Dataset Information

Effect of intra-pregnancy nonsurgical periodontal therapy on inflammatory biomarkers and adverse pregnancy outcomes: a systematic review with meta-analysis.

ABSTRACT:

Background

The aim of this systematic review with meta-analysis was to analyze the effects of intra-pregnancy nonsurgical periodontal therapy on periodontal inflammatory biomarkers and adverse pregnancy outcomes.

Methods

On June 5, 2017, we searched PubMed, Cochrane, SCOPUS, Web of Science, LILACS, ProQuest, Open Grey, and Google Scholar databases. Randomized clinical trials in which pregnant women with chronic periodontitis underwent nonsurgical periodontal therapy, compared with an untreated group, tested for inflammatory biomarkers, and followed till delivery were included. Primary outcomes were preterm birth, low birth weight, and preeclampsia. Meta-analysis was performed with 5.3.5 version of Review Manager software.

Results

We found 565 references in the databases, 326 after duplicates removal, 28 met criteria for full text reading, and 4 met eligibility criteria for quantitative and qualitative synthesis. Intra-pregnancy nonsurgical periodontal therapy improved periodontal clinical parameters (periodontal pocket depth, clinical attachment level, and bleeding on probing) and reduced biomarker level from gingival crevicular fluid (GCF), and some from blood serum; however, it did not influence biomarker level from umbilical cord blood. Meta-analysis showed tendency for reduction of the risk of preterm birth before 37 weeks for treated group (risk ratio (RR) = 0.54, 95% CI 0.38-0.77; p = 0.0007; inconsistency indexes (I2) 32%) but did not show any difference for low birth weight occurrence (RR = 0.78, 95%CI 0.50-1.21; p = 0.27; I2 41%). No included study considered preeclampsia as a gestational outcome.

Conclusions

These results demonstrated that the intra-pregnancy nonsurgical periodontal therapy decreased periodontal inflammatory biomarker levels from gingival crevicular fluid and some from serum blood, with no influence on inflammatory biomarker level from cord blood, and it did not consistently reduce adverse gestational adverse outcome occurrence.

Systematic review registration

PROSPERO CRD42015027750.

SUBMITTER: da Silva HEC

PROVIDER: S-EPMC5635531 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Publications

Effect of intra-pregnancy nonsurgical periodontal therapy on inflammatory biomarkers and adverse pregnancy outcomes: a systematic review with meta-analysis.

da Silva Helbert Eustáquio Cardoso HEC Stefani Cristine Miron CM de Santos Melo Nilce N de Almeida de Lima Adriano A Rösing Cassiano Kuchenbecker CK Porporatti André Luís AL Canto Graziela De Luca GL

Systematic reviews 20171010 1

<h4>Background</h4>The aim of this systematic review with meta-analysis was to analyze the effects of intra-pregnancy nonsurgical periodontal therapy on periodontal inflammatory biomarkers and adverse pregnancy outcomes.<h4>Methods</h4>On June 5, 2017, we searched PubMed, Cochrane, SCOPUS, Web of Science, LILACS, ProQuest, Open Grey, and Google Scholar databases. Randomized clinical trials in which pregnant women with chronic periodontitis underwent nonsurgical periodontal therapy, compared with ...[more]

PMID: 29017560

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Project description:Rationale & objectiveObservational studies have suggested that periodontal disease may be a modifiable risk factor for chronic kidney disease (CKD). The Kidney and Periodontal Disease (KAPD) Study was designed to determine the feasibility of conducting a periodontal disease treatment trial among a high-risk (mostly poor and racial/ethnic minority) population and estimate the magnitude and variability of kidney and inflammatory biomarker levels in response to intensive periodontal treatment.Study designSingle-center, unmasked, intention-to-treat, randomized, controlled, pilot trial with 2:1 allocation to the treatment and comparison groups.Setting & participantsEnglish- and Spanish-speaking individuals aged 20 to 75 years receiving primary care within the San Francisco Community Health Network with evidence of both moderate to severe periodontal disease and CKD.InterventionImmediate intensive nonsurgical periodontal treatment versus rescue treatment for progressive disease at baseline and 4, 8, and 12 months.OutcomesFeasibility and process outcomes. Levels of biomarkers of kidney function, kidney injury, and systemic inflammation obtained at baseline and 4 and 12 months.ResultsKAPD randomly assigned 51 participants to the immediate (34 participants) or rescue (17 participants) groups. 14% dropped out of the study (4 immediate, 3 rescue) and 80% completed all 4 visits of the 12-month protocol (28 immediate, 13 rescue). Fewer than half the teeth recommended for extraction were extracted and 40% of immediate group visits were outside the protocol window. Bleeding on probing and probing depth improved more in the immediate group than in the rescue group; there was no significant separation in periodontal status. Levels of markers of vascular endothelial and systemic injury declined in both groups.LimitationsNo true control group.ConclusionsThis 12-month, pilot, randomized, controlled trial successfully recruited and retained a high-risk population but was less successful observing treatment adherence, treatment effect, and variability of biomarker levels. Although KAPD did not meet all of its goals, important lessons learned can be applied to future studies.FundingNational Institute of Diabetes and Digestive and Kidney Disease (Bethesda, MD; grant number 1K23DK093710-01A1) and Harold Amos Medical Faculty Development Program of the Robert Wood Johnson Foundation, Princeton, NJ. Funders had no role in study design; collection, analysis, or interpretation of data; writing the report; or the decision to submit the report for publication.Trial registrationNCT01802216.

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Dataset Information

Effect of intra-pregnancy nonsurgical periodontal therapy on inflammatory biomarkers and adverse pregnancy outcomes: a systematic review with meta-analysis.

Background

Methods

Results

Conclusions

Systematic review registration

Publications

Effect of intra-pregnancy nonsurgical periodontal therapy on inflammatory biomarkers and adverse pregnancy outcomes: a systematic review with meta-analysis.

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