Association between periodontitis, periodontopathogens and preterm birth: is it real?

Martínez-Martínez, Rita Elizabeth; Moreno-Castillo, Diana Francisca; Loyola-Rodríguez, Juan Pablo; Sánchez-Medrano, Ana Gabriela; Miguel-Hernández, Jesús Héctor San; Olvera-Delgado, José Honorio; Domínguez-Pérez, Rúben Abraham

doi:10.1007/s00404-015-3945-1

Cited by 30 publications

(22 citation statements)

References 40 publications

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“…Pregnant women with periodontitis harbor a very complex and pathogenic subgingival microbiota, including a high prevalence of Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas gingivalis, and Parvimona micra [9]. Martínez-Martínez et al [44] did not find association between periodontal bacteria and premature birth. In opposition to this, Santa Cruz et al [9] found a significant association between the presence of Eikenella corrodens with preterm birth and the presence of Capnocytophaga spp.…”

Section: Discussionmentioning

confidence: 99%

Non-Surgical Treatment of Periodontal Disease in a Pregnant Caucasian Women Population: Adverse Pregnancy Outcomes of a Randomized Clinical Trial

Caneiro-Queija

López-Carral

Martín-Lancharro

et al. 2019

IJERPH

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Aim: To analyze if non-surgical treatment of periodontitis in a pregnant Caucasian women population can reduce adverse pregnancy outcomes. Methods and results: A parallel randomized clinical trial was designed and approved by the Ethical Committee of Sanitary Area Santiago-Lugo, Spain (registration number: 2016/451). Forty patients with periodontitis stage II grade B were randomly allocated to receive either comprehensive non-surgical periodontal therapy (test group; n = 20) or professional tooth cleaning (control group; n = 20) before 24 gestational weeks. Randomization was computer-generated by the statistic program Epidat v.4.1 and allocation was performed using sealed opaque envelopes. Clinical measurements and peripheral blood samples for biochemical variables were collected at baseline, in the middle of second trimester before non-surgical treatment, and in the third trimester. Microbiological samples were collected in the second and third trimester. A statistically significant reduction was verified in all clinical and microbiological parameters after periodontal treatment in the test group. No significant differences were observed for the rest of the variables, including preterm birth and/or low birth weight. No adverse events related to periodontal treatment were reported. Conclusions: Non-surgical periodontal treatment in Caucasian patients with periodontitis stage II grade B did not significantly reduce the risk of adverse pregnancy outcomes.

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Section: Discussionmentioning

confidence: 99%

Non-Surgical Treatment of Periodontal Disease in a Pregnant Caucasian Women Population: Adverse Pregnancy Outcomes of a Randomized Clinical Trial

Caneiro-Queija

López-Carral

Martín-Lancharro

et al. 2019

IJERPH

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“…As the included studies did not differ in their outcome definitions, we used a random-effect approach to compute the mean difference in either DMFT or DMFS between PTB and non-PTB. In one study by Martinez-Martinez et al , 35 the SD were not available, and we thus conservatively used the largest values recorded in the other included studies.…”

Section: Methodsmentioning

confidence: 99%

Dental caries and preterm birth: a systematic review and meta-analysis

et al. 2018

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ObjectivesThe primary objective of this systematic review was to evaluate the association between dental caries and preterm birth (PTB). The secondary objective was ascertaining the difference between women with dental caries who experienced PTB and those who did not with regard to decayed, missing and filled teeth (DMFT), and decayed, missing and filled surfaces (DMFS) indices.MethodsMEDLINE, Embase, CINAHL and Cochrane databases were searched initially in November 2015 and repeated in December 2016. We included observational cohort and case–control studies. Only studies reporting the risk of PTB in women affected compared with those not affected by dental caries in pregnancy were included. Random-effect meta-analyses were used to compute the summary OR of PTB among women with caries versus women without caries, and the mean difference in either DMFT or DMFS indices between women experiencing PTB and those without PTB.ResultsNine observational studies (4826 pregnancies) were included. Women affected by dental caries during pregnancy did not show a significantly higher risk of PTB (OR: 1.16, 95% CI 0.90 to 1.49, P=0.25, I2=35%). Also, the women with PTB did not show significantly higher DMFT or DMFS indices (summary mean differences: 1.56, P=0.10; I2=92% and −0.15, P=0.9, I2=89%, respectively).ConclusionDental caries does not appear to be a substantial risk factor for PTB.Trial registration numberNCT01675180; Pre-results.

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“…Based on significant correlations between serum PGE 2 level and probing depth, clinical attachment loss (CAL, Figure 1 C), and GCF TNF-α in PTB, periodontitis may increase the risk of labor triggers and hence contribute to preterm labor onset. However, in 2016 Martinez-Martinez et al ( 12 ) suggested that PTB is a multifactorial condition and that periodontitis and the presence of periodontal pathogens are not sufficient to trigger PTB.…”

Section: Epidemiological Resultsmentioning

confidence: 99%

Role of Maternal Periodontitis in Preterm Birth

Ren

2017

Front. Immunol.

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In the last two decades, many studies have focused on whether periodontitis is a risk factor for preterm birth (PTB). However, both epidemiological investigation and intervention trials have reached contradictory results from different studies. What explains the different findings, and how should future studies be conducted to better assess this risk factor? This article reviews recent epidemiological, animal, and in vitro studies as well as intervention trials that evaluate the link between periodontitis and PTB. Periodontitis may act as a distant reservoir of microbes and inflammatory mediators and contribute to the induction of PTB. Animal studies revealed that maternal infections with periodontal pathogens increase levels of circulating IL-1β, IL-6, IL-8, IL-17, and TNF-α and induce PTB. In vitro models showed that periodontal pathogens/byproducts induce COX-2, IL-8, IFN-γ, and TNF-α secretion and/or apoptosis in placental tissues/cells. The effectiveness of periodontal treatment to prevent PTB is influenced by the diagnostic criteria of periodontitis, microbial community composition, severity of periodontitis, treatment strategy, treatment efficiency, and the period of treatment during pregnancy. Although intervention trials reported contradictory results, oral health maintenance is an important part of preventive care that is both effective and safe throughout pregnancy and should be supported before and during pregnancy. As contradictory epidemiological and intervention studies continue to be published, two new ideas are proposed here: (1) severe and/or generalized periodontitis promotes PTB and (2) periodontitis only promotes PTB for pregnant women who are young or HIV-infected or have preeclampsia, pre-pregnancy obesity, or susceptible genotypes.

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Association between periodontitis, periodontopathogens and preterm birth: is it real?

Cited by 30 publications

References 40 publications

Non-Surgical Treatment of Periodontal Disease in a Pregnant Caucasian Women Population: Adverse Pregnancy Outcomes of a Randomized Clinical Trial

Non-Surgical Treatment of Periodontal Disease in a Pregnant Caucasian Women Population: Adverse Pregnancy Outcomes of a Randomized Clinical Trial

Dental caries and preterm birth: a systematic review and meta-analysis

Role of Maternal Periodontitis in Preterm Birth

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