Subgingival biofilm microbiome in individuals with asthma and periodontitis: Metagenomic analysis.

OBJECTIVE: This observational study aimed to explore the metagenomics of subgingival biofilms in individuals with varying degrees of asthma, from severe to none, to elucidate the association between the subgingival microbiome and asthma. MATERIALS AND METHODS: Subgingival biofilm samples were collected from thirty participants at the Asthma Control Program Outpatient Clinic in Bahia (ProAR). These samples were categorized into six groups based on the severity of asthma and the presence or absence of periodontitis. We employed next-generation sequencing (Illumina MiSeq), targeting the 16S rRNA gene, to characterize the microbial communities present. Our analysis included descriptive statistics and sequencing data, evaluated using multivariate statistical methods such as the Shannon index, principal coordinate analysis, and the Bray-Curtis dissimilarity. RESULTS: Our findings indicate a higher prevalence of periodontally detrimental bacterial genera in individuals with severe asthma and periodontitis. Additionally, individuals with asthma, but without periodontitis, exhibited a tendency toward dysbiosis, particularly in cases of severe asthma. CONCLUSION: This research provides new insights into the composition of the subgingival microbiome in individuals with varying severities of asthma and periodontitis. The genera identified in this study underscore the need for further investigations to build upon these findings.

Single nucleotide variants in the IL33 and IL1RL1 (ST2) genes are associated with periodontitis and with Aggregatibacter actinomycetemcomitans in the dental plaque biofilm: A putative role in understanding the host immune response in periodontitis.

The Interleukin (IL)-33 is important in several inflammatory diseases and its cellular receptor is the Interleukin 1 receptor-like 1 (IL1RL1), also called suppression of tumorigenicity 2 ligand (ST2L). This study investigated associations between single nucleotide variants (SNVs) in the IL33 gene and in the IL1RL1 (ST2) gene with periodontitis. Additionally, aimed to determine the role of Aggregatibacter actinomycetemcomitans (Aa) relative amount in the subgingival biofilm in these associations. A cross-sectional study was carried out with 506 individuals that answered a structured questionnaire used to collect their health status, socioeconomic-demographic, and behavioral characteristics. Periodontal examination was performed to determine the presence and severity of periodontitis, and subgingival biofilm samples were collected to quantify the relative amount of Aa by real time polymerase chain reaction. Human genomic DNA was extracted from whole blood cells and SNV genotyping was performed. Logistic regression estimated the association measurements, odds ratio (OR), and 95% confidence interval (95%CI), between the IL33 and ST2 genes with periodontitis, and subgroup analyses assessed the relative amount of Aa in these associations. 23% of individuals had periodontitis. Adjusted measurements showed a statistically significant inverse association between two SNVs of the ST2; rs148548829 (C allele) and rs10206753 (G allele). These two alleles together with a third SNV, the rs11693204 (A allele), were inversely associated with moderate periodontitis. One SNV of the IL33 gene also showed a statistically significant inverse association with moderate periodontitis. Nine SNVs of the ST2 gene were inversely associated with the relative amount of Aa. In the high Aa subgroup, there was a direct association between 11 SNVs of the ST2 gene and moderate periodontitis and two SNVs of the ST2 gene and severe periodontitis, and eight SNVs of the ST2 gene and periodontitis. These exploratory findings of genetic variants in IL-33/ST2 axis support the concept that the different tissue responses among individuals with periodontitis may be modulated by the host's genetics, influencing the physiopathology of the disease.

Periodontitis and its higher levels of severity are associated with the triglyceride/high density lipoprotein cholesterol ratio.

