Estado periodontal y microbiota subgingival en mujeres preeclampticas
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Resumen: Objetivos: describir el estado periodontal y la microbiota
subgingival de mujeres gestantes con diagnostico de preeclampsia en el Hospital Universitario del
Valle (HUV) de Cali-Colombia. Metodología: participaron 8l mujeres con diagnóstico de preeclampsia,
internadas en el HUV, se les colectaron datos médicos, odontológicos y periodontales tales como
profundidad de sondeo, nivel de inserción clínico, se tomaron muestras microbiológicas subgingivales
para cultivo y se realizo el diagnóstico clínico periodontal teniendo en cuenta los parámetros de la
AAP consensus report-1999. Resultados: el 63% de la gestantes presento preeclampsia leve y el 27.2%
preeclampsia severa. Un 91.4% (n=74) de las pacientes presento afección en el estado de salud
periodontal dentro del cual el 59.3% (n=48) presentó un diagnóstico de periodontitis crónica y solo
el 8.6% de las gestantes presento un buen estado de salud periodontal. Los microorganismos
periodontopáticos más frecuentes en las mujeres con preeclampsia fueron Fusobacterium ssp 80.2%
(n=65), Porphyromonas gingivalis 59.3% (n=48) y Prevotella intermedian/nigrescens 51.9% (n=42).
Conclusiones: Se encontró en un alto porcentaje de mujeres con preeclampsia afección en el estado
periodontal predominando un diagnostico clínico de periodontitis crónica y presencia de una
microbiota periodontopática y solo un bajo porcentaje de las gestantes presentaron un estado de
salud periodontal. Revista Estomatología 2005; 13(2): 5-17. Palabras clave: Preeclampsia.
Periodontitis crónica Summary: Objective: to describe the clinical periodontal status and the
subgingival microbiota composition in a group of 81 women having preeclampsia. Methods: clinical,
medical and periodontal data were determined in women with preeclampsia at the University Hospital
of Valle in Cali-Colombia. Periodontal status and diagnosis were determined by means of probing
depth and clinical attachment level (Diagnosis Consensus AAP-1999). A sample of subgingival plaque
was taken for microbiological analysis. Results: 63% of the cases had mild preeclampsia and 27.2%
had severe preeclampsia. The periodontal status was affected in 91.4% of patients (n=64); 59.3%
(n=48) of them presented chronic periodontitis and only 8.6% presented healthy periodontium.
Periodontopathic bacteria was found in preeclamptic women, the most prevalent microorganisms were
Fusobacterium ssp 80.2% (n=65), P. gingivalis 59.3% (n=48) and Prevotella intermedia/nigrescens
51.9% (n=42). Conclusion: preeclamptic women showed a high percentage of chronic periodontitis and
presented also periodontopathic microbiota. A low percentage of pregnant women presented healthy
periodontium. Key words: Preclampsia. Chronic periodontitis. Subgingival microbiota.
between periodontal disease and systemic
health. Periodontology 2000 2001; 25: 21-36.
2. Genco RJ. Periodontal disease and risk for
myocardial infarction and cardiovascular
disease. Cardiovasc. Rev. Rep. 1998; 19: 34-
40.
3. Scannapieco FA, Papandanatos GD, Dunford
RG. Associations between oral conditions and
respiratory disease in a national sample survey
population. Annals Periodontol. 1998; 3: 251
-256.
4. Offenbacher S, Katz V, Gertik G, Collins J,
Boyd D, Maynor G. Periodontal infection as
a possible risk factor for preterm low birth
weight. J. Periodontol. 1996; 67: 1103-1113.
5. Academy American of Periodontology.
The pathogenesis of periodontal diseases
(Informational paper). J. Periodontol. 1999;
70: 457-470.
6. Gemmel E, Marsahall R and Seymour G.
Gytoikines and prostaglandins inmmune
homeostasis and tissue destruction in
periodontal desease. Periodontology 2000.
1997; 14: 112-146.
7. Cifuentes R. Hipertensión arterial y embarazo
Obstetricia Alto Riesgo 1994; 24: 525-584.
8. Herrera J.A, Chaudhuri G, López J. Is infection
major risk factor for preeclamsia? Medical
Hypothesis 2001; 57(3): 393-397.
9. Otomo C.J., Esteimberg JB. Periodontal
Medicine and the female patient. Medicine
Periodontal 2000; 9: 157-166.
10. Kornamn KS, Loesche WJ. The subgingival
flora during pregnancy. J Periodontal Res.
1980; 15(2): 111-22.
11. Ojanotko H, Harri MP, Hurtti HM, Sewon LA.
Aktered tissue metabolism of progesterone in
pregnancy gingivitis and granuloma. J. Clinic
Periodonyol. 1991; 18(4) 232-6.
16 Revista Estomatología
12. Jessen J, Lijemark W, Bloomquis C. The effect
of female sex hormones on subgingival plaque.
J. Periodontol. 1981; 52(10): 599-602.
13. Lieff S, Bogges KA, Murtha A, Beck J,
Offenbacher S. The Oral Conditions and
Pregnancy Study: Perlodontal Status of a
Cohort of Pregnant Women. J Periodontol.
2604; 75: 116-126.
