Detection of Porphyromonas gingivalis in the amniotic fluid in pregnant women with a diagnosis of threatened premature labor

BACKGROUND: Epidemiologic and randomized controlled studies have shown that periodontal diseases may be associated with preterm labor and delivery of infants with low birth weights. The purpose of the present study was to determine the presence of microbial invasion of the amniotic cavity by periodontopathic bacteria in pregnant women with a diagnosis of threatened premature labor. METHODS: A periodontal examination and collection of amniotic fluid and subgingival plaque samples were performed on women identified as having threatened premature labor (preterm premature rupture of membranes without clinical infection or labor and preterm labor with intact membranes) and a gestational age ranging between 24 and 34 weeks. Samples collected from amniotic fluid and from the four deepest periodontal pockets in each patient were pooled in prereduced transport fluid and cultured. Porphyromonas gingivalis was identified primarily by colony morphology under stereoscopic microscope and rapid biochemical tests. Amniotic fluid or plaque samples were homogenized, DNA was extracted, and polymerase chain reaction (PCR) amplification of 16S rRNA with specific and universal primers was carried out. RESULTS: Twenty-six women with threatened premature labor were included: eight with preterm premature rupture of membranes and 18 with preterm labor with intact membranes. Eight women presented with gingivitis, 12 with chronic periodontitis, and six without periodontal disease. Microbial invasion of the amniotic cavity as detected by P. gingivalis PCR was 30.8% (eight of 26 patients). In these eight patients, P. gingivalis was present in both the subgingival samples and the respective amniotic fluid sample. CONCLUSION: The presence of microbial invasion of the amniotic cavity by P. gingivalis could indicate a role for periodontal pathogenic bacteria in pregnant women with a diagnosis of threatened premature labor.     

Periodontal status and preterm low birth weight: a case control study

BACKGROUND: Previous studies have suggested that periodontal disease may be an important risk factor for preterm low birth weight. However, the link between periodontal health status of pregnant women and preterm low birth weight is contentious, as recent studies found no association between periodontitis and pregnancy outcome. OBJECTIVE: The aim of this study was to investigate this potential link in a German Caucasian population. METHODS: Fifty-nine pregnant women with a high risk for a preterm low birth weight infant (suffering from preterm contractions, cases, group 1) as well as 42 control women with no preterm contractions during pregnancy and having an infant appropriate for date and weight (>or= 37 weeks gestation, >or= 2500 g, group 2) were examined. Clinical periodontal status was recorded on a full mouth basis. Subgingival plaque samples were taken and periodontal pathogens were identified by polymerase chain reaction. Additionally, interleukin-1 beta level in gingival crevicular fluid was analysed. RESULTS: The mean percentage of sites showing moderate to advanced attachment loss (>or=3 mm) was low in all study groups (group 1: 9.9 +/- 11.2%; group 2:10.6 +/- 14.1%, respectively). No significant differences between the groups in any aspects of the studied periodontitis parameters could be detected. Using a logistic regression model controlling for known preterm low birth weight risk factors, no periodontitis-associated factors increased risk for preterm contractions or preterm low birth weight. The odds ratio (OR) was 1.19 for preterm contractions, the 95% confidence interval (CI) 0.46; 3.11 and 0.73 for preterm low birth weight; 95% CI: 0.13; 4.19, respectively. CONCLUSION: In this population, periodontitis was not a detectable risk factor for preterm low birth weight in pregnant women.     

牙周状况、血清白细胞介素-1β水平与妊娠关系初探

目的探讨牙周状况、血清白细胞介素- 1β（IL- 1β）水平与妊娠间的关系。方法以40例先兆早产孕妇（TPL组）和40例正常孕妇（Non- TPL组）为研究对象，检查全口牙齿的牙周状况，记录菌斑指数（PLI）、探诊深度、临床附着丧失和出血指数（BI），并计算牙周炎位点率。酶联免疫吸附试验检测血清IL- 1β水平。对各项检查指标进行统计分析。结果①TPL组40例孕妇中26例足月产（TPL- TB小组），14例早产（TPL- PB小组）；Non- TPL组40例孕妇皆足月产。TPL组和Non- TPL组、TPL- TB小组和TPL- PB小组的分娩孕周、新生儿出生体重、PLI、牙周炎位点率和血清IL- 1β水平间的差异均有统计学意义（P<0.05）。②分娩孕周和牙周炎位点率、BI、IL- 1β水平呈负相关（P<0.05），IL- 1β水平与牙周炎位点率和BI呈正相关（P<0.05）。结论牙周感染可能是早产的原因之一。     