BACKGROUND: Periodontitis and the Triglyceride/High Density Lipoprotein Cholesterol (TG/HDL-C) ratio have both been associated with cardiovascular disease, metabolic syndrome, and obesity. Additionally, the ratio is a possible substitute for predicting insulin resistance. This study investigated the association between periodontitis, its severity levels (exposures), and the TG/HDL-C ratio (outcome). METHODS: A cross-sectional study of public health service users in Brazil considered socioeconomic-demographic characteristics, lifestyle behavior, and general and oral health conditions. Anthropometric measurements and blood pressure were also measured. Systemic biomarker data were obtained, as well as assessment of periodontal diagnosis and its severity. The TG/HDL-C ratio was calculated using the serum triglyceride level over HDL cholesterol and the cut-off point, TG/HDL-C ≥2.3 serving as the cutoff indicting dyslipidemia. Logistic and linear regressions were used to statistically analyze the data. RESULTS: A total of 1011 participants were included, with 84.17% having periodontitis and 49.85% having a TG/HDL-C ratio ≥2.3. For individuals with periodontitis, the odds of TG/HDL-C ratio ≥2.3 were 1.47 times greater than in those without periodontitis (ORAdjusted  = 1.47, 95% CI: 1.02-2.14). Similar results were found for those with moderate and severe periodontitis, with a slight increase in the measurement magnitude with disease severity. CONCLUSION: A positive relationship between periodontitis and the TG/HDL-C ratio ≥2.3 was found, suggesting a possible association with periodontal disease severity.

Prevalence of overweight and obesity and associated factors among women of childbearing age in Brazil.

OBJECTIVE: To assess the factors associated with overweight and obesity among women of childbearing age in Brazil. DESIGN: Cross-sectional study. SETTING: Using the National Health Survey (PNS) database, from the year 2013. The socio-economic and demographic factors analysed were age, race/skin colour, region, marital status, education level, employment and family income. Concerning health history, diagnoses of hypertension, diabetes mellitus, high cholesterol, heart attack, stroke, chronic kidney disease, menarche, parity and depression were evaluated. For lifestyle information, health status, alcoholic beverage consumption, smoking and physical activity were included. The outcomes were obesity and overweight. The association of excess weight with socio-economic and demographic factors, health history and lifestyle characteristics was investigated according to the appropriate theoretical-conceptual model for the topic. PARTICIPANTS: The sample size was 17 109 women aged 18-49 years. RESULTS: The prevalence of women with excess weight was 55·20 %, with 33·26 % being overweight and 21·94 % with obesity. The factors associated with excess weight were age, non-white skin colour, having a partner, family income of up to two minimum wages, menarche before the age of 12, multiparity, diabetes mellitus, depression, hypertension, high cholesterol, stroke and heart attack. CONCLUSION: The results showed an association between excess weight and socio-demographic factors, both determinants of general and reproductive health history. Implementation of effective public health policies is necessary to prevent unfavourable outcomes related to the health of women of childbearing age with excess weight.

Severe and moderate periodontitis are associated with acute myocardial infarction.

BACKGROUND: An association between periodontitis and cardiovascular disease is now well documented; however, the effect of periodontitis severity levels on this outcome, specifically on acute myocardial infarction (AMI), remains unexplored. This study investigated the association between levels of periodontitis severity (exposure) and AMI (outcome). METHODS: This case-control study, matched by sex and age, was conducted with 621 participants, with 207 individuals treated in the emergency department of Santa Izabel and Ana Nery Hospitals in Salvador, Bahia, Brazil, diagnosed with a first AMI event, and compared to 414 individuals without a diagnosis of AMI. Levels of periodontitis severity followed two criteria: (1) Center for Disease Prevention and Control and American Academy of Periodontology; (2) Gomes-Filho et al. (2018) using criteria that also evaluated bleeding upon probing. Conditional logistic regression analysis was performed and odds ratios (ORs) and their 95% confidence intervals (CIs) were obtained. RESULTS: The adjusted association measurements showed a positive association between both severe (ORadjusted ranged from 2.21 to 3.92; 95% CI ranged from 1.03 to 10.05) and moderate periodontitis (ORadjusted ranged from 1.96 to 2.51; 95% CI ranged from 1.02 to 6.19), and AMI, for both periodontitis diagnostic criteria. It demonstrated that among those with moderate and severe periodontitis, the chance of having AMI was approximately two to four times greater than among those without periodontitis. CONCLUSION: The findings demonstrate that there is an association between the severity of the periodontal condition and AMI, suggesting a possible relationship among the levels of periodontitis severity and the cardiovascular condition.

