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Arbildo-Vega HI, Padilla-Cáceres T, Caballero-Apaza L, Cruzado-Oliva FH, Mamani-Cori V, Cervantes-Alagón S, Vásquez-Rodrigo H, Coronel-Zubiate FT, Aguirre-Ipenza R, Meza-Málaga JM, Luján-Valencia SA, Castillo-Cornock TB, Serquen-Olano K. Effect of Treating Periodontal Disease in Pregnant Women to Reduce the Risk of Preterm Birth and Low Birth Weight: An Umbrella Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:943. [PMID: 38929560 PMCID: PMC11205593 DOI: 10.3390/medicina60060943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 05/25/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024]
Abstract
Background: The aim of this review was to evaluate the effects of periodontal disease (PD) treatment in pregnant women to reduce the risk of preterm birth (PB) and low birth weight (LBW) by conducting an umbrella review. Methods: A comprehensive search for the literature up to April 2024 was conducted across multiple databases including PubMed, Cochrane Library, Scopus, EMBASE, Scielo, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We specifically targeted systematic reviews (SRs) with or without meta-analyses, irrespective of language or time constraints, focusing on primary studies examining the effect of PD treatment in pregnant women to reduce the risk of PB and LBW. Various types of non-systematic reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded from consideration. The quality and overall confidence of the included studies were assessed using the AMSTAR-2 tool. Results: After the initial search, 232 articles were identified, of which only 24 met the selection criteria after exclusion. The majority of these studies indicated that periodontal treatment reduces the risk of PB and LBW. Conclusions: According to the findings and conclusions drawn from the SRs with a high overall confidence level, PD treatment in pregnant women reduces the risk of PB and LBW.
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Affiliation(s)
- Heber Isac Arbildo-Vega
- Department of General Dentistry, Dentistry School, San Martín de Porres University, Chiclayo 14012, Peru; (H.I.A.-V.); (H.V.-R.); (T.B.C.-C.); (K.S.-O.)
- Department of Human Medicine, School of Human Medicine, San Martín de Porres University, Chiclayo 14012, Peru
| | - Tania Padilla-Cáceres
- Department of General Dentistry, Dentistry School, University of the Altiplano, Puno 21001, Peru; (T.P.-C.); (L.C.-A.); (V.M.-C.); (S.C.-A.)
- Research Institute in Environmental Sciences, Health and Biodiversity—IICASB, University of the Altiplano, Puno 21001, Peru
| | - Luz Caballero-Apaza
- Department of General Dentistry, Dentistry School, University of the Altiplano, Puno 21001, Peru; (T.P.-C.); (L.C.-A.); (V.M.-C.); (S.C.-A.)
- Department of Nursing, School of Nursing, University of the Altiplano, Puno 21001, Peru
| | - Fredy Hugo Cruzado-Oliva
- Department of Stomatology, School of Stomatology, National University of Trujillo, Trujillo 13011, Peru;
| | - Vilma Mamani-Cori
- Department of General Dentistry, Dentistry School, University of the Altiplano, Puno 21001, Peru; (T.P.-C.); (L.C.-A.); (V.M.-C.); (S.C.-A.)
- Research Institute in Environmental Sciences, Health and Biodiversity—IICASB, University of the Altiplano, Puno 21001, Peru
| | - Sheyla Cervantes-Alagón
- Department of General Dentistry, Dentistry School, University of the Altiplano, Puno 21001, Peru; (T.P.-C.); (L.C.-A.); (V.M.-C.); (S.C.-A.)
- Amazonian Andean Research and Development Institute—IIDEAA, University of the Altiplano, Puno 21001, Peru
| | - Hernán Vásquez-Rodrigo
- Department of General Dentistry, Dentistry School, San Martín de Porres University, Chiclayo 14012, Peru; (H.I.A.-V.); (H.V.-R.); (T.B.C.-C.); (K.S.-O.)
- Department of Dentistry, Dentistry School, Norbert Wiener University, Lima 15046, Peru
| | - Franz Tito Coronel-Zubiate
- Faculty of Health Sciences, Stomatology School, Toribio Rodríguez of Mendoza National University of Amazonas, Chachapoyas 01001, Peru
| | | | - Joan Manuel Meza-Málaga
- Faculty of Dentistry, Dentistry School, Católica de Santa María University, Arequipa 04013, Peru; (J.M.M.-M.); (S.A.L.-V.)
- Faculty of Medicine, Medicine School, Católica de Santa María University, Arequipa 04013, Peru
| | - Sara Antonieta Luján-Valencia
- Faculty of Dentistry, Dentistry School, Católica de Santa María University, Arequipa 04013, Peru; (J.M.M.-M.); (S.A.L.-V.)
- Postgraduate School, Católica de Santa María University, Arequipa 04013, Peru
| | - Tania Belú Castillo-Cornock
- Department of General Dentistry, Dentistry School, San Martín de Porres University, Chiclayo 14012, Peru; (H.I.A.-V.); (H.V.-R.); (T.B.C.-C.); (K.S.-O.)
- Faculty of Health Sciences, Stomatology School, Señor de Sipán University, Chiclayo 14000, Peru
| | - Katherine Serquen-Olano
- Department of General Dentistry, Dentistry School, San Martín de Porres University, Chiclayo 14012, Peru; (H.I.A.-V.); (H.V.-R.); (T.B.C.-C.); (K.S.-O.)
- Faculty of Health Sciences, Stomatology School, Señor de Sipán University, Chiclayo 14000, Peru
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Pax K, Buduneli N, Alan M, Meric P, Gurlek O, Dabdoub SM, Kumar PS. Placental TLR recognition of salivary and subgingival microbiota is associated with pregnancy complications. MICROBIOME 2024; 12:64. [PMID: 38532461 DOI: 10.1186/s40168-024-01761-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 01/08/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Pre-term birth, the leading cause of neonatal mortality, has been associated with maternal periodontal disease and the presence of oral pathogens in the placenta. However, the mechanisms that underpin this link are not known. This investigation aimed to identify the origins of placental microbiota and to interrogate the association between parturition complications and immune recognition of placental microbial motifs. Video Abstract METHODS: Saliva, plaque, serum, and placenta were collected during 130 full-term (FT), pre-term (PT), or pre-term complicated by pre-eclampsia (PTPE) deliveries and subjected to whole-genome shotgun sequencing. Real-time quantitative PCR was used to measure toll-like receptors (TLR) 1-10 expression in placental samples. Source tracking was employed to trace the origins of the placental microbiota. RESULTS We discovered 10,007 functionally annotated genes representing 420 taxa in the placenta that could not be attributed to contamination. Placental microbial composition was the biggest discriminator of pregnancy complications, outweighing hypertension, BMI, smoking, and maternal age. A machine-learning algorithm trained on this microbial dataset predicted PTPE and PT with error rates of 4.05% and 8.6% (taxonomy) and 6.21% and 7.38% (function). Logistic regression revealed 32% higher odds of parturition complication (95% CI 2.8%, 81%) for every IQR increase in the Shannon diversity index after adjusting for maternal smoking status, maternal age, and gravida. We also discovered distinct expression patterns of TLRs that detect RNA- and DNA-containing antigens in the three groups, with significant upregulation of TLR9, and concomitant downregulation of TLR7 in PTPE and PT groups, and dense correlation networks between microbial genes and these TLRs. 70-82% of placental microbiota were traced to serum and thence to the salivary and subgingival microbiomes. The oral and serum microbiomes of PTPE and PT groups displayed significant enrichment of genes encoding iron transport, exosome, adhesion, quorum sensing, lipopolysaccharide, biofilm, and steroid degradation. CONCLUSIONS Within the limits of cross-sectional analysis, we find evidence to suggest that oral bacteria might translocate to the placenta via serum and trigger immune signaling pathways capable of inducing placental vascular pathology. This might explain, in part, the higher incidence of obstetric syndromes in women with periodontal disease.
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Affiliation(s)
- Kazune Pax
- Division of Oral Biosciences, College of Dentistry, The Ohio State University, Columbus, OH, 43210, USA
| | - Nurcan Buduneli
- Faculty of Clinical Sciences, Department of Periodontology, Ege University, İzmir, Turkey
| | - Murat Alan
- Department of Obstetrics and Gynecology, Izmir Tepecik Training and Research Hospital, Tepecik, 35120, Izmir, Türkiye
| | - Pinar Meric
- Faculty of Clinical Sciences, Department of Periodontology, Ege University, İzmir, Turkey
| | - Onder Gurlek
- Faculty of Clinical Sciences, Department of Periodontology, Ege University, İzmir, Turkey
| | - Shareef M Dabdoub
- Department of Periodontics, Division of Biostatistics and Computational Biology, The University of Iowa School of Dentistry, Iowa City, IA, 52242-1010, USA
| | - Purnima S Kumar
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, 48109, USA.
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Minervini G, Basili M, Franco R, Bollero P, Mancini M, Gozzo L, Romano GL, Marrapodi MM, Gorassini F, D'Amico C, Pedullà E, Fiorillo L. Periodontal Disease and Pregnancy: Correlation with Underweight Birth. Eur J Dent 2023; 17:945-950. [PMID: 36513345 PMCID: PMC10756724 DOI: 10.1055/s-0042-1757906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Periodontal disease is a risk factor for many systemic diseases including preterm birth and underweight birth. The purpose of this systematic review is to analyze the literature and to highlight any clinical correlation. Information sources such as PubMed, MEDLINE, and Web of Science were consulted to obtain our results with these keywords "periodontal disease," "pregnancy," "weight loss" using the connector "AND." After the first screening by authors, only 27 articles were included in this review. From the analysis of the literature, it was noted that the presence of periodontal disease could have a correlation with underweight birth. Surely, control oral hygiene and oral health is essential during pregnancy to reduce risks, and these results should be essential in establishing a protocol to be maintained during pregnancy.
