***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 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: 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 BACKGROUND AND OBJECTIVE A low- grade systemic inflammatory status originating from periodontal infection has been proposed to explain the association between periodontal disease and systemic conditions , including adverse obstetric outcomes . The aim of this study was to evaluate the effect of periodontal therapy during pregnancy on the gingival crevicular fluid and serum levels of six cytokines associated with periodontal disease and preterm birth . MATERIAL AND METHODS A sub sample of 60 women ( 18 - 35 years of age ) up to 20 gestational weeks , previously enrolled in a larger r and omized clinical trial , was recruited for the present study . Participants were r and omly allocated to receive either comprehensive nonsurgical periodontal therapy before 24 gestational weeks ( n = 30 , test group ) or only one appointment for supragingival calculus removal ( n = 30 , control group ) . Clinical data , and sample s of blood and gingival crevicular fluid , were collected at baseline , at 26 - 28 gestational weeks and 30 d after delivery . The levels of interleukin (IL)-1β , IL-6 , IL-8 , IL-10 , IL-12p70 and tumor necrosis factor-α were analyzed by flow cytometry . RESULTS After treatment , a major reduction in periodontal inflammation was observed in the test group , with bleeding on probing decreasing from 49.62 % of sites to 11.66 % of sites ( p < 0.001 ) . Periodontal therapy significantly reduced the levels of IL-1β and IL-8 in gingival crevicular fluid ( p < 0.001 ) . However , no significant effect of therapy was observed on serum cytokine levels . After delivery , the levels of IL-1β in the gingival crevicular fluid of the test group were significantly lower than were those in the control group ( p < 0.001 ) , but there were no significant differences between test and control groups regarding serum cytokine levels . CONCLUSION Although periodontal therapy during pregnancy successfully reduced periodontal inflammation and gingival crevicular fluid cytokine levels , it did not have a significant impact on serum biomarkers 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  Preterm low birth weight was reported to be related to periodontal infections that might influence the fetus-placenta complex . The aim of this study was to provide periodontal treatment for pregnant women and to evaluate if this treatment can interfere with pregnancy duration and weight of the newborn . METHODS The sample consisted of 450 pregnant women who were under prenatal care at a polyclinic in Três Corações , Brazil . Women with risk factors , such as systemic alterations ( ischemic cardiopathy , hypertension , tuberculosis , diabetes , cancer , anemia , seizure , psychopathology , urinary tract infection , sexually transmitted diseases , asthma , and human immunodeficiency virus ) , and /or users of alcohol , tobacco , and drugs were excluded from the study . Data related to age , socioeconomic level , race , marital status , number of previous pregnancies , and previous preterm delivery also were evaluated . Initially , the sample was divided into two groups : 122 healthy patients ( group 1 ) and 328 patients with periodontal disease  ( group 2 ) . In group 2 , 266 patients underwent treatment and 62 patients dropped out . After mothers gave birth , pregnancy duration and the weight of all infants were analyzed and recorded . RESULTS There was no statistical difference between the healthy and treated groups . However , there was a difference in the non-treated group , with a 79 % incidence of preterm low birth weight . Educational level , previous preterm birth , and periodontal disease were related significantly to preterm delivery ( P < 0.001 ) . CONCLUSION Periodontal disease was related significantly to preterm low birth weight BACKGROUND Periodontitis has been associated with increased risk of adverse pregnancy outcomes and elevated C-reactive protein ( CRP ) concentrations in non-pregnant adults . We examined the relationship between periodontitis and CRP among women who provided dental radiographs and had blood collected during early pregnancy , excluding smokers and diabetic patients . METHODS From Project Viva , an ongoing cohort study , we measured plasma CRP in 35 subjects with periodontitis ( i.e. , at least one site with > or =3 mm of alveolar bone loss ) and a r and om sample of 66 periodontally healthy subjects matched on age and race/ethnicity . We performed linear regression analysis with log-transformed CRP levels as the outcome . RESULTS The mean ( + /- SE ) CRP level was 65 % higher ( 95 % confidence interval : -2 % , 180 % ; P = 0.06 ) in women with periodontitis ( 2.46 + /- 0.52 mg/l ) than in controls ( 1.49 + /- 0.22 mg/l ) , adjusting for factors related to CRP levels , including age , race/ethnicity , pre-pregnancy body mass index , alcohol intake , education , income , and