar, Bangalore, India	70 patients with vasculogenic ED; mean age: 35.3 y	IIEF-5 questionnaire and colored penile Doppler ultrasound	PD 5 mm and attachment loss (CA loss 3 mm at >30% sites with radiographic evidence of bone loss (distance of CEJ to alveolar bone crest of 6 mm))
Tsao et al., 2015 [29]	Association between ED and CP; extraction on ED	Longitudinal Health Insurance Database 2000 (LHID2000) which is a randomly sampled subset of the NHIRD	5105 ED cases; 10,210 age-matched controls; 20 y	ICD-9-CM code 607.84; 2 ED diagnoses with at least one by a urologist	ICD-9-CM code 523.4; 2 CP diagnoses prior to ED diagnosis
Uppal et al., 2014 [25]	Association between ED and CP	Outpatient departments of the hospitals in Ferozepur city, Punjab, India	53 patients with vasculogenic ED; >20 permanent teeth, no periodontal therapy in last 6 months, no aggressive periodontitis, and no systemic diseases	IIEF-5 questionnaire	PD >5 mm and radiographic evidence of bone loss in at least one site in the jaw with distance of CEJ to alveolar bone crest of 6 mm
Zadik et al., 2009 [30]	Association between ED and CP	Israel Defense Forces (IDF) personnel ≥25 y who filled the SHIM questionnaire during SPEC examinations	305 men who completed the IIEF-5 questionnaire and had posterior bitewing dental radiographs; mean age: 39.5 y	Clinician administered IIEF-5 questionnaire	Alveolar bone loss in at least one site in the jaw with distance of CEJ to alveolar bone crest of 6 mm
Zuo et al., 2011 [32]	Biologic relationship between CP and ED (rats)	Sprague-Dawley rats purchased from the Experimental Animal Center of Luzhou Medical College	5 CP-induced cases; 5 age-matched controls; 12 weeks old	Ratio of ICP/MAP 100; eNOS expression; NOS and cGMP activity; ultrastructure of penile cavernous tissue	Periodontitis features including easy gum bleeding, periodontal pocket formation, alveolar bone absorption, and junctional epithelium moved to the apical root around the mandibular first molar tooth area
Eltas et al., 2013 [15]	Periodontal treatment on ED	Patient pool of the Department of Urology at İnönü University	120 patients with both CP and severe or moderate ED; >20 permanent teeth; 30–40 y	Clinician administered IIEF questionnaire	>30% of sites had PD and CA loss 4 mm at baseline

ED, erectile dysfunction; CP, chronic periodontitis; PD, probing depth; ICP, intracavernosal pressure; MAP, mean arterial pressure; CA loss, clinical attachment loss; BoP, bleeding on probing; CEJ, cementoenamel junction.