Effect of levonorgestrel implants on the periodontium

Abstract

passive smoking, particularly among Greek women. The findings demonstrate the urgent need to implement a systematic approach to healthcare and health policy among pregnant women in Crete.

Depot Medroxyprogesterone Acetate Use and Periodontal Health in 15‐ to 44‐Year‐Old US Females

“…Hormonal contraceptives have been reported to impact the oral health of females 1,2 . Oral contraceptives primarily containing estrogen have been associated with increased gingival inflammation and periodontitis, although a consensus has not been reached in the literature 3‐6 .…”

“…Oral contraceptives primarily containing estrogen have been associated with increased gingival inflammation and periodontitis, although a consensus has not been reached in the literature 3‐6 . Although less studied, progestin‐only contraceptives, which contain a synthetic version of the sex hormone progesterone, may also impact periodontal tissues 1,7,8 . Progesterone has been associated with changes in gingival and other intraoral tissues in females, especially during life periods such as pregnancy 9‐11 .…”

“…Progesterone has been associated with changes in gingival and other intraoral tissues in females, especially during life periods such as pregnancy 9‐11 . Furthermore, progesterone has been shown to reduce corpuscular flow rate, allowing for accumulation of inflammatory cells, increased vascular permeability, 1,12 and increased vascular proliferation 13,14 …”

“…Progestin‐only contraceptive use has been associated with periodontal changes in adult females 1,7,24 . Tilakaratne et al 8 observed that females who used a progestin‐only injectable contraceptive (DMPA) for >2 years had significantly higher levels of gingival inflammation and clinical attachment loss (AL) compared with non‐users.…”

“…In a clinical study by Seck‐Diallo et al, 7 females using injectable progestin‐only contraceptives demonstrated more gingival inflammation, periodontal pocketing, and AL than non‐users. More recently, in a prospective 6‐month clinical study examining the effect of the levonorgestrel implant on the periodontium, 1 females using the progestin implant contraceptives exhibited a statistically significant increase in gingival probing depths (PDs) over the study period compared with non‐users. However, these studies have important limitations, such as low number of DMPA users, reporting DMPA use and oral contraceptive use together, and lack of control for important periodontal disease‐associated confounders.…”