***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Objectives The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes . Material and Methods Pregnant patients during the 1st and 2nd trimesters at antenatal care in a Public Health Center were divided into 2 groups : NIG – " no intervention " ( n=17 ) or IG- " intervention " ( n=16 ) . IG patients were su bmi tted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning ( SRP ) , professional prophylaxis ( PROPH ) and oral hygiene instruction ( OHI ) . NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery . Periodontal evaluation was performed by a single trained examiner , blinded to periodontal treatment , according to probing depth ( PD ) , clinical attachment level ( CAL ) , plaque index ( PI ) and sulcular bleeding index ( SBI ) at baseline and 35 gestational weeks-28 days post-partum . Primary adverse pregnancy outcomes were preterm birth ( < 37 weeks ) , low birth weight ( < 2.5 kg ) , late abortion ( 14 - 24 weeks ) or abortion ( < 14 weeks ) . The results obtained were statistically evaluated according to OR , unpaired t test and paired t test at 5 % significance level . Results No significant differences were observed between groups at baseline examination . Periodontal treatment result ed in stabilization of CAL and PI ( p>0.05 ) at IG and worsening of all periodontal parameters at NIG ( p<0.0001 ) , except for PI . Significant differences in periodontal conditions of IG and NIG were observed at 2nd examination ( p<0.001 ) . The rate of adverse pregnancy outcomes was 47.05 % in NIG and 6.25 % in IG . Periodontal treatment during pregnancy was associated to a decreased risk of developing adverse pregnancy outcomes [ OR=13.50 ; CI : 1.47 - 123.45 ; p=0.02 ] . Conclusions Periodontal treatment during the second trimester of gestation contributes to decrease adverse pregnancy outcomes BACKGROUND One hypothesis to explain the association between periodontal disease ( PD ) preterm/low birth weight ( PT/LBW ) is that PT/LBW may be indirectly mediated through translocation of bacteria or bacterial products in the systemic circulation . Transient bacteremias occur in subjects with marginal periodontitis or with gingivitis , and it is possible that bacteria and their products may reach the placental membranes hematogenously and provide the inflammatory effect to induce preterm labor . The effect of gingivitis as a potential risk factor for PT/LBW has still not been studied . A r and omized controlled trial was undertaken to determine the effect of routine plaque control and scaling on the pregnancy outcomes in women with gingivitis . METHODS Eight hundred seventy ( 870 ) pregnant women with gingivitis , aged 18 to 42 , were enrolled while receiving prenatal care in Santiago , Chile . Women were r and omly assigned in a two-to-one fashion to either a treatment group ( N = 580 ) , receiving periodontal treatment before 28 weeks of gestation or to a control group ( N = 290 ) , receiving periodontal treatment after delivery . Periodontal therapy consisted of plaque control , scaling , and daily rinsing with 0.12 % clorhexidine . Maintenance therapy was provided every 2 to 3 weeks until delivery , and consisted of oral hygiene instruction and supragingival plaque removal by instrumentation , as needed . The primary outcomes assessed were delivery at less than 37 weeks of gestation or an infant weighing less than 2,500 g. RESULTS Of the 870 women enrolled , 36 women ( 27 in the treatment group and nine in the control group ) were excluded from the analyses for different reasons . The incidence of PT/LBW in the treatment group was 2.14 % ( 12/560 ) and in the control group , 6.71 % ( 19/283 ) ( odds ratio [ OR ] 3.26 ; 95 % confidence interval [ CI ] 1.56 to 6.83 ; P = 0.0009 ) . Multivariate logistic regression analysis showed that , after adjusting for several known risk factors for PT/LBW , women with gingivitis were at a higher risk of PT/LBW than women who received periodontal treatment ( OR 2.76 ; 95%CI 1.29 to 5.88 ; P = 0.008 ) . CONCLUSIONS Periodontal treatment significantly reduced the PT/LBW rate in this population of women with pregnancy-associated gingivitis . Within the limitions of this study , we conclude that gingivitis appears to be an independent risk factor for PT/LBW for this population