牙周治疗可降低不良妊娠结局的发生率：一项对照临床试验。
Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial.
机构信息
Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
出版信息
J Appl Oral Sci. 2011 Apr;19(2):130-6. doi: 10.1590/s1678-77572011000200009.
OBJECTIVES
The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes.
MATERIAL AND METHODS
Pregnant patients during the 1st and 2nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG--"no intervention" (n=17) or IG--"intervention" (n=16). IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP), professional prophylaxis (PROPH) and oral hygiene instruction (OHI). NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD), clinical attachment level (CAL), plaque index (PI) and sulcular bleeding index (SBI) at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (<37 weeks), low birth weight (<2.5 kg), late abortion (14-24 weeks) or abortion (<14 weeks). The results obtained were statistically evaluated according to OR, unpaired t test and paired t test at 5% significance level.
RESULTS
No significant differences were observed between groups at baseline examination. Periodontal treatment resulted in stabilization of CAL and PI (p>0.05) at IG and worsening of all periodontal parameters at NIG (p<0.0001), except for PI. Significant differences in periodontal conditions of IG and NIG were observed at 2nd examination (p<0.001). The rate of adverse pregnancy outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy was associated to a decreased risk of developing adverse pregnancy outcomes [OR=13.50; CI: 1.47-123.45; p=0.02].
CONCLUSIONS
Periodontal treatment during the second trimester of gestation contributes to decrease adverse pregnancy outcomes.
目的
本研究旨在评估妊娠期中期非手术治疗牙周病对不良妊娠结局的影响。
材料与方法
在一家公共卫生中心进行产前护理的 1 至 2 个月大的孕妇被分为 2 组：NIG-“无干预”（n=17）或 IG-“干预”（n=16）。IG 患者接受了由一位牙周病专家进行的非手术牙周治疗，包括洁治和根面平整（SRP）、专业预防（PROPH）和口腔卫生指导（OHI）。NIG 在怀孕期间接受了 PROPH 和 OHI，并在分娩后接受治疗。牙周评估由一位经过培训的检查者进行，该检查者对牙周治疗不知情，根据基线和 35 孕周-产后 28 天的探诊深度（PD）、临床附着水平（CAL）、菌斑指数（PI）和龈沟出血指数（SBI）进行。主要不良妊娠结局为早产（<37 周）、低出生体重（<2.5 公斤）、晚期流产（14-24 周）或流产（<14 周）。根据 OR、未配对 t 检验和配对 t 检验，在 5%的显著水平下对获得的结果进行了统计评估。
结果
基线检查时，两组之间无显著差异。牙周治疗导致 IG 的 CAL 和 PI 稳定（p>0.05），而 NIG 的所有牙周参数恶化（p<0.0001），除了 PI。IG 和 NIG 的牙周状况在第二次检查时存在显著差异（p<0.001）。NIG 的不良妊娠结局发生率为 47.05%，IG 为 6.25%。妊娠期牙周治疗与不良妊娠结局的发生风险降低相关[OR=13.50；CI：1.47-123.45；p=0.02]。
结论
妊娠期中期的牙周治疗有助于降低不良妊娠结局的风险。
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