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Wen X, Fu X, Zhao C, Yang L, Huang R. The bidirectional relationship between periodontal disease and pregnancy via the interaction of oral microorganisms, hormone and immune response. Front Microbiol 2023; 14:1070917. [PMID: 36778874 PMCID: PMC9908602 DOI: 10.3389/fmicb.2023.1070917] [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: 10/15/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023] Open
Abstract
Periodontal disease has been suggested to be linked to adverse pregnancy outcomes such as preterm birth, low birth weight, and preeclampsia. Adverse pregnancy outcomes are a significant public health issue with important clinical and societal repercussions. This article systematically reviews the available epidemiological studies involving the relationship between periodontal disease and adverse pregnancy outcomes over the past 15 years, and finds a weak but independent association between adverse pregnancy outcomes and periodontal disease. The bidirectional association and the potential mechanisms are then explored, focusing on three possible mechanisms: inflammatory reaction, oral microorganisms and immune response. Specifically, elevated systemic inflammation and increased periodontal pathogens with their toxic products, along with a relatively suppressed immune system may lead to the disruption of homeostasis within fetal-placental unit and thus induce adverse pregnancy outcomes. This review also explains the possible mechanisms around why women are more susceptible to periodontal disease. In conclusion, pregnant women are more likely to develop periodontal disease due to hormonal changes, and periodontal disease has also been suspected to increase the incidence of adverse pregnancy outcomes. Therefore, in order to lessen the risk of adverse pregnancy outcomes, both obstetricians and dentists should pay attention to the development of periodontal diseases among women during pregnancy.
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Zhang Y, Feng W, Li J, Cui L, Chen ZJ. Periodontal Disease and Adverse Neonatal Outcomes: A Systematic Review and Meta-Analysis. Front Pediatr 2022; 10:799740. [PMID: 35601423 PMCID: PMC9114501 DOI: 10.3389/fped.2022.799740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The aim of this study was to evaluate the association between maternal periodontal disease (PD) and three main adverse neonatal outcomes, namely, preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA). Methods The Ovid Medline, Web of Science, Embase, and Cochrane Library were searched up to 6 December 2020 for relevant observational studies on an association between PD and risk of PTB, LBW, and SGA. Eligibility criteria included observational studies which compared the prevalence of PTB and/or LBW and/or SGA between PD women and periodontal health controls. The exclusion criteria included incomplete data, animal research, and mixing up various pregnancy outcomes, such as "preterm low birth weight" and languages other than Chinese and English. Data were extracted and analyzed independently by two authors. The meta-analysis was performed using Stata Statistical Software, Release 12 (StataCorp LP, College Station, TX, USA). Odds ratio (OR), confidence intervals (CIs), and heterogeneity (I 2) were computed. Results Fourteen case-control studies and 10 prospective cohort studies, involving 15,278 participants, were identified. Based on fixed effect meta-analysis, PTB showed a significant association with PD (OR = 1.57, 95% CI: 1.39-1.77, P < 0.00001) and LBW also showed a significant association with PD (OR = 2.43, 95% CI: 1.75-3.37, P < 0.00001) in a random effect meta-analysis. However, a random effect meta-analysis showed no relationship between PD and SGA (OR = 1.62, 95% CI: 0.86-3.07, P = 0.136). Conclusion Our findings indicate that pregnant women with PD have a significantly higher risk of PTB and LBW. However, large prospective, blinded cohort studies with standardized diagnostic criteria of PD and adequate control of confounding factors are still required to confirm the relationship between PD and adverse neonatal outcomes.
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Affiliation(s)
- Youzhen Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Wanbing Feng
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Jingyu Li
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Linlin Cui
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Sociodemographic Differences in Health Awareness and Oral Health in Pregnant Women. Geburtshilfe Frauenheilkd 2020; 80:834-843. [PMID: 32817990 PMCID: PMC7428374 DOI: 10.1055/a-1205-0601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/22/2020] [Indexed: 10/25/2022] Open
Abstract
Abstract
Objective The aim of this study was to determine the present oral health status of pregnant women depending on selected sociodemographic differences and deduce any resulting consequences for health prevention.
Methods The participantsʼ data of relevance to the study such as age, school leaving qualification, migration background, smoking habits or last dentist visit were recorded using a questionnaire. The subsequent dental check-up concentrated on open carious lesions, any initiated root canal treatments and missing teeth. Finally, the Periodontal Screening Index was recorded to diagnose the presence of any gingivitis or periodontitis. The subsequent biometric evaluation comprised descriptive data analysis, χ2 test and logistical regression.
