Clínica Odontológica Universitaria Hospital General Universitario Morales Meseguer. 2ª planta Avenida Marqués de los Vélez, s/n. 30008, Murcia
Med Oral Patol Oral Cir Bucal. 2024 Nov 1;29(6):e857-e865. doi: 10.4317/medoral.26830.
Periodontal disease (PD) is a chronic inflammatory disease of multifactorial origin that affects the supporting tissues of the tooth. According to WHO in 2022, it affects around 19% of the adult population worldwide. Its risk factors include the presence of periodontopathogenic bacteria in biofilm and the susceptibility of the host's immune system, among others. Preterm birth is defined as birth occurring before 37 weeks of gestational age. It also has a multifactorial origin and it's associated with risk factors such as intrauterine and extrauterine infections. There is a possibility that periodontal disease in pregnant women increases the risk of preterm birth through hematogenous pathways or the presence and intervention of inflammatory mediators.
Through a systematic review of existing scientific articles from 2014 to 2024, five randomized clinical trials were selected, including a total of 1984 pregnant patients diagnosed with periodontal disease. Half of these patients received non-surgical treatment, while the other half did not, aiming to evaluate a possible association between periodontal disease and/or its treatment and the occurrence of preterm birth. The risk of bias was assessed using the Cochrane "RoB 2" tool, and finally, a meta-analysis was conducted to compare the results obtained in the selected studies.
Four articles showed a trend favoring non-surgical periodontal treatment as a preventive measure for preterm birth. These articles accounted for 92.2% of the total weight, while the remaining 7.85% corresponded to the single article that did not favor the treatment. However, none of the articles showed statistically significant results.
There is no demonstrated association between periodontal disease in pregnant women and the incidence of preterm birth. On the other hand, there is a slightly favorable trend towards non-surgical periodontal treatment during pregnancy as a measure to reduce the incidence of preterm birth, but it's not statistically significant. To obtain a definitive answer, more randomized clinical trials following similar study and design parameters are needed.
牙周病（PD）是一种多因素起源的慢性炎症性疾病，影响牙齿的支持组织。根据 2022 年世界卫生组织的数据，全球约有 19%的成年人受其影响。其危险因素包括生物膜中牙周病病原体的存在和宿主免疫系统的易感性等。早产是指在妊娠 37 周前发生的分娩。它也有多种起源，与宫内和宫外感染等危险因素有关。有研究表明，孕妇的牙周病可能通过血源性途径或炎症介质的存在和干预增加早产的风险。
通过对 2014 年至 2024 年现有科学文献的系统回顾，选择了五项随机临床试验，共纳入 1984 名被诊断为牙周病的孕妇。这些患者的一半接受了非手术治疗，另一半则未接受治疗，旨在评估牙周病及其治疗与早产发生之间可能存在的关联。使用 Cochrane“RoB 2”工具评估偏倚风险，最后对选定研究的结果进行荟萃分析。
四项研究表明，非手术牙周治疗作为预防早产的措施有一定的趋势。这些文章占总权重的 92.2%，而其余 7.85%则对应于一篇不支持治疗的文章。然而，没有一篇文章显示出统计学上的显著结果。
孕妇牙周病与早产发生率之间没有明显的关联。另一方面，在怀孕期间进行非手术牙周治疗作为降低早产发生率的措施有轻微的有利趋势，但没有统计学意义。为了得出明确的结论，需要更多遵循类似研究和设计参数的随机临床试验。
