Abstract | U stanju trudnoće povećava se rizik od nastanka parodontnih bolesti. Kombinacija
bakterija u plaku i povećanih ženskih spolnih hormona u krvotoku uzrokuje intenzivniju
pojavu simptoma već i kod manje količine plaka. Neke od najučestalijih parodontnih bolesti
koje se pojavljuju u trudnoći su gingivitis, parodontitis i trudnički granulom. U parodontitisu,
parodontni džepovi djeluju poput žarišta koje može utjecati na odaljene organe. Zato, s
perzistirajućom parodontnom bolesti, postoje rizici od nepovoljnih ishoda trudnoće kao što su
preeklampsija, prijevremeni porod, niska porođajna težina, infekcije, gestacijski dijabetes i
mrtvorođenost.
Rizični čimbenici pospješuju nastanak i progresiju parodontne bolesti. Mogu se
podijeliti na nemodificirane faktore kao što su genetski čimbenici, dob, etnička pripadnost,
spol i sustavne bolesti, a u modificirane se ubrajaju socioekonomski status, oralna higijena,
pretilost, stres, specifične hormonske promjene tijekom trudnoće i pušenje, koje ima utjecaj
na plod i radi štetnosti duhanskog dima.
Liječenje parodontne bolesti se postiže nekirurškom parodontnom terapijom koja je
sigurna u gestacijskom razdoblju, te je drugi trimestar najpovoljniji za njeno provođenje.
Iznimno je važno uzeti anamnezu pacijentice, napraviti temeljiti klinički pregled i shodno
tome, plan terapije. Rendgensko snimanje se može provesti ako je nužno, te se mogu i
primijeniti analgetici, anestetici i antibiotici, izuzev tetraciklina. Osim parodontne terapije,
važno je obrazovati trudnice o temeljitoj oralnoj higijeni, upotrebi mekanih četkica i
interdentalnih sredstava uz redovite posjete doktoru dentalne medicine. |
Abstract (english) | During pregnancy, the risk of periodontal disease is increased. The combination of
bacteria in plaque and increased female sex hormones in the bloodstream can cause intense
symptoms, even when it comes to smaller amounts of plaque. Some of the most common
periodontal diseases that occur during pregnancy are gingivitis, periodontitis and pregnancy
granuloma. In periodontitis, periodontal pockets act like a focal point that can affect the
distant organs. Therefore, with persistent periodontal disease, risks of adverse pregnancy
outcomes arise, such as preeclampsia, premature birth, low birth weight, infection, gestational
diabetes, and morbidity.
Risk factors promote the onset and progression of periodontal disease itself. They can be
divided into unmodified factors such as genetic factors, age, ethnicity, gender and systemic
diseases; and into modified factors such as socioeconomic status, oral hygiene, obesity,
stress, specific hormonal changes during pregnancy and smoking, which has detrimental
influence on the foetus due to the danger of tobacco smoke.
Treatment of periodontal disease can be achieved through non-surgical periodontal
therapy that is safe during the gestational period, while the second trimester is most
conducive to its implementation. It is extremely important to take into consideration the
patient's medical history, to make a thorough clinical examination and to devise a therapy
plan accordingly. X-ray recording can be performed if necessary, and analgesics, anesthetics
and antibiotics can be used, with the exception of tetracycline. In addition to periodontal
therapy, it is important to educate pregnant women on thorough oral hygiene, using soft
toothbrushes and interdental agents with regular examinations at the dentist.
Keywords: adverse pregnancy outcomes; periodontal disease; periodontal therapy; pregnancy |