gestational age at blood collection . CONCLUSIONS These findings suggest that periodontitis may increase CRP levels in pregnancy . CRP could potentially mediate the association of periodontitis with adverse pregnancy outcomes BACKGROUND The purpose of this study is to present the use of a non-r and omized experimental design with multiple controls , with emphasis on a historical control group , as an alternative method ologic re source for studies on the association between periodontal disease and prematurity/low birth weight . METHODS The sample consisted of 234 pregnant women : 54 in the Test Group ( treatment of periodontal disease ) ; 68 in Control Group I ( without periodontal disease ) ; and 112 in Control Group II ( historical control group , with untreated periodontal disease ) . The diagnosis of periodontal disease was established by means of a complete clinical examination , using measurements of probing depth , gingival recession , clinical attachment loss , and bleeding index . The women in the Test Group were treated for periodontitis and followed-up with periodontal support therapy throughout their pregnancies . After delivery , they were reevaluated regarding their periodontal condition , and information on the newborn 's birth weight was obtained . This was also done for Control Groups I and II . Descriptive analyses on the study variables were performed using the χ(2 ) and Fisher exact tests . Association measurements ( relative risk ) were obtained using a significance level of 5 % . RESULTS The frequency of low birth weight among the Test Group was similar to Control Group I and lower than Control Group II . CONCLUSION The results suggest that successful periodontal therapy in pregnant women suffering from periodontitis is a protective factor promoting the birth of children with normal weight BACKGROUND Recent studies have suggested that periodontal disease is a risk factor for  preterm low birth weight ( PLBW ) .  A r and omized controlled trial was undertaken to help further evaluate the proposed association between periodontal disease and PLBW . METHODS Four hundred pregnant women with periodontal disease , aged 18 to 35 , were enrolled while receiving prenatal care in Santiago , Chile . Women were r and omly assigned to either an experimental group ( n = 200 ) , which received periodontal treatment before 28 weeks of gestation or to a control group ( n = 200 ) which received periodontal treatment after delivery . Previous and current pregnancies and known risk factors were obtained from patient medical records and interviews . The primary outcome assessed was the delivery at less than 37 weeks of gestation or an infant weighing less than 2,500 g. RESULTS Of the 400 women enrolled , 49 were excluded from the analyses for different reasons . The incidence of PLBW in the treatment group was 1.84 % ( 3/163 ) and in the control group was 10.11 % ( 19/188 ) , ( odds ratio [ OR ] 5.49 , 95 % confidence interval [ CI ] 1.65 to 18.22 , P= 0.001 ) . Multivariate logistic regression analysis showed that periodontal disease was the strongest factor related to PLBW ( OR 4.70 , 95 % CI 1.29 to 17.13 ) . Other factors significantly associated with such deliveries were : previous PLBW ( OR 3.98 , 95 % CI 1.11 to 14.21 ) , less than 6 prenatal visits ( OR 3.70 , 95 % Cl 1.46 to 9.38 ) , and maternal low weight gain ( OR 3.42 , 95 % CI 1.16 to 10.03 ) . CONCLUSIONS Periodontal disease appears to be an independent risk factor for PLBW .  Periodontal therapy significantly reduces the rates of PLBW in this population of women with periodontal disease AIM Determine whether periodontitis progression during pregnancy is associated with adverse birth outcomes . METHODS We used clinical data and birth outcomes from the Obstetrics and Periodontal Therapy Study , in which r and omly selected women received periodontal treatment before 21 weeks of gestation ( N=413 ) or after delivery ( 410 ) . Birth outcomes were available for 812 women and follow-up periodontal data for 722 , including 75 whose pregnancies ended < 37 weeks . Periodontitis progression was defined as > or=3 mm loss of clinical attachment . Birth outcomes were compared between non-progressing and progressing groups using the log rank and t tests , separately in all women and in un 
    Output:
    
Intra-pregnancy nonsurgical periodontal therapy improved periodontal clinical parameters ( periodontal pocket depth , clinical attachment level , and bleeding on probing ) and reduced biomarker level from gingival crevicular fluid ( GCF ) , and some from blood serum ; however , it did not influence biomarker level from umbilical cord blood .
Conclusions These results demonstrated that the intra-pregnancy nonsurgical periodontal therapy decreased periodontal inflammatory biomarker levels from gingival crevicular fluid and some from serum blood , with no influence on inflammatory biomarker level from cord blood , and it did not consistently reduce adverse gestational adverse outcome occurrence .