Causes of Adverse Pregnancy Outcomes and the Role of Maternal Periodontal Status – A Review of the Literature

Preterm (PT) and Low birth weight (LBW) are considered to be the most relevant biological determinants of newborn infants survival, both in developed and in developing countries. Numerous risk factors for PT and LBW have been defined in the literature. Infections of the genitourinary tract infections along with various biological and genetic factors are considered to be the most common etiological factors for PT/LBW deliveries. However, evidence suggests that sub-clinical infection sites that are also distant from the genitor-urinary tract may be an important cause for PT/LBW deliveries. Maternal periodontal status has also been reported by many authors as a possible risk factor for PT and LBW, though not all of the actual data support such hypothesis. The aim of this paper is to review the evidence from various published literature on the association between the maternal periodontal status and adverse pregnancy outcomes. Although this review found a consistent association between periodontitis and PT/LBW, this finding should be treated with great caution until the sources of heterogeneity can be explained

Periodontitis and Infertility: An Evidence-Based Review

Periodontal diseases are initiated by a pathogenic biofilm, in a susceptible host, affecting the tooth periodontium. Its possible association with many biologic systems has been studied. In this evidence based review, a comprehensive literature search was carried out to assess if there is an association between periodontal diseases and female infertility. An extensive search was conducted in PubMed and Cochrane Library. Epidemiological studies, experimental studies, inquiries or editorials on the theme periodontitis and infertility published until May 2016 were included. The initial search retrieved 47 papers, from which six were selected due to inclusion criteria. The epidemiological study with the highest level of evidence concluded that periodontal disease might be a factor that increases the time to conception, on average, in two months more, which is as negative as obesity. The authors stated that all patients before attempting to conceive could be oriented to have a dental checkup, as they are currently advised to smoking discontinuation, weight loss, and folate supplementation. The experimental studies pointed out that the infertility problem is a secondary outcome in rodents challenged with periodontitis. The possible biological explanation is that periodontitis causes a systemic inflammation, which could: a) prevent ovulation; b) prevent implantation of the embryo or does not sustain its implantation. It is known that oral health incorporation into general health agenda is crucial for optimal health and general wellbeing. Therefore, women trying to conceive should be in the best possible health, which will be achievable through an effective multidisciplinary teamwork.</p

Periodontal disease and systemic complications

Periodontal diseases comprise a number of infectious and inflammatory conditions brought about by the interaction between supragingival and subgingival biofilms and the host inflammatory response. Periodontal diseases should be considered systemic conditions. This means that they are both modulated by the body's systems and play a role as a risk factor for systemic derangements. The current evidence supports some of these interactions, such as smoking as a risk factor for periodontal disease and diabetes mellitus, as both influenced by and influencing inflammatory changes in the periodontal tissue. Other potential associations are still being researched, such as obesity, hormonal changes, cardiovascular disease, and adverse outcomes in pregnancy. These, and others, still require further investigation before the repercussions of periodontal disease can be fully elucidated. Nevertheless, at the present time, the treatment of periodontal diseases-and, most importantly, their prevention-enables adequate intervention as a means of ensuring periodontal health

Resveratrol: biological activities and potential use in health and disease

Resveratrol (RV) is a polyphenol non-flavonoid compound present in strongly pigmented vegetables and fresh fruits as well as dried nuts such as peanuts. High concentrations of this natural compound were found, in the modern occidental world, in the peel of the berries of the red grape Vitis vinifera, but usage of this natural drug in popular medicine has been documented much earlier. Resveratrol exhibits diverse biological activities such as antitumor, antioxidant, antiviral, and phytoestrogenic. In particular, as the work reported from our laboratories, the compound shows an inhibitory effect on murine polyomavirus DNA replication, while at higher concentrations, RV shows a significant cytotoxic effect. This complex dose-dependent behavior is not intrinsic to the drug. Other natural substances behave in a similar way, curcumin and a semi-purified fraction of the whole neem oil being two different examples. Most likely, the administration of RV to cultured cells alters the permeability and fluidity of the cell membrane. Also, data presented in literature ascribe to RV an antiproliferative action, thus rendering this drug a good candidate for the control of neoplastic growth. The potential usage of RV both in human and veterinary medicine is also examined in this review