Maternal periodontitis and the causes of preterm birth: the case–control Epipap study

Aim: To analyse the association between maternal periodontitis and preterm birth (<37 weeks' gestation) according to the causes of preterm birth. Materials and Methods: Epipap is a case–control multi‐centre study of singleton livebirths. One thousand one hundred and eight women with preterm deliveries and 1094 with deliveries at term (37 weeks) at six French maternity units were included. Periodontal examinations after delivery identified localized and generalized periodontitis. Cases were classified according to four causes of preterm birth. Polytomous logistic regression analysis was used to control for confounders (maternal age, parity, nationality, educational level, marital status, employment during pregnancy, body mass index before pregnancy, smoking status) and the examiner. Results: Localized periodontitis was identified in 129 (11.6%) cases and in 118 (10.8%) control women and generalized periodontitis in 148 (13.4%) and 118 (10.8%), respectively. A significant association was observed between generalized periodontitis and induced preterm birth for pre‐eclampsia [adjusted odds ratio 2.46 [95% confidence intervals (95% CI)1.58‐3.83]. Periodontitis was not associated with spontaneous preterm birth or preterm premature rupture of membranes or with the other causes. Conclusion: Maternal periodontitis is associated with an increased risk of induced preterm birth due to pre‐eclampsia.     

The secretion of prostaglandin E2 and interleukin 1-beta in women with periodontal diseases and preterm low-birth-weight

Prematurity is of one of the main causes of neonatal morbidity and mortality. Clinical observations show, that periodontitis in pregnant women can be a direct risk factor for preterm labor, with a greater influence rate compared to other risk factors. The aim of the study was to asses the relationship between periodontal diseases and PLBW in the population of women from the Lower Silesian Region (Poland), and the evaluation of prostaglandin E2 (PGE2), interleukin-1 beta (IL-1 beta) levels in gingival cervicular (GCF) and blood serum in women with PLBW and women giving birth on time as well as secretion of these proinflammatory mediators in whole blood after bacterial lipopolysaccharide stimulation. The study group consisted of 84 women with PLBW (39.2% primiparous), aged 17-41 (mean 27.57). The controls were 44 women (47.7% primiparous) aged 16-38 (mean 26.36) who gave birth on time to a normal birthweight baby. PGE2 and IL-1 beta concentrations in serum and GCF were determined by means of immunoenzymatic method (EIA). In the studied population women over 28 years and exposed to medical risk factors had more frequent PLBW occurrence probability. In primiparous over 28 there is 4 times greater probability of preterm labor, and in case of the severe and generalized periodontitis presence there is 3.9 times higher possibility of PLBW compared to women with healthy periodontium. In all women with PLBW there is a significantly higher PGE2 and IL-1 beta concentration in GCF, and in primiparous also PGE2 level in blood serum, compared to controls.     

Effect of periodontal therapy on pregnancy outcome in women affected by periodontitis

BACKGROUND: There is convincing evidence to suggest that infections affecting the mother during pregnancy may produce alterations in the normal cytokine- and hormone-regulated gestation, which could result in preterm labor, premature rupture of membranes, and preterm birth (PTB). Studies in the late 1990s associated periodontitis with preterm low birth weight (PLBW) deliveries, and this may have similar pathogenic mechanisms as other maternal infections. This study determined the effect of non-surgical periodontal therapy on pregnancy outcome. METHODS: A total of 200 pregnant women with periodontitis were randomly assigned to treatment and control groups. Detailed data about previous and current pregnancies were obtained. All women received a full-mouth periodontal examination, including oral hygiene index-simplified, bleeding index, and clinical attachment level. The women in the treatment group received non-surgical periodontal therapy during the gestational period, and those in the control group received periodontal treatment after delivery. Periodontal therapy included plaque control instructions and scaling and root planing performed under local anesthesia. The outcome measures assessed were gestational age and birth weight of the infant. PTB was recorded when delivery occurred at <37 weeks of gestation, and low birth weight (LBW) was recorded when the infant weighed<2,500 g. RESULTS: There were 53 PTBs in the treatment group and 68 PTBs in the control group. Twenty-six LBW infants were recorded in the treatment group, and 48 LBW infants were noted in the control group. The mean gestational ages were 33.8+/-2.8 weeks and 32.7+/-2.8 weeks in the treatment and control groups, respectively. The difference was statistically significant at P<0.006. The mean birth weight was 2,565.3+/-331.2 g in the treatment group and 2,459.6+/-380.7 g in the control group, with the difference being statistically significant at P<0.044. A multiple regression model showed a significant effect of periodontal treatment on birth outcomes. CONCLUSIONS: Non-surgical periodontal therapy can reduce the risk for preterm births in mothers who are affected by periodontitis. Additional multicentered, randomized, controlled clinical trials are required to confirm this link between periodontitis and PLBW.     

