Gingival inflammation and female sex hormones. A clinical investigation of pregnant women and experimental studies in dogs.
About: This article is published in Journal of Periodontal Research.The article was published on 1970-08-01. It has received 104 citations till now. The article focuses on the topics: Gingivectomy.
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TL;DR: Pregnancy and specifically steroid hormones appear capable of influencing the normal bacterial flora and inducing alterations in the subgingival ecology.
Abstract: The subgingival bacterial flora from 2 gingival sites was cultured and characterized monthly in twenty periodontitis-free women during pregnancy and again post-partum. Monthly plaque samples were also cultured in eleven age and disease matched non-pregnant women. Plaque was processed anaerobically on selective and nonselective media and the predominant colony types were characterized. A portion of each plaque sample was tested for bacterial uptake of Ci4-estradiol and C^-progesterone. Plasma levels of estrogens and progesterone were measured four times in each subject. The number of gingival bleeding sites, the Gingival Index and the Plaque Index were determined at each sampling period. In the second trimester there was a significant increase in gingivitis, the ratio of anaerobic to aerobic bacteria, and the proportional levels of Bacteroides melaninogenicus ss. intermedius. In the third trimester both gingivitis and the levels of B. melaninogenicus ss. mtermedius decreased. Plaque uptake of Ci4-steroids increased significantly during pregnancy and paralleled the plaque levels of B. melaninogenicus ss. intermedius. In the second trimester, recovery of B. melaninogenicus ss. intermedius was strongly correlated with plasma levels of estrogens and progesterone. No changes were observed in clinical parameters or the subgingival flora of non-pregnant subjects. Pregnancy and specifically steroid hormones appear capable of influencing the normal bacterial flora and inducing alterations in the subgingival ecology.
465 citations
Cites background from "Gingival inflammation and female se..."
...Hugoson (1970) reports, however, a decrease in the Plaque Index in the third trimester....
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...Cross-sectional and longitudinal studies have consistently shown a gradual increase in gingivitis during pregnancy with apparent resolution following parturition (Loe & Silness 1963, Silness & Loe 1964, Hugoson 1970, Cohen et al. 1971)....
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...One longitudinal study (Hugoson 1970) confirmed that pattern , and another (Cohen et al. 1971) observed a statistically significant increase in gingivitis at six months gestation and a slight decrease in the third trimester....
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...in gingivitis independent of a change in clinically detectable plaque mass led to the suggestion that altered steroid levels increased the inflammatory response to a given plaque challenge (Lindhe, Attstrom & Bjorn 1968, Hugoson 1970, Lindhe, Hellden & Lundgren 1972)....
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TL;DR: The periodontal status of three groups of women; pregnant, taking oral contraceptives, and nonpregnant, were evaluated clinically and microbiologically for changes in their gingiva and any corresponding changes in the subgingival microbial plaque, specifically the percentage of Fusobacteria species and Bacteroides species.
Abstract: The periodontal status of three groups of women; pregnant, taking oral contraceptives, and nonpregnant, were evaluated clinically and microbiologically for changes in their gingiva and any corresponding changes in the subgingival microbial plaque, specifically the percentage of Fusobacterium species and Bacteroides species. Overall, the women had relatively good gingival health. However, statistically significant increased scores were observed in the Gingival Index and the gingival crevicular fluid flow in the pregnant group compared with the nonpregnant group. The most dramatic microbial changes were the increased proportions of Bacteroides species both in the pregnant group and the group taking oral contraceptives over the nonpregnant group. Increased female sex hormones substituting for the napthaquinone requirement of certain Bacteroides were most likely responsible for this increase. No statistically significant clinical difference was noted between the group taking oral contraceptives and the nonpregnant group, although a 16-fold increase in Bacteroides species was observed in the group taking oral contraceptives.
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189 citations
TL;DR: The main hormonal effect accentuates false pocketing, rather than initiating a change in attachment levels, except in cases of progressive periodontal disease associated with plaque induced inflammation and bone loss.