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Affiliation(s)
- Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Manuele Basili
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata," Rome, Italy
| | - Rocco Franco
- Department of Systems Medicine, University of Rome "Tor Vergata," Rome, Italy
| | - Patrizio Bollero
- Department of Systems Medicine, University of Rome "Tor Vergata," Rome, Italy
| | - Maura Mancini
- Unit of Ophthalmology, Department of Scienze Biomediche, Odontoiatriche e Delle Immagini Morfologiche e Funzionali, University of Messina, Messina, Italy
| | - Lucia Gozzo
- Clinical Pharmacology Unit, Regional Pharmacovigilance Centre, University Hospital of Catania, Catania, Italy
| | - Giovanni Luca Romano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Francesca Gorassini
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, G. Martino Polyclinic, Messina, Italy
| | - Cesare D'Amico
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, G. Martino Polyclinic, Messina, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Luca Fiorillo
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, G. Martino Polyclinic, Messina, Italy
- Department of Prosthodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, India
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Ben David M, Callen Y, Eliasi H, Peretz B, Odeh-Natour R, Ben David Hadani M, Blumer S. Oral Health and Knowledge among Postpartum Women. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1449. [PMID: 36291384 PMCID: PMC9600570 DOI: 10.3390/children9101449] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/07/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
Oral health behavior and risks during pregnancy and after birth affect the oral health of babies and toddlers. We examined the oral and gingival health and caries prevalence of 150 postpartum women shortly after giving birth and assessed their knowledge of oral hygiene using a questionnaire. We also compared the oral health knowledge of nulliparous and multiparous women. Although most participants (98.0%) understood the importance of maintaining oral hygiene in children, their overall knowledge of oral health was medium-low, regardless of the number of previous pregnancies. Only 4.6% of women received oral health advice from their obstetrician during their pregnancy. Most participants had a high gingival index score, which correlated with dental pain during pregnancy. In contrast, the number of decayed, missing and filled teeth was significantly lower in first-time mothers. There was a statistically significant positive correlation between women who regularly visit their dentist and those who regularly take their children to the dentist. Expecting mothers should be educated about their own oral health and that of their developing fetus and children. Raising awareness among obstetricians with regards to this topic may be an effective way to achieve this.
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Affiliation(s)
- Mordechai Ben David
- Department of Obstetrics and Gynecology, Laniado Hospital, Netanya 42223, Israel
| | - Yaffa Callen
- Department of Paediatric Dentistry, The Maurice and Gabriela Goldshleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Hila Eliasi
- Department of Paediatric Dentistry, The Maurice and Gabriela Goldshleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Benjamin Peretz
- Department of Paediatric Dentistry, The Maurice and Gabriela Goldshleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Rasha Odeh-Natour
- Department of Obstetrics and Gynecology, Laniado Hospital, Netanya 42223, Israel
| | | | - Sigalit Blumer
- Department of Paediatric Dentistry, The Maurice and Gabriela Goldshleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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Savitha JN, Bhavya B, Yadalam U, Khan SF. Detection of Porphyromonas gingivalis in umbilical cord blood of new-born and in subgingival plaque of pregnant participants with periodontal disease and its association with pregnancy outcomes: An observational study. J Indian Soc Periodontol 2022; 26:365-372. [PMID: 35959303 PMCID: PMC9362802 DOI: 10.4103/jisp.jisp_45_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 09/19/2021] [Accepted: 10/17/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Preterm low birth weight (PLBW) is one of the causes of infant mortality and morbidity. Most of the studies have indicated the periodontal-systemic interlink. The association of periodontal pathogen on pregnancy outcome still stands inconclusive. The aim of the study was to detect the prevalence of Porphyromonas gingivalis in umbilical cord blood of new-born infant and correlate the same pathogen in subgingival plaque of pregnant women and to determine the adverse pregnancy outcomes and also to determine the correlation between periodontitis and the association of P. gingivalis in preterm birth/low birth. Materials and Methods: The present study included 130 pregnant participants in their full-term and preterm delivery with periodontitis. Periodontal disease was diagnosed clinically using gingival index, pocket depth, plaque index, and clinical attachment level. Umbilical cord blood samples and plaque samples collected using Gracey curette were subjected to culture for the detection of P. gingivalis. The results were subjected to the statistical analysis using the SPSS software. Results: The comparison of P. gingivalis in umbilical cord blood and plaque between preterm and full-term group was found to be significantly increased in preterm group. A statistically significant difference was also seen for the clinical parameters between the two groups, with increased values seen in case of preterm labor. Odd's ratio on the comparison of prevalence of periodontitis among full term and preterm group was statistically significant in preterm birth as compared with full-term birth. Conclusion: The study results showed statistically significant association of P. gingivalis with PLBW. Periodontal disease significantly affects the adverse pregnancy outcome.
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Affiliation(s)
- J N Savitha
- Community Health Center, Shantigrama, Hassan, Karnataka, India
| | - B Bhavya
- Department of Periodontology, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
| | - Umesh Yadalam
- Department of Periodontics, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Bengaluru, Karnataka, India
| | - Safiya Fatima Khan
- Department of Periodontology, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
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6
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Jang H, Patoine A, Wu TT, Castillo DA, Xiao J. Oral microflora and pregnancy: a systematic review and meta-analysis. Sci Rep 2021; 11:16870. [PMID: 34413437 PMCID: PMC8377136 DOI: 10.1038/s41598-021-96495-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/02/2021] [Indexed: 02/07/2023] Open
Abstract
Understanding changes in oral flora during pregnancy, its association to maternal health, and its implications to birth outcomes is essential. We searched PubMed, Embase, Web of Science, and Cochrane Library in May 2020 (updated search in April and June 2021), and conducted a systematic review and meta-analyses to assess the followings: (1) oral microflora changes throughout pregnancy, (2) association between oral microorganisms during pregnancy and maternal oral/systemic conditions, and (3) implications of oral microorganisms during pregnancy on birth outcomes. From 3983 records, 78 studies were included for qualitative assessment, and 13 studies were included in meta-analysis. The oral microflora remains relatively stable during pregnancy; however, pregnancy was associated with distinct composition/abundance of oral microorganisms when compared to postpartum/non-pregnant status. Oral microflora during pregnancy appears to be influenced by oral and systemic conditions (e.g. gestational diabetes mellitus, pre-eclampsia, etc.). Prenatal dental care reduced the carriage of oral pathogens (e.g. Streptococcus mutans). The Porphyromonas gingivalis in subgingival plaque was more abundant in women with preterm birth. Given the results from meta-analyses were inconclusive since limited studies reported outcomes on the same measuring scale, more future studies are needed to elucidate the association between pregnancy oral microbiota and maternal oral/systemic health and birth outcomes.
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Affiliation(s)
- Hoonji Jang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Alexa Patoine
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, USA
| | - Daniel A Castillo
- Miner Library, University of Rochester Medical Center, Rochester, NY, USA
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
- Perinatal Oral Health, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, 14620, USA.
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Bostanci N, Krog MC, Hugerth LW, Bashir Z, Fransson E, Boulund F, Belibasakis GN, Wannerberger K, Engstrand L, Nielsen HS, Schuppe-Koistinen I. Dysbiosis of the Human Oral Microbiome During the Menstrual Cycle and Vulnerability to the External Exposures of Smoking and Dietary Sugar. Front Cell Infect Microbiol 2021; 11:625229. [PMID: 33816334 PMCID: PMC8018275 DOI: 10.3389/fcimb.2021.625229] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/11/2021] [Indexed: 12/18/2022] Open
Abstract
Physiological hormonal fluctuations exert endogenous pressures on the structure and function of the human microbiome. As such, the menstrual cycle may selectively disrupt the homeostasis of the resident oral microbiome, thus compromising oral health. Hence, the aim of the present study was to structurally and functionally profile the salivary microbiome of 103 women in reproductive age with regular menstrual cycle, while evaluating the modifying influences of hormonal contraceptives, sex hormones, diet, and smoking. Whole saliva was sampled during the menstrual, follicular, and luteal phases (n = 309) of the cycle, and the participants reported questionnaire-based data concerning their life habits and oral or systemic health. No significant differences in alpha-diversity or phase-specific clustering of the overall microbiome were observed. Nevertheless, the salivary abundances of genera Campylobacter, Haemophilus, Prevotella, and Oribacterium varied throughout the cycle, and a higher species-richness was observed during the luteal phase. While the overall community structure maintained relatively intact, its functional properties were drastically affected. In particular, 11 functional modules were differentially abundant throughout the menstrual cycle, including pentose phosphate metabolism, and biosynthesis of cobalamin and neurotransmitter gamma-aminobutyric acid. The menstrual cycle phase, but not oral contraceptive usage, was accountable for greater variations in the metabolic pathways of the salivary microbiome. Further co-risk factor analysis demonstrated that Prevotella and Veillonella were increased in current smokers, whereas high dietary sugar consumption modified the richness and diversity of the microbiome during the cycle. This is the first large study to systematically address dysbiotic variations of the oral microbiome during the course of menstrual cycle, and document the additive effect of smoking and sugar consumption as environmental risk factors. It reveals the structural resilience and functional adaptability of the oral microbiome to the endogenous hormonal pressures of the menstrual cycle, while revealing its vulnerability to the exogenous exposures of diet and smoking.