Obesity and periodontitis are not associated in pregnant women.

OBJECTIVE: The objective of this study was to investigate an association between obesity (exposure) and periodontitis (outcome) in pregnant women. BACKGROUND: This association was investigated and only five studies were identified as showing a positive association. However, some of these studies had limitations such as reduced sample sizes, inadequate exposure criteria and outcome measures, which question the internal validity of these investigations. METHODS: A cross-sectional study was carried out with a sample of 644 pregnant women of the public health service of the municipality of Santo Antônio de Jesus, Bahia, Brazil. Data were obtained by collecting of socioeconomic-demographic information, health behavior, health conditions, and reproductive history through an interview. Obesity was evaluated using body mass index adjusted for gestational age and expected weight gain. The diagnosis of periodontitis followed two criteria: (a) Center for Disease Prevention and Control and American Academy of Periodontology (CDC/AAP); (b) Gomes-Filho et al (2018) using criterion that also evaluated bleeding upon probing; Prevalence ratios and respective 95% confidence intervals were obtained by Poisson regression analysis. RESULTS: In accordance with the outcome diagnostic criterion, the frequency of periodontitis was 17.24% (Gomes-Filho et al) and 66.92% (CDC/AAP). The participants were classified as low weight (19.72%), adequate weight (42.39%), overweight (24.84%), and obesity (13.04%), based on the exposure diagnostic criterion. The low weight and overweight groups were excluded from the data analysis, giving a final sample of 357 pregnant women. The association between obesity in pregnant women and periodontitis was not statistically significant, after adjusting for confounders such as age, schooling level, alcoholic beverage consumption, alimentary and nutritional orientation, urinary infection, and dental flossing. CONCLUSIONS: The findings showed a high frequency of periodontitis, obesity, and overweight in the studied population but no association between obesity and periodontitis in pregnant women was found.

Prevotella intermedia and periodontitis are associated with severe asthma.

BACKGROUND: Periodontitis, an inflammatory disease of multibacterial etiology that affects the protective and supporting tissues surrounding teeth, can influence the course of respiratory diseases, such as asthma, due to epithelial alterations arising from inflammatory and immunological processes, bronchial remodeling, or by the aspiration of pathogenic colonizers found in periodontal pockets. This study evaluated the levels of periodontal pathogens Prevotella intermedia, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans in the subgingival biofilm of individuals with and without severe asthma. METHODS: A case-control study enrolling 457 individuals (220 with asthma and 237 without asthma) was conducted at the Program for Control of Asthma in Bahia (ProAR) Clinic located in Salvador, Bahia, Brazil. A structured questionnaire was used to obtain data on sociodemographic, health status, and lifestyle habits. A clinical periodontal assessment was performed, including bleeding on probing, probing depth, and clinical attachment level. Subgingival biofilm was collected at the deepest site of each sextant, and bacterial DNA was extracted. Quantitative real-time PCR analysis was performed to detect and relatively quantify periodontopathogens in the biofilm. RESULTS: Statistically significant positive associations were found between periodontitis and severe asthma, (odds ratio [OR]adjusted] : 4.00; 95% confidence interval [CI]: 2.26 to 7.10). High levels of P. intermedia were found in association with the presence of severe asthma (ORadjusted : 2.64; 95% CI: 1.62 to 4.39; P < 0.01). CONCLUSIONS: The present results suggest that periodontitis and P. intermedia are associated with severe asthma. However, the functional consequences of this dysbiosis upon asthma susceptibility and its phenotypes remain unclear.

Common mental disorder is associated with periodontitis.

