Huda Sabrina, Doering Hendrik, Tenenbaum Howard C, Whittle Wendy, Sigal Michael J, Glogauer Michael
Department of Paediatrics, Faculty of Dentistry, University of Toronto, Toronto, ON.
J Periodontol. 2015 Jan;86(1):72-81. doi: 10.1902/jop.2014.140116.
A multitude of studies suggest an association between periodontal disease and adverse birth outcomes, but the findings have been equivocal. Although the evidence is controversial, it is biologically plausible, and the key link may be inflammation. Because periodontitis is at times either active or inactive, trying to correlate the presence of pockets, for example, to adverse outcome of pregnancy might be preordained to failure or at least confusion. Alternatively, if inflammatory activity associated with periodontitis could be measured, it might be possible to correlate oral inflammatory load (OIL) to adverse pregnancy outcomes more precisely, but given the low incidence of adverse pregnancy outcomes, large populations must be studied. This underscores the need to use a means for assessment of OIL that is reliable, reproducible, and so simple to perform that it does not require dental expertise and can be used for large numbers of patients attending obstetrics units. The objective of this study was to demonstrate that OIL can be measured in a cohort of pregnant females presenting for obstetric care and secondarily to ensure that there was a realistic correlation to the presence of periodontitis.
Sixty-three pregnant females were recruited, and 15-second saline rinses were collected to measure OIL as represented by counts of oral neutrophil levels. Periodontal examinations were performed to determine the extent of the correlation between the presence of clinical markers of periodontitis, such as pockets and clinical attachment loss to the OIL.
Using this small cohort of patients, a test for oral inflammatory disease could be administered successfully in a non-dental setting. In addition, there was a statistically significant increase (two-fold, P < 0.05) in oral neutrophil counts found in patients with periodontitis compared with those without periodontitis.
The rinse assay can be used as a screening tool for oral inflammation, which was also related to the presence of periodontitis, in pregnant females attending a medical clinic.
众多研究表明牙周疾病与不良分娩结局之间存在关联，但研究结果并不明确。尽管证据存在争议，但从生物学角度来看是合理的，关键联系可能是炎症。由于牙周炎有时处于活动期，有时处于非活动期，例如试图将牙周袋的存在与妊娠不良结局相关联可能注定会失败，或者至少会造成混淆。另外，如果能够测量与牙周炎相关的炎症活动，那么或许有可能更精确地将口腔炎症负荷（OIL）与不良妊娠结局相关联，但鉴于不良妊娠结局的发生率较低，必须对大量人群进行研究。这突出表明需要一种评估OIL的方法，该方法要可靠、可重复，并且操作简单，不需要牙科专业知识，可用于大量前往产科就诊的患者。本研究的目的是证明可以在前来接受产科护理的怀孕女性队列中测量OIL，其次是确保其与牙周炎的存在有实际关联。
招募了63名怀孕女性，收集15秒的盐水漱口液以测量OIL，用口腔中性粒细胞水平计数来表示。进行牙周检查以确定牙周炎临床标志物（如牙周袋和临床附着丧失）的存在与OIL之间的相关程度。
利用这一小群患者，能够在非牙科环境中成功进行口腔炎症疾病检测。此外，与无牙周炎的患者相比，牙周炎患者的口腔中性粒细胞计数有统计学意义的显著增加（两倍，P < 0.05）。
漱口液检测可作为在医疗诊所就诊的怀孕女性口腔炎症的筛查工具，口腔炎症也与牙周炎的存在有关。
