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Table 2 Characteristics of included studies

From: Is the use of contraceptives associated with periodontal diseases? A systematic review and meta-analyses

Author, year, country;

Participants

Age

Periodontal Evaluation

Administration

Statitic analysis

Results

Type of study

Study site

Sample size

Smadi and Zakarya [20]; Jordan

Case Control

Ginecology Clinic at the Islamic Hospital

(281)

Case Group

(142)

Control Group

(139)

Mean: Case Group

(26.7 ± 7.5)

Control Group

(24.5 ± 6.9)

OHI-S, SBI, CAL, GI (number of teeth examined)

Oral

Student’s t‑test

There was statistically significant difference in all evaluated clinical parameters among groups OHI-S (p = 0.002), GI (p = 0.001), SBI (p = 0.001), CAL (p = 003)

Farhad et al. [19]. Iran

Case control

Azad Dental School of Khorasgan

(60)

Case group

(35)

Case Control

(25)

Mean:

28.5 years

PD, CAL, PI, BOP

Oral

Student’s t-test and Mann–Whitney test

Only PI did not show statistically significant difference among groups (p < 0.05)

Abd-Ali [21]

Case Control

Hospital of collage of Al-Mustansiri

(80)

Case group

(40)

Control group

(40)

Mean ± SD

Case Group 29.15 ± 5.83

Control Group

28.45 ± 3.75

GI (GI of Loe and Silness (39))

Niveis de IgA

Oral

Simple linear regression

Gingival index was significantly higher among oral contraceptive users than non-users (p < 0.01)

Domingues; Ferraz. et al. [23]; Brazil

Case Control

Bauru School of Dentistry, Universaty of São Paulo, Brazil

(50)

Case Group

(25)

Control Group

(25)

Mean: 24 years

PD, CAL, SBI and Pl.I

Oral

unpaired t, Pearson’s correlation test, Spearman’s correlation test for non-linear measurements

The test group showed increased PD (p < 0.0001) and SBI (p < 0.0001) as compared to controls. No significant differences between groups were found in CAL (p = 0.11). The control group showed greater Pl.I than the test group (p < 0.0001)

Brusca et al. [22]; Argentina

Case Control

University and private clinic offices

(92)

Case Group

(41)

Control group

(51)

Mean ± SD

30.34 ± 6.2

Years

GI, PI, PD, CAL

Oral

Chi-square test

Contraceptive users, particularly smokers, demonstrated a statistically significant higher prevalence of severe periodontitis (p < 0.01) and deeper probing depths ≥ 5 mm) than non-users. Moreover, contraceptive users presented higher GI scores and CAL, ≥ 2 and, ≥ 5 mm, respectively, than non-users (p < 0.01)

Haerian-Ardakan et al. [24]; Iran

Case Control

Kasturba Medical College

(60)

Case group

(35)

Control

Group

(25)

Mean: 24 years

PD, BOP, PI, CAL

Oral

Mann–Whitney and t-test, p < 0.05

A statistically significant difference in GI and BOP was observed (p < 0.0001)

Vijay et al. [24], Índia

Case Control

Kasturba Medical College

(65)

Case group

(43)

Control group

(22)

Mean ± SD

Case Group I: 26.94 ± 3.28

II: 29.05 ± 2.04

III: 30.75 ± 2.06

Control Group:

25.09 ± 3.26

PI (Silness e Loe) PI (Russel), Radiographic paramaters

Oral

Student’s t’s test

Statistically significant difference was observed in all parameters (p < 000.1)

Kazerooni et al. [30]; Iran

Cross-sectional

 

(148)

Case Group

(101)

Control group

(47)

 

PD

Levonorgestrel Implants

Mann–Whitney test, test V2

In the study group, the pocket depth around the distal (p = 0.001) and middle (p = 0.001) aspects of the anterior teeth and the middle aspect of the premolars (p = 0.02) was significantly increased at 6 months. In comparison with the control group, except around the distal aspect of the premolars (p = 0.09) and the mesial aspect of the anterior teeth (p = 0.07), pocket depth was significantly increased in the study group

Seck et al. [34]; França

Case Control

Centre de Soins Integres Abass Ndao

(200)

Case Group

(100)

Control Group

(100)