OBJECTIVES: This research evaluated the association between exposure to common mental disorder (CMD) and the presence of periodontitis. BACKGROUND: Common mental disorder is characterized by the presence of irritation, fatigue, insomnia, forgetfulness, decreased ability to concentrate, anxiety, and depression. It has been associated with several diseases; however, there are few studies that have associated it with periodontitis. METHODS: This cross-sectional study was carried out with 621 individuals. Data collection involved the application of a general questionnaire and the self-reporting questionnaire for diagnosis of CMD. The diagnosis of periodontitis involved a full mouth periodontal examination using: clinical attachment level, probing depth, and bleeding on probing. Prevalence ratios and 95% confidence intervals between CMD (exposure) and periodontitis (outcome) were obtained. RESULTS: In the final sample, 38.16% (237) of the individuals were classified with CMD. Among these, 28.27% (67) had periodontitis. Association measurements showed that the occurrence of periodontitis among those exposed to CMD is approximately 50% higher than in those without this mental condition, with statistical significance, after adjustment for age, sex, family income, current smoking habit, alcohol beverage consumption, and cardiovascular disease (PRadjusted  = 1.54, 95% CI: [1.13 to 2.10]). CONCLUSIONS: The findings showed a positive association between exposure to CMD and periodontitis, revealing the importance of broadening public actions targeting mental health, which seems to be related to oral health, mainly due to the high frequency of the diseases in the studied sample.

Relationship between periodontal outcomes and serum biomarkers changes after non-surgical periodontal therapy.

The systemic effect of chronic periodontitis (CP) has been suggested by several studies as an etiologic factor and modulator of diseases based on the changes in the inflammatory marker levels. This study aimed to investigate the relationship between the changes in clinical periodontal outcomes and serum biomarkers (CRP, IL-6, albumin and percentage of leukocytes) after non-surgical periodontal therapy in systemically healthy adults. An interventional study was conducted with a sample of 29 individuals without CP (control group) and 33 with CP (CP group). Periodontal clinical variables were recorded, and the serum levels of inflammatory markers were measured. Statistical analysis included the chi-square and Student's t-tests and Pearson's correlation analysis. After 90 days of non-surgical periodontal treatment, a reduction of periodontal parameters and IL-6 in both groups could be observed (P < 0.001). The correlation analysis revealed a directly proportional correlation between changes in the probing depth (r = 0.349, P = 0.049) and clinical attachment level (r = 0.374, P = 0.034) with CRP in the CP group. The findings suggest a reduction of IL-6 serum concentration and periodontal clinical measures 90 days after periodontal therapy in both groups.

Apoptosis Transcriptional Profile Induced by Porphyromonas gingivalis HmuY.

This study aimed at evaluating the transcriptional profile of apoptosis-related genes after in vitro stimulation of peripheral blood mononuclear cells (PBMCs) derived from individuals with periodontitis (P) and healthy nonperiodontitis (NP) control subjects with P. gingivalis HmuY protein. PBMCs from the P and NP groups were stimulated with HmuY P. gingivalis protein, and the expression of genes related to apoptosis was assessed by custom real-time polymerase chain reaction array (Custom RT2 PCR Array). Compared with the NP group, the P group showed low relative levels of apoptosis-related gene expression, downregulated for FAS, FAS ligand, TNFSF10 (TRAIL), BAK1, CASP9, and APAF1 after P. gingivalis HmuY protein stimulation. Furthermore, the P group exhibited low levels of relative gene expression, downregulated for CASP7 when the cells were not stimulated. Our data suggest that P. gingivalis HmuY protein might participate differently in the modulation of the intrinsic and extrinsic apoptosis pathways.

Production of interferon-gamma, interleukin-6, and interleukin-1ß by human peripheral blood mononuclear cells stimulated with novel lys-gingipain synthetic peptides.

