Periodontitis and Preeclampsia in Pregnancy: A Systematic Review and Meta-Analysis.

OBJECTIVES: A conflicting body of evidence suggests localized periodontal inflammation spreads systemically during pregnancy inducing adverse pregnancy outcomes. This systematic review and meta-analysis aim to specifically evaluate the relationship between periodontitis and preeclampsia. METHODS: Electronic searches were carried out in Medline, Pubmed, Embase, Lilacs, Cochrane Controlled Clinical Trial Register, CINAHL, ClinicalTrials.gov, and Google Scholar with no restrictions on the year of publication. We identified and selected observational case-control and cohort studies that analyzed the association between periodontal disease and preeclampsia. This meta-analysis was conducted following the PRISMA checklist and MOOSE checklist. Pooled odds ratios, mean difference, and 95% confidence intervals were calculated using the random effect model. Heterogeneity was tested with Cochran's Q statistic. RESULTS: Thirty studies including six cohort- and twenty-four case-control studies were selected. Periodontitis was significantly associated with increased risk for preeclampsia (OR 3.18, 95% CI 2.26 - 4.48, p < 0.00001), especially in a subgroup analysis including cohort studies (OR 4.19, 95% CI 2.23 - 7.87, p < 0.00001). The association was even stronger in a subgroup analysis with lower-middle-income countries (OR 6.70, 95% CI 2.61 - 17.19, p < 0.0001). CONCLUSIONS: Periodontitis appears as a significant risk factor for preeclampsia, which might be even more pronounced in lower-middle-income countries. Future studies to investigate if maternal amelioration of periodontitis prevents preeclampsia might be warranted.

DIFFERENTIAL IMPACT OF PERIODONTAL TREATMENT STRATEGIES DURING PREGNANCY ON PERINATAL OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVES: This study aimed to evaluate the impact of different periodontal treatment strategies during pregnancy on perinatal outcomes. STUDY SELECTION: This systematic review and meta-analysis of clinical trials was conducted according to PRISMA guidelines to assess the effect of mouthwash in addition to scaling and root planning (SRPM) on pregnancy outcomes, including preterm birth, low birth weight, gestational age, and birth weight. Pooled risk ratios (RR), mean differences (MD), and 95% confidence intervals (CI) were calculated using the random effect model. RESULTS: Twenty trials involving 5938 participants, including thirteen trials comparing scaling and root planning (SRP) and seven trials comparing SRPM with control groups. SRPM was associated with reduced risk of preterm birth (RR = 0.37; 95%CI = 0.16-0.84; P = .017; I2=93.26%; P < .001; number needed to treat (NNT): 3), low birth weight (RR = 0.54; 95%CI = 0.40-0.74; P < .0001; I2 = 0%; P = .46; NNT: 13), increased gestational age (MD = 0.78; 95%CI: 0.19-1.37; P = .009; I2 = 87.15%; P < .001), and birth weight (MD = 121.77; 95%CI = 3.19-240.34; P = .044; I2 = 80.68%; P < .001). There were no statistically significant differences in the analysis of SRP group, except for the increased birth weight (MD = 93.85; 95% CI = 3.27-184.42; P = .042; I2 = 84.11%; P < .001). CONCLUSION: Using mouthwash in addition to scaling and root planning (SRPM) for the treatment of periodontal disease during pregnancy significantly improves perinatal outcomes.

Does Treatment of Gingivitis During Pregnancy Improve Pregnancy Outcomes? A Systematic Review and Meta-Analysis.

