Effect of intra-pregnancy nonsurgical periodontal therapy on inflammatory biomarkers and adverse pregnancy outcomes: a systematic review with meta-analysis

被引:34
作者
Cardoso da Silva, Helbert Eustaquio [1 ,6 ]
Stefani, Cristine Miron [2 ]
Melo, Nilce de Santos [2 ]
de Lima, Adriano de Almeida [2 ]
Rosing, Cassiano Kuchenbecker [3 ]
Porporatti, Andre Luis [4 ]
Canto, Graziela De Luca [5 ]
机构
[1] Fdn Teaching & Res Hlth Sci, Postgrad Program, Brasilia, DF, Brazil
[2] Brasilia Univ, Fac Hlth Sci, Dent Dept, Brasilia, DF, Brazil
[3] Univ Fed Rio Grande do Sul, Dept Conservat Dent, Fac Dent, Porto Alegre, RS, Brazil
[4] Univ Fed Santa Catarina, Brazilian Ctr Evidence Based Res, Dept Dent, Florianopolis, SC, Brazil
[5] Univ Alberta, Sch Dent, Fac Med & Dent, Edmonton, AB, Canada
[6] Condominio Mansoes Entrelagos, Etapa 1,Conjunto S,Casa 9, BR-73255900 Brasilia, DF, Brazil
关键词
Nonsurgical periodontal therapy; Pregnancy; Women's health; Cytokine(s); Systematic review; Meta-analysis; LOW-BIRTH-WEIGHT; C-REACTIVE PROTEIN; PRETERM BIRTH; CYTOKINE LEVELS; DISEASE; ASSOCIATION; RISK; SERUM; DEFINITIONS; PARAMETERS;
D O I
10.1186/s13643-017-0587-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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
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页数:12
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