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

Caneiro-Queija, Leticia; López-Carral, Jose; Martín-Lancharro, Pablo; Limeres-Posse, Jacobo; Dios, Pedro Diz; Blanco‐Carrión, Juan

doi:10.3390/ijerph16193638

Cited by 17 publications

(27 citation statements)

References 46 publications

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“…Os coeficientes Kappa interexaminadores foram de 1 (para a fase de leitura de títulos e resumos) e 0,90 (para a fase de leitura do texto na íntegra). Entre os 15 artigos utilizados no levantamento bibliográfico, três eram estudos transversais [4,18,27], oito caso controle [13,16,21,24,26,30,37,42], dois de coorte prospectivos [5,45] e dois ensaios clínicos randomizados [6,34]. Os estudos foram conduzidos em nove países: África do Sul, Brasil, Colômbia, Espanha, Hungria, Itália, Irã, Tanzânia e Turquia.…”

Section: Resultsunclassified

“…Dados do tratamento periodontal não cirúrgico de intervenção foram abordados com efeitos dicotômicos no desfecho da associação entre periodontite, prematuridade e BPN. Um estudo relevou efeitos benéficos do tratamento periodontal na diminuição das taxas de prematuridade [34], e estudos atuais ressaltaram tal tratamento como indiferente em mulheres caucasianas, sem reduzir significativamente o risco de resultados adversos na gravidez [5,6].…”

Section: Resultsunclassified

“…Cerca de dez estudos apontaram para associação entre os indicadores clínicos periodontais, as alterações no tempo gestacional e o crescimento intrauterino [4,13,18,21,24,27,34,37,45], no entanto cinco outras pesquisas falharam em demonstrar tal associação [5,6,16,30,42]. Todos os artigos foram organizados segundo autor(es), país, desenho do estudo/descrição da amostra, critérios de diagnóstico para periodontite e conclusão (Tabela II).…”

Section: Resultsunclassified

“…Com base nessa revisão, a maioria dos estudos mostrou associação entre indicadores clínicos de DP e desfechos adversos gestacionais, tais como PP e BPN [4,5,13,18,21,22,24,26,28,34,37,45]. Também houve a não associação específica relatada em outros estudos [6,16,27,30,42]. É plausível que outras condições possam determinar desfechos gestacionais, como idade gestacional no momento da infecção, qualidade dos cuidados neonatais, infecções urogenitais, uso de medicamentos e fatores relacionados ao trabalho de parto [40,43,51].…”

Section: Discussionunclassified

“…Especula-se que o tratamento padrão de raspagem e alisamento radicular não seria eficaz na eliminação de patógenos orais que semearam os tecidos da placenta antes do tratamento periodontal [15]. O tratamento da periodontite grau II não evidencia nenhuma proteção para o BPN nem para a prematuridade nas populações dos estudos [5,6]. Fogacci et al [16] relataram parâmetros clínicos periodontais (NIC, PS, índice de placa dentária e índice de sangramento gengival) semelhantes em mães de recém-nascidos prematuros e/ou com BPN (casos) e em mães de recém-nascidos a termo e com peso normal ao nascer (controles) [16].…”

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Relação entre doença periodontal, prematuridade e baixo peso ao nascer: uma revisão integrativa da literatura

Vieira¹,

Magalhães²,

Chaves³

et al. 2021

RSBO

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Revisar a literatura sobre a associação da doença periodontal com prematuridade e com baixo peso ao nascer. Material e métodos: No banco de dados PubMed e Google Scholar, utilizando a seguinte combinação de palavras: “Periodontal Diseases” [Majr] AND (Prematurity OR Low Birth Weight), foi realizada uma revisão integrativa da literatura envolvendo estudos humanos publicados no período de 2015 a 2020, avaliando a associação entre doença periodontal e prematuridade/baixo peso ao nascer. Resultados: A busca eletrônica resultou num total de 352 referências, reduzidas aos critérios de estudos humanos a 343, ao período a 53 e à leitura de títulos e resumos a 16. Após leitura da íntegra dos 16 artigos, foram selecionados 15 para o presente estudo, entre os quais três são estudos transversais, oito caso controle, dois estudos de coorte prospectivos e dois ensaios clínicos randomizados com resultados divergentes para tal associação. Conclusão: A maioria dos estudos analisados considera a relação da doença periodontal com parto prematuro e baixo peso ao nascer. Há necessidade de medidas preventivas, padronização de métodos e pesquisas específicas para evitar os efeitos adversos gestacionais.

