Comparative evaluation of subgingival plaque microflora in pregnant and non-pregnant women: A clinical and microbiologic study

Abstract

Context:Gingival changes in pregnancy have been attributed to changes in the subgingival biofilm related to hormonal variations.Aims:To evaluate the subgingival plaque microflora in pregnant and nonpregnant women to determine if pregnancy induces any alterations in the subgingival plaque and to associate these changes with changes in periodontal status.Settings and Design:Thirty pregnant and 10 nonpregnant women within the age group of 20-35 years having a probing pocket depth (PPD) of 3-4 mm were included in the study. The pregnant women were equally divided into 3 groups of 10, each belonging to I, II, and III trimester.Materials and Methods:Plaque index, gingival index, PPD, and microbiologic evaluation for specific bacterial counts for Prevotella intermedia, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Parvimonas micra, and Fusobacterium nucleatum were carried out for all subjects.Statistical Analysis:Mann–Whitney U test.Results:Increase in gingival inflammation was observed in II and III trimester as compared with I trimester and control. Plaque scores did not show any significant difference between pregnant and nonpregnant women. Specific bacterial examination revealed an increase in proportion of P. intermedia in pregnant women of both II and III trimester as compared with I trimester and nonpregnant women.Conclusions:A definite increase in proportions of P. intermedia occurs in subgingival plaque microflora in pregnancy that may be responsible for the exaggerated gingival response.

Longitudinal study on clinical and microbial analysis of periodontal status in pregnancy

“…23 Although in the healthy state, there is a balance between microbiota virulence factors and host defense factors, if this equilibrium is disrupted by microbial or host factors, including hormonal changes during pregnancy, these specific pathogens can increase in number and lead to the development of periodontal disease (gingivitis and periodontitis). Although these aspects were not evaluated in this study, this theory is accepted by other authors 13,15 who have suggested that P. gingivalis, P. nigrescens, C. rectus, and A. actinomycetemcomitans can be implicated as risk factors for adverse pregnancy outcomes, including prematurity and low birth weight.…”

“…Most studies on periodontal microbiota have used cultures, 12,15,19 conventional PCR, 22 real-time PCR, 14 checkerboard DNA-DNA hybridization, 9,16,23 and, most recently, DNA sequencing technologies. 24 However, because these approaches are based on various parameters and have differing sensitivities, it is very difficult to compare the results to clearly elucidate microbial community structure.…”

“…1,2,3,4,5,6 Several factors have been investigated during research on periodontal disease in pregnancy, including hormone levels, 7,8 virulence factors of microorganisms, 9,10 changes in immunologic responses, 5,11 and microbiota. 12,13,14,15,16,17,18 Various types of analysis and models have proven helpful in understanding the multi-factorial causes of periodontal disease. 7,8,19,20,21 Of these, bacterial challenge studies have provided a valuable contribution to understanding the complex pathogenesis of periodontal disease.…”

“…13,14,32 Although the presence of periodontal bacteria can be demonstrated using various methods, including DNA-DNA hybridization or oral microbiota culture, 12,15,19 our use of FISH allows for direct counts of the cell numbers of each microorganism in relation to the total cell count.…”

Treg regulation in periodontal disease during pregnancy.

“…4B). This is in agreement with periodontal pathogens presence found in the analysis of subgingival microbial composition of pregnant women who experienced increased gingival inflammation (Borgo et al, 2014;Emmatty et al, 2013). As a result of exacerbated gingival inflammation, some women developed permanent periodontal tissue damage and alveolar bone loss (Christensen et al, 1998;Lieff et al, 2004;Machuca et al, 1999;Moss et al, 2005;Taani et al, 2003).…”