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Affiliation(s)
- Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maria Christine Krog
- The Recurrent Pregnancy Loss Units, Copenhagen University Hospitals, Rigshospitalet and Hvidovre Hospital, Copenhagen, Denmark.,Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Luisa W Hugerth
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
| | - Zahra Bashir
- The Recurrent Pregnancy Loss Units, Copenhagen University Hospitals, Rigshospitalet and Hvidovre Hospital, Copenhagen, Denmark.,Department of Obstetrics and Gynaecology, Holbæk Hospital, Holbæk, Denmark
| | - Emma Fransson
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
| | - Fredrik Boulund
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Lars Engstrand
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
| | - Henriette Svarre Nielsen
- The Recurrent Pregnancy Loss Units, Copenhagen University Hospitals, Rigshospitalet and Hvidovre Hospital, Copenhagen, Denmark.,Department of Obstetrics and Gynaecology, Hvidovre Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ina Schuppe-Koistinen
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
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8
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Zorba M, Melidou A, Patsatsi A, Poulopoulos A, Gioula G, Kolokotronis A, Minti F. The role of oral microbiome in pemphigus vulgaris. Arch Microbiol 2021; 203:2237-2247. [PMID: 33634320 DOI: 10.1007/s00203-021-02199-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/27/2021] [Accepted: 02/08/2021] [Indexed: 12/24/2022]
Abstract
While the impact of oral microbiome dysbiosis on autoimmune diseases has been partially investigated, its role on bullous diseases like Pemphigus Vulgaris (PV) is a totally unexplored field. This study aims to present the composition and relative abundance of microbial communities in both healthy individuals and patients with oral PV lesions. Ion Torrent was used to apply deep sequencing of the bacterial 16S rRNA gene to oral smear samples of 15 healthy subjects and 15 patients. The results showed that the most dominant phyla were Firmicutes (55.88% controls-c vs 61.27% patients-p, p value = 0.002), Proteobacteria (9.17%c vs 12.33%p, p value = 0.007) and Fusobacteria (3.39%c vs 4.09%p, p value = 0.03). Alpha diversity showed a significant difference in the number of genera between patients and controls (p value = 0.04). Beta diversity showed statistical differences in the microbial community composition between two groups. Fusobacterium nucleatum, Gemella haemolysans and Parvimonas micra were statistically abundant in patients. We noticed the characteristic fetor coming out of oral PV lesions. Most of anaerobic bacteria responsible for oral halitosis are periopathogenic. Though, only F. nucleatum and P. micra were differentially abundant in our patients. Especially, F. nucleatum has been reported many times as responsible for bad breath. Furthermore, Streptococcus salivarius and Rothia mucilaginosa, species mostly associated with clean breath, were found in relative abundance in the healthy group. Consequently, the distinct malodor observed in PV patients might be attributed either to the abundance of F. nucleatum and P. micra and/or to the lower levels of S. salivarius and R. mucilanginosa in oral lesions.
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Affiliation(s)
- Matina Zorba
- Department of Oral Medicine and Oral Pathology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Angeliki Melidou
- Department of Microbiology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini Patsatsi
- Autoimmune Skin and Bullous Diseases Outpatient Unit of Papageorgiou General Hospital, 2nd Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasios Poulopoulos
- Department of Oral Medicine and Oral Pathology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Gioula
- Department of Microbiology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Kolokotronis
- Department of Oral Medicine and Oral Pathology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fani Minti
- Department of Microbiology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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9
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Zorba M, Melidou A, Patsatsi A, Ioannou E, Kolokotronis A. The possible role of oral microbiome in autoimmunity. Int J Womens Dermatol 2020; 6:357-364. [PMID: 33898698 PMCID: PMC8060669 DOI: 10.1016/j.ijwd.2020.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 07/15/2020] [Accepted: 07/28/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE The human microbiome refers to the entire habitat, including microorganisms, their genomes and the surrounding environmental conditions of the microbial ecosystem. When the equilibrium between microbial habitats and host is disturbed, dysbiosis is caused. The oral microbiome (OMB) has been implicated in the manifestation of many intra- and extraoral diseases. Lately, there has been an intense effort to investigate and specify the relationship between microbial complexes, especially that of the oral cavity and intestine and autoimmunity. This study aimed to review the current literature about the possible role of the OMB in the pathogenesis of autoimmune diseases. METHODS We searched for published articles in English indexed in PubMed, Medline, Research Gate and Google Scholar using a search strategy that included terms for oral microbiome, autoimmune diseases, dysbiosis and next-generation sequencing. RESULTS An important number of articles were gathered and used for the description of the possible impact of dysbiosis of OMB in the pathogenesis of Sjögren's syndrome, systemic lupus erythematosus, rheumatoid arthritis, Behcet's disease, Crohn's disease and psoriasis. CONCLUSION This review article draws attention to the relationship between OMB and the triggering of a number of autoimmune diseases. Although this specific topic has been previously reviewed, herein, the authors review recent literature regarding the full list of nosological entities related to the OMB, point out the interaction between the microbiome and sex hormones with regard to their role in autoimmunity and discuss novel and promising therapeutic approaches for systemic autoimmune diseases. Furthermore, the question arises of whether the OMB is associated with oral bullous autoimmune diseases.
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Affiliation(s)
- Matina Zorba
- Department of Oral Medicine and Maxillofacial Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece
| | - Angeliki Melidou
- Department of Microbiology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Aikaterini Patsatsi
- Second Dermatology Department of Papageorgiou General Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Eleftheria Ioannou
- Department of Biological Applications and Technology, Aristotle University of Thessaloniki, Greece
| | - Alexandros Kolokotronis
- Department of Oral Medicine and Maxillofacial Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece
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Mahapatra A, Nayak R, Satpathy A, Pati BK, Mohanty R, Mohanty G, Beura R. Maternal periodontal status, oral inflammatory load, and systemic inflammation are associated with low infant birth weight. J Periodontol 2020; 92:1107-1116. [PMID: 33155287 DOI: 10.1002/jper.20-0266] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/24/2020] [Accepted: 10/20/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Periodontal disease and pregnancy outcomes have been claimed to be associated with conflicting reports. The purpose of this study was to prospectively examine the association between maternal periodontal status, oral inflammatory load and serum C- reactive protein (CRP) level, and infant birth weight. METHODS A total of 156 pregnant women (age 26.62 ± 3.93 years) within the gestational age group of 13 to 32 weeks participated in this cross-sectional study. Oral inflammatory load (OIL) was assessed in a salivary rinse sample using fluorescence microscopy. Clinical periodontal parameters were recorded and serum C-reactive protein level (CRP) was assessed. Participants were followed till delivery, details of parturition and infant birth weight (IBW) was recorded. RESULTS OIL was significantly more in participants with mild and moderate periodontitis as compared to those with gingivitis in mid and late stages of pregnancy. Periodontal and systemic inflammatory parameters were positively correlated. A significant negative correlation was found between IBW and OIL (P = 0.006) and serum CRP (P < 0.001). The GI score (P = 0.039), BOP% (P = 0.023), serum CRP level (P < 0.001) and oral polymorphonuclear neutrophil (oPMN) count (P < 0.001) was significantly more in mothers delivering babies with low IBW. A multiple linear regression analysis showed that only oPMN (β = - 0.244, P = 0.021) and serum CRP (β = - 0.226, P = 0.019) were included in the best model (R2 = 0.12, F(3,152) = 7.15, P < 0.001) for significantly predicting the infant birth weight. CONCLUSIONS Poor maternal periodontal status, increased oral inflammatory load and increased systemic inflammation have an adverse effect on infant birth weight.
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Affiliation(s)
- Annuroopa Mahapatra
- Department of Periodontics, SCB Dental College and Hospital, Cuttack, Odisha, India.,Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Rashmita Nayak
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Anurag Satpathy
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Basanta Kumar Pati
- Department of Obstetrics and Gynaecology, Institute of Medical Sciences & SUM Hospital, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Rinkee Mohanty
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Gatha Mohanty
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Rajdeep Beura
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India.,Department of Periodontics, Hi-Tech Dental College & Hospital, Bhubaneswar, Odisha, India
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11
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Costantinides F, Vettori E, Conte M, Tonni I, Nicolin V, Ricci G, Di Lenarda R. Pregnancy, oral health and dental education: an overview on the northeast of Italy. J Perinat Med 2020; 48:829-835. [PMID: 32710719 DOI: 10.1515/jpm-2020-0032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/02/2020] [Indexed: 02/07/2023]
Abstract
Objectives To evaluate the level of knowledge of pregnant women and puerpers about oral health and prevention during and after gestation. Methods One hundred women aged 18-49 years (mean age 33±6 years) were included in this cross-sectional study. An anonymous questionnaire with 24 items related to oral health has been administered during or just after pregnancy. Firstly, answers have been analyzed on the full population and then subdividing the sample on the base of age ranges (G1: 18-25 years, G2: 26-35 years and G3: >35 years) and number of pregnancies (FP: first pregnancy; SP: second or more pregnancies). Parametric tests have been chosen for the statistical analysis; in particular, Anova test for independent samples was used to evaluate differences of baseline demographic characteristics among subgroups G1, G2, G3 while chi-square test was used for FP and SP subgroups. Anova test was also used to intercept differences on answers given to the questionnaire among G1, G2 and G3 group; for FP and SP group was used t-test. Results Level of information and knowledge of the full sample was medium-low and no significant differences have been observed between groups regarding awareness of the own level of the oral hygiene and knowledge of oral care. Conclusions Results of this survey underline the high necessity of educational programs regarding oral care in pregnant and puerpers women. A strict collaboration between medical figures (dentist, oral hygienist, gynecologist and obstetric) is strongly encouraged to spread the concept of prevention.
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Affiliation(s)
| | - Erica Vettori
- School of Dental Sciences, University of Trieste, Trieste, Italy
| | - Martina Conte
- School of Dental Sciences, University of Trieste, Trieste, Italy
| | - Ingrid Tonni
- School of Dental Sciences, University of Brescia, Brescia, Italy
| | - Vanessa Nicolin
- School of Dental Sciences, University of Trieste, Trieste, Italy
| | - Giuseppe Ricci
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.,Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
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12
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Association of periodontitis with pre term low birth weight – A review. Placenta 2020; 95:62-68. [DOI: 10.1016/j.placenta.2020.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 03/16/2020] [Indexed: 01/26/2023]
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13
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Govindasamy R, Periyasamy S, Narayanan M, Balaji VR, Dhanasekaran M, Karthikeyan B. The influence of nonsurgical periodontal therapy on the occurrence of adverse pregnancy outcomes: A systematic review of the current evidence. J Indian Soc Periodontol 2020; 24:7-14. [PMID: 31983838 PMCID: PMC6961443 DOI: 10.4103/jisp.jisp_228_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/13/2019] [Accepted: 08/15/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The poor maternal oral health in the pregnancy has an impact on the fetus through the oral-systemic link. Various studies have proven the relationship between poor maternal oral health and the occurrence of adverse pregnancy outcomes. Hence, periodontal therapy becomes indispensable during pregnancy. Previous systematic reviews and meta-analysis conducted to assess the influence of periodontal therapy on the occurrence of adverse pregnancy outcomes have shown inconsistent results. Hence, we conducted the present review to assess the influence of periodontal therapy on the occurrence of adverse pregnancy outcomes including the studies published till date. MATERIALS AND METHODS We searched for the relevant studies using the databases PUBMED, MEDLINE, CINAHL, and EMBASE on the randomized controlled trials evaluating the influence of periodontal treatment on adverse pregnancy outcomes from 2000 to 2018. Nineteen studies were considered for the present review based on the predetermined criteria. The risk of bias tool by Cochrane was used to evaluate the risk of bias among the studies. RESULTS Among the studies included for the present review, the occurrence of preterm birth among the pregnant mothers who received periodontal therapy ranged from 0% to 53.5%, while in the control group, the range was 6.38%-72%. The rate of LBW among the mothers treated for periodontal disease ranged from 0% to 36%, and in the control group, it varied from 1.15% to 53.9%. CONCLUSION With best possible evidence, it can be inferred that nonsurgical periodontal therapy is safe during pregnancy. Even though it does not completely avert the occurrence of adverse pregnancy outcomes, it can be recommended as a part of antenatal care.
