ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title For Pregnant Women With Periodontitis, Periodontal Therapy Does Not Reduce The Incidence of Pre-eclampsia
Clinical Question Do pregnant women with periodontitis who receive periodontal therapy during gestation have lower risk for pre-eclampsia than pregnant women with periodontitis who do not receive periodontal treatment during gestation?
Clinical Bottom Line Published systematic review of Randomized Controlled Trials report that the risk of pre-eclampsia cannot be lowered if periodontal disease--a bacterial infection which activates a chronic low-grade inflammatory response, is treated.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 21070324Kunnen/2010Pregnant women with periodontal disease (more than 12 sites of pocket probing depth of 4 mm) receiving periodontal therapy. Systematic review of randomized trials
Key resultsIn three Randomized Controlled Trials (RCTs) reviewed, a total of 3650 women with maternal periodontitis during gestation were randomized to a treatment group receiving nonsurgical periodontal therapy during gestation and a control group receiving similar treatment post-partum. Although, periodontal disease and pre-eclampsia were thought to be related, none of the RTCs demonstrated a reduction in pre-eclampsia after a successful periodontal treatment was delivered (overall Risk Ratio of pre-eclampsia for the three RCTs=1.0/ 95% Confidence interval =0.78, 1.28). The statistical heterogeneity was not found to be significant, supported with a p value of 0.198.
Evidence Search “Periodontal Diseases” [MeSH] OR periodont *gingivitis) AND (“Pre-Eclampsia” [MeSH] OR preeclampsia OR eclampsia OR eclamp* OR proteinuria OR “pregnancy induced hypertension” OR gestosis OR EPH “pregnancy toxemia” OR (“ hypertensive disorders of pregnancy”) OR “gestational pregnancy” OR “pregnancy-associated hypertension” OR “[pregnancy hypertension”)
Comments on
The Evidence
Validity: Some subject-related factors such as ethnicity, weight, smoking and diet were not reported in most of these studies. This makes the values obtained to be partially acceptable and requires caution in interpretation of results. Perspective: This systematic/meta-analysis review not only focuses on the prevalence of pre-eclampsia in pregnant women, but also the effect of periodontal treatment during different stages of gestational period to minimize the risk of complications such as preeclampsia.
Applicability This evidence based review shows that pregnant women with periodontal disease receiving periodontal therapy will not exhibit a minimized risk of getting complications such as pre-eclampsia. This information is also pertinent to dental practitioners who seek to reassure their patients that performing surgical/non-surgical periodontal therapy during gestation period will not alleviate pre-eclampsia.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords pre-eclampsia, periodontal disease, pregnancy outcomes, inflammation, pregnancy complications
ID# 3050
Date of submission: 03/19/2016spacer
E-mail deresea@livemail.uthscsa.edu
Author Amsale Derese
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Brian Mealey, DDS, MS
Faculty mentor/Co-author e-mail mealey@uthscsa.edu
Basic Science Rationale
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