Raber-Durlacher J E, van Steenbergen T J, Van der Velden U, de Graaff J, Abraham-Inpijn L
Department of General Pathology and Internal Medicine, Academic Centre for Dentistry Amsterdam, The Netherlands.
J Clin Periodontol. 1994 Sep;21(8):549-58. doi: 10.1111/j.1600-051x.1994.tb01172.x.
The purpose of this study was to assess whether an intensive oral hygiene regimen practised during pregnancy results in a clinically healthy gingival state, and to assess whether experimentally-induced gingivitis differs in severity during pregnancy as compared to post-partum. In addition, levels of black-pigmented Gram negative anaerobes at subgingival and oral mucosal sites and plasma concentrations of free estrogens and prosterone were determined. These parameters were studied during a 14-day episode of experimental gingivitis induced in the 25th week of pregnancy, and again 6 months post-partum. The subjects were selected on shallow pockets < or = 4 mm and interproximal loss of attachment not exceeding 2 mm. As a result of controlled oral hygiene, the gingival condition improved both during pregnancy and post-partum. At day 0 during pregnancy, however, gingival swelling, redness, and bleeding on probing were found to be higher than post-partum. Free plasma levels of estrogens and progesterone were found to be normal throughout the study. It was hypothesized that the increase in severity of gingival symptoms during pregnancy reflect microvascular physiologic effects of increased levels of these hormones. During pregnancy, more swelling, redness and bleeding on probing developed during experimental gingivitis than post-partum, whereas the amount of plaque was similar in both phases. This suggests that as a result of dental plaque accumulation, gingival inflammation develops superimposed on pregnancy-associated physiologic alterations. Microbiological evaluation showed that the mean proportions of Prevotella intermedia in subgingival plaque increased during experimental gingivitis performed during pregnancy, whereas no increase of this micro-organism was found post-partum.
本研究的目的是评估孕期实施强化口腔卫生措施是否能带来临床健康的牙龈状态，以及评估实验性诱发的牙龈炎在孕期与产后的严重程度是否存在差异。此外，还测定了龈下和口腔黏膜部位黑色色素革兰氏阴性厌氧菌的水平以及游离雌激素和孕酮的血浆浓度。在孕期第25周诱发的为期14天的实验性牙龈炎期间以及产后6个月再次对这些参数进行了研究。研究对象选择为牙周袋浅（≤4mm）且邻面附着丧失不超过2mm者。由于进行了口腔卫生控制，孕期和产后牙龈状况均有所改善。然而，在孕期第0天时，发现牙龈肿胀、发红及探诊出血情况比产后更为严重。在整个研究过程中，血浆中游离雌激素和孕酮水平均正常。据推测，孕期牙龈症状严重程度增加反映了这些激素水平升高对微血管的生理影响。在孕期，实验性牙龈炎期间出现的牙龈肿胀、发红及探诊出血情况比产后更多，而两个阶段的菌斑量相似。这表明由于牙菌斑堆积，牙龈炎症在与妊娠相关的生理改变基础上叠加发生。微生物学评估显示，在孕期进行实验性牙龈炎期间，龈下菌斑中中间普氏菌的平均比例增加，而产后未发现该微生物增加。