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Affiliation(s)
- Rohini Govindasamy
- Department of Periodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - Sugavanesh Periyasamy
- Department of Public Health Dentistry, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - Mohan Narayanan
- Department of Oral Medicine and Radiology, Vinayaga Mission Dental College, Salem, Tamil Nadu, India
| | | | - Manikandan Dhanasekaran
- Department of Periodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - Balakrishnan Karthikeyan
- Department of Periodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
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Golofast B, Vales K. The connection between microbiome and schizophrenia. Neurosci Biobehav Rev 2019; 108:712-731. [PMID: 31821833 DOI: 10.1016/j.neubiorev.2019.12.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/01/2019] [Accepted: 12/06/2019] [Indexed: 12/15/2022]
Abstract
There has been an accumulation of knowledge about the human microbiome, some detailed investigations of the gastrointestinal microbiota and its functions, and the highlighting of complex interactions between the gut, the gut microbiota, and the central nervous system. That assumes the involvement of the microbiome in the pathogenesis of various CNS diseases, including schizophrenia. Given this information and the fact, that the gut microbiota is sensitive to internal and environmental influences, we have speculated that among the factors that influence the formation and composition of gut microbiota during life, possible key elements in the schizophrenia development chain are hidden where gut microbiota is a linking component. This article aims to describe and understand the developmental relationships between intestinal microbiota and the risk of developing schizophrenia.
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Affiliation(s)
- Bogdana Golofast
- National Institute of Mental Health, Topolova 748, 250 67 Klecany, Prague East, Czech Republic; Third Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague 10, Czech Republic.
| | - Karel Vales
- National Institute of Mental Health, Topolova 748, 250 67 Klecany, Prague East, Czech Republic
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15
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Makeeva IM, Ignatko AA, Churganova AA, Lebedev VA, Makeeva MK. [Periodontal diseases and complicated pregnancy]. STOMATOLOGII︠A︡ 2019; 98:70-73. [PMID: 30830097 DOI: 10.17116/stomat20199801170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Based on the datas available in the modern literature, to conduct a study on the effect of dental diseases on the course of pregnancy and outcome; mainly, the impact of periodontal disease on the low birth weight of the newborn and premature birth. MATERIAL AND METHODS This article is based on the study of materials from foreign and domestic studies found in the databases Pubmed and Elibrary. Literature data were used for the last 15 years. RESULTS The majority of pregnant women who are not receiving due dental examination and suffering with those or other diseases of the oral cavity have an unfavorable outcome of pregnancy, including premature births and low weight of the premature newborn. The role of the chronic effect of oral microorganisms Porphyromonas gingivalis (P. gingivalis) and Fusobacterium nudeatum, as well as local increase in prostaglandin E2 (PGE2) and tumor necrosis factor (TNF-α), in the implementation of the inflammatory reaction leading to a decrease in the weight of the fetus by 15-18%. CONCLUSION Due to the conducted research it was established that periodontal diseases and other infectious diseases of the oral cavity negatively affect the course of pregnancy and its outcome. The main problems were the lack of women's health education in terms of preparing for pregnancy and sanitation of foci of infection in the oral cavity both before pregnancy and at the time, as well as poor access to the dentist and not receiving proper prevention and, if necessary, treatment of oral diseases.
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Affiliation(s)
- I M Makeeva
- I.M. Sechenov First Moscow State Medical University of Ministry of Health of the Russian Federation, Moscow, Russia
| | - A A Ignatko
- I.M. Sechenov First Moscow State Medical University of Ministry of Health of the Russian Federation, Moscow, Russia
| | - A A Churganova
- I.M. Sechenov First Moscow State Medical University of Ministry of Health of the Russian Federation, Moscow, Russia
| | - V A Lebedev
- I.M. Sechenov First Moscow State Medical University of Ministry of Health of the Russian Federation, Moscow, Russia
| | - M K Makeeva
- People Friendship University of Russia, Moscow, Russia
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16
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Wanhong W, Changchang Y, Ping H. [Research progress on the relationship and mechanisms between periodontal disease and preterm birth and low-birth-weight infants]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 35:527-532. [PMID: 29188651 DOI: 10.7518/hxkq.2017.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Preterm birth (PB) is defined as the birth of a baby less than 37 weeks of gestational age. Low birth weight (LBW) is defined as a newborn baby's weight of less than 2 500 g. PB is often accompanied by LBW. Preterm low birth weight (PLBW) is the leading cause of newborn deaths. Periodontal disease (PD) is a chronic oral infectious disease, and it is closely related with general health. Epidemiological data show that PD is a risk factor for PLBW and other adverse pregnancy outcomes. The possible mechanisms include the direct effects of periodontal bacteria, inflammatory reactions, and immune response; however, the exact pathogenetic mechanism involved remains controversial. This article aims to review the research progress on the relationship between PD and PLBW and their underlying mechanisms, as well as the effects of periodontal treatment on PLBW incidence.
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Affiliation(s)
- Wu Wanhong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ye Changchang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Huang Ping
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Gao L, Xu T, Huang G, Jiang S, Gu Y, Chen F. Oral microbiomes: more and more importance in oral cavity and whole body. Protein Cell 2018; 9:488-500. [PMID: 29736705 PMCID: PMC5960472 DOI: 10.1007/s13238-018-0548-1] [Citation(s) in RCA: 392] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 04/16/2018] [Indexed: 12/18/2022] Open
Abstract
Microbes appear in every corner of human life, and microbes affect every aspect of human life. The human oral cavity contains a number of different habitats. Synergy and interaction of variable oral microorganisms help human body against invasion of undesirable stimulation outside. However, imbalance of microbial flora contributes to oral diseases and systemic diseases. Oral microbiomes play an important role in the human microbial community and human health. The use of recently developed molecular methods has greatly expanded our knowledge of the composition and function of the oral microbiome in health and disease. Studies in oral microbiomes and their interactions with microbiomes in variable body sites and variable health condition are critical in our cognition of our body and how to make effect on human health improvement.
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Affiliation(s)
- Lu Gao
- Central Laboratory, Peking University Hospital of Stomatology, Beijing, 100081, China
- Department of Orthodontics, Peking University Hospital of Stomatology, Beijing, 100081, China
| | - Tiansong Xu
- Central Laboratory, Peking University Hospital of Stomatology, Beijing, 100081, China
| | - Gang Huang
- Central Laboratory, Peking University Hospital of Stomatology, Beijing, 100081, China
| | - Song Jiang
- Central Laboratory, Peking University Hospital of Stomatology, Beijing, 100081, China
| | - Yan Gu
- Department of Orthodontics, Peking University Hospital of Stomatology, Beijing, 100081, China
| | - Feng Chen
- Central Laboratory, Peking University Hospital of Stomatology, Beijing, 100081, China.
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18
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Vivares-Builes AM, Rangel-Rincón LJ, Botero JE, Agudelo-Suárez AA. Gaps in Knowledge About the Association Between Maternal Periodontitis and Adverse Obstetric Outcomes: An Umbrella Review. J Evid Based Dent Pract 2018; 18:1-27. [DOI: 10.1016/j.jebdp.2017.07.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/04/2017] [Accepted: 07/10/2017] [Indexed: 01/01/2023]
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An Umbrella Review Exploring the Effect of Periodontal Treatment in Pregnant Women on the Frequency of Adverse Obstetric Outcomes. J Evid Based Dent Pract 2017; 18:218-239. [PMID: 30077375 DOI: 10.1016/j.jebdp.2017.10.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/27/2017] [Accepted: 10/27/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE In the recent years, efforts have been made to reduce epidemiologic indicators of periodontal disease in pregnant women. This umbrella review aims to analyze the systematic reviews/meta-analyses investigating the effect of periodontal therapy in pregnant women on the frequency of obstetric complications (low birth weight, preterm delivery, and preeclampsia) and to identify the gaps in the scientific literature. METHODS A systematic review of systematic reviews with and without meta-analysis of intervention studies was conducted. Quality evaluation and qualitative analysis of the reviews were performed. RESULTS A total of 223 articles were obtained, and 18 of them were included in the analysis, 13 articles included meta-analysis, where 11 were of high quality and 7 of medium quality according to the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) guide. These systematic reviews/meta-analyses included a total of 19 studies (17 randomized clinical trials). Descriptive systematic reviews showed that periodontal therapy has positive effects on reducing the frequency of adverse pregnancy outcomes. In systematic reviews with meta-analysis, overall effect estimators were not significant, although a reduction in the incidence of obstetric complications was observed. Subgroup analysis resulted in significant effects, depending on sociodemographic conditions. CONCLUSIONS Differential findings are not enough to demonstrate that there is a significant reduction in the frequency of adverse pregnancy outcomes in pregnant women receiving periodontal therapy. Possible explanations are related to factors such as the type of studies analyzed, indicator of obstetric complication considered, and specific variables included in the analysis. Many systematic reviews did not address publication bias and did identify gaps in knowledge that require further clarification.
