Oral–Systemic Interactions: Biomarkers, Inflammatory Pathways, and Disease Cross-Talk

Background and Objectives: The present study aimed to evaluate the association between dental caries, periodontal pockets, and radiologically detected periapical lesions with serum levels of Dickkopf-1 (Dkk-1) and tartrate-resistant acid phosphatase 5 (TRAP-5) in oncological patients with ear, nose, and throat (ENT) cancer compared with healthy controls. Materials and Methods: The study included 63 subjects divided into a study group of 33 patients diagnosed with ENT cancer and a control group of 30 healthy individuals. Blood samples were collected to determine serum Dkk-1 levels using a sandwich enzyme immunoassay and TRAP-5 levels. Dental radiological evaluation consisted of orthopantomography (OPT) and cone-beam computed tomography (CBCT) to assess the number and depth of dental caries and the presence of periapical lesions. Periodontal pockets were recorded through clinical examination. Results: OPT assessment showed a maximum of eight carious sites in both groups. The mean number of carious lesions was higher in healthy subjects (2.97 ± 2.48) than in cancer patients (2.06 ± 2.29). CBCT evaluation revealed 0–8 carious lesions in healthy individuals (maximum = 8) and 0–6 lesions in cancer patients (maximum = 6). The mean number of caries detected by CBCT was significantly higher in the control group (2.97 ± 2.48) compared with the cancer group (1.85 ± 1.89). Periodontal pockets were more frequent in cancer patients (mean: 0.67 ± 1.32) than in controls (0.37 ± 0.81). OPT evaluation showed a higher mean number of periapical lesions in cancer patients (0.82 ± 1.29) compared with controls (0.37 ± 0.67). CBCT examination demonstrated that the mean number of periapical lesions in cancer patients was more than twice that of the control group; however, this difference did not reach statistical significance. Conclusions: Patients with ENT cancer presented a higher prevalence of periodontal pockets and periapical lesions compared with healthy controls, while carious lesions were more frequently detected in healthy individuals. Radiological findings, together with systemic biomarkers such as Dkk-1 and TRAP-5, may contribute to a better understanding of oral–systemic interactions in oncological patients.