Periodontal therapy and risk for adverse pregnancy outcomes

Periodontitis has been associated with adverse pregnancy outcomes. Results from intervention studies are few and controversial. The present study assessed the effects of non-surgical periodontal treatment in the occurrence of adverse pregnancy outcomes. Two hundred forty-six eligible women were randomly divided into two groups: periodontitis intervention (n = 122; undergoing non-surgical treatment during gestation) and periodontitis control (n = 124; not treated during gestation). Univariate analysis was performed and estimates of relative risk were reported. Data from 225 women were analyzed. No differences for preterm birth (p = 0.721), low birth weight (p = 0.198), and preterm low birth weight (p = 0.732) rates were observed. Relative risk estimates for preterm birth, low birth weight, and preterm low birth weight in the periodontitis intervention group were 0.915 (95% CI 0.561–1.493), 0.735 (95% CI 0.459–1.179), and 0.927 (0.601–1.431), respectively. Non-surgical periodontal treatment during the second semester of gestation did not reduce the risk for preterm birth, low birth weight, and preterm low birth weight.     

Periodontal bacterial profiles in pregnant women: response to treatment and associations with birth outcomes in the obstetrics and periodontal therapy (OPT) study

BACKGROUND: A recent clinical trial (Obstetrics and Periodontal Therapy [OPT] Study) demonstrated that periodontal therapy during pregnancy improved periodontal outcomes but failed to impact preterm birth. The present study evaluated seven target bacteria, Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia (previously T. forsythensis), Prevotella intermedia, Campylobacter rectus, and Fusobacterium nucleatum, in subgingival dental plaque of pregnant women in the OPT Study and their association with birth outcomes. METHODS: Pregnant women were randomly assigned to receive periodontal treatment before 21 weeks' gestation or after delivery. Subgingival plaque was sampled at baseline (13 to 16 weeks; 6 days of gestation) and at 29 to 32 weeks. We analyzed subgingival plaque samples from women who experienced fetal loss, delivered a live preterm infant (preterm women), or delivered a full-term infant (full-term women). Samples were analyzed using quantitative polymerase chain reaction. Associations between preterm birth and bacterial counts and percentages were tested using multiple linear regression. RESULTS: No significant differences were observed at baseline between preterm and full-term women for any measured bacterial species or group of species, after accounting for multiple comparisons. Changes in bacterial counts and proportions during pregnancy also were not associated with birth outcomes. In full-term and preterm women, periodontal therapy significantly reduced (P <0.01) counts of all target species except for A. actinomycetemcomitans. CONCLUSIONS: In pregnant women with periodontitis, non-surgical periodontal therapy significantly reduced levels of periodontal pathogens. Baseline levels of selected periodontal pathogens or changes in these bacteria resulting from therapy were not associated with preterm birth.     

Persistence of Helicobacter pylori in the oral cavity after systemic eradication therapy

AIM: The present study aimed to evaluate if the oral cavity of chronic periodontitis patients can harbor Helicobacter pylori after systemic eradication therapy. MATERIALS AND METHODS: Samples of 30 patients (15 with gingivitis and 15 with chronic periodontitis) positive for H. pylori in the stomach were evaluated. Samples were collected 3 months after triple systemic antibiotic therapy from saliva, microbiota from the dorsum of the tongue, supra- and sub-gingival plaque as well as gastric biopsies. DNA of each sample was extracted by the boiling method and used as a template in polymerase chain reaction with the primers JW22/23. RESULTS: Eighteen patients (60%) harboured H. pylori in their mouths. Five patients (16.6%) were positive in saliva, two (6.6%) on the dorsum of the tongue, nine (30%) in supra-gingival plaque, 14 (46.6%) in sub-gingival plaque and three (10%) in the stomach. There was no statistically significant difference between study groups. CONCLUSION: Eradication of H. pylori after therapy was more effective for the stomach than for the mouth (p<0.001). Mouths of patients with gingivitis or with chronic periodontitis, who are positive for H. pylori in their stomachs, may be considered as reservoirs of these bacteria.     

