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牙周治疗对妊娠结局的影响。

The effects of periodontal treatment on pregnancy outcomes.

作者信息

Michalowicz Bryan S, Gustafsson Anders, Thumbigere-Math Vivek, Buhlin Kåre

机构信息

Department of Developmental and Surgical Sciences, University of Minnesota School of Dentistry, Minneapolis, MN 55455, USA.

出版信息

J Periodontol. 2013 Apr;84(4 Suppl):S195-208. doi: 10.1902/jop.2013.1340014.

Abstract

BACKGROUND

Preterm infants are at greater risk than term infants for physical and developmental disorders. Morbidity and mortality increases as gestational age at delivery decreases. Observational studies indicate an association between poor periodontal health and risk for preterm birth or low birthweight, making periodontitis a potentially modifiable risk factor for prematurity.

AIM

To identify randomized controlled trials (RCTs) published between January 2011 and July 2012 and discuss all published RCTs testing whether periodontal therapy reduces rates of preterm birth and low birthweight.

METHODS

Search of databases including PubMed, ISI Web of Science and Cochrane Library.

RESULTS

The single RCT identified showed no significant effect of periodontal treatment on birth outcomes.

DISCUSSION

All published trials included non-surgical periodontal therapy; only two included systemic antimicrobials as part of test therapy. The trials varied substantially in terms of sample size, obstetric histories of subjects, study preterm birth rates and the periodontal treatment response. The largest trials--also judged to be high-quality and at low risk of bias--have yielded consistent results, and indicate that treatment does not alter rates of adverse pregnancy outcomes.

CONCLUSION

Non-surgical periodontal therapy, scaling and root planing, does not improve birth outcomes in pregnant women with periodontitis.

摘要

背景

与足月儿相比,早产儿出现身体和发育障碍的风险更高。随着分娩时孕周的减少,发病率和死亡率会增加。观察性研究表明,牙周健康状况不佳与早产或低出生体重风险之间存在关联,这使得牙周炎成为早产的一个潜在可改变风险因素。

目的

识别2011年1月至2012年7月期间发表的随机对照试验(RCT),并讨论所有已发表的测试牙周治疗是否能降低早产率和低出生体重率的RCT。

方法

检索包括PubMed、科学引文索引(ISI)数据库和Cochrane图书馆在内的数据库。

结果

所识别的单个RCT显示,牙周治疗对分娩结局无显著影响。

讨论

所有已发表的试验均包括非手术牙周治疗;只有两项试验将全身用抗菌药物作为试验治疗的一部分。这些试验在样本量、受试者的产科病史、研究早产率以及牙周治疗反应方面差异很大。规模最大的试验——也被判定为高质量且偏倚风险低——得出了一致的结果,表明治疗不会改变不良妊娠结局的发生率。

结论

非手术牙周治疗,即龈上洁治和龈下刮治,不能改善患有牙周炎的孕妇的分娩结局。

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