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Kumar PS. From focal sepsis to periodontal medicine: a century of exploring the role of the oral microbiome in systemic disease. J Physiol 2017; 595:465-476. [PMID: 27426277 PMCID: PMC5233655 DOI: 10.1113/jp272427] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 07/01/2016] [Indexed: 12/19/2022] Open
Abstract
The oral microbiome is established within a few minutes after birth and consists of stable multi-species communities that engage in a dynamic equilibrium with the host immune system. Dental caries, endodontic infections and periodontal diseases are bacterially driven diseases that are caused by dysbiotic microbiomes. Over a century ago, the focal infection theory implicated these infections in the aetiology of several systemic diseases, ranging from arthritis to neurodegenerative diseases. However, a lack of concrete evidence, combined with the urgency with which clinicians embraced this approach without regard for appropriate case selection, led to its demise within 30 years. In the last decade of the 20th century, the concept of periodontal medicine was introduced to explain the correlations that were being observed between periodontitis and cardiovascular disease, rheumatoid arthritis, Alzheimer's disease, pulmonary disease, pre-term delivery of low birth weight infants and metabolic disease. It was proposed that periodontal pathobionts played a causal role in the initiating or exacerbating certain diseases either by direct invasion or by stimulating a florid immune-inflammatory response that extended into the systemic circulation. This review will examine the strength of current evidence in establishing a causal link between oral pathobionts and systemic disease.
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Affiliation(s)
- Purnima S. Kumar
- Division of Periodontology, College of DentistryThe Ohio State UniversityColumbusOHUSA
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21
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Rajapakse PS, Nagarathne M, Chandrasekra KB, Dasanayake AP. Periodontal Disease and Prematurity among Non-smoking Sri Lankan Women. J Dent Res 2016; 84:274-7. [PMID: 15723870 DOI: 10.1177/154405910508400313] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The hypothesis that periodontal disease is associated with pre-term low birthweight was tested in a prospective follow-up study of rural prima-gravida women (N = 227) who were free of tobacco, alcohol, and drug use. Women with 3rd trimester mean probing pocket depths, plaque, and bleeding scores that were greater than the median value in the cohort were defined as ‘exposed’. There were 17 (7.5%) preterm low birthweight singleton deliveries in the cohort (among ‘exposed’ = 12%; among ‘unexposed’ = 5.6%; Odds Ratio = 2.3; 95% CI = 0.9−6.3). After adjustment for the independent variables, the OR for preterm low birthweight in relation to ‘exposure’ was 1.9 (95% CI = 0.7−5.4). Our results are only suggestive of an association between periodontal disease and preterm low birthweight, perhaps indicating that previously reported associations may have been subjected to residual confounding due to tobacco, alcohol, and drug use.
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Affiliation(s)
- P S Rajapakse
- Faculty of Dental Sciences, University of Peradeniya, Sri Lanka
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Machado FC, Cesar DE, Apolônio ACM, Ribeiro LC, Ribeiro RA. Longitudinal study on clinical and microbial analysis of periodontal status in pregnancy. Braz Oral Res 2016; 30:e87. [PMID: 27556678 DOI: 10.1590/1807-3107bor-2016.vol30.0087] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 05/24/2016] [Indexed: 11/22/2022] Open
Abstract
This study was aimed to provide a longitudinal overview of the subgingival bacterial microbiome using fluorescence in situ hybridization (FISH) technique, in women in the second trimester of pregnancy (between 14 and 24 weeks), and 48 h and 8 weeks postpartum. Of 31 women evaluated during pregnancy, 24 returned for the 48-h and 18 for their 8-week exams postpartum. Probing depth (PD), bleeding on probing, clinical attachment level, and presence of calculus were recorded. Subgingival plaque samples were collected, and FISH was used to identify the numbers of eight periodontal pathogens. Friedman test was used to compare differences between follow-up examinations, followed by a multiple comparison test for a post hoc pairwise comparison. Clinically, a significantly greater number of teeth with PD = 4-5 mm were found during pregnancy than on postpartum examinations. Microbial analysis showed a statistically significant decrease in cell count over the study period for Prevotella nigrescens. P. intermedia, Campylobacter rectus, and Porphyromonas gingivalis also decrease, although not significantly, and Aggregatibacter actinomycetemcomitans increased. No significant changes were found for Fusobacterium nucleatum, Treponema denticola, or Tannerella forsythia. Our data demonstrate a change in the subgingival microbiota during pregnancy, at least for P. nigrescens.
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Affiliation(s)
| | - Dionéia Evangelista Cesar
- Universidade Federal de Juiz de Fora - UFJF, Biological Sciences Institute, Department of Ecology, Juiz de Fora, MG, Brazil
| | - Ana Carolina Morais Apolônio
- Universidade Federal de Juiz de Fora - UFJF, Biological Sciences Institute, Department of Parasitology, Microbiology and Immunology, Juiz de Fora, MG, Brazil
| | - Luiz Claudio Ribeiro
- Universidade Federal de Juiz de Fora - UFJF, Department of Statistics, Juiz de Fora, MG, Brazil
| | - Rosangela Almeida Ribeiro
- Universidade Federal de Juiz de Fora - UFJF, School of Dentistry, Department of Social and Child Dentistry, Juiz de Fora, MG, Brazil
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Prevalence and Relationship Between Maternal Periodontal Disease and Preterm Low Birth Weight Baby. JOURNAL OF FETAL MEDICINE 2016. [DOI: 10.1007/s40556-016-0091-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Michalowicz BS, Gustafsson A, Thumbigere-Math V, Buhlin K. The effects of periodontal treatment on pregnancy outcomes. J Periodontol 2016; 84:S195-208. [PMID: 23631579 DOI: 10.1902/jop.2013.1340014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Preterm infants are at greater risk than term infants for physical and developmental disorders. Morbidity and mortality increases as gestational age at delivery decreases. Observational studies indicate an association between poor periodontal health and risk for preterm birth or low birthweight, making periodontitis a potentially modifiable risk factor for prematurity. AIM To identify randomized controlled trials (RCTs) published between January 2011 and July 2012 and discuss all published RCTs testing whether periodontal therapy reduces rates of preterm birth and low birthweight. METHODS Search of databases including PubMed, ISI Web of Science and Cochrane Library. RESULTS The single RCT identified showed no significant effect of periodontal treatment on birth outcomes. DISCUSSION All published trials included non-surgical periodontal therapy; only two included systemic antimicrobials as part of test therapy. The trials varied substantially in terms of sample size, obstetric histories of subjects, study preterm birth rates and the periodontal treatment response. The largest trials--also judged to be high-quality and at low risk of bias--have yielded consistent results, and indicate that treatment does not alter rates of adverse pregnancy outcomes. CONCLUSION Non-surgical periodontal therapy, scaling and root planing, does not improve birth outcomes in pregnant women with periodontitis.
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Affiliation(s)
- Bryan S Michalowicz
- Department of Developmental and Surgical Sciences, University of Minnesota School of Dentistry, Minneapolis, MN 55455, USA.
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Michalowicz BS, Gustafsson A, Thumbigere-Math V, Buhlin K. The effects of periodontal treatment on pregnancy outcomes. J Clin Periodontol 2016; 40 Suppl 14:S195-208. [PMID: 23627329 DOI: 10.1111/jcpe.12081] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 01/08/2013] [Accepted: 11/14/2012] [Indexed: 12/31/2022]
Abstract
BACKGROUND Preterm infants are at greater risk than term infants for physical and developmental disorders. Morbidity and mortality increases as gestational age at delivery decreases. Observational studies indicate an association between poor periodontal health and risk for preterm birth or low birthweight, making periodontitis a potentially modifiable risk factor for prematurity. AIM To identify randomized controlled trials (RCTs) published between January 2011 and July 2012 and discuss all published RCTs testing whether periodontal therapy reduces rates of preterm birth and low birthweight. METHODS Search of databases including PubMed, ISI Web of Science and Cochrane Library. RESULTS The single RCT identified showed no significant effect of periodontal treatment on birth outcomes. DISCUSSION All published trials included non-surgical periodontal therapy; only two included systemic antimicrobials as part of test therapy. The trials varied substantially in terms of sample size, obstetric histories of subjects, study preterm birth rates and the periodontal treatment response. The largest trials - also judged to be high-quality and at low risk of bias - have yielded consistent results, and indicate that treatment does not alter rates of adverse pregnancy outcomes. CONCLUSION Non-surgical periodontal therapy, scaling and root planing, does not improve birth outcomes in pregnant women with periodontitis.
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Affiliation(s)
- Bryan S Michalowicz
- Department of Developmental and Surgical Sciences, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA.
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Stadelmann PFM, Eick S, Salvi GE, Surbek D, Mohr S, Bürgin W, Ramseier CA, Sculean A. Increased periodontal inflammation in women with preterm premature rupture of membranes. Clin Oral Investig 2014; 19:1537-46. [PMID: 25420538 DOI: 10.1007/s00784-014-1371-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 11/14/2014] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To evaluate possible differences in periodontal inflammatory, microbiological and clinical parameters between women with preterm premature rupture of membranes (PPROM) and controls with uncomplicated pregnancies. MATERIALS AND METHODS Fifty-six women (32 test (PPROM) and 24 controls (uncomplicated pregnancies)) were examined at three time-points (T1: gestational weeks 20-35, T2: within 48 h after parturition, T3: 4-6 weeks after parturition). The examinations included assessment of the Periodontal Screening Index, collection of gingival crevicular fluid (GCF) and subgingival as well as vaginal bacterial sampling. RESULTS Periodontal inflammation was found to be higher in the test compared with the control group (p < 0.05) and decreased over time in both groups (p < 0.05). Microbiological outcomes showed no intergroup differences (p > 0.05) in prevalence of bacteria, but a decrease in subgingival periodontopathogens from T1 to T2 in the test group (p < 0.05) was observed. Interleukin (IL)-1β levels in GCF at T2 were not different between groups (p > 0.05). In women with PPROM, GCF levels of IL-8 (p < 0.05) and C-reactive protein (p < 0.05) were lower and IL-10 levels higher (p < 0.05) compared with controls. CONCLUSIONS Periodontal inflammation is elevated during pregnancy and seems to be more pronounced in women with PPROM. CLINICAL RELEVANCE The findings of the present study revealed an association between periodontal inflammation and PPROM, thus emphasizing the importance of optimizing self-performed oral hygiene in pregnant women.