BACKGROUND: Periodontitis is a progressive inflammatory process, and its pathogenesis is related to the presence of a dysbiotic subgingival biofilm that elicits the immune response. Porphyromonas gingivalis is a keystone pathogen, and its Lys-gingipain (Kgp) virulence factor is involved in the pathogen-host interaction through the production of cytokines by host cells, but the specific mechanisms of this interaction have not been elucidated. The present study evaluated the in vitro production of interferon-gamma (IFN-γ), interleukin (IL)-6, and IL-1ß cytokines in response to antigenic stimulation of peripheral blood mononuclear cells (PBMCs) with novel Kgp synthetic peptides. METHODS: Our previous in silico study predicted 16 immunogenic peptides from Kgp protein. Nine peptides derived from different regions of the protein were chemically synthesized. The synthetic peptides Kgp12, 17, and 18 were selected based on the immunoglobulin G immunoreactivity in the serum of patients with periodontitis (P) and individuals without periodontitis (WP), and they were used in in vitro stimulation of PBMC derived from groups P and WP. Enzyme-linked immunosorbent assay and microsphere-based flow cytometric assay were used to verify the levels of the cytokines produced in PBMC cultures after 48 hours. RESULTS: Kgp12, 17, and 18 peptides induced lower production of IFN-γ. Kgp12 induced higher levels of IFN-γ in WP than in P individuals. Kgp12 induced higher production of IL-6 and IL-1ß compared with the other stimuli. CONCLUSION: The novel Kgp synthetic peptides tested herein are immunogenic peptides (epitopes) since they induced the production of cytokines by PBMC and therefore may be useful tools in evaluating the pathogen-host interaction.

Maternal Anemia and Low Birth Weight: A Systematic Review and Meta-Analysis.

OBJECTIVE: To systematically analyze the relationship between maternal anemia and low birth weight. METHODS: A search of studies was conducted in the main databases (Medline, Embase, Scopus, Web of Science, SciELO, and Lilacs), the gray literature, and the reference lists of selected articles. Cohort and case-control studies that met the eligibility criteria were included in the review. There was no limitation on the language or date of publication. Article selection and data extraction were performed by two independent reviewers. Meta-analyses with random effects, subgroup analyses and meta-regressions were performed. Publication bias was measured using Egger regression and visual funnel plot inspection. RESULTS: A total of 7243 articles were found, of which 71 comprised the systematic review and 68 were included in the meta-analyses. Maternal anemia was associated with low birth weight with an adjusted OR: 1.23 (95% CI: 1.06⁻1.43) and I²: 58%. The meta-regressions confirmed that the sample size and the methodological quality may partially explain the statistical heterogeneity. CONCLUSIONS: Maternal anemia was considered a risk factor for low birth weight.

Relationship Among Mothers' Glycemic Level, Periodontitis, and Birth Weight.

BACKGROUND: The aim of this study is to determine the influence of glycemic level on the relationship between periodontitis and low birth weight (LBW). METHODS: A case-control study was conducted with 372 females divided into cases (109 mothers of newborns with birth weight < 2,500 g) and controls (263 mothers of newborns with birth weight ≥ 2,500 g). The birth weight of children was obtained from medical records, whereas information on sociodemographic, lifestyle, and health characteristics of the participants was obtained through an interview. Glycated hemoglobin (HbA1c) levels were measured, and probing depth, clinical attachment levels, and bleeding on probing were used to determine the periodontal status. Results were analyzed using logistic regression. RESULTS: The likelihood of having children with LBW among the mothers with periodontitis was six times greater than that observed among mothers without periodontitis (adjusted odds ratio [OR adjusted] = 6.02, 95% confidence interval [CI] = 2.47 to 15.17), even after adjustment. There was also a strong, statistically significant relationship between periodontitis and LBW in both the normal glycemic-level group (HbA1c levels < 5.6%, unadjusted odds ratio [OR unadjusted] = 8.30, 95% CI = 3.56 to 19.35) and the high glycemic-level group (HbA1c levels ≥ 5.6% and < 6.5%, OR unadjusted = 5.73, 95% CI = 1.75 to 18.70). After adjustment for confounders, the magnitude of the association continued to be strong in the normal glycemic-level group (OR adjusted = 7.59, 95% CI = 2.7 to 24.28), an increase of 25% when compared to the main association measurement. In those with high glycemic levels (OR adjusted = 4.03, 95% CI = 0.81 to 19.96), the OR decreased almost 50%, and the association lost statistical significance. CONCLUSION: Periodontitis and glycemic levels appeared to have opposing influences on birth weight, with periodontitis being associated with LBW and the magnitude of the association being altered depending on maternal blood glucose level.