Abstract: It is the purpose of this review to survey the influence of corticosteroids, androgens, oestrogens and progesterone on gingival tissues and to show the relationship of such influences to periodontal disease. The clinical changes seen in plaque-induced gingivitis are accentuated by circulating levels of the above hormones via mechanisms such as partial immune suppression, increased fluid exudation, stimulation of bone resorption and stimulation of fibroblast synthetic activity. High counts of Bacteroides intermedius have been observed in users of oral contraceptives and also in the second trimester of pregnancy, in the absence of overt gingival inflammation. This is due to competition for binding between progesterone and naphthaquinone, which have a structural similarity; and the latter is an essential nutrient for the microbe. Hence high counts of Bacteroides intermedius may be a more sensitive indicator of an altered systemic hormonal condition than the usual clinical parameters. The main hormonal effect accentuates false pocketing, rather than initiating a change in attachment levels, except in cases of progressive periodontal disease associated with plaque induced inflammation and bone loss.
180 citations
TL;DR: Answering critical questions regarding host-parasite interactions in periodontal diseases may provide new insight in the pathogenesis of other biomedical disorders, and result in new guidelines for unambiguous disease definition and diagnosis in the future.
Abstract: Periodontal diseases are among the most common diseases affecting humans. Dental biofilm is a contributor to the etiology of most periodontal diseases. It is also widely accepted that immunological and inflammatory responses to biofilm components are manifested by signs and symptoms of periodontal disease. The outcome of such interaction is modulated by risk factors (modifiers), either inherent (genetic) or acquired (environmental), significantly affecting the initiation and progression of different periodontal disease phenotypes. While definitive genetic determinants responsible for either susceptibility or resistance to periodontal disease have yet to be identified, many factors affecting the pathogenesis have been described, including smoking, diabetes, obesity, medications, and nutrition. Currently, periodontal diseases are classified based upon clinical disease traits using radiographs and clinical examination. Advances in genomics, molecular biology, and personalized medicine may result in new guidelines for unambiguous disease definition and diagnosis in the future. Recent studies have implied relationships between periodontal diseases and systemic conditions. Answering critical questions regarding host-parasite interactions in periodontal diseases may provide new insight in the pathogenesis of other biomedical disorders. Therapeutic efforts have focused on the microbial nature of the infection, as active treatment centers on biofilm disruption by non-surgical mechanical debridement with antimicrobial and sometimes anti-inflammatory adjuncts. The surgical treatment aims at gaining access to periodontal lesions and correcting unfavorable gingival/osseous contours to achieve a periodontal architecture that will provide for more effective oral hygiene and periodontal maintenance. In addition, advances in tissue engineering have provided innovative means to regenerate/repair periodontal defects, based upon principles of guided tissue regeneration and utilization of growth factors/biologic mediators. To maintain periodontal stability, these treatments need to be supplemented with long-term maintenance (supportive periodontal therapy) programs.
163 citations
References
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TL;DR: In this paper, the correlation between oral hygiene and periodontal condition was investigated in the context of pregnant women with Periodontal Disease in Pregnancy II (PDI II).
Abstract: (1964). Periodontal Disease in Pregnancy II. Correlation Between Oral Hygiene and Periodontal Condition. Acta Odontologica Scandinavica: Vol. 22, No. 1, pp. 121-135.
7,017 citations
TL;DR: (1963).
Abstract: (1963). Periodontal Disease in Pregnancy I. Prevalence and Severity. Acta Odontologica Scandinavica: Vol. 21, No. 6, pp. 533-551.
6,408 citations
425 citations
TL;DR: To find out whether differences exist between males and females, the levels for the sexes within various age groups were compared, breaking these down into “fine” and “coarse” subgroups, and the results fitted the results better than the semilogarithmic one used by others.
Abstract: WE have determined the IgG, IgA, and IgM levels of 315 normal adults and 503 children of various ages1. To find out whether differences exist between males and females, we compared the levels for the sexes within various age groups, breaking these down into “fine” and “coarse” subgroups. There were fourteen fine groups of about thirty children each and five coarse groups of about 100 children each. The subjects were laboratory personnel, blood donors, college students, school-children, babies, and inmates of a home for recently abandoned children, all apparently healthy. Immunoglobulins were determined by a single radial immunodiffusion method2 using commercial antibody-agar plates standardized against purified immunoglobulins. The standardization curves used were the least-squares linear regressions of log mg/100 c.c. versus the log ring diameter. This relationship fitted the results better than the semilogarithmic one used by others2–4. The males and females in each group were compared by Student's t test. We used log mg/100 c.c. for the t tests and to calculate the means, because the distributions of the three major immunoglobulins among adults are approximately log normal.
339 citations
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