Maternal periodontitis and adverse pregnancy outcomes

Abstract – Objectives: Maternal periodontal diseases have been associated with increased risk of preterm birth and restricted fetal growth among relatively low socioeconomic groups. Whether the association can be generalized to middle‐class populations remains uncertain. We evaluated periodontitis in relation to preterm birth (<37 weeks’ gestation) and small‐for‐gestational‐age (SGA, birth weight below the 10th percentile of birth weight for gestational age) among a group of medically insured women. Methods: We conducted a prospective study among participants of Project Viva, a US cohort study of pregnant women and their offspring from 1999 to 2002. Pregnancy outcomes were obtained from medical records. Self‐reported periodontitis was assessed during the second trimester of pregnancy, and validated against radiographs. Logistic regression analyses were employed to evaluate the association of periodontitis with pregnancy outcomes adjusted for age, race/ethnicity, smoking status, income, frequency of dental check‐ups, prepregnancy body mass index, pregnancy weight gain, gravidity, prior history of preterm birth and history of genitourinary infection. Results: Of the 1635 women, 72.7% were Caucasian, 65.0% had annual household income >$70 000, 3.8% reported having periodontitis, 6.4% delivered preterm, 5.4% delivered SGA babies, and 11.0% had poor pregnancy outcome (either preterm birth or SGA). The odds ratio (OR) associated with periodontitis was 1.74 (95% CI 0.65–4.66) for preterm delivery and 2.11 (95% CI 0.76–5.86) for SGA individually. When preterm delivery and/or SGA were combined, the OR was 2.26 (95% CI 1.05–4.85) relating periodontitis with poor pregnancy outcome. Conclusion: Within the limitations of the study, the results suggest that periodontitis is an independent risk factor for poor pregnancy outcome among middle‐class women.     

A possible association between preterm birth and early periodontitis. A pilot study

According to many studies, generalised periodontitis can be a risk factor for preterm birth (PB). A case-control study was carried out to examine if early localised periodontitis could be a risk factor for adverse pregnancy outcome. MATERIAL AND METHODS: Postpartum women without any systemic disease were included into the study. Similar numbers of patients belonged to the case (41) and to the control (44) groups. A PB case was defined if a patient had a threatening premature labour during pregnancy, preterm premature rupture of membranes, or spontaneous preterm labour, and/or the weight of the newborn was < or = 2499 g. Control women had delivery after the 37th gestational week and the newborn's weight was > or = 2500 g. Known risk factors like smoking, alcohol, drug consumption, socio-economic status and the periodontal status were recorded. RESULTS: A significant association was found between PB and early localised periodontitis of the patient with the following criterion having bleeding at > or = 50% of the examined sites (6 at each tooth) and having at least at one site > or = 4 mm probing depth (p = 0.001). The odds ratio was 5.46 at the 95% confidence interval. The average weight of the newborns in the periodontitis group was less than in the control group, the difference is significant (p = 0.047). CONCLUSION: The results indicate that early localised periodontitis of the patient during pregnancy can be regarded as an important risk factor for PB.     

Possible association between mother's periodontal status and preterm delivery

BACKGROUND: A case-control study was undertaken to detect whether initial chronic localized periodontitis could be a risk factor for preterm birth (PB) and foetal growth restriction. METHODS: A PB case was defined if a patient had a threatening premature event during pregnancy pre-term premature rupture of membranes, or spontaneous pre-term delivery, before the 37th week of pregnancy, and/or the weight of the newborn was <2500 g. Into the PB (case) group, 77 women were allocated, while 84 were included in the control group, all of whom had delivery after the 37th gestational week and with a newborn weighing >or=2500 g. RESULTS: A significant association was found between PB and initial chronic localized periodontitis, the criteria being bleeding at >or=50% of the examined teeth and having at least at one site at >or=4 mm probing depth (p=0.0001). The adjusted odds ratio for initial chronic localized periodontitis was 3.32, 95% CI: 1.64-6.69. The average weight of newborns of mothers with periodontitis was significantly less than that of the women without periodontitis (p=0.002). CONCLUSIONS: The results support the hypothesis that initial chronic localized periodontitis of pregnant women could lead to PB, and birth-weight reduction.     