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Affiliation(s)
- Pascale F M Stadelmann
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
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Bulut G, Olukman O, Calkavur S. Is there a relationship between maternal periodontitis and pre-term birth? A prospective hospital-based case-control study. Acta Odontol Scand 2014; 72:866-73. [PMID: 24850505 DOI: 10.3109/00016357.2014.919663] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study is to verify the existence of an association between maternal periodontal disease and pre-term delivery in an unselected population of post-partum Turkish women. MATERIALS AND METHODS This case-control study was conducted on 100 women who gave birth in either a special or a government maternity hospital. The case group consisted of 50 mothers who had delivered an infant before 37 weeks' gestation and weighed under 2500 g. The control group included 50 mothers who had given birth to an infant with a birth weight of more than 2500 g and a gestational age of ≥37 weeks. Data of mothers and infants were collected using medical registers and questionnaires. Clinical periodontal examinations were carried out in six sites on every tooth in the mother's mouth. A participant who presented at least four teeth with one or more sites with a PPD ≥4 mm and CAL ≥3 mm at the same site was considered to have periodontal disease. Statistical methods included parametric and non-parametric tests and multiple logistic regression analysis. RESULTS There were no statistically significant differences between the cases and controls with regard to periodontal disease and pre-term delivery (OR = 1.48; 95% CI = 0.54-4.06). CONCLUSION The findings indicated that maternal periodontitis was not a possible risk factor for pre-term delivery. Further studies with additional clinical trials are needed to explore the possible relationship between periodontal disease and pre-term birth.
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The oral microbiome diversity and its relation to human diseases. Folia Microbiol (Praha) 2014; 60:69-80. [PMID: 25147055 DOI: 10.1007/s12223-014-0342-2] [Citation(s) in RCA: 188] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 08/11/2014] [Indexed: 02/07/2023]
Abstract
As one of the most clinically relevant human habitats, the human mouth is colonized by a set of microorganisms, including bacteria, archaea, fungi, and viruses. Increasing evidence has supported that these microbiota contribute to the two commonest oral diseases of man (dental caries and periodontal diseases), presenting significant risk factors to human health conditions, such as tumor, diabetes mellitus, cardiovascular diseases, bacteremia, preterm birth, and low birth weight in infants. It is widely accepted that oral microorganisms cause diseases mainly by a synergistic or cooperative way, and the interspecies interactions within the oral community play a crucial role in determining whether oral microbiota elicit diseases or not. Since a comprehensive understanding of the complex interspecies interactions within a community needs the knowledge of its endogenous residents, a plenty of research have been carried out to explore the oral microbial diversity. In this review, we focus on the recent progress in this field, including the oral microbiome composition and its association with human diseases.
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Jacob PS, Nath S. Periodontitis among poor rural Indian mothers increases the risk of low birth weight babies: a hospital-based case control study. J Periodontal Implant Sci 2014; 44:85-93. [PMID: 24778903 PMCID: PMC3999357 DOI: 10.5051/jpis.2014.44.2.85] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 02/28/2014] [Indexed: 11/16/2022] Open
Affiliation(s)
- Pulikottil Shaju Jacob
- Department of Clinical Dentistry, International Medical University School of Dentistry, Kuala Lumpur, Malaysia
| | - Sonia Nath
- Department of Periodontology, Vananchal Dental College and Hospital, Garhwa, India
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Cassini MA, Pilloni A, Condò SG, Vitali LA, Pasquantonio G, Cerroni L. Periodontal bacteria in the genital tract: are they related to adverse pregnancy outcome? Int J Immunopathol Pharmacol 2014; 26:931-9. [PMID: 24355228 DOI: 10.1177/039463201302600411] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
One of the most important factors implicated in preterm birth (PTB) is acute genitourinary tract infection. The bacteria causing chronic periodontal inflammation include Gram-negative rods and anaerobes similar to those found in women with bacterial vaginosis. The aim of this prospective study is to investigate the relationship between oral and vaginal microflora and preterm low birth weight. Real-time polymerase chain reaction was used to detect both the presence and level of six periodontitis-related species: Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), Fusobacterium nucleatum ssp(Fn), and Prevotella intermedia (Pi) for both oral samples of subgingival plaque and cervical samples, obtained from 80 patients, during gynaecological examinations. The more representative oral pathogen (less than 60 percent) species in oral samples of preterm and term group were Tf, Td, and Fn. 24.4 percent of pregnant women presented periodontal pathogens in vaginal swab; the most representative species with a percentage over 0.1 percent of total bacteria in genital tract of preterm group were Tf, Td, and Piwith a positive correlation (less than 0.5). The presence of the bacterium T. denticolain the vagina, regardless of the amount, adversely affects preterm delivery.
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Affiliation(s)
- M A Cassini
- Department of Odontostomatologic and Maxillofacial Science, Sapienza University of Rome, Italy
| | - A Pilloni
- Department of Odontostomatologic and Maxillofacial Science, Sapienza University of Rome, Italy
| | - S G Condò
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - L A Vitali
- School of Pharmacy, Microbiology Unit, University of Camerino, Camerino, Italy
| | - G Pasquantonio
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - L Cerroni
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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Abstract
During pregnancy profound perturbations in innate and adaptive immunity impact the clinical course of a number of infectious diseases, including those affecting periodontal tissues. Conversely, it has been suggested that periodontal infections may increase the risk of adverse pregnancy outcomes. In this review, a summary of the literature associated with the bidirectional relationship between pregnancy and periodontal disease as well as the possible mechanisms behind this interaction were examined.
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Oral microbiota and systemic disease. Anaerobe 2013; 24:90-3. [PMID: 24128801 DOI: 10.1016/j.anaerobe.2013.09.010] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 09/17/2013] [Accepted: 09/19/2013] [Indexed: 01/08/2023]
Abstract
It is well known that bacteria are the primary cause of infectious diseases, however, evidence is emerging that these organisms are also indirectly responsible for several diseases including cancer and rheumatoid arthritis. The oral cavity is home to several million bacteria that can cause two major diseases-periodontitis and caries. The relationship between periodontopathic bacteria and systemic diseases has been explored for several years. The concept of the oral cavity as a source of distant infection has been debated for at least a century. This review will discuss the historic aspects of the development of the focal infection theory, the reasons for its demise, its re-emergence and current status.
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Wang YL, Liou JD, Pan WL. Association between maternal periodontal disease and preterm delivery and low birth weight. Taiwan J Obstet Gynecol 2013; 52:71-6. [PMID: 23548222 DOI: 10.1016/j.tjog.2013.01.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2012] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE It has been suggested that periodontal disease is an important risk factor for preterm low birth weight (PLBW). The purpose of this study was to determine the association of maternal periodontitis with low birth weight (LBW) and preterm birth (PB). MATERIALS AND METHODS Pregnant women (n = 211) aged 22-40 years were enrolled while receiving prenatal care. Dental plaque, probing depth, bleeding on probing, and clinical attachment level were used as criteria to classify three groups: a healthy group (HG; n = 82), a gingivitis group (GG; n = 67), and a periodontitis group (PG; n = 62). At delivery, birth weight was recorded. RESULTS Mean infant weight at delivery was 3084.9 g. The total incidence of preterm birth and LBW infants was 10.4% and 8.1%, respectively. The incidence of LBW infants was 4.2% for term and 40.9% for preterm gestations. Maternal height was not correlated with infant birth weight (p = 0.245). Significant differences in mean infant birth weight were observed among the HG, GG, and PG groups (p = 0.030). No significant relationship was found between periodontal disease and PB, but the association between periodontal disease and LBW was significant. CONCLUSION After appropriately controlling for confounding variables, our results do not support the hypothesis of an association that was observed in previous studies of maternal periodontal disease and infant PB, but the association between periodontal disease and LBW is significant.
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Affiliation(s)
- Yen-Li Wang
- Department of Periodontics, Dental Section, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Wu YM, Liu J, Sun WL, Chen LL, Chai LG, Xiao X, Cao Z. Periodontal status and associated risk factors among childbearing age women in Cixi City of China. J Zhejiang Univ Sci B 2013; 14:231-9. [PMID: 23463766 DOI: 10.1631/jzus.b1200034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To investigate the periodontal status and associated risk factors among women of childbearing age to increase the awareness of oral health. METHODS The study was conducted on childbearing age women in Cixi, a city in Zhejiang Province in the southeast of China. A total of 754 women participated in periodontal examination while receiving prenatal care. Data of the women were collected from the Cixi Family Planning Commission and during an interview. Clinical periodontal indices, such as bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were measured during the examination. Statistical analysis on subject-based data was performed. RESULTS The prevalence of periodontal disease among childbearing age women in Cixi was high (84.7%). A significant association was found between the disease and educational level, pregnancy, taking oral contraceptives, stress, alcohol consumption, overweight, dental visit, and teeth brushing (P<0.05). Women who suffered periodontal disease showed deep PD, obvious BOP, and clinical attachment loss. Among this population, pregnancy was closely associated with higher BOP percentage; teeth brushing no more than once per day or brushing for less than 1 min (P<0.001) after adjusting for age and stress. CONCLUSIONS The periodontal status of childbearing age women in Cixi needs to be improved urgently. Attention towards the periodontal health should be warranted, especially for those in special statuses and with poor awareness.
