Department of Periodontology, Faculty of Dentistry, Gaziosmanpasa University, Tokat, Turkey.
Department of Periodontology, Faculty of Dentistry, Abant Izzet Baysal University, Bolu, Turkey.
Clin Oral Investig. 2021 Apr;25(4):1677-1684. doi: 10.1007/s00784-018-2569-9. Epub 2018 Jul 31.
The aim of this study was to compare the effects of periodontal treatment on the inflammatory markers in gingival crevicular fluid and the concentration of salivary cortisol between non-pregnant and pregnant women with gingivitis.
This study included 30 non-pregnant women (mean age 27.93 ± 6.61 years) and 30 pregnant women (mean age 28.93 ± 4.04 years). Each participant presented with the clinical symptoms of generalized, moderate-to-severe gingivitis. Saliva samples were collected by using the spitting method, and gingival crevicular fluid (GCF) samples were collected by using the intrasulcular method at baseline and after 3 weeks. Non-surgical periodontal treatment (NPT) comprising scaling and oral hygiene instruction was administered after sample collection. The interleukin-6 and interleukin-10 levels in GCF and salivary cortisol concentrations were determined with using enzyme-linked immunosorbent assay.
The pregnant women exhibited significantly deeper pockets (p < 0.05) and greater gingival inflammation (p < 0.05) than the non-pregnant women after periodontal therapy. Moreover, the levels of interleukin-6 in the GCF were significantly higher in the pregnant women compared to the non-pregnant women after periodontal therapy: 17.73 ± 9.82 pg per site and 8.08 ± 4.51 pg per site, respectively, p < 0.05. No differences in the levels of interleukin-10 were observed. The pregnant women also exhibited higher cortisol concentration in the saliva after periodontal therapy, compared to the non-pregnant women, while the levels of stress (as seen on the perceived stress scale-10) were similar in both groups.
Although non-surgical periodontal therapy may reduce the clinical parameters of gingivitis, increasing levels of stress in pregnancy may reduce the individual's response to it. However, further studies are necessary to substantiate these early findings.
Psychosocial stress may increase the risk of periodontal disease by altering the behavioral and immune responses of the individual. Therefore, the levels of stress should be taken into consideration in order to increase the efficacy of periodontal therapy in pregnant patients.
本研究旨在比较牙周治疗对患有牙龈炎的非孕妇和孕妇龈沟液中炎症标志物和唾液皮质醇浓度的影响。
本研究纳入了 30 名非孕妇（平均年龄 27.93±6.61 岁）和 30 名孕妇（平均年龄 28.93±4.04 岁）。每位参与者均表现出广泛的、中重度牙龈炎的临床症状。使用吐口水法收集唾液样本，使用沟内法在基线和 3 周后收集龈沟液（GCF）样本。在收集样本后，进行非手术性牙周治疗（NPT），包括洁治和口腔卫生指导。使用酶联免疫吸附试验测定 GCF 中的白细胞介素-6 和白细胞介素-10 水平以及唾液皮质醇浓度。
牙周治疗后，孕妇的牙周袋深度明显更深（p<0.05），牙龈炎症更严重（p<0.05）。此外，牙周治疗后，孕妇 GCF 中的白细胞介素-6 水平明显高于非孕妇：分别为 17.73±9.82 pg/位点和 8.08±4.51 pg/位点，p<0.05。白细胞介素-10 水平无差异。牙周治疗后，孕妇唾液中的皮质醇浓度也高于非孕妇，而两组的应激水平（如 10 项感知压力量表所示）相似。
尽管非手术性牙周治疗可能会降低牙龈炎的临床参数，但妊娠期间的压力增加可能会降低个体对其的反应。然而，需要进一步的研究来证实这些早期发现。
社会心理压力可能通过改变个体的行为和免疫反应来增加牙周病的风险。因此，应该考虑压力水平，以提高牙周治疗在孕妇中的疗效。
