"Does Periodontal Treatment During Pregnancy Reduce" by Ashraf Elzer, Raga A. Elzahaf et al.
  •  
  •  
 

Abstract

Objective: To find out if scaling and root planing for periodontal disease during pregnancy lowers the incidence of preterm births. Methods: This is a meta-analysis study design; searches were conducted in the PubMed database and on Google Scholar between January 2000 and December 2023. Only randomized controlled trials (RCTs) were considered. The studies will be examined to determine the relationship between non-surgical periodontal treatment and preterm birth rates among pregnant women. Results: Only 14 trials were included out of 194 articles identified. The overall result indicated a statistically significant reduction in preterm birth rate when we use the random effects model (odds ratio 0.64, 95% CI: 0.46 to 0.89; p = 0.008). Conclusions: This meta-analysis demonstrates that treating chronic periodontitis with scaling and root planing in pregnant women has a significant impact on reducing the incidence of preterm birth rate. Periodontal disease is common in pregnancy, resulting in a lower quality of life, frequent systemic pathologies, and poor pregnancy outcomes. Given the negative consequences, public health implications, and large disease burden, it is worthwhile to look into more aspects of periodontal disease during pregnancy. Further well-organized studies are still needed.

References

  1. Macones GA, Parry S, Nelson DB, Strauss JF, Ludmir J, Cohen AW, Stamilio DM, Appleby D, Clothier B, Sammel MD, Jeffcoat M. Treatment of localized periodontal disease in pregnancy does not reduce the occurrence of preterm birth: Results from the Periodontal Infections and Prematurity Study (PIPS). Am J Obstet Gynecol. 2010; 202(2):147.e1–8.
  2. Alnasser BH, Alkhaldi NK, Alghamdi WK, Alghamdi FT. The potential association between periodontal diseases and adverse pregnancy outcomes in pregnant women: A systematic review of randomized clinical trials. Cureus. 2023; 15(1):e33216.
  3. Govindasamy R, Periyasamy S, Narayanan M, Balaji VR, Dhanasekaran M, Karthikeyan B. The influence of nonsurgical periodontal therapy on the occurrence of adverse pregnancy outcomes: A systematic review of the current evidence. J Indian Soc Periodontol. 2020; 24(1):7–14.
  4. Elzer A, GabAlla ES, Sassi KO, Jedeh MS. Effects of non-surgical periodontal treatment on serum C-reactive protein level among coronary artery disease patients: Meta-analysis. Int Sci Technol J. 2017; 11:1–17.
  5. Tenenbaum A, Azogui-Levy S. Oral health knowledge, attitudes, practices, and literacy of pregnant women: A scoping review. Oral Health Prev Dent. 2023; 21:185–98.
  6. Offenbacher S, Beck JD, Jared HL, Mauriello SM, Mendoza LC, Couper DJ, Stewart DD, Murtha AP, Cochran DL, Dudley DJ, Reddy MS, Geurs NC, Hauth JC; Maternal Oral Therapy to Reduce Obstetric Risk (MOTOR) Investigators. Effects of periodontal therapy on rate of preterm delivery: A randomized controlled trial. Obstet Gynecol. 2009; 114(3):551–9.
  7. Vergnes JN, Sixou M. Preterm low birth weight and maternal periodontal status: A meta-analysis. Am J Obstet Gynecol. 2007; 196(2):135.e1–7.
  8. Figuero E, Han YW, Furuichi Y. Periodontal diseases and adverse pregnancy outcomes: Mechanisms. Periodontol 2000. 2020; 83(1):175–88.
  9. Naavaal S, Harless DW. Comprehensive pregnancy dental benefits improved dental coverage and increased dental care utilization among Medicaid-enrolled pregnant women in Virginia. Front Oral Health. 2022; 3:989659.