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Affiliation(s)
- Yan-min Wu
- Department of Oral Medicine, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Pulikkotil SJ, Nath S. Commentary on "Relationship between maternal periodontal disease and Apgar score of newborns". J Periodontal Implant Sci 2013; 43:141-2. [PMID: 23837129 PMCID: PMC3701836 DOI: 10.5051/jpis.2013.43.3.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 05/11/2013] [Indexed: 12/04/2022] Open
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Boland MR, Hripcsak G, Albers DJ, Wei Y, Wilcox AB, Wei J, Li J, Lin S, Breene M, Myers R, Zimmerman J, Papapanou PN, Weng C. Discovering medical conditions associated with periodontitis using linked electronic health records. J Clin Periodontol 2013; 40:474-82. [PMID: 23495669 DOI: 10.1111/jcpe.12086] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2013] [Indexed: 12/12/2022]
Abstract
AIM To use linked electronic medical and dental records to discover associations between periodontitis and medical conditions independent of a priori hypotheses. MATERIALS AND METHODS This case-control study included 2475 patients who underwent dental treatment at the College of Dental Medicine at Columbia University and medical treatment at NewYork-Presbyterian Hospital. Our cases are patients who received periodontal treatment and our controls are patients who received dental maintenance but no periodontal treatment. Chi-square analysis was performed for medical treatment codes and logistic regression was used to adjust for confounders. RESULTS Our method replicated several important periodontitis associations in a largely Hispanic population, including diabetes mellitus type I (OR = 1.6, 95% CI 1.30-1.99, p < 0.001) and type II (OR = 1.4, 95% CI 1.22-1.67, p < 0.001), hypertension (OR = 1.2, 95% CI 1.10-1.37, p < 0.001), hypercholesterolaemia (OR = 1.2, 95% CI 1.07-1.38, p = 0.004), hyperlipidaemia (OR = 1.2, 95% CI 1.06-1.43, p = 0.008) and conditions pertaining to pregnancy and childbirth (OR = 2.9, 95% CI: 1.32-7.21, p = 0.014). We also found a previously unreported association with benign prostatic hyperplasia (OR = 1.5, 95% CI 1.05-2.10, p = 0.026) after adjusting for age, gender, ethnicity, hypertension, diabetes, obesity, lipid and circulatory system conditions, alcohol and tobacco abuse. CONCLUSIONS This study contributes a high-throughput method for associating periodontitis with systemic diseases using linked electronic records.
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Affiliation(s)
- Mary Regina Boland
- Department of Biomedical Informatics, Columbia University, New York, NY 10032, USA.
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Shirmohammadi A, Abdollahifard S, Chitsazi MT, Behlooli S. Relationship between maternal periodontal disease and Apgar score of newborns. J Periodontal Implant Sci 2012; 42:212-6. [PMID: 23346464 PMCID: PMC3543936 DOI: 10.5051/jpis.2012.42.6.212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 11/28/2012] [Indexed: 11/12/2022] Open
Abstract
Purpose The aim of this study was to evaluate the relationship between maternal periodontal disease and the health status of newborns using Apgar scores. Methods One hundred pregnant women with periodontal disease were included in the case series and 100 pregnant women without periodontal disease were placed in the control group, respectively. The periodontal parameters of bleeding on probing (BOP), clinical attachment loss (CAL), probing depth (PD), birth weight, and Apgar scores were recorded in both groups. T-tests and Pearson's correlation coefficient were used to determine the birth weight odds ratio to analyze the relationship between the periodontal parameters of BOP, CAL, and PD on the one hand and an Apgar score of less than 7. An unpaired Student's t-test was used to analyze differences in means between the case and control groups using SPSS ver. 13. Results The means of the ages, periodontal pocket depths, attachment loss, areas with BOP, Apgar score in the first 5 minutes and infant birth weight exhibited statistically significant differences between the case and control groups. The ratio of an Apgar score of <7 to periodontal disease was 3.14; the ratio of low birth weight risk in mothers with periodontal disease to that in mothers without periodontal disease was 2.74. Pearson's correlation coefficient revealed a significant correlation between the infant birth weight and BOP, CAL, and PD of the mother. In addition, there was a significant correlation between the Apgar score and BOP, CAL, and PD and also between the Apgar score and infant birth weight. Conclusions The results of this study showed a significant relationship between periodontal disease and infant birth weight; in addition, there was a significant relationship between the periodontal indexes of BOP, CAL, and PD on the one hand and the Apgar score on the other.
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Affiliation(s)
- Adileh Shirmohammadi
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences Faculty of Dentistry, Tabriz, Iran
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Kumar PS. Sex and the subgingival microbiome: Do female sex steroids affect periodontal bacteria? Periodontol 2000 2012; 61:103-24. [DOI: 10.1111/j.1600-0757.2011.00398.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Santa Cruz I, Herrera D, Martin C, Herrero A, Sanz M. Association between periodontal status and pre-term and/or low-birth weight in Spain: clinical and microbiological parameters. J Periodontal Res 2012; 48:443-51. [DOI: 10.1111/jre.12024] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2012] [Indexed: 11/28/2022]
Affiliation(s)
- I. Santa Cruz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - D. Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - C. Martin
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - A. Herrero
- Section of Periodontology; School of Dentistry; University Complutense; Madrid Spain
| | - M. Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
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Acharya S, Pentapati KC, Bhat PV. Dental neglect and adverse birth outcomes: a validation and observational study. Int J Dent Hyg 2012; 11:91-8. [PMID: 22998417 DOI: 10.1111/idh.12001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objectives of this study were to validate the Indian translation of the Dental Neglect Scale (DNS) among a sample of parturient Indian women and to investigate dental neglect as a possible risk indicator in adverse birth outcomes. SUBJECTS AND METHODS Three hundred and sixteen parturient women were administered the DNS and the Modified Dental Beliefs Scale (MDBS) and were also clinically examined for oral health status. Information regarding socio-economic status, weeks of gestation and birth weight was also collected. A gestation period of less than 37 weeks was considered as preterm and a birth weight of less than 2500 gm as 'low birth weight'. RESULTS The Indian version of the DNS was found to be reliable (Cronbach's Alpha = 0.72) and valid for assessing dental neglect among the women. Factor analysis of the DNS revealed a two-factor structure accounting for 56% variance. Dental neglect was higher among those with poorer oral health status, lower socio-economic and educational status. Multinomial logistic regression showed high dental neglect and negative dental beliefs and not poor oral health, as significant risk indicators for occurrence of adverse birth outcomes. CONCLUSION The finding of an association of adverse birth outcomes with dental neglect and beliefs, but not with poor oral health could be due to the influence of other more important general factors which had a direct bearing on birth outcomes. There is a need for further research to assess the role of behavioural factors like dental neglect as risk indicators for adverse birth outcomes.
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Affiliation(s)
- S Acharya
- Department of Community Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, India.
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Guimarães AN, Silva-Mato A, Siqueira FM, Cyrino RM, Cota LOM, Costa FO. Very low and low birth weight associated with maternal periodontitis. J Clin Periodontol 2012; 39:1024-31. [PMID: 22994882 DOI: 10.1111/jcpe.12000] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2012] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to evaluate the association of very low and low birth weight (VLBW and LBW) with maternal periodontitis. MATERIAL AND METHODS Overall, 1206 women were examined at post-partum and two alternative criteria for periodontitis definition were used: (1) four or more teeth with at least one site with probing depth (PD) ≥ 4 mm and clinical attachment loss (CAL) ≥ 3 mm; and (2) at least one site with PD and CAL ≥ 4 mm. For each definition, two multivariate analyses were performed: (1) linear regression for birth weight; (2) ordinal logistic regression for birth weight, categorized as adequate (n = 1046), LBW (n = 145) and VLBW (n = 15). RESULTS Linear regression showed that maternal periodontitis was associated with a decrease in mean birth weight (periodontitis definition 1: p = 0.027; periodontitis definition 2: p = 0.003). Ordinal logistic regression showed that maternal periodontitis was associated with LBW and VLBW [odds ratio (OR) = 2.0; 95% confidence interval (CI) 1.39-2.90, when considering periodontitis definition 2]; and with LBW (OR = 1.65; 95% CI 1.15-2.36, when considering periodontitis definition 1). CONCLUSION Maternal periodontitis was associated with a decrease in mean birth weight, as well as with LBW and VLBW.
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Affiliation(s)
- Alessandra N Guimarães
- Department of Health and Socio-Medical Sciences, Biostatistics Unit, Faculty of Medicine, Alcalá University, Madrid, Spain
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Cetin I, Pileri P, Villa A, Calabrese S, Ottolenghi L, Abati S. Pathogenic mechanisms linking periodontal diseases with adverse pregnancy outcomes. Reprod Sci 2012; 19:633-41. [PMID: 22421445 DOI: 10.1177/1933719111432871] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In the last 2 decades, a large proportion of studies have focused on the relationship between maternal periodontal disease and poor obstetric outcomes. The aim of the present review is to summarize the current knowledge about human studies on the pathogenetic mechanisms linking periodontal diseases with adverse pregnancy outcomes. A search of the medical literature was conducted using NIH (National Institute of Health) Pubmed through April 2011. Articles were identified with the Medical Subject Heading (MeSH) and free text terms "small for gestational age (SGA)," "preeclampsia," "preterm labor," and "periodontal disease." Experimental human studies have shown that periodontal pathogens may disseminate toward placental and fetal tissues accompanied by an increase in inflammatory mediators in the placenta. As such, new inflammatory reactions within the placental tissues of the pregnant woman may occur, the physiological levels of prostaglandin E(2) (PGE(2)) and tumor necrosis factor-α (TNF-α) in the amniotic fluid may increase and eventually lead to premature delivery. Although many data from clinical trials suggest that periodontal disease may increase the adverse pregnancy outcome, the exact pathogenetic mechanism involved remains controversial. The findings explain the potential link between periodontal infections and adverse pregnancy outcomes. First, periodontal bacteria can directly cause infections both of the uteroplacenta and the fetus; second, systemic inflammatory changes induced by periodontal diseases can activate responses at the maternal-fetal interface. Of note, associative studies have produced different results in different population groups and no conclusive evidence has still been produced for the potential role of preventive periodontal care to reduce the risk factors of preterm birth.
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Affiliation(s)
- I Cetin
- Unit of Obstetrics and Gynecology, Department of Clinical Sciences L. Sacco, and Center for Fetal Research Giorgio Pardi, University of Milan, Milan, Italy.