Results The higher the school leaving qualification, the lower the probability that a pregnant woman smoked prior to pregnancy (OR 0.291; 95% CI 0.114 – 0.743) and that tartar was diagnosed (OR 0.424; 95% CI 0.185 – 0.973). Regular dentist visits (OR 4.026; 95% CI 1.613 – 10.049) increase with the attained school leaving qualification. There is a greater chance that women born in Germany taking part in the study were aware of dental risks in pregnancy (OR 2.652; 95% CI 1.285 – 5.472) and attended the dentist during pregnancy (OR 2.507; 95% CI 1.281 – 4.907).
Conclusion The rate of awareness of the risks and consequences of pregnancy for oral health must be increased. The main aim for primary prophylaxis should be a reduction in the periodontal bacteria and caries of the mother and father.
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Naavaal S, Brickhouse TH, Hafidh S, Smith K. Factors Associated with Preventive Dental Visits Before and During Pregnancy. J Womens Health (Larchmt) 2019; 28:1670-1678. [PMID: 31084459 DOI: 10.1089/jwh.2018.7509] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Poor prenatal oral health has implications for maternal, fetal, and infant health. Studies have shown an association between periodontal disease and adverse pregnancy outcomes, such as preterm delivery, low birth weight, and pre-eclampsia. The objective of this study was to identify the factors associated with preventive dental visits before and during pregnancy and examine the relationship of dental insurance with those visits among Virginia women. Methods: The Virginia Pregnancy Risk Assessment Monitoring System (2012-2014) cross-sectional data were used to explore the use of dental cleaning visit among women. The bivariate and multivariate analyses included sociodemographic variables, health risk factors, chronic conditions, oral health knowledge, and oral health promotion variables. All estimates were weighted; p < 0.05 was considered statistically significant. Results: A total of 1,344 weighted respondents represented ∼293,608 women in Virginia. Overall, 56% of women reported a before pregnancy dental cleaning visit, and 47% of women reported a during pregnancy dental cleaning visit. Nearly 60% of women were non-Hispanic white, 78% were between 20 and 34 years of age, and 67% reported having dental insurance. Dental insurance (odds ratio [OR] = 3.5; 95% confidence interval [95% CI] = 2.17-5.67) and oral health knowledge (OR = 2.8; 95% CI = 1.42-5.48) were associated with before pregnancy dental visit. During pregnancy dental visit was strongly associated with dental insurance (OR = 5.8; 95% CI = 2.80-11.97), before pregnancy dental visit (OR = 20.72, 95% CI = 11.14-38.54), and oral health promotion by health provider (OR = 12.37, 95% CI = 7.31-20.93). Conclusions: Overall, the use of a preventive dental visit before and during pregnancy was low among Virginia women. Improving the use of routine dental visits before pregnancy, increasing access to dental insurance, and engaging health care providers to promote oral health can impact the use of dental care during pregnancy.
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Affiliation(s)
- Shillpa Naavaal
- Department of Oral Health Promotion and Community Outreach, School of Dentistry, Oral Health in Childhood and Adolescence Core, Institute for Inclusion, Inquiry and Innovation, Virginia Commonwealth University, Richmond, Virginia
| | - Tegwyn H Brickhouse
- Department of Oral Health Promotion and Community Outreach, School of Dentistry, Oral Health in Childhood and Adolescence Core, Institute for Inclusion, Inquiry and Innovation, Virginia Commonwealth University, Richmond, Virginia
| | - Shahid Hafidh
- Division of Population Health Data, Office of Family Health Services, Virginia Department of Health, Richmond, Virginia
| | - Kenesha Smith
- Division of Population Health Data, Office of Family Health Services, Virginia Department of Health, Richmond, Virginia
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Mattera MSDLC, Chiba FY, Lopes FL, Tsosura TVS, Peres MA, Brito VGB, Oliveira SHP, Pereira RF, Marani F, dos Santos RM, Belardi BE, Tessarin GWL, Benites ML, Ervolino E, Heimann JC, Sumida DH. Effect of maternal periodontitis on GLUT4 and inflammatory pathway in adult offspring. J Periodontol 2019; 90:884-893. [DOI: 10.1002/jper.18-0568] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/02/2019] [Accepted: 01/08/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Maria Sara de Lima Coutinho Mattera
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Fernando Yamamoto Chiba
- Department of Child and Social DentistrySchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | | | - Thaís Verônica Saori Tsosura
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Maria Angelica Peres
- Department of Internal MedicineLaboratory of Experimental Hypertension, School of Medicine, University of São Paulo São Paulo Brazil
| | - Victor Gustavo Balera Brito
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Sandra Helena Penha Oliveira
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Renato Felipe Pereira
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Fernando Marani
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Rodrigo Martins dos Santos
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Bianca Elvira Belardi
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Gestter Willian Lattari Tessarin
- Institute of BiosciencesSão Paulo State University (UNESP) Botucatu Brazil
- Department of Basic SciencesDivision of HistologyDental School of AracatubaUNESP‐Univ Estadual Paulista Araçatuba Brazil
| | - Mariana Lopes Benites
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Edilson Ervolino
- Institute of BiosciencesSão Paulo State University (UNESP) Botucatu Brazil