Effects of periodontal therapy during pregnancy on periodontal status, biologic parameters, and pregnancy outcomes: a pilot study

BACKGROUND: Few studies have examined the potential effects of periodontal treatment during pregnancy on pregnancy outcomes, periodontal status, and inflammatory biomarkers. METHODS: A randomized, delayed-treatment, controlled pilot trial was conducted to evaluate the effects of second-trimester scaling and root planing and the use of a sonic toothbrush on the rate of preterm delivery (<37 weeks gestation). Secondary outcome measures included changes in periodontal status, levels of eight oral pathogens, levels of gingival crevicular fluid (GCF) interleukin-1beta (IL-1beta), prostaglandin E(2) (PGE(2)), 8-isoprostane (8-iso), and IL-6, and serum levels of IL-6, soluble intercellular adhesion molecule 1 (sICAM1), 8-isoprostane, soluble glycoprotein 130 (sGP130), IL-6 soluble receptor (IL-6sr), and C-reactive protein (CRP). Logistic regression models were used to test for effects of treatment on preterm delivery. Secondary outcomes were analyzed by analysis of covariance adjusting for subject baseline values. RESULTS: Periodontal intervention resulted in a significantly decreased incidence odds ratio (OR) for preterm delivery (OR = 0.26; 95% confidence interval = 0.08 to 0.85), adjusting for baseline periodontal status which was unbalanced after randomization. Pregnancy without periodontal treatment was associated with significant increases in probing depths, plaque scores, GCF IL-1beta, and GCF IL-6 levels. Intervention resulted in significant improvements in clinical status (attachment level, probing depth, plaque, gingivitis, and bleeding on probing scores) and significant decreases in levels of Prevotella nigrescens and Prevotella intermedia, serum IL-6sr, and GCF IL-1beta. CONCLUSIONS: Results from this pilot study (67 subjects) provide further evidence supporting the potential benefits of periodontal treatment on pregnancy outcomes. Treatment was safe, improved periodontal health, and prevented periodontal disease progression. Preliminary data show a 3.8-fold reduction in the rate of preterm delivery, a decrease in periodontal pathogen load, and a decrease in both GCF IL-1beta and serum markers of IL-6 response. However, further studies will be needed to substantiate these early findings.     

FcγRIIB polymorphisms, periodontitis and preterm birth in Japanese pregnant women

Iwanaga R, Sugita N, Hirano E, Sasahara J, Kikuchi A, Tanaka K, Yoshie H. FcγRIIB polymorphisms, periodontitis and preterm birth in Japanese pregnant women. J Periodont Res 2011; 46: 292–302.©2011 John Wiley & Sons A/S Background and Objective: Recently, numerous studies have investigated the association of preterm birth with periodontitis. FcγRIIb is a human low‐affinity receptor for immunoglobulin G (IgG). We have previously demonstrated single nucleotide polymorphisms (SNPs) of FcγRIIb to be associated with periodontitis and the serum‐specific IgG level against periodontopathic bacteria. In this study, we investigated whether FcγRIIB gene polymorphisms were associated with periodontitis and/or pregnancy outcome. Material and Methods: We assessed the periodontal conditions of 122 Japanese pregnant women within 5 d of delivery, and polymorphisms in FcγRIIB and in other Fcγ receptors were detected from the genomic DNA. Using clinical and genomic data, we analyzed the relationship between periodontitis, preterm birth and Fcγ receptor polymorphisms. Results: A significant difference was observed in the distribution of FcγRIIB‐nt645+25A/G (rs2125685) between preterm and term birth groups, with a higher prevalence of nt645+25AA in the preterm birth group (p = 0.032). Additionally, the FcγRIIB‐nt645+25GG carrier showed significantly higher results for the prevalence of periodontitis (p = 0.048), mean pocket depth (p = 0.021), mean clinical attachment level (p = 0.010), percentage of sites with pocket depth ≥ 4 mm (p = 0.005) and percentage of sites with clinical attachment level ≥ 3 mm (p = 0.007) than the AA carrier. An association between preterm birth and periodontitis was not observed in this study. Conclusion: These findings suggest that FcγRIIB‐nt645+25AA carriers are more likely to experience preterm birth than FcγRIIB‐nt645+25AG and GG carriers. Also, women with FcγRIIB‐nt645+25G exhibited a greater tendency to have periodontitis than those with nt645+25A.     

