All ETDs from UAB

Advisory Committee Chair

Nicolaas Geurs

Advisory Committee Members

Amjad Javed

Mia L Geisinger

Michael S Reddy

Philip J Vassilopoulos

Document Type

Thesis

Date of Award

2013

Degree Name by School

Master of Science in Dentistry (MScD) School of Dentistry

Abstract

Background: Recent evidence suggests that systemic inflammation as host immune response to oral microbial challenge may well underlie the observed association between periodontal disease and preterm birth/low birth weight (PTB/LBW). The aim of this pilot study was to evaluate the effect of vigorous oral hygiene regimen on gingival inflammation and gingival crevicular fluid (GCF)/serum biomarkers (TNF-&alpha, IL-1&beta and IL-6) during pregnancy and its impact on pregnancy outcome. Methods: 120 participants with pregnancy between 16-24 weeks gestation and with gingival index (GI) scores &ge 2 at &ge 50 % of tooth sites were recruited from the available pool of patients at the Center for Women's Reproductive Health (CWRH) at University of Alabama at Birmingham (UAB). At baseline (visit 1) and 8 weeks (visit 3) subjects were examined and their levels of plaque index (PI), probing depth (PD), clinical attachment level (CAL), gingival index (GI), periodontal epithelial surface area (PESA) and periodontal inflamed surface area (PISA) were recorded and GCF and blood collected. Dental prophylaxis was performed at baseline. Intensive oral hygiene instructions were provided at baseline, 4, and 8-week visits. Mean change in clinical variable, GCF and serum cytokine level at visit 1 and visit 3, calculated using paired t-test. GCF samples were assayed using luminex multiplex system and serum samples using ELISA. Results: Participants who completed all study visits (n=90), demonstrated decrease in whole mouth scores of all the periodontal variables between visit 1 and 3 with difference in means for PD (0.34±0.47), PI (0.71±0.50), GI (0.73±0.39), CAL (0.21±0.57), PISA (550.50±533.80) and PESA (228.90±317.40) at p <0.0001. Statistically significant decrease in the level of GCF TNF-&alpha and IL-1&beta was observed at visit 3. The rate of occurrence of PTB in this pilot study (6.7%) was lower when compared to the historic controls with PTB rate of (9.5%). Conclusion: Intensive and systematic oral hygiene instructions and counseling during pregnancy showed clinically and statistically significant reduction in gingival inflammation, although it had a variable impact on GCF and serum biomarkers. There was decrease in PTB rate as compared to historic controls. Large scale randomized studies will be needed to substantiate these findings.

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