PURPOSE: This study aimed to investigate whether treatment of gingivitis in pregnant women affects pregnancy outcomes. MATERIALS AND METHODS: This was a systematic review and meta-analysis of clinical trials using PRISMA guidelines to appraise the treatment of gingivitis on pregnancy outcomes, including preterm birth (less than 37 weeks), low birth weight (less than 2,500 g), gestational age and birth weight. Pooled odds ratios (OR), mean difference, and 95% confidence intervals (CI) were calculated using the random effect model. A search was conducted in databases including Medline, Pubmed, Web of Science, Google Scholar and Embase without restrictions regarding language or date of publication. RESULTS: Three clinical trials comprising 1,031 participants were included in this review. Treatment of gingivitis during pregnancy was associated with a decreased risk of preterm birth (OR = 0.44, 95% CI [0.20-0.98], P = 0.045) and higher birth weight (weighted mean difference (WMD) =105.36 g, 95% CI [36.72-174.01], P = 0.003). Gestational age at birth in the treatment group (WMD = 0.31 weeks, 95% CI [-0.02-0.64], P = 0.64) as well as likelihood of low birth weight (OR = 0.92, 95% CI [0.38-2.21], P = 0.851) did not reach statistical significance. CONCLUSION: The results of this meta-analysis indicate that treatment of gingivitis in pregnancy may improve pregnancy outcomes including increased infants birth weight and reduced preterm births. Future trials are warranted to validate the true effect size of gingivitis treatment on pregnancy outcomes.

Evaluation of dental arch dimensions in 12 year-old Vietnamese children - A cross-sectional study of 4565 subjects.

This study aimed to define the width and length of the dental arch in 12-year-old Vietnamese children, and to elucidate differences between genders and among ethnic groups. A cross-sectional study was conducted in 4565 12 years-old children from the 4 major ethnic groups in Vietnam (Kinh, Muong, Thai, and Tay), with a healthy and full set of 28 permanent teeth that had never had any orthodontic treatment and with no reconstructive materials at the measured points. The mean variables in all subjects were 36.39 mm for upper inter-canine width; 46.88 mm for upper inter-first molar width; 59.43 mm for upper inter-second molar width; 10.41 mm for upper anterior length; 32.15 mm for upper posterior length 1; 45.52 mm for upper posterior length 2; 28.31 mm for lower inter-canine width; 41.63 mm for lower inter-first molar width; 54.57 mm for lower inter-second molar width (LM2W); 7.06 mm for lower anterior length (LAL); 26.87 mm for lower posterior length 1 (LP1L); and 41.29 mm for lower posterior length 2. Significant differences in these parameters between genders were found in all ethnic groups, except for LAL in the Kinh and Thai groups, and LP1L in the Tay group. Significant ethnic differences were also found in almost all parameters except LM2W in both males and females. Taken together, the representative sizes of dental arches of 12-year-old Vietnamese children have been defined. Our data indicate that there are some variations in dental arch dimensions among ethnic groups and between genders.

Author Correction: Evaluation of dental arch dimensions in 12 year-old Vietnamese children - A cross-sectional study of 4565 subjects.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Generation of a TP53-modified porcine cancer model by CRISPR/Cas9-mediated gene modification in porcine zygotes via electroporation.

TP53 (which encodes p53) is one of the most frequently mutated genes in cancers. In this study, we generated TP53-mutant pigs by gene editing via electroporation of the Cas9 protein (GEEP), a process that involves introducing the Cas9 protein and single-guide RNA (sgRNA) targeting exon 3 and intron 4 of TP53 into in vitro-fertilized zygotes. Zygotes modified by the sgRNAs were transferred to recipients, two of which gave birth to a total of 11 piglets. Of those 11 piglets, 9 survived. Molecular genetic analysis confirmed that 6 of 9 live piglets carried mutations in TP53, including 2 piglets with no wild-type (WT) sequences and 4 genetically mosaic piglets with WT sequences. One mosaic piglet had 142 and 151 bp deletions caused by a combination of the two sgRNAs. These piglets were continually monitored for 16 months and three of the genome-edited pigs (50%) exhibited various tumor phenotypes that we presumed were caused by TP53 mutations. Two mutant pigs with no WT sequences developed mandibular osteosarcoma and nephroblastoma. The mosaic pig with a deletion between targeting sites of two sgRNAs exhibited malignant fibrous histiocytoma. Tumor phenotypes of TP53 mosaic mutant pigs have not been previously reported. Our results indicated that the mutations caused by gene editing successfully induced tumor phenotypes in both TP53 mosaic- and bi-allelic mutant pigs.