14. Gibbs RS, Romero R, Hillier SL, Eschenbach
DA, Sweet RL. A review of premature birth and
subclinicai infections. Am J Obstet Gynecol.
1992;166(5):1515-28.
15. Andrevvs WW, Hauth IC, Goldberg RL,
Gomez R, Romero R, Case GH, Amniotic fluid
interlukin-6 correlation with upper genital tract
microbial colonization and gestational age
in women delivered after spontaneous labor
versus indicated delivery. Am J Obstet Gynecol
1995; 173: 606-612.
16. Golderberg RI. Intrauterine infection preterm
delivery. Journal of Medicine. 2000; 20: 342.
17. Desanyake AP. Poor periodontal health of the
pregnant woman as a risk. Ann Perio. 1998; 3:
212.
18. Offenbacher S, Jared HL, O’Reilly PG.
Potential pathogenic mechanism of periodontitis
associated pregnancy complications. Ann
Periodonlol. 1990: 3: 233-250.
19. Sacks GP, Studena K, Sargent IL, Redman
C. Normal pregnancy And preeclampsia both
produce inflammatory changes in peripheral
blood leucocytes chin to those of sepsis. Am J
Obstet Gynecol . 1998; 179: 80-86.
20. Hüi GB. Investigating the source of amníotic
fluid isolates of Fusobacteria. Clin infect Dis.
1993; 16: 423-424.
21. López N, Smith P, GuSerrez J. Periodontal
therapy may reduce the risk of preterm low
birth weight in woman with periodontal
disease: A randomized controlled trial. J
Periadontol. 2002; 73: 911-924.
22. Boggess K, Lieff S, Murtha A, Moss K,
Beck J, Offenbacher S. Maternal periodontal
disease is associated with an increased risk
for preeclampsia. Obstet Gynecol. 2003; 101:
227-231.
23. Riché L, Boggess K, Lieff S, Murtha A, Auten
R, Beck J, Offenbacher S. Periodontal Disease
increases the Risk of Preteren Delivery Among
Preeclamptic Women. Ann Periodontol. 2002;
7: 95-101.
24. Madianos P, Lieff S, Murtha AP , Boggess
K, Auten Jr RL, Beck JD and Offenbacher S.
Maternal Periodontitis and Prematurity. Part
ll: Maternal Infection and Fetal Exposure. Ann
Periodontol. 2001; 16: 175-132.
25. Silness J, Loé H. Periodontal disease in
pregnancy. Correiation between oral hygiene
and periodontal condition. Acta Odont Scand.
1964; 22: 112-135.
26. Muhiemann HR. Gingival sulcus-bleeding a
leading symptom in initial gingivitis. Helv
Odontol Act. 1971; 15: 107-113.
27. Loé H. The gingival índex, the plaque índex
and the Retention índex system. J. Periodontol.
1967; 38(Suppl 61): 0-6116.
28. Pllülleman HR. Tooth mobility. The measuring
method. Initial and secondary tooth mobility.
J Periodonfoi. 1954; 25: 22-29.
29. International Workshop for a Classification of
Periodontal disease and Conditions. Papers
Brook, Illinois. Ann Periodontol. 1999; 4:(1):
1-112.
30. Lóe H, Silness J Periodontal disease in
pregnacy 1. Prevalence and Severity. Acta
Odontol. Scand. 1963 2: 533-551.
31. O’neal TCA. Maternal T - lymphocyte response
and gingivitis in pregnacy. J. Periodontol 1979;
50: 178-184.
32. Listgarten MA. Bacteria invasion of periodontal
tissues. J. Periodontol. 1980; 59: 412-419.
33. Lin D., Smith MA, Elter J. Porphyromonas
gingivitis infection in pregnant mice is
associated with placenta dissemination, and
increase in the placental Th1/th2 cytokine
ratio and fetal growth restriction. Infection
and lmmunity. Infect Immun. 2003; 71: 5163-
5168.
34. Slots J, Listgarten MA. Bacteroides gingivalis,
Bacteroides indermedius and Actinobacilus
Volumen 13 Nº 2 2005 17
actinomiycetemcomitans in human periodontal
diseases. J. Clin. Periodontol. 1988; 15: 85-
93
35. Genco J, Slots J. Host responses in periodontal
disease. J. Den. Res. 1984; 63: 441.
36. Barak-Oettinger O, Barak S, Ohel G, Oettinger
M, Kreutzer H, Peled M and Machtei E.
Severe Pregnancv complication (Preeclampsia)
ls associated with Greather Periodontal
Destrucción. J. Periodontol. 2005; 76: 134-
137.
37. Offenbacher S. Maternal Periodontal Infections,
prematury and growth restriction. Clinical
Obstetrics and Ginecology. 2001; 47 (4): 808-
821.
38. Moss KL., Beck JD. Offenbacher S. Clinical
risk factors associated with incidence and
progression of periodontal conditions in
pregnant women. J. Clinic Periodontol. 2005;
31: 492-498.
39. Jarjoura K, Devine P, Perez-Delboy, Herrera
-Abreu, Dalton M, Papapanou N. Markers
of periodontal infection and preterm
birth. American Journal of Obstetrics and
Gynecology. 2005; 192: 513-519.
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