Proteomic evaluation of GCF in the development of pregnancy related periodontal disease: A pilot clinical study

OBJECTIVE: This pilot study analyzed the possible changes of periodontal disease status in female patients during the period following pregnancy. Both clinical and laboratory data were collected and analyzed. PATIENTS AND METHODS: A non-randomized controlled clinical trial was conducted by the Periodontal Department of the Dental Clinic in collaboration with the Pediatrics Department, at Fondazione Policlinico Universitario A. Gemelli, Rome, Italy. Ten female patients, who completed the pregnancy without complications, were enrolled in this research protocol forming the experimental group. During the first post-partum days, gingival crevicular fluid (GCF) samples were collected and analyzed with high-performance liquid chromatography associated with high-resolution mass spectrometry (HPLC ESI MS); periodontal parameters as pocket depth (PD), full mouth plaque score (FMPS) and full mouth bleeding score (FMBS) were recorded, and a professional oral hygiene session was performed. The same protocol was applied after three months with the same patients forming the recall group. A control group was created in order to compare the results with GCF samples from 10 not pregnant fertile women. RESULTS: Student's t-test has been used to evaluate the statistical significance of the collected data. Mean levels of PD decreased from 3.75 mm ± 1.2 mm after pregnancy to 2.88 mm ± 0.85 mm at three months post-partum (p<0.01). Mean value of FMPS and FMBS decreased from 21.8% ± 1.35% and 34.27% ± 1.5% after pregnancy to 13% ± 2.81% and 17.55% ± 2.84% at three months post-partum, respectively (p<0.05). The concentration of each analyzed peptide has changed in relation to the general improvement of the periodontal status at three months post-partum. CONCLUSIONS: Pregnancy may be associated with an increased risk of periodontal disease. Both clinical and laboratory data have demonstrated that a professional oral hygiene session can affect the course of pregnancy inducing periodontal diseases allowing a faster healing and restitutio ab integrum.