妊娠期非手术牙周治疗对炎症生物标志物和不良妊娠结局的影响：系统评价和荟萃分析。
Effect of intra-pregnancy nonsurgical periodontal therapy on inflammatory biomarkers and adverse pregnancy outcomes: a systematic review with meta-analysis.
机构信息
Post-Graduation Program, Foundation for Teaching and Research in Health Sciences, Brasilia, Brazil.
Condomínio Mansões Entrelagos, Etapa 1, conjunto S, casa 9, Paranoá, Brasília, DF, 73255-900, Brazil.
出版信息
Syst Rev. 2017 Oct 10;6(1):197. doi: 10.1186/s13643-017-0587-3.
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.
背景
本系统评价和荟萃分析的目的是分析妊娠期非手术牙周治疗对牙周炎症生物标志物和不良妊娠结局的影响。
方法
我们于 2017 年 6 月 5 日检索了 PubMed、Cochrane、SCOPUS、Web of Science、LILACS、ProQuest、Open Grey 和 Google Scholar 数据库。纳入了接受非手术牙周治疗的慢性牙周炎孕妇与未治疗组相比，检测炎症生物标志物并随访至分娩的随机临床试验。主要结局为早产、低出生体重和子痫前期。采用 Review Manager 软件 5.3.5 版进行荟萃分析。
结果
我们在数据库中发现了 565 篇参考文献，去除重复后为 326 篇，经过全文阅读筛选后为 28 篇，4 篇符合定量和定性综合的纳入标准。妊娠期非手术牙周治疗改善了牙周临床参数（牙周袋深度、临床附着水平和探诊出血），降低了龈沟液（GCF）和一些血清生物标志物的水平，但对脐血生物标志物的水平没有影响。荟萃分析显示，治疗组 37 周前早产的风险有降低的趋势（风险比（RR）=0.54，95%置信区间 0.38-0.77；p=0.0007；不一致指数（I2）为 32%），但低出生体重的发生没有差异（RR=0.78，95%置信区间 0.50-1.21；p=0.27；I2 为 41%）。没有纳入的研究将子痫前期作为妊娠结局。
结论
这些结果表明，妊娠期非手术牙周治疗降低了龈沟液和一些血清生物标志物的水平，但对脐血生物标志物的水平没有影响，也没有一致降低不良妊娠结局的发生。
系统评价注册
PROSPERO CRD42015027750。
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