Periodontal status and serum biomarkers levels in haemodialysis patients.

AIM: To investigate the association between periodontal status and serum biomarkers levels in haemodialysis patients. METHODS: This cross-sectional study included 96 haemodialysis patients. The periodontal evaluation was realized using clinical attachment level (CAL), probing depth (PD), gingival bleeding index (GBI), visible plaque index (VPI) and gingival index (GI). Biochemical and haematological data - serum albumin, phosphorus, creatinine, transferrin, ferritin, iron, alkaline phosphatase, calcium, potassium and haemoglobin - were collected from the medical records. The subject was diagnosed with periodontitis if he/she had at least two inter-proximal sites in different teeth with CAL ≥4 mm and/or at least two inter-proximal sites in separate teeth with PD ≥5 mm. RESULTS: The study population consisted of 45 men and 51 women, with mean time under haemodialysis of 45.6 ± 33.1 months. Periodontitis was observed in 59.4% of the subjects. The periodontitis group had albumin (p = 0.021) and phosphorus (p = 0.024) serum levels lower than the no periodontitis group. Thus, there was a positive association of periodontitis with hypoalbuminaemia (OR = 9.10, p = 0.006) and a negative association with hyperphosphataemia (OR = 0.21, p = 0.010). CONCLUSIONS: These findings suggest that periodontitis is associated with albumin and phosphorus serum levels in haemodialysis patients.

Effect of osteoporosis on periodontal therapy among post-menopausal women.

OBJECTIVE: This intervention study aimed to investigate the effect of osteoporosis on periodontal condition among 48 post-menopausal women undergoing periodontal therapy. MATERIAL AND METHODS: The experimental group, which underwent non-surgical periodontal therapy, was composed of 16 women with periodontitis to be treated, and the control group was formed by 32 women without periodontitis. Oral condition was assessed on three occasions: at the start of the treatment (first examination), 1 month (first re-examination) and 4 months after the end of the therapy (second re-examination). In the second re-examination, recurrence of periodontal disease was evaluated by comparing the clinical measurements obtained pre- and post-treatment. The diagnosis of osteoporosis was made by investigating densitometry reports obtained previously. Descriptive analysis, analysis of variance and the Bonferroni post hoc test were applied to the data gathered, with statistical significance level of 5%. RESULTS: The frequency of periodontitis was 50% in the treated group and 25% in the group without periodontitis. In both groups, this recurrence was greater in subjects with osteoporosis (37.5 and 18.75%, respectively) than in the individuals without osteoporosis (12.5 and 6.25%, respectively). CONCLUSIONS: The preliminary results indicate that osteoporosis possibly has an influence on periodontal condition among individuals undergoing non-surgical periodontal treatment.

Porphyromonas gingivalis antigens differently participate in the proliferation and cell death of human PBMC.