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Relationship between periodontal diseases and preterm birth: recent epidemiological and biological data. J Pregnancy 2011; 2011:164654. [PMID: 22132334 PMCID: PMC3205685 DOI: 10.1155/2011/164654] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 10/03/2011] [Indexed: 01/02/2023] Open
Abstract
For ten years, the incidence of preterm birth does not decrease in developed countries despite the promotion of public health programs. Many risk factors have been identified including ethnicity, age, tobacco, and infection. However, almost 50% of preterm birth causes remain unknown. The periodontal diseases are highly prevalent inflammatory and infectious diseases of tooth supporting tissues leading to an oral disability. They influence negatively general health worsening cardiovascular diseases and diabetes. Periodontal diseases have been also suspected to increase the rate of preterm birth, but data remain contradictory. The objective of this review is to present the principal results of epidemiological, biological, and interventional studies on the link between periodontal diseases and preterm birth. The conclusions of this work underline the importance for the physician/obstetrician to identify women at risk for preterm birth and to address these patients to dentist for periodontal examination and treatment in order to limit adverse pregnancy outcomes.
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Sant'Ana ACP, Campos MRD, Passanezi SC, Rezende MLRD, Greghi SLA, Passanezi E. Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial. J Appl Oral Sci 2011; 19:130-6. [PMID: 21552714 PMCID: PMC4243751 DOI: 10.1590/s1678-77572011000200009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2009] [Accepted: 02/21/2010] [Indexed: 11/22/2022] Open
Abstract
Objectives The aim of this study was to evaluate the effects of non-surgical treatment of
periodontal disease during the second trimester of gestation on adverse pregnancy
outcomes. Material and Methods Pregnant patients during the 1st and 2nd trimesters at
antenatal care in a Public Health Center were divided into 2 groups: NIG – "no
intervention" (n=17) or IG- "intervention" (n=16). IG patients were submitted to a
non-surgical periodontal treatment performed by a single periodontist consisting
of scaling and root planning (SRP), professional prophylaxis (PROPH) and oral
hygiene instruction (OHI). NIG received PROPH and OHI during pregnancy and were
referred for treatment after delivery. Periodontal evaluation was performed by a
single trained examiner, blinded to periodontal treatment, according to probing
depth (PD), clinical attachment level (CAL), plaque index (PI) and sulcular
bleeding index (SBI) at baseline and 35 gestational weeks-28 days
post-partum. Primary adverse pregnancy outcomes were preterm
birth (<37 weeks), low birth weight (<2.5 kg), late abortion (14-24 weeks)
or abortion (<14 weeks). The results obtained were statistically evaluated
according to OR, unpaired t test and paired t test at 5% significance level. Results No significant differences were observed between groups at baseline examination.
Periodontal treatment resulted in stabilization of CAL and PI (p>0.05) at IG
and worsening of all periodontal parameters at NIG (p<0.0001), except for PI.
Significant differences in periodontal conditions of IG and NIG were observed at
2nd examination (p<0.001). The rate of adverse pregnancy
outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy
was associated to a decreased risk of developing adverse pregnancy outcomes
[OR=13.50; CI: 1.47-123.45; p=0.02]. Conclusions Periodontal treatment during the second trimester of gestation contributes to
decrease adverse pregnancy outcomes.
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Xiong X, Buekens P, Goldenberg RL, Offenbacher S, Qian X. Optimal timing of periodontal disease treatment for prevention of adverse pregnancy outcomes: before or during pregnancy? Am J Obstet Gynecol 2011; 205:111.e1-6. [PMID: 21620355 DOI: 10.1016/j.ajog.2011.03.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 01/27/2011] [Accepted: 03/08/2011] [Indexed: 10/18/2022]
Abstract
Several large randomized controlled clinical trials failed to find that standard periodontal therapy during pregnancy reduces the incidence of adverse pregnancy outcomes (eg, preterm birth and low birthweight). However, treating periodontal disease during pregnancy may be too late to reduce the inflammation that is related to the adverse pregnancy outcomes. Moreover, periodontal treatment during pregnancy can cause bacteremia, which itself may initiate the pathway leading to the adverse pregnancy outcomes. Finally, the periodontal treatments provided during pregnancy are not always effective in preventing the progression of periodontal disease during pregnancy. Pregnancy may not be an appropriate period for periodontal intervention(s). We hypothesize that periodontal treatment before pregnancy may reduce the rates of adverse pregnancy outcomes. Future randomized controlled trials are needed to test if treating periodontal disease in the prepregnancy period reduces the rate of adverse pregnancy outcomes.
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Kawar N, Alrayyes S. Periodontitis in pregnancy: the risk of preterm labor and low birth weight. Dis Mon 2011; 57:192-202. [PMID: 21569882 DOI: 10.1016/j.disamonth.2011.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Deshpande K, Jain A, Sharma R, Prashar S, Jain R. Diabetes and periodontitis. J Indian Soc Periodontol 2011; 14:207-12. [PMID: 21731243 PMCID: PMC3118068 DOI: 10.4103/0972-124x.76917] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Accepted: 08/23/2010] [Indexed: 01/12/2023] Open
Abstract
The main aim of this review is to update the reader with practical knowledge concerning the relationship between diabetes mellitus and periodontal diseases. Exclusive data is available on the association between these two chronic diseases till date. Articles published on this relationship often provide the knowledge of definitions of diabetes mellitus and periodontal diseases, prevalence, extent, severity of periodontal disease, complications of diabetes along with the possible underlying mechanisms. The authors reviewed human epidemiological studies, cross-sectional observations and longitudinal cohort, case control that evaluated variables exclusively over the past 30 years and the predominant findings from the “certain” articles are summarized in this review. This review clarifies certain queries such as 1) Do periodontal diseases have an effect on the metabolic control of diabetes? 2) Does diabetes act as a risk factor of periodontitis? 3) What are the possible underlying mechanisms relating the connection between these two chronic diseases? 4) What is the effect of periodontal intervention on metabolic control of diabetes? After a thorough survey of literature, it was observed that diabetes acts as a risk factor in development of periodontitis as periodontitis is significantly aggravated in patients suffering from diabetes having long term hyperglycemia. Different mechanisms underlying the association between the accelerated periodontal disease and diabetes are emerging but still more work is required. Major efforts are required to elucidate the impact of periodontal diseases on diabetes. At the same time, patients are needed to be made aware of regular periodontal maintenance schedule and oral hygiene.
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Affiliation(s)
- Kalyani Deshpande
- Department of Biochemistry, Dr. HS Judge Institute of Dental Sciences & Hospital, Panjab University, Sector 25, Chandigarh, India
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Hunter LP, Yount SM. Oral health and oral health care practices among low-income pregnant women. J Midwifery Womens Health 2011; 56:103-9. [PMID: 21429073 DOI: 10.1111/j.1542-2011.2011.00041.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Access to dental care is a problem in California as in many parts of the United States. Many women, including half of those having dental problems, do not see a dentist during pregnancy. The objective of this study was to describe the oral health status and oral health practices of low-income pregnant women in San Diego, California, and to determine the needs for oral health care education in this population. METHODS This descriptive, retrospective, correlational study examined oral health and oral health care practices by age, ethnicity, and gravidity by using medical records from a convenience sample of 380 low-income pregnant women. RESULTS Most participants were primigravida, aged between 19 and 29 years, of Hispanic ethnicity, and insured by the state (Medi-Cal). All women received education on oral health. The majority (84%) were encouraged to get a dental examination. It had been more than 1 year since the last dental visit for most women (55%). Hispanic women were in need of dental care more than Filipina women or women of other ethnicities. A broken tooth was the primary reason for immediate dental referrals. Regularity of flossing and brushing teeth differed significantly (P= .015, P < .001) across ethnic groups, with Filipina women reporting better oral care practices. DISCUSSION The results provide information for the future planning of effective dental health promotion programs. Findings suggest that low-income pregnant women have some healthy oral health care practices but are in need of dental services and oral health education. An oral health history, oral health education, dental screening, and dental referral, if needed, should be a routine part of prenatal care and annual examinations.
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Affiliation(s)
- Lauren P Hunter
- San Diego State University, School of Nursing, San Diego, CA, USA.
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Baskaradoss JK, Geevarghese A, Kutty VR. Maternal periodontal status and preterm delivery: a hospital based case-control study. J Periodontal Res 2011; 46:542-9. [PMID: 21507002 DOI: 10.1111/j.1600-0765.2011.01371.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE Recent studies have presented evidence that periodontal disease in pregnant women may be a determining factor for preterm delivery. However, this finding has not been consistently observed. The present investigation was carried out to explore the association between maternal periodontal disease and preterm delivery in the state of Kerala, India. MATERIAL AND METHODS The case-control study had a sample of 300 (100 cases and 200 controls) postpartum women over 18 years of age. Cases were women who had undergone spontaneous preterm delivery (< 37 wk of gestation) and controls were women who delivered at term (≥ 37 wk of gestation). Standard, clinical and periodontal examinations were performed at the maternity wards, and the existence of an association between periodontal disease and preterm delivery was evaluated by means of a multivariate logistic regression model that also considered other risk factors for preterm delivery. RESULTS Periodontitis was diagnosed in 25% of the mothers in the case group and in 14.5% of the mothers in the control group. Logistic regression analysis indicated a risk of nearly threefold for preterm delivery in mothers with periodontitis [adjusted odds ratio (OR(a) ) = 2.72; 95% confidence interval (CI): 1.68-6.84]. The other factors significantly associated with preterm birth were physical exertion (OR(a) = 2.80; 95% CI: 1.18-6.65), a previous history of preterm birth (OR(a) = 2.65; 95% CI: 1.20-5.83) and previous abortion/death of infant (OR(a) = 4.08; 95% CI: 1.56-10.65). CONCLUSION Periodontal disease is a possible risk factor for preterm delivery in this population.
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Affiliation(s)
- J K Baskaradoss
- Achutha Menon Centre for Health Science Studies (AMCHSS), Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India.
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Cibulka NJ, Forney S, Goodwin K, Lazaroff P, Sarabia R. Improving oral health in low-income pregnant women with a nurse practitioner-directed oral care program. ACTA ACUST UNITED AC 2011; 23:249-57. [DOI: 10.1111/j.1745-7599.2011.00606.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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