Author, year, country | Age in yearsmean ± SD and/or range | Case definitions (PD and PTB/LBW) | Groups (n*) and treatments | Source biomarkers | Outcomeincidence of PTB/ LBW/preeclampsia n (%) and p value inflammatory markers between groups—p value | Main conclusions | Risk of bias assessments |
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Offenbacher et al., 2006, USA | > 18 years old treated 26.8 ± 5.5. untreated 25.7 ± 5.4 p > 0.05. | PD: two or more sites measuring ≥ 5-mm probing depths plus periodontal attachment loss of 1 to 2 mm at one or more sites with PDs ≥ 5 mm.PTB: delivery < 37 weeks. | Treated (n = 40) periodontal scaling and root planing and polishing. Oral health instructions. Untreated (n = 34) supragingival debridement. Periodontal treatment and oral health instructions after delivery. | GCF PGE2, d-8-iso PGF2a, IL-1β, and IL-6 at first and last dental examinations. Serum sICAM-1, sGP-130, IL-6 sr, d-8-iso, PGF2a, and CRP at first obstetric visit and at delivery. | PT:Treated: 9/35 (25, 7%)Untreated: 14/32 (43.8%) p = 0.026 Preeclampsiap Treated: 1/40 (2.5%) Untreated: 2/34 (5.9%) GCF IL-1β—p = 0.01 (lower on treated group) PGE2, [iso] PGE2a, and IL-6—p > 0.05 Serum IL-6 sr—p = 0.03 (lower on treated group) IL-6, sICAM-1, d-8-iso PGE2a, soluble glycoprotein-130 (sGP-130)n, and CRP—p > 0.05. | This pilot study provides further evidence supporting the potential benefits of periodontal treatment on pregnancy outcomes. Treatment was safe, improved periodontal health, and prevented periodontal disease progression. Preliminary data show a 3.8-fold reduction in the rate of preterm delivery, a decrease in periodontal pathogen load, and a decrease in both GCF IL-1β and serum markers of IL-6 response. | Moderate |
Pirie et al., 2013, Ireland | > 18 years old treated: 30.5 ± 4.5. untreated: 30.5 ± 5.5. | PD: PPD ≥ 4 mm at ≥ 4 sites and CAL ≥ 2 mm at ≥ 4 sites. PTB < 37 weeks. LBW < 2500 g. | Treated (n = 49) nonsurgical periodontal therapy. Untreated (n = 50) oral hygiene instruction and supragingival cleaning of all teeth at baseline. | Serum cord IL-1β, IL-6, and IL-8 at delivery. | PTB Treated: 4/49 (8.2%) Untreated: 1/50 (2%) p > 0.05 LBW Treated: 3/49 (6.2%) Untreated: 1/50 (2%) p > 0.05 (IL)-1β, IL-6 and IL-8 between groups p > 0.05. | Intra-pregnancy nonsurgical periodontal treatment, completed at 20 to 24 weeks, did not reduce the risk of preterm, low-birth-weight delivery in this population. | Low |
Khairnar et al., 2015, India | 17 to 35 years old (mean and SD not available). | PD: > 2 mm CAL: at > 50% examined sites. PTB: < 37 weeks. LBW: < 2500 g. | Treated (n = 50) scaling and root planing with 0.2% chlorhexidine rinse once a day. Untreated (n = 50) same treatment after delivery. | Serum CRP at baseline and after delivery. | PTB Treated: 16/50 (32%) Untreated: 36/50 (72%) p < 0.05 LBW Treated: 18/50 (36%) Untreated: 26/50 (52%) p < 0.05 CRP Treated: reduction (p < 0.05) Untreated: no reduction (p > 0.05). | Nonsurgical supportive periodontal therapy can significantly reduce the risk of PTB and LBW deliveries. Nonsurgical supportive periodontal therapy can reduce raised serum CRP levels in pregnant females affected with periodontitis. | High |
Penova-Vaselinovic et al., 2015, Australia | > 16 years old treated 31.9 ± 5.4. untreated31.7 ± 5.0 p = 0.651. | PD: ≥ 3.5 mm PPD at 25% of sites. PTB: < 37 week. | Treated (n = 40) nonsurgical debridement of the sub- and supra-gingival plaque and removal of calculus and overhanging restoration adjustments. Untreated (n = 39) same treatment after delivery. | GCF IL-1β, IL-6, IL-8, IL-10, IL-12p70, IL-17A, MCP-1, and TNF-α at 20 and 28 weeks of gestation. | PTB Treated: 5/40 (12.5%) Untreated: 4/39 (10.3%) p = 0.754 GCF IL-1β, IL-10, IL-12p70, IL-17 and IL-6—p < 0.05 (lower on treated group) MCP-1, IL-8 and TNF-α: p < 0.05 (increased on treated group). | PD treatment in pregnancy reduces the levels of some inflammatory mediators in the GCF and improves dental parameters, with no overt effects on pregnancy outcome. | Moderate |