Effect of nonsurgical periodontal therapy on patients with mild preeclampsia

Abstract Objective This study aims to evaluate the effect of nonsurgical periodontal treatment during the second trimester on pregnant women with mild preeclampsia. Material and methods In all, 50 pregnant women with mild preeclampsia (blood pressure levels ≥140/90 mm and proteinuria >300 mg/l in 24 h urine) and chronic moderate periodontitis were included in the study. Pregnant women were randomized into two groups: the treatment group (group 1 = 25) and the control group (group 2 = 25). All women received oral hygiene instruction. The women in the treatment group received nonsurgical periodontal treatment consisting of scaling and root planning during the gestational period and those in the control group received periodontal treatment after delivery. Maternal demographic, medical, and periodontal data were obtained from both groups. A periodontal evaluation was performed and blinded to periodontal treatment; according to plaque index (PI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), periodontal epithelial surface area (PESA), and periodontal inflamed surface area (PISA) were recorded at baseline at 20 weeks, 32 weeks, and 36 gestational weeks. In addition, samples of blood and GCF were collected at 20 weeks and 36 weeks of gestation, and GCF and serum cytokines levels, C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor (TNF-α) were analyzed. The progression from mild to severe preeclampsia and eclampsia was evaluated in both groups. Results The periodontal therapy resulted in a statistically significant reduction in all periodontal clinical parameters (plaque index, bleeding on probing, periodontal pocket depth, and clinical attachment level) and reduced biomarker levels from gingival crevicular fluid (GCF), and from blood serum in the treatment group, but no significant difference was observed in the progression from mild to severe preeclampsia, eclampsia, in both groups. Conclusions The nonsurgical periodontal therapy improved the periodontal status and decreased periodontal inflammatory biomarker levels from gingival crevicular fluid and from the blood, but did not alter the frequency of maternal complications in mild preeclampsia patients.