  10. Bretelle F, Loubière S, Desbriere R, Loundou A, Blanc J, Heckenroth H, Schmitz T, Benachi A, Haddad B, Mauviel F, Danoy X, Mares P, Chenni N, Ménard JP, Cocallemen JF, Slim N, Sénat MV, Chauleur C, Bohec C, Kayem G, Trastour C, Bongain A, Rozenberg P, Serazin V, Fenollar F; Groupe de Recherche en Obstetrique et Gynécologie (GROG) Investigators. Effectiveness and costs of molecular screening and treatment for bacterial vaginosis to prevent preterm birth: The AuTop randomized clinical trial. JAMA Pediatr. 2023; 177(9):894–902.
  11. Kahwati LC, Clark R, Berkman N, Urrutia R, Patel SV, Zeng J, Viswanathan M. Screening for bacterial vaginosis in pregnant adolescents and women to prevent preterm delivery: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2020; 323(13):1293–309.
  12. Klebanoff MA, Schuit E, Lamont RF, Larsson PG, Odendaal HJ, Ugwumadu A, Kiss H, Petricevic L, Andrews WW, Hoffman MK, Shennan A, Seed PT, Goldenberg RL, Emel LM, Bhandaru V, Weiner S, Larsen MD. Antibiotic treatment of bacterial vaginosis to prevent preterm delivery: Systematic review and individual participant data meta-analysis. Paediatr Perinat Epidemiol. 2023; 37(3):239–51.
  13. Michalowicz BS, Hodges JS, DiAngelis AJ, Lupo VR, Novak MJ, Ferguson JE, Buchanan W, Bofill J, Papapanou PN, Mitchell DA, Matseoane S, Tschida PA; OPT Study. Treatment of periodontal disease and the risk of preterm birth. N Engl J Med. 2006; 355(18):1885–94.
  14. Machado V, Ferreira M, Lopes L, Mendes JJ, Botelho J. Adverse pregnancy outcomes and maternal periodontal disease: An overview on meta-analytic and methodological quality. J Clin Med. 2023; 12(11):3635.
  15. Higgins JP, Altman DG, Sterne JA. Chapter 8: Assessing risk of bias in included studies. In: Higgins JP, Churchill R, Chandler J, Cumpston MS, Editors. Cochrane Handbook for Systematic Reviews of Interventions version 5.2. Wiley Blackwell; 2017.
  16. Ioannidis JP, Trikalinos TA. The appropriateness of asymmetry tests for publication bias in meta-analyses: A large survey. CMAJ. 2007; 176(8):1091–6.
  17. Terzic M, Aimagambetova G, Terzic S, Radunovic M, Bapayeva G, Laganà AS. Periodontal pathogens and preterm birth: Current knowledge and further interventions. Pathogens. 2021; 10(6):730.
  18. Ye C, Kapila Y. Oral microbiome shifts during pregnancy and adverse pregnancy outcomes: Hormonal and Immunologic changes at play. Periodontol 2000. 2021; 87(1):276–81.
  19. Jang H, Patoine A, Wu TT, Castillo DA, Xiao J. Oral microflora and pregnancy: A systematic review and meta-analysis. Sci Rep. 2021; 11(1):16870.
  20. Latorre Uriza C, Velosa-Porras J, Roa NS, Quiñones Lara SM, Silva J, Ruiz AJ, Escobar Arregoces FM. Periodontal disease, inflammatory cytokines, and PGE2 in pregnant patients at risk of preterm delivery: A pilot study. Infect Dis Obstet Gynecol. 2018; 2018:7027683.
  21. Radnai M, Pál A, Novák T, Urbán E, Eller J, Gorzó I. Benefits of periodontal therapy when preterm birth threatens. J Dent Res. 2009; 88(3):280–4.
  22. López NJ, Da Silva I, Ipinza J, Gutiérrez J. Periodontal therapy reduces the rate of preterm low birth weight in women with pregnancy-associated gingivitis. J Periodontol. 2005; 76(11 Suppl):2144–53.
  23. López NJ, Smith PC, Gutierrez J. Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: A randomized controlled trial. J Periodontol. 2002; 73(8):911–24.
  24. Tarannum F, Faizuddin M. Effect of periodontal therapy on pregnancy outcome in women affected by periodontitis. J Periodontol. 2007; 78(11):2095–103.
