Tratamiento de la enfermedad periodontal y riesgo de parto prematuro

Revista del Hospital Materno Infantil Ramón Sardá 01/2007;
Source: DOAJ

ABSTRACT Algunos autores han establecido una asociación entre la enfermedad periodontal materna y un mayor riesgo de parto prematuro y de bajo peso al nacer. Estudiamos el efecto del tratamiento periodontal no quirúrgico sobre la tasa de partos prematuros. Métodos: Se realizó una asignación aleatoria de mujeres con embarazos de entre 13 y 17 semanas de gestación a las que se les realizaría raspado y alisado radicular, ya fuera antes de las 21 semanas (413 pacientes del grupo de tratamiento) o después del parto (410 pacientes del grupo de control). Las pacientes del grupo de control también recibieron un pulido dental e instrucción sobre higiene dental. La variable de interés principal fue la edad gestacional al final del embarazo. Las variables secundarias fueron el peso al nacer y la proporción de casos de bajo peso para la edad gestacional. Resultados: En el análisis de seguimiento, se registraron 49 partos prematuros (antes de las 37 semanas de gestación) entre 407 pacientes (12%) dentro del grupo de tratamiento (44 nacimientos con vida), y 52 partos prematuros (12,8%) entre 405 pacientes del grupo de control (38 nacimientos con vida). Si bien el tratamiento periodontal mejoró los resultados de la periodontitis (P <0,001), no afectó significativamente el riesgo de parto prematuro (P= 0,70; razón de riesgo para el grupo de tratamiento vs. grupo de control: 0,93; intervalo de confianza [IC 95%, 0,63 a 1,37). No se registraron diferencias significativas entre los grupos de tratamiento y de control respecto del peso al nacer (3.239 g y 3.258 g, P= 0,64) o de la cantidad de neonatos con bajo peso para la edad gestacional (12,7% y 12,3%; odds ratio: 1,04; IC 95%, 0,68 a 1,58). Hubo 5 abortos espontáneos o muertes fetales en el grupo de tratamiento, y 14 en el grupo de control (P= 0,08). Conclusiones: El tratamiento de la periodontitis en las mujeres embarazadas mejora el estado de la enfermedad periodontal y resulta seguro, pero no altera significativamente las tasas de parto prematuro, bajo peso al nacer o restricción del crecimiento intrauterino (, NCT00066131).

Download full-text


Available from: Anthony J Diangelis, Dec 11, 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Analysis of Egyptian hieroglyphics and medical papyri indicate that non-surgical periodontal treatment was common 3000-4000 years ago. Even today, scaling and root planing (SRP) remains an essential part of successful periodontal therapy. The collective evidence from numerous clinical trials reveals a consistency of clinical response in the treatment of chronic periodontitis by SRP using manual, sonic, or ultrasonic instrumentation. Thus, SRP remains the 'gold standard' to which more recently developed therapeutic modalities must be compared. Inherent to the clinical evaluation of SRP are such concerns as manual versus sonic and ultrasonic instrumentation, control of sub-gingival bacterial populations, removal of calculus, root smoothness and changes in various clinical parameters, e.g. probing depth, attachment levels, bleeding on probing and gingival inflammation. Lastly, an abbreviated discussion is presented on a relatively new paradigm of complete mouth 'disinfection' in a compressed time-frame that includes SRP as a significant component of the treatment regimen.
    Journal Of Clinical Periodontology 06/2002; 29 Suppl 2(Suppl. 2):6-16. DOI:10.1034/j.1600-051X.29.s2.4.x · 3.61 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In this paper, for right censored competing risks data, a class of tests developed for comparing the cumulative incidence of a particular type of failure among different groups. The tests are based on comparing weighted averages of the hazards of the subdistribution for the failure type of interest. Asymptotic results are derived by expressing the statistics in terms of counting processes and using martingale central limit theory. It is proposed that weight functions very similar to those for the $G^p$ tests from ordinary survival analysis be used. Simulation results indicate that the asymptotic distributions provide adequate approximations in moderate sized samples.
    The Annals of Statistics 09/1988; 16(3). DOI:10.1214/aos/1176350951 · 2.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study described the 5-year incidence of periodontal attachment loss (ALOSS) among older Australians. Clinical examination data were obtained at baseline and 5 years from participants in a cohort study of South Australians aged 60+. Periodontal measurements (gingival recession, GR; probing depth, PD) were made for each tooth at 3 sites. An incident case of ALOSS was identified as an individual having 2+ sites with 3+ mm ALOSS. Some 342 (42.7%) of the 801 individuals examined at baseline were re-examined after 5 years, contributing longitudinal data from a total of 15,522 sites (6102 in the maxilla and 9420 in the mandible). Most sites showed no change in either GR or PD. Using a threshold of 3+ mm for change, ALOSS occurred at 2.3% of mesiobuccal sites, 2.5% of buccal sites, and 3.4% of distolingual sites. Distolingual sites on molars showed the highest progression rates. The major component of ALOSS was increased GR. Overall, only 10.1% of the observed ALOSS was contributed by increases in PD. Nearly two-thirds of the sites that experienced ALOSS had <3 mm of ALOSS at baseline. The weighted 5-year incidence estimate for ALOSS was 43.2% (N=145), and was higher among diabetics or those who had lost 1+ teeth since baseline. Smoking was not a significant predictor. The rates and patterns of ALOSS among older South Australians are largely similar to those recently reported for North Carolinians. Most ALOSS in older people manifests as increases in GR, rather than PD. Diabetics should be targeted for intensive primary and secondary prevention of periodontal disease.
    Journal Of Clinical Periodontology 02/2004; 31(2):119-25. DOI:10.1111/j.0303-6979.2004.00460.x · 3.61 Impact Factor
Show more