Background and Objective:Over a century, an increased prevalence of gingival disease associated with increasing plasma sex steroid hormone levels has been reported. These situations present unique challenges to the oral health care professional. It is believed that hormonal fluctuations such as those associated with pregnancy, menstruation, and use of hormonal contraceptives lead to an increase in tooth mobility. However, this effect of female sex hormones on periodontal ligament and tooth supporting alveolar bone has rarely been investigated. So this study was undertaken to understand the effect on tooth mobility because of hormonal changes during the menstrual cycle.Materials and Methods:The mobility of index teeth 16, 13, 21, 23, 24, 36, 33, 41, 43, and 44 was measured with Periotest in 50 females at menstruation, ovulation, and premenstruation time points. Simplified oral hygiene index, plaque index, gingival index, and probing depth were also evaluated during the different phases of menstrual cycle for each subject participating in the study.Statistical Analysis:The results of the study were subjected to statistical analysis. Data analysis was done by applying Z test for comparing difference between two sample means.Result:The stages of menstrual cycle had no significant influence on the Periotest value. Despite no significant change in plaque levels, GI was significantly higher during ovulation and premenstruation time points.Conclusion:No change in tooth mobility was seen during the phases of the menstrual cycle. However, an exaggerated gingival response was seen during ovulation and premenstruation time when the entire menstrual cycle was observed.

Pregnancy had a significant influence on tooth mobility. Highest value of tooth mobility was seen in the last month of pregnancy. The maximum severity of gingivitis was also seen during the third trimester of pregnancy.

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Incidence of ectopic pregnancy after Invitro fertilization and embryo transfer (IVF-ET) in patients with prior bilateral tubal occlusion is negligible and if it occurs, it happens at unusual sites which are both difficult to diagnose as well as to treat. The possibility of early uterine rupture with life threatening haemorrhage is very high in such cases, therefore treatment of these pregnancies often require hysterectomy as a life saving measure. Our case of triplet lives ectopic pregnancy followed embryo transfer of three blastocysts. She had undergone laparoscopic bilateral proximal tubal occlusion 5 years ago. In this case, trans-abdominal ultrasound guided suction evacuation was attempted unsuccessfully. Hysteroscopy followed, which confirmed normal endometrial cavity with no gestational sac within it. Post adhesiolysis and bowel dissection, left sided cornual bulge was seen suggestive of left isthmic pregnancy. Putrescin was injected, incision made, products evacuated, and hemostatic sutures applied. On the right side, post bowel dissection hydrosalpinx seen and drained followed by putrescin injection at uterine angle. While de-roofing hydrosalpinx from the angle of uterus, products of conception were seen to extrude from posterior side of the uterine musculature at the angular area, which were evacuated, and hemostatic sutures applied. This case highlights the importance as well as need of using a gambit of diagnostic and operative procedures to enable treatment of such complicated cases successfully. This case report also highlights the misery and complications which could follow transfer of multiple good quality blastocysts especially if these implant at ectopic sites.