  25. Sant'Ana AC, Campos MR, Passanezi SC, Rezende ML, Greghi SL, Passanezi E. Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: A controlled clinical trial. J Appl Oral Sci. 2011; 19(2):130–6.
  26. Caneiro-Queija L, López-Carral J, Martin-Lancharro P, Limeres-Posse J, Diz-Dios P, Blanco-Carrion J. Non-Surgical treatment of periodontal disease in a pregnant caucasian women population: Adverse pregnancy outcomes of a randomized clinical trial. Int J Environ Res Public Health. 2019; 16(19):3638.
  27. Newnham JP, Newnham IA, Ball CM, Wright M, Pennell CE, Swain J, Doherty DA. Treatment of periodontal disease during pregnancy: A randomized controlled trial. Obstet Gynecol. 2009; 114(6):1239–48.
  28. Sadatmansouri S, Sedighpoor N, Aghaloo M. Effects of periodontal treatment phase I on birth term and birth weight. J Indian Soc Pedod Prev Dent. 2006; 24(1):23–6.
  29. Jeffcoat M, Parry S, Sammel M, Clothier B, Catlin A, Macones G. Periodontal infection and preterm birth: Successful periodontal therapy reduces the risk of preterm birth. BJOG. 2011; 118(2):250–6.
  30. Pirie M, Linden G, Irwin C. Intrapregnancy non-surgical periodontal treatment and pregnancy outcome: A randomized controlled trial. J Periodontol. 2013; 84(10):1391–400.
  31. Weidlich P, Moreira CH, Fiorini T, Musskopf ML, da Rocha JM, Oppermann ML, Aass AM, Gjermo P, Susin C, Rösing CK, Oppermann RV. Effect of nonsurgical periodontal therapy and strict plaque control on preterm/low birth weight: a randomized controlled clinical trial. Clin Oral Investig. 2013; 17(1):37–44.
  32. Khader YS, Ta'ani Q. Periodontal diseases and the risk of preterm birth and low birth weight: A meta-analysis. J Periodontol. 2005; 76(2):161–5.
  33. Teshome A, Yitayeh A. Relationship between periodontal disease and preterm low birth weight: Systematic review. Pan Afr Med J. 2016; 24:215.
  34. Corbella S, Taschieri S, Francetti L, De Siena F, Del Fabbro M. Periodontal disease as a risk factor for adverse pregnancy outcomes: A systematic review and meta-analysis of case-control studies. Odontology. 2012; 100(2):232–40.
  35. Bi WG, Emami E, Luo ZC, Santamaria C, Wei SQ. Effect of periodontal treatment in pregnancy on perinatal outcomes: A systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2021; 34(19):3259–68.
  36. Moliner-Sánchez CA, Iranzo-Cortés JE, Almerich-Silla JM, Bellot-Arcís C, Ortolá-Siscar JC, Montiel-Company JM, Almerich-Torres T. Effect of per capita income on the relationship between periodontal disease during pregnancy and the risk of preterm birth and low birth weight newborn. Systematic review and meta-analysis. Int J Environ Res Public Health. 2020; 17(21):8015.
  37. Manrique-Corredor EJ, Orozco-Beltran D, Lopez-Pineda A, Quesada JA, Gil-Guillen VF, Carratala-Munuera C. Maternal periodontitis and preterm birth: Systematic review and meta-analysis. Community Dent Oral Epidemiol. 2019; 47(3):243–51.
  38. Iheozor-Ejiofor Z, Middleton P, Esposito M, Glenny AM. Treating periodontal disease for preventing adverse birth outcomes in pregnant women. Cochrane Database Syst Rev. 2017; 6(6):CD005297.
  39. Alobaid AS. Effect of periodontal treatment on preterm birth rate: Meta-analysis. World J Dent. 2013; 4(4):256–61.
  40. Schwendicke F, Karimbux N, Allareddy V, Gluud C. Periodontal treatment for preventing adverse pregnancy outcomes: A meta- and trial sequential analysis. PLoS One. 2015; 10(6):e0129060.
  41. Sayeed G, Varghese SS. Treating periodontal disease for preventing adverse pregnancy outcomes: Overview of systematic reviews. J. Datta Meghe Inst Med Sci Univ. 2022; 17(4):975–83.

Download

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.