تاثــير مستوى الاسترادايول والبروجستيرون في اللعاب على حالة صحة الفم عند النساء اثناء الحمل == Effects of Salivary Level of Estradiol And Progesterone On Oral Health Status In Women During Pregnancy
Author name:
زينة كامل كاظم
Supervisor name:
هاجر ابراهيم عبد الله
General topic:
Dentistry
Specific topic:
Oral and Maxillofacial Surgery
Degree:
Master
University:
Mustansiriyah University
Language:
English
University location:
Baghdad
First pages:
20T392 - p.pdf
Abstract:
الحمل هو حالة فسيولوجية تجلب مجموعة واسعة من التغييرات في حياة المراة، بما في ذلك التعرض لامراض اللثة، ربما بسبب التغيرات الهرمونية المرتبطة مع الحمل. قد تؤثر الهرمونات الجنسية على اغشية الفم واللثة وربما هذا يؤدي الى العديد من الامراض اللثوية. ان هرمونا | Pregnancy is a physiological state that brings a wide range of changes in a woman’s life, including a susceptibility to gingival disease, probably due to hormonal changes associated with pregnancy. These female sex hormones may modify the oral mucosa and may lead to various degrees of gingival inflammation. The hormonal changes occurring during pregnancy may be associated with pregnancy gingivitis and gingival bleeding. Sex hormones are specific regulatory molecules have long been considered to play an influential role on periodontal tissues especially gingiva, bone turnover rate, wound healing and periodontal disease progression. Aims of the study1. Assessment of oral hygiene level and dental status in both second and third trimester pregnant women and compares results.2. Assessment salivary hormonal levels of endogenous female sex steroids in both second and third trimester pregnant women and compares results.3. Comparison of oral health status and endogenous female sex steroids salivary hormonal levels between gingivitis and non - gingivitis subgroups of both second and third trimester pregnant women groups.4. Find out the association between the gingival health status and salivary hormonal levels of endogenous female sex steroids (Estradiol and progesterone).Materials and methods This study was carried out on seventy - eight pregnant women who were attended for routine and regular follow up visits in obstetrics and gynecology department at Al - Yarmouk Teaching Hospital, from February 2013 to July 2013. This study was approved by the scientific committee in the department of oral medicine college of dentistry Al - Mustansiriya University. They were divided according to gestational age in to second trimester group and third trimester group. Fifty pregnant women (age range 18 - 38 years) and at gestational age was ranged between (20 - 27 weeks) were recruited as 2nd trimester group and Twenty - eight pregnant women (age range 18 - 39 years) at gestational age ranged between (28 - 33 weeks) were recruited as 3rd trimester group and according to Loe and Silness gingival index these two groups subdivided into gingivitis and non - gingivitis groups. Oral clinical examination including an assessment of gingival inflammation (Loe and Silness Gingival Index), Plaque amount (Silness and Loe Plaque Index), dental status (Decayed Missing Filling Teeth), and salivary flow rate (SFR) had also been done. Samples of whole unstimulated (resting) saliva were collected from all participants then investigated for sex steroids salivary hormonal levels of Estradiol, Progesterone. Results and discussion Oral health measurements including : GI, PLI, SFR and DMFT showed no significant difference between 2nd trimester and 3rd trimester groups. Sex steroids salivary hormonal levels of Progesterone showed a significant difference with higher mean value in 3rd trimester pregnant women than 2nd trimester pregnant women while sex steroids salivary hormonal levels of Estradiol showed no significant difference between two groups. Comparisons between gingivitis and non - gingivitis subgroups of 2nd trimester pregnant women group showed that there was highly significant difference in SFR with higher mean value in non - gingivitis group, and there was highly significant difference in PLI with higher mean value in gingivitis group, DMFT showed non - significant difference between the subgroups and (Estradiol and progesterone) salivary hormonal levels showed highly significant difference with higher mean values in gingivitis group. Comparisons between gingivitis and non - gingivitis subgroups of 3rd trimester pregnant women group showed that there was a non - significant difference in SFR, DMFT and a highly significant difference in PLI with higher mean value in gingivitis group, while progesterone salivary hormonal levels showed non - significant difference and Estradiol salivary hormonal levels showed a highly significant difference with higher mean value in gingivitis group. Comparison of GI between gingivitis groups of both 2nd and 3rd trimester pregnant women showed that there was a significant difference with higher mean value in 3rd trimester. Estradiol and progesterone salivary hormonal levels were non - significantly correlated with PLI and GI for gingivitis and non - gingivitis group of 2nd trimester pregnant women. Progesterone salivary hormonal level was non - significantly correlated with PLI and GI for gingivitis and non - gingivitis group of 3rd trimester pregnant women while Estradiol salivary hormonal level was non - significantly correlated with PLI and GI for non - gingivitis group and significantly correlated with PLI and GI for gingivitis group. GI and PLI for gingivitis groups of both 2nd and 3rd trimester revealed that there was a highly significant correlation.Conclusions Female Sex steroids hormones (Estradiol and Progesterone) salivary hormonal levels significantly increase from the second to the third trimester especially Estradiol and Play an important role in influencing gingival inflammation during pregnancy. These hormones are neither necessary nor sufficient to produce gingival changes by themselves. However, they may alter periodontal tissue responses to microbial plaque and thus indirectly contribute to gingivitis. Dental status in pregnant women is not significantly different between 2nd and 3rd trimester pregnant women groups. Women should be offered training in good oral hygiene habits, and community awareness programs should be conducted to increase their awareness of the crucial importance of such habits especially during pregnancy
