Section of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, Brazil, 90035-003.
Clin Oral Investig. 2013 Jan;17(1):37-44. doi: 10.1007/s00784-012-0679-3.
This randomized controlled clinical trial was carried out to assess the effect of comprehensive nonsurgical periodontal treatment and strict plaque control performed during pregnancy on the reduction of preterm and/or low birth weight rates (PTLBW).
Three hundred and three women were randomly allocated to receive periodontal treatment either during pregnancy (n = 147, test group) or after delivery (n = 156, control group). During pregnancy, the control group received only one session of supragingival scaling and oral hygiene instruction. In contrast, the test group received comprehensive periodontal treatment including multiple sessions of scaling and root planing, oral hygiene instructions, and frequent maintenance visits.
At baseline, periodontal inflammation was observed in approximately 50% of sites and attachment loss affected <15% of sites. Compared to controls, women in the test group had significant reductions in the percentage of sites with plaque (48.5% vs. 10.3%, p < 0.001), gingival bleeding (23.3% vs. 2.5%, p < 0.001), calculus (21.3% vs. 4.1%, p < 0.001), bleeding on probing (38.1% vs. 2.6%, p < 0.001) and probing depth ≥3 mm (19.97% vs. −2.45%, p < 0.001). No significant differences were observed between the groups in the occurrence of PT (11.7% vs. 9.1%, p = 0.57), LBW (5.6 % vs. 4.1%, p = 0.59), and PTLBW (4.15% vs. 2.60%, p = 0.53).
Comprehensive periodontal treatment and strict plaque control significantly improved periodontal health; however, no reduction of PTLBW rates was observed. Thus, remaining periodontal inflammation posttreatment cannot explain the lack of effect of periodontal treatment on PTLBW. Clinical relevance This study demonstrated that periodontal diseases may be successfully treated during pregnancy. Our results do not support a potential beneficial effect of periodontal treatment on PTLBW.
本随机对照临床试验旨在评估在妊娠期间进行全面非手术牙周治疗和严格菌斑控制对降低早产和/或低出生体重率（PTLBW）的影响。
将 303 名妇女随机分配到妊娠期间接受牙周治疗（n=147，试验组）或分娩后接受牙周治疗（n=156，对照组）。在妊娠期间，对照组仅接受一次龈上洁治和口腔卫生指导。相比之下，试验组接受了全面的牙周治疗，包括多次龈下刮治和根面平整、口腔卫生指导和频繁的维护就诊。
在基线时，约有 50%的位点存在牙周炎症，附着丧失影响了<15%的位点。与对照组相比，试验组女性的菌斑百分比显著降低（48.5% vs. 10.3%，p<0.001），牙龈出血（23.3% vs. 2.5%，p<0.001），牙石（21.3% vs. 4.1%，p<0.001），探诊出血（38.1% vs. 2.6%，p<0.001）和探诊深度≥3mm（19.97% vs. -2.45%，p<0.001）。两组间早产（11.7% vs. 9.1%，p=0.57）、低出生体重（5.6% vs. 4.1%，p=0.59）和 PTLBW（4.15% vs. 2.60%，p=0.53）的发生率无显著差异。
全面的牙周治疗和严格的菌斑控制显著改善了牙周健康，但未观察到 PTLBW 率降低。因此，治疗后残留的牙周炎症并不能解释牙周治疗对 PTLBW 缺乏影响。
本研究表明，妊娠期牙周病可以得到成功治疗。我们的结果不支持牙周治疗对 PTLBW 有潜在的有益作用。