OBJECTIVE: Modulation of cell-mediated immunity by microorganisms in periodontal diseases has been widely studied; however, the proliferative activity and/or programmed death of mononuclear cells under periodontopathogenic stimuli are not yet well understood. The aim of this study was to investigate in vitro proliferation and death of peripheral blood mononuclear cells (PBMC) upon stimulation with Porphyromonas gingivalis (Pg) antigens. DESIGN: In 19 patients with chronic periodontitis (CP) and 16 controls without periodontitis (NP) the following clinical parameters were evaluated: bleeding on probing, probing depth, and clinical attachment level. PBMC were cultured under Pg stimuli and apoptosis/necrosis and proliferation assays were carried out for 18 and 48 h, respectively. Fluorescence of labelled cells was determined using flow cytometry. RESULTS: PBMC of CP and NP subjects exhibited a lower proliferative response to Pg LPS (p<0.05) and HmuY protein (p<0.001) compared with non-stimulated cells. Early apoptosis was induced by Pg LPS (p<0.01) and Pg extract (p<0.05), whilst all antigens induced late apoptosis (Pg LPS: p<0.001; Pg extract: p<0.001; HmuY: p<0.01) and necrosis (Pg LPS: p<0.01; Pg extract: p<0.001; HmuY: p<0.001). Pg LPS induced higher late apoptosis than HmuY (p<0.05). Only Pg LPS-induced necrosis tended to be higher in CP compared with NP. CONCLUSIONS: The inhibitory effect of cell proliferation caused by Pg LPS and HmuY protein is not observed when these antigens comprise Pg extract. Despite induced apoptosis, some still unknown mechanism determines the inflammatory outcome in cell death stimulated by HmuY.

Periodontal therapy and low birth weight: preliminary results from an alternative methodologic strategy.

BACKGROUND: The purpose of this study is to present the use of a non-randomized experimental design with multiple controls, with emphasis on a historical control group, as an alternative methodologic resource for studies on the association between periodontal disease and prematurity/low birth weight. METHODS: The sample consisted of 234 pregnant women: 54 in the Test Group (treatment of periodontal disease); 68 in Control Group I (without periodontal disease); and 112 in Control Group II (historical control group, with untreated periodontal disease). The diagnosis of periodontal disease was established by means of a complete clinical examination, using measurements of probing depth, gingival recession, clinical attachment loss, and bleeding index. The women in the Test Group were treated for periodontitis and followed-up with periodontal support therapy throughout their pregnancies. After delivery, they were reevaluated regarding their periodontal condition, and information on the newborn's birth weight was obtained. This was also done for Control Groups I and II. Descriptive analyses on the study variables were performed using the χ(2) and Fisher exact tests. Association measurements (relative risk) were obtained using a significance level of 5%. RESULTS: The frequency of low birth weight among the Test Group was similar to Control Group I and lower than Control Group II. CONCLUSION: The results suggest that successful periodontal therapy in pregnant women suffering from periodontitis is a protective factor promoting the birth of children with normal weight.

Respiratory disease and the role of oral bacteria.

The relationship between oral health and systemic conditions, including the association between poor oral hygiene, periodontal disease, and respiratory disease, has been increasingly debated over recent decades. A considerable number of hypotheses have sought to explain the possible role of oral bacteria in the pathogenesis of respiratory diseases, and some clinical and epidemiological studies have found results favoring such an association. This review discusses the effect of oral bacteria on respiratory disease, briefly introduces the putative biological mechanisms involved, and the main factors that could contribute to this relationship. It also describes the role of oral care for individuals who are vulnerable to respiratory infections.

Periodontal therapy for pregnant women and cases of low birthweight: an intervention study.

BACKGROUND: Over the past decade, strong evidence for an association between maternal periodontitis and low birthweight has started to appear. However, few intervention studies have been proposed for investigating this hypothesis. The aim of this study was to evaluate whether periodontal therapy among pregnant women would reduce the incidence of low birthweight. METHODS: A nonrandomized intervention study was performed, with two control groups. The sample comprised 339 pregnant women: 141 in the experimental group (treated for periodontitis), 145 in control group 1 (without periodontitis) and 53 in control group 2 (with untreated periodontitis). The experimental group received periodontal treatment throughout pregnancy, whereas control group 1 was only monitored over the same period. After delivery, birthweight information on the newborns was obtained. The analysis procedures consisted of stratified analysis followed by logistic regression. RESULTS: The frequency of low birthweight among the women with treated periodontitis was 9.22%, while it was 13.10% in the group without periodontal disease. However, the difference was not statistically significant (RR 0.72; 95% CI 0.36-1.45). The occurrence of this outcome in the group with untreated periodontitis (24.53%) was greater than in the other two groups. CONCLUSION: This suggests that periodontal therapy is a protective factor for birthweight.