先兆早产孕妇的牙周状况分析

目的:通过比较先兆早产(TPL)孕妇与正常孕妇的牙周状况,探讨先兆早产孕妇的牙周状况、血清IL-6水平及与早产的关系。方法:收集诊断为TPL住院治疗的孕妇40例,同期定期产前检查但无产兆的正常孕妇40例作为对照组。检查记录菌斑指数(PLI)、探诊深度(PD)、临床附着丧失(CAL)和出血指数(BI),计算牙周炎位点(PD>3mm,CAL≥2mm)率。ELISA法检测血清IL-6水平。采用SPSS11.0统计软件包对相应数据进行χ2检验、t检验和Pearson相关分析。结果:TPL孕妇中26例足月产(TPL-TB),14例早产(TPL-PB);对照组(Non-TPL)40例均足月产。TPL-TB和TPL-PB组间的分娩孕周和新生儿出生体重有显著差异(P<0.05)。TPL组的PLI、牙周炎位点率和血清IL-6水平显著高于对照组。先兆早产组中,TPL-PB组的PLI、BI、牙周炎位点率显著高于TPL-TB组。分娩孕周和牙周炎位点率、BI呈显著负相关(P<0.05)。结论:先兆早产孕妇的牙周状况显著差于正常孕妇,血清IL-6水平显著高于正常孕妇,牙周感染是否为早产的原因之一,有待于进一步明确。     

Preterm low birth weights associated with periodontal disease in the Fiji Islands

AIM: To determine any association between pre-term low birth weight (PTLBW) neonates and periodontal disease during the mother's pregnancy. DESIGN: A multi-centered prospective case cohort study. SETTING: Ante-natal clinics at the Colonial War Memorial and Lautoka Hospitals, Fiji from 1st January to 30th June 2004. PARTICIPANTS: 670 multiethnic pregnant women. METHODS: Participants were interviewed to identify confounding variables--medical conditions, smoking, alcohol consumption, maternal age and history of preterm birth. Oral examination was conducted and included the Community Periodontal Index of Treatment Needs (CPITN). Delivery outcome was recorded for each woman. RESULTS: The mean age of participants was 25.80 +/- 5.56 years. 1.9% (n=13) women delivered preterm babies. More than 50% of this group displayed moderate to severe periodontitis compared with 13% of women who had a normal delivery. Preterm birth was also associated with the mother having had a previous preterm birth and who was more likely to be Indo-Fijian (p < 0.01). There was no significant association with where the mother lived; however, rural women with PTLBW babies had more severe periodontal disease (p = 0.0001). CONCLUSION: There is a highly significant association between pre-term birth and moderate to severe periodontal disease (p = 0.0001).     

Longitudinal evaluation of prostaglandin E2 (PGE2) and periodontal status in HIV+ patients

The study aim was to determine whether prostaglandin E(2) (PGE(2)) in gingival crevicular fluid (GCF) could serve as a risk factor for periodontitis in human immunodeficiency virus-positive (HIV(+)) patients. Clinical measurements, including gingival index (GI), plaque index, bleeding index, probing depth (PD), attachment loss (AL) and GCF samples were taken from two healthy sites (including sites with gingival recession, GI=0; PD< or =3 mm; AL< or =2 mm), three gingivitis sites (GI>0; PD< or =3 mm; AL=0) and three periodontitis sites (GI>0; PD> or =5 mm; AL> or =3 mm) of each of the 30 patients at baseline and 6-month visits. GCF samples were also taken by means of paper strips. GCF PGE(2) levels were determined by a sandwich ELISA. The progressing site was defined as a site which had 2 mm or more attachment loss during the 6-month study period. The mean amounts of PGE(2) were significantly higher in gingivitis and periodontitis sites than in healthy sites (p<0.0001). GCF levels of PGE(2) were significantly correlated with probing depth, attachment loss, CD4(+) cells, viral load, age and smoking pack-years at baseline and 6-month visits (0.0001相似文献   