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Section: Resultsunclassified

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Relação entre doença periodontal, prematuridade e baixo peso ao nascer: uma revisão integrativa da literatura

Vieira¹,

Magalhães²,

Chaves³

et al. 2021

RSBO

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Association of Chlorhexidine Use and Scaling and Root Planing With Birth Outcomes in Pregnant Individuals With Periodontitis

et al. 2022

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ImportanceChlorhexidine mouthwash enhances treatment effects of conventional periodontal treatment, but data on chlorhexidine as a source of heterogeneity in meta-analyses assessing the treatment of maternal periodontitis in association with birth outcomes are lacking.ObjectiveTo assess possible heterogeneity by chlorhexidine use in randomized clinical trials (RCTs) evaluating the effect of periodontal treatment (ie, scaling and root planing [SRP]) vs no treatment on birth outcomes.Data SourcesCochrane Oral Health’s Trials Register, Cochrane Pregnancy and Childbirth’s Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database), US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov), and the WHO International Clinical Trials Registry Platform were searched through March 2022.Study SelectionRCTs were included if they were conducted among pregnant individuals with periodontitis, used interventions consisting of SRP vs no periodontal treatment, and assessed birth outcomes.Data Extraction and SynthesisData were abstracted with consensus of 2 reviewers using Rayyan and assessed for bias with the Cochrane Risk of Bias 2 tool before random effects subgroup meta-analyses. Analyses were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline.Main Outcomes and MeasuresOutcomes of interest were preterm birth (ie, &lt;37 weeks’ gestation) and low birth weight (ie, &lt;2500 g).ResultsThere were 12 studies with a total of 5735 participants evaluating preterm birth. Control group participants did not receive any treatment or use chlorhexidine during pregnancy. All intervention group participants received SRP; in 5 of these studies (with 2570 participants), pregnant participants in the treatment group either received chlorhexidine mouthwash or advice to use it, but participants in the remaining 7 studies (with 3183 participants) did not. There were 8 studies with a total of 3510 participants evaluating low birth weight, including 3 studies with SRP plus chlorhexidine (with 594 participants) and 6 studies with SRP only (with 2916 participants). The SRP plus chlorhexidine groups had lower risk of preterm birth (relative risk [RR], 0.56; 95% CI, 0.34-0.93) and low birth weight (RR, 0.47; 95% CI, 0.32-0.68) but not the SRP-only groups (preterm birth: RR, 1.03; 95% CI, 0.82-1.29; low birth weight: RR, 0.82; 95% CI, 0.62-1.08).Conclusions and RelevanceThese findings suggest that treating maternal periodontitis with chlorhexidine mouthwash plus SRP was associated with reduced risk of preterm and low birth weight. Well-conducted RCTs are needed to test this hypothesis.

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Systematic review and meta-analysis of randomized controlled trials evaluating the efficacy of non-surgical periodontal treatment in patients with concurrent systemic conditions

Joseph,

Prabhakar,

Holtfreter

et al. 2023

Clin Oral Invest

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Objective To conduct a systematic review of the published scientific evidence to evaluate the efficacy of nonsurgical periodontal therapy (NSPT) in treating periodontitis in patients with concurrent systemic conditions (diabetes, CVD, erectile dysfunction, chronic kidney disease, rheumatoid arthritis, polycystic ovarian syndrome, obesity, pregnancy). We hypothesised that NSPT results in better periodontal outcomes when compared to untreated controls after follow-up. Materials and methods A systematic search (PUBMED/EMBASE) was conducted from 1995 to 2023 to identify randomised controlled trials (RCTs) with a minimum follow-up of 3 months. The primary outcome was the difference in mean probing depth (PD), and the secondary outcomes were mean clinical attachment loss (CAL), percentage of sites with PD ≤ 3 mm (%PD ≤ 3 mm) and percentage of sites with bleeding on probing (%BOP) between the treated and untreated control group in patients with comorbidities. Results The electronic search resulted in 2,403 hits. After removing duplicates, 1,565 titles and abstracts were screened according to the eligibility criteria, resulting in 126 articles for full-text screening. Following this, 44 studies were analysed. Restricting to studies with low bias or some concerns, NSPT group demonstrated a 0.55 mm lower mean PD (95%CI: −0.69; −0.41) after 3 months compared to the control group. Conclusion Compared to the untreated controls, NSPT notably reduced mean PD, mean CAL, and %BOP while increasing %PD ≤ 3 mm in patients with concurrent systemic conditions. These findings suggest that NSPT is also an effective procedure in managing periodontitis in patients with concurrent systemic conditions. Trial registration This systematic review was registered under the protocol registration number CRD42021241517/PROSPERO.

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

Cited by 17 publications

References 46 publications

Relação entre doença periodontal, prematuridade e baixo peso ao nascer: uma revisão integrativa da literatura

Relação entre doença periodontal, prematuridade e baixo peso ao nascer: uma revisão integrativa da literatura

Association of Chlorhexidine Use and Scaling and Root Planing With Birth Outcomes in Pregnant Individuals With Periodontitis

Systematic review and meta-analysis of randomized controlled trials evaluating the efficacy of non-surgical periodontal treatment in patients with concurrent systemic conditions

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