- Department of Basic SciencesDivision of HistologyDental School of AracatubaUNESP‐Univ Estadual Paulista Araçatuba Brazil
| | - Joel Claudio Heimann
- Department of Internal MedicineLaboratory of Experimental Hypertension, School of Medicine, University of São Paulo São Paulo Brazil
| | - Doris Hissako Sumida
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
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Gugliandolo E, Fusco R, D'Amico R, Peditto M, Oteri G, Di Paola R, Cuzzocrea S, Navarra M. Treatment With a Flavonoid-Rich Fraction of Bergamot Juice Improved Lipopolysaccharide-Induced Periodontitis in Rats. Front Pharmacol 2019; 9:1563. [PMID: 30705631 PMCID: PMC6345201 DOI: 10.3389/fphar.2018.01563] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 12/21/2018] [Indexed: 12/12/2022] Open
Abstract
Objective: In this study, we investigated the effects of a flavonoid-rich fraction of Bergamot juice (BJe) in rats subjected to experimental periodontitis induced by a single intragingival injection of lipopolysaccharides (LPS). Main Methods: Periodontitis was induced by a single intragingival injection of 1 μl LPS (10 μg/μl) derived from Salmonella typhimurium in sterile saline solution. The injection was made in the mesolateral side at the interdental papilla between the first and the second molar. Fourteen days after LPS injection, we performed radiographic analyses and then we surgically removed the gingivomucosal tissue surrounding the mandibular first molar for histological, immunohistochemical and molecular analysis. Results: LPS significantly induced oedema, tissue damage and increased neutrophil infiltration. At molecular level, we found increased NF-κB translocation as well as raised both TNF-α and IL-1β expression, other than modulation of apoptosis-associated proteins. Moreover, the increased myeloperoxidase activity was associated with up-regulation of adhesion molecules. Immunohistochemical analysis for nitrotyrosine and poly ADP-ribose displayed an intense staining in the gingivomucosal tissue. Oral administration of BJe for 14 consecutive days reduced tissue injury and several markers of gingival inflammation including nuclear NF-κB translocation, cytokines expression, myeloperoxidase activity and the expression of some adhesion molecules such as ICAM and P-selectin. BJe also decreased both nitrosative stress and PARP positive staining. Moreover, it caused down-regulation of Bax and up-regulation of Bcl-2 expression. Conclusion: Our findings demonstrate that BJe improves LPS-induced periodontitis in rats by reducing the typical markers of inflammation, thus suggesting its potential in the treatment of periodontal diseases.
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Affiliation(s)
- Enrico Gugliandolo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Roberta Fusco
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Ramona D'Amico
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Matteo Peditto
- Department of Biomedical Sciences, Dentistry and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Giacomo Oteri
- Department of Biomedical Sciences, Dentistry and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Rosanna Di Paola
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Salvatore Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy.,Department of Pharmacological and Physiological Science, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Michele Navarra
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
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Lafaurie GI, Gómez LA, Montenegro DA, De Avila J, Tamayo MC, Lancheros MC, Quiceno J, Trujillo TG, Noriega LA, Grueso ML, Cepeda K. Periodontal condition is associated with adverse perinatal outcomes and premature rupture of membranes in low-income pregnant women in Bogota, Colombia: a case-control study. J Matern Fetal Neonatal Med 2018; 33:16-23. [PMID: 29852806 DOI: 10.1080/14767058.2018.1484092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Objectives: To assess the periodontal condition as a factor associated with adverse perinatal outcomes, premature rupture of membranes (PRM), and preeclampsia in low-income pregnant women treated at public hospitals in Bogotá, Colombia.Methods: Pregnant women with preterm birth (PTB) and low birth weight (LBW) or both conditions (n = 107/428), or only PTB (n = 73/292) or LBW (n = 74/296) or with PRM (n = 98/392) or preeclampsia (n = 76/304) in a ratio of four controls for each case, coming from three hospitals of the public Northern Network of Bogotá, Colombia were studied. Sociodemographic, perinatal adverse outcome history, antenatal care, chronic infections, periodontal condition, threatened abortion, bleeding in the second half of pregnancy, oligohydramnios, diabetes, gestational diabetes, alcohol consumption, hypertension, smoking, alcohol during pregnancy were determined. Logistic regression was conducted to establish factors associated to perinatal adverse outcomes. Multiple correspondence analysis was conducted as secondary analysis.Results: Threatened abortion, absence of antenatal care, hypertension, chronic infections, and periodontal condition were the most important factors associated with perinatal adverse outcomes. The presence of periodontal pockets was associated with LBW OR 2.52 (IC95% 1.36-4.70), PTB OR 2.04 (IC95% 1.10-3.64), PTB-LBW or both OR 2.08 (IC95% 1.18-3.31), PRM OR 2.04 (IC95% 1.17-3.56). Periodontal pockets presence was not associated with preeclampsia. Multiple correspondence analyses showed high correlation between PRM with chronic infection and presence of periodontal pockets.Conclusions: Periodontal condition is a factor independent of other important risk factors for a perinatal adverse outcome and PRM. Prevention of periodontal disease should be included in preconception and prenatal care programs.