15–45 years

PI (Loe and Silness), GI (Loe & Silness), PD, CAL

Oral, Injectable, implants

Wilcoxon test

With equal hygiene, the scores of the gingival index were significantly higher among women under contraceptive (p < 0.001). Inflammation was significantly more marked for the women Who used contraception in injectable form compared to the control group (p < 0.001). Probing depth and clinical attachment loss were significantly higher among women under contraceptive (p < 0.001)

Mullualy et al. [32]; Irlanda do Norte

Case Control

University Belfast, Belfast, Northern Irland

(42)

Case group (21)

Control Group

(21)

Mean: 26.5 years

GI (GI of Loe and Siiness (39)), PI, BOP, PD, CAL

Oral

ANOVA

Regression analysis

Current pill users had deeper mean probing depths compared to nonusers (p = 0.006) and more severe attachment loss p = 0.015). Pill users had more sites with bleeding on probing (p = 0.017)

Taichman et al. [35]

Cross-sectional

First and third

National Health and Nutrtion Examination Suryeys (NHANES I and NHANES III)

NHANES I: (4413)

Case Group:

(3307) NHANES II: 4169

Case group: (842)

Control Group:

(3327)

Mean: 33.5 years

PI, OHI-S, CAL, PD

Oral

Logistic regression multivariable

Premenopausal women who use HC are more likely to present severe gingivitis and periodontitis (p < 0.05). However, in the postmenopausal phase it was reported that estrogen supplementation would be associated with improved gingival health

Tilakaratne et al. [36]; London

Case Control

University Of Peradeniya. Sri-Lanka;

(88)

Case group

(49)

Control group

(39)

Mean:

26.5 years

PI, GI, CAL

Oral and injetable

one-way

ANOVA

The contraceptive users had a significantly higher level of GI and CAL, compared to the non-users (p, 0.001)

Jensen et al. [28]; EUA

Case control

University of Minnesota Obstetrics and Gynecological Clinic

(104)

Case group-NPP

(50)

Control Group- NP:

(54)

Mean: 29 years

GI,GCF, DP

Oral

Kornman and Loesche

There was not statistical difference among groups in all parameters (p > 0.05)

Pankhurst et al. [33]; London

Case control

Margaret Pyke Centre London

(151)

Case group

(112)

Control group

(39)

Mean: 29 years

% PI, GI, CAL, PD

Oral

Two-way analysis of variance

A statistically significant higher gingival inflammation was observed and related to the duration of drug therapy. There were no significant differences in CAL between groups

Kalkawarf [29]; EUA

Case control

Dentustry clinic of the University of Nebraska College of Dentistry

(189)

Case group

(114)

Control

Group

(75)

Mean: 26.5 Years

Mean Oral Debris Index an a mean Gingival Inflammatory Index

Oral

Mean ± SD

The use of different hormonal contraceptives is associated with different degrees of gingival inflammation depending on the concentration of progesterone and estrogen (p < 0.001)

Grower et al. [27]; EUA

Case control

 

(12)

Case group

(05)

Control group

(07)

Mean: 26.6 Years

PI, GI

Oral

Mean ± SD, Mann, Whitney U-test

There was not statistically significant difference among all parameters (p > 0.05)

Knight et al. [31]; Reino Unido

Case Control

Margaret Pyke Centre Of The Family in London

(171)

Case group

(89)

Control group

(72)

Mean: 17–23 years

PI, GI, CAL

Oral

Student’s t test

A statistically significant difference was observed only in GI (p < 000.1)

El-Ashiry et al. [26]; Egypt

Cross-sectional

University School of Dentistry, Cairo, Egypt

(120)

Case group

(70)

Control group

(50)

Mean: 28.5 years

Gengival Mean Calculus Scores

Oral

Gingival mean, Calculus Scores and T test

The highest effects of HC are observed during the first 3 months and gingival exudate only increases during the first 6 months, due to the greater release of mast cells during this period of HC intake (p < 0.01)

  1. BOP: Bleeding on probing; CAL: Clinical attachment level; GCF: Gingival crevicular fluid; GI: Gingival index; OHI-S: Oral hygiene index; PD: Probing depth; PI: Plaque index; SBI: Sulcular bleeding index