Periapicale aandoeningen bij zwangeren en jonggeborenen

Geïnfecteerde wortelkanalen kunnen de oorzaak zijn van periapicale ontstekingen. Uit de onderzoeksliteratuur blijkt dat deze infectie zich kan uitbreiden naar de omgeving van het aangedane gebitselement en zelfs naar andere delen van het lichaam zoals de huid, de sinussen of naar de vaatstelsels. Maar omdat het ontstekingsgebied relatief gering is, zullen de systemische verschijnselen in het algemeen ook gering zijn. In diermodellen konden bij parodontitis apicalis echter geen of zeer zelden verhoogde ontstekingsparameters in het bloed worden aangetoond, uitzonderingen daargelaten.

The objective of this study was to determine whether the presence of maternal tooth periapical lesions was associated with foetal brain inflammation in a pregnant rat model. Sprague-Dawley rats were divided into two groups: pregnant rats with induced periapical abscesses (E, n=8) and sham-operated control pregnant rats (S, n=8). The pulps of the first and second maxillary right molars had been exposed and the tooth left open to the oral environment for two weeks prior to initiation of the pregnancy. Following delivery of the pups (E, n=99; S, n=101), each pup was decapitated and the brain was removed and immediately frozen in liquid nitrogen. The tissues were solubilized in PBS containing a protease inhibitor, and norepinephrine (NE), IL-6, IL-1-β, TNF-α, and myelin basic protein (MBP) were determined by ELISA. Group means were compared by factorial analysis of variance, a post E pups were significantly heavier than S pups. Brain tissue concentrations of IL-6, IL-1-β, and TNF-α were significantly higher and MBP and norepinephrine concentrations significantly lower in E pups than S pups. Concentrations of IL-6, TNF-α and IL-1-β were significantly correlated between E serum, pup birthweight, and E pup brain tissue. MBP, NE and IL-6 were significantly correlated within the brain tissues of E pups.The data suggest that brain inflammation may be associated with maternal periapical inflammation. This association identifies a modifiable risk factor for adverse pregnancy outcomes.

Bron

Bain JL, Lester SR, Henry WD, Pongetti JL, Blackman ME, Johnson RB. Association between maternal periapical lesions and brain inflammation in rat pups. Arch Oral Biol 2013; 58: 266-271. doi: 10.1016/j.archoralbio.2012.11.007. Epub 2012 Dec 12.