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Affiliation(s)
- Gloria Inés Lafaurie
- Unit of Basic Oral Investigation - UIBO, School of Dentistry, Universidad El Bosque, Bogota, Colombia
| | - Luz Amparo Gómez
- Unit of Basic Oral Investigation - UIBO, School of Dentistry, Universidad El Bosque, Bogota, Colombia
| | | | - Juliette De Avila
- Unit of Basic Oral Investigation - UIBO, School of Dentistry, Universidad El Bosque, Bogota, Colombia
| | - Martha Cecilia Tamayo
- Unit of Basic Oral Investigation - UIBO, School of Dentistry, Universidad El Bosque, Bogota, Colombia
| | | | - Johanna Quiceno
- Unit of Basic Oral Investigation - UIBO, School of Dentistry, Universidad El Bosque, Bogota, Colombia
| | - Tamy Goretty Trujillo
- Unit of Basic Oral Investigation - UIBO, School of Dentistry, Universidad El Bosque, Bogota, Colombia
| | - Luis Antonio Noriega
- Unit of Basic Oral Investigation - UIBO, School of Dentistry, Universidad El Bosque, Bogota, Colombia
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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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Hartnett E, Haber J, Krainovich-Miller B, Bella A, Vasilyeva A, Lange Kessler J. Oral Health in Pregnancy. J Obstet Gynecol Neonatal Nurs 2016; 45:565-73. [DOI: 10.1016/j.jogn.2016.04.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 12/22/2022] Open
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Maternal periodontitis decreases plasma membrane GLUT4 content in skeletal muscle of adult offspring. Life Sci 2016; 148:194-200. [DOI: 10.1016/j.lfs.2016.02.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 02/04/2016] [Accepted: 02/04/2016] [Indexed: 02/07/2023]
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Gogeneni H, Buduneli N, Ceyhan-Öztürk B, Gümüş P, Akcali A, Zeller I, Renaud DE, Scott DA, Özçaka Ö. Increased infection with key periodontal pathogens during gestational diabetes mellitus. J Clin Periodontol 2015; 42:506-12. [PMID: 25959628 PMCID: PMC4699310 DOI: 10.1111/jcpe.12418] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2015] [Indexed: 12/13/2022]
Abstract
AIM Gestational diabetes mellitus (GDM), gingivitis, infection with specific periodontal pathogens and systemic inflammation each increase the risk for poor pregnancy outcome. We set out to monitor the interactions of gingivitis and GDM with respect to oral infection and the systemic inflammatory burden. MATERIALS AND METHODS Four case-control groups (n = 117) were recruited, (1) No gingivitis, No GDM (n = 27); (2) Gingivitis, No GDM (n = 31); (3) No gingivitis, GDM (n = 21); and (4) Gingivitis, GDM (n = 38). Oral infection with three key periodontal pathogens was determined by PCR. Systemic inflammation was determined by quantification of CRP by EIA. RESULTS Gingivitis during pregnancy was associated with oral infection with Porphyromonas gingivalis, Filifactor alocis and Treponema denticola and combinations thereof (all p < 0.01). GDM was also associated with increased infection with individual and multiple oral pathogens (all p < 0.05). Gingivitis during pregnancy led to a 325% increase in systemic CRP (mean, 2495 versus 8116 ng/ml, p < 0.01). CONCLUSIONS Diabetes and gingivitis act in concert to increase risk biomarkers for poor pregnancy outcome.
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Affiliation(s)
- Himabindu Gogeneni
- Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Nurcan Buduneli
- Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Banu Ceyhan-Öztürk
- Department of Endocrine and Metabolic Diseases, Aydın State Hospital, Aydın, Turkey
| | - Pınar Gümüş
- Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Aliye Akcali
- Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Iris Zeller
- Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Diane E. Renaud
- Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - David A. Scott
- Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Özgün Özçaka
- Periodontology, School of Dentistry, Ege University, Izmir, Turkey
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