Periodontal disease ( PD ) in pregnancy is associated with an increased risk of adverse pregnancy outcomes including miscarriage and preterm birth . Evidence exists that periodontal disease treatment may reduce inflammatory mediators in gingival crevicular fluid ( GCF ) and the risk of inflammation-associated pregnancy complications . The aim was to determine if periodontal disease treatment during mid-pregnancy alters local inflammation in GCF and has beneficial effects on clinical dental parameters . Eighty pregnant women with clinical ly diagnosed PD were recruited from a r and omised controlled trial on the treatment of periodontal disease in pregnancy conducted in Perth , Australia . The treatment group underwent intensive PD treatment ( 20 - 28 weeks ' GA ) , while the control group underwent the same treatment postnatally . GCF was collected at 20 and 28 weeks ' gestation and concentrations of cytokines determined by multiplex assay : IL-1β , IL-6 , IL-8 , IL-10 , IL-12p70 , IL-17 , TNF-α and MCP-1 . Periodontal treatment significantly reduced the GCF levels of IL-1β , IL-10 , IL-12p70 and IL-6 at 28 weeks ' GA compared with controls , while levels of MCP-1 , IL-8 and TNF-α exhibited a significant gestational age-dependent increase , but no treatment response . Post-treatment clinical parameters improved with significant reductions in bleeding on probing , clinical attachment loss , and probing depth . No changes in pregnancy-related outcomes were observed , although the severity of periodontal disease was significantly associated with an increased risk of infants born small for gestational age . PD treatment in pregnancy reduces the levels of some inflammatory mediators in the GCF and improves dental parameters , with no overt effects on pregnancy outcome Periodontitis has been associated with  adverse pregnancy outcomes .  Results from intervention studies are few and controversial . The present study assessed the effects of non-surgical periodontal treatment in the occurrence of adverse pregnancy outcomes .  Two hundred forty-six eligible women were r and omly divided into two groups : periodontitis intervention ( n = 122 ; undergoing non-surgical treatment during gestation ) and periodontitis control ( n = 124 ; not treated during gestation ) . Univariate analysis was performed and estimates of relative risk were reported . Data from 225 women were analyzed . No differences for preterm birth ( p = 0.721 ) , low birth weight ( p = 0.198 ) , and preterm low birth weight ( p = 0.732 ) rates were observed . Relative risk estimates for preterm birth , low birth weight , and preterm low birth weight in the periodontitis intervention group were 0.915 ( 95 % CI 0.561–1.493 ) , 0.735 ( 95 % CI 0.459–1.179 ) , and 0.927 ( 0.601–1.431 ) , respectively . Non-surgical periodontal treatment during the second semester of gestation did not reduce the risk for preterm birth , low birth weight , and preterm low birth weight Considering the high prevalence of preterm birth ( PTB ) and low birth weight ( LBW ) and their complications as well as the role played by periodontal disease in their incidence and the lack of any report of periodontal therapy on these problems in Iran , the goal of the present research was to determine the effects of periodontal treatment on PLBW incidence among women with moderate or advanced periodontitis who were referred to Javaheri hospital ( 2004 - 2005 ) . This clinical trial research was conducted on 30 pregnant women age ranging from 18 - 35 years old , with moderate or advanced periodontitis . Fifteen subjects r and omly underwent the first phase of periodontal treatment including scaling , root planning and the use of 0.2 % chlorhexidine mouth rinse for one week . None of these steps were taken for the controls . After necessary follow ups , the effect of periodontal treatment on birth term and birth weight were analyzed statistically . This research was conducted on 30 subjects , 15 controls and 15 cases in study group . In the control group , the observed rate of PLBW was 26.7 % whereas among periodontally treated group , phase I , PLBW infant was not observed ( P < 0.05 ) . Infants birth weight were ( 3059.3 - 389.7 ) gms in study group and ( 3371 - 394.2 ) gms in the control group and respectively ( P < 0.05 ) . Periodontal therapy , phase I , results in a reduction in PLBW incidence rate . Therefore , the application of such a simple method among periodontally diseased pregnant women is recommended BACKGROUND The purpose of the present study is to investigate the potential link between maternal periodontitis and pregnancy outcomes , including  preterm birth ( < 37 weeks ) and low birth weight ( < 2,500 g ) . METHODS Ninety nine pregnant females with mild/moderate periodontitis were r and omly allocated to a control ( n = 50 ) or test ( n = 49 ) group . Test group participants received intrapregnancy non-surgical periodontal treatment , whereas this was deferred until after delivery for controls  . Demographic and baseline clinical data were obtained for all participants at initial assessment pretreatment . Clinical data were rerecorded for test participants at review 8 weeks after treatment . Birth outcomes were completed at delivery by midwives who also collected cord blood sample s when possible ; the latter were analyzed to determine the presence/levels of cytokines interleukin (IL)-1β , IL-6 , and IL-8 . All data were analyzed on an intention-to-treat basis using appropriate statistical tests . RESULTS R and om allocation of participants result ed in well-balanced control and test groups . All test group participants and all but one control participant gave birth to a live infant . No significant differences were detected between control and test groups with regard to birth outcome measures of birth weight and gestational age or in relation to cytokine prevalence/levels . CONCLUSION Intrapregnancy non-surgical periodontal treatment , completed at 20 to 24 weeks , did not reduce the risk of preterm , low-birth-weight delivery in this population BACKGROUND Few studies have examined the potential effects of  periodontal treatment during pregnancy on  pregnancy outcomes , periodontal status , and inflammatory biomarkers . METHODS A r and omized , delayed-treatment , controlled pilot trial was conducted to evaluate the effects of second-trimester scaling and root planing and the use of a sonic toothbrush on the rate of preterm delivery ( < 37 weeks gestation ) . Secondary outcome measures included changes in periodontal status , levels of eight oral pathogens , levels of gingival crevicular fluid ( GCF ) interleukin-1beta ( IL-1beta ) , prostagl and in E(2 ) ( PGE(2 ) ) , 8-isoprostane ( 8-iso ) , and IL-6 , and serum levels of IL-6 , soluble intercellular adhesion molecule 1 ( sICAM1 ) , 8-isoprostane , soluble glycoprotein 130 ( sGP130 ) , IL-6 soluble receptor ( IL-6sr ) , and C-reactive protein ( CRP ) . Logistic regression models were used to test for effects of treatment on preterm delivery . Secondary outcomes were analyzed by analysis of covariance adjusting for subject baseline values . RESULTS Periodontal intervention result ed in a significantly decreased incidence odds ratio ( OR ) for preterm delivery ( OR = 0.26 ; 95 % confidence interval = 0.08 to 0.85 ) , adjusting for baseline periodontal status which was unbalanced after r and omization . Pregnancy without periodontal treatment was associated with significant increases in probing depths , plaque scores , GCF IL-1beta , and GCF IL-6 levels . Intervention result ed in significant improvements in clinical status ( attachment level , probing depth , plaque , gingivitis , and bleeding on probing scores ) and significant decreases in levels of Prevotella nigrescens and Prevotella intermedia , serum IL-6sr , and GCF IL-1beta . CONCLUSIONS Results from this pilot study ( 67 subjects ) provide further evidence supporting the potential benefits of periodontal treatment on pregnancy outcomes . Treatment was safe , improved periodontal health , and prevented periodontal disease progression . Preliminary data show a 3.8-fold reduction in the rate of preterm delivery , a decrease in periodontal pathogen load , and a decrease in both GCF IL-1beta and serum markers of IL-6 response . However , further studies will be needed to substantiate these early findings BACKGROUND A recent clinical trial ( Obstetrics and Periodontal Therapy [ OPT ] Study ) demonstrated that periodontal therapy during pregn 
    Output:
    
Conclusion : With best possible evidence , it can be inferred that nonsurgical periodontal therapy is safe during pregnancy .