先兆早产孕妇牙周状况与妊娠结局的关系

目的通过比较先兆早产(TPL)孕妇与健康孕妇的牙周状况,对牙周病变程度、血清肿瘤坏死因子α(TNF-α)水平与早产间的关系作初步探讨。方法收集 TPL 孕妇40例(TPL 组),同期做定期产前检查无产兆的健康孕妇40名(对照组)。TPL 组中26例足月产(TPL-TB),14例早产(TPL-PB);对照组均足月产。检查记录菌斑指数(PLI)、探诊深度(PD)、临床附着丧失(CAL)和出血指数(BI),并计算牙周炎位点(PD>3 mm,CAL≥2mm)率。ELISA 法检测血清 TNF-α水平。结果TPL 组的 PLI(0.94±0.05)、牙周炎位点率(2.93%)和血清 TNF-α水平[14.81 ng/L(13.40～15.64 ng/L)]均明显高于对照组的0.59±0.03、1.32%和11.47 ng/L(10.82～12.86 ng/L),P<0.001。TPL-PB 组的 PLI(0.96±0.06)、BI(2.99±0.14)、牙周炎位点率(3.61%)和 TNF-α水平[18.35ng/L(15.47～31.94 ng/L)]显著高于 TPL-TB 组的0.66±0.04、2.76±0.12、2.25%和13.70 ng/L(12.64～14.80ng/L)。分娩孕周和牙周炎位点率、TNF-α水平呈显著负相关(P<0.05)。TNF-α水平与牙周炎位点率呈显著正相关(P<0.05)。结论牙周感染可能是早产的原因之一。     

Periodontal disease as a risk factor for adverse pregnancy outcomes: a prospective cohort study

Aim: The aim of this study was to determine the association between periodontitis and the incidence of preterm birth (PB), low birth weight (LBW) and preterm low birth weight (PLBW) Material and Methods: One thousand and ninty‐six women were enrolled. Periodontal data, pregnancy outcome variables and information on other factors that may influence adverse pregnancy outcomes were collected. Data were analysed using a logistic regression model. Results: The incidence of PB and LBW was 6.6% and 6.0%, respectively. The incidence of PLBW was 3.3%. PB was related to mother's age, systemic diseases, onset of prenatal care, previous PBs, complications of pregnancy, type of delivery, the presence of untreated caries and the presence of periodontitis (odds ratio 1.77, 95% confidence interval: 1.08–2.88). LBW was related to mother's smoking habits, ethnicity, systemic diseases, previous LBW babies, complications of pregnancy and type of delivery. PLBW was related to mother's age, onset of prenatal care, systemic diseases, previous LBW babies, complications of pregnancy and type of delivery. Conclusions: The factors involved in many cases of adverse pregnancy outcomes have still not being identified, although systemic infections may play a role. This study found a modest association between periodontitis and PB. Further research is required to establish whether periodontitis is a risk factor for PB and/or LBW.     

Interleukin-1 and IL-1 receptor antagonist in gingival crevicular fluid

BACKGROUND/AIMS: This study aimed to investigate the cytokine IL-1beta and its receptor antagonist IL-1ra in gingival crevicular fluid (GCF), in patients with adult periodontitis. METHOD: A total of 40 GCF samples were harvested from 10 subjects with moderate to severe adult periodontitis and 10 healthy controls. Subjects were selected from both genders, with all the upper anterior teeth present, and with no relevant systemic illness, pregnancy or recent medication. All subjects were non-smokers and had not received any periodontal therapy within the preceding 3 months. Deep bleeding sites, deep non-bleeding sites and healthy sites were investigated in relation to upper anterior teeth. Clinical measurements were recorded for each site, after obtaining a GCF sample. IL-1beta and IL-1ra were quantified using new commercially available ELISA kits (Quantikine), and could be detected in all samples. RESULTS: The mean concentration for IL-1beta was 0.11 (SD 0.14) pg/microl for bleeding periodontitis sites, 0.04 (0.05) pg/microl for non-bleeding periodontitis sites, and 0.01 (0.03) pg/microl for healthy sites (p<0.001). In contrast, the mean concentration for IL-1ra was 6.99 (9.78) pg/microl for healthy sites, 0.59 (0.44) pg/microl for non-bleeding periodontitis sites, and 0.44 (0.36) pg/microl for bleeding periodontitis sites (p<0.001, except for comparisons between bleeding and non-bleeding periodontitis sites, p>0.05). For healthy sites, a strong inverse relationship was found between IL-1beta and IL-1ra levels in GCE. CONCLUSIONS: The results suggest a strong relationship between the severity of adult periodontitis and the increasing GCF levels of IL-1beta and decreasing levels of IL-1ra.