Early and innovative diagnostic strategies are required to predict the risk of developing pre-eclampsia (PE). The purpose of this study was to evaluate the performance of gingival crevicular fluid (GCF) placental alkaline phosphatase (PLAP) concentrations to correctly classify women at risk of PE. A prospectively collected, retrospectively stratified cohort study was conducted, with 412 pregnant women recruited at 11–14 weeks of gestation. Physical, obstetrical, and periodontal data were recorded. GCF and blood samples were collected for PLAP determination by ELISA assay. A multiple logistic regression classification model was developed, and the classification efficiency of the model was established. Within the study cohort, 4.3% of pregnancies developed PE. GCF-PLAP concentration was 3- to 6-fold higher than in plasma samples. GCF-PLAP concentrations and systolic blood pressure were greater in women who developed PE (p = 0.015 and p < 0.001, respectively). The performance of the multiparametric model that combines GCF-PLAP concentration and the levels of systolic blood pressure (at 11–14 weeks gestation) showed an association of systolic blood pressure and GCF-PLAP concentrations with the likelihood of developing PE (OR:1.07; 95% CI 1.01–1.11; p = 0.004 and OR:1.008, 95% CI 1.000–1.015; p = 0.034, respectively). The model had a sensitivity of 83%, a specificity of 72%, and positive and negative predictive values of 12% and 99%, respectively. The area under the receiver operating characteristic (AUC-ROC) curve was 0.77 and correctly classified 72% of PE pregnancies. In conclusion, the multivariate classification model developed may be of utility as an aid in identifying pre-symptomatic women who subsequently develop PE.

Introduction The quick spread of COVID-19 has caused part of the world's population to adopt quarantine protocols that have limited professional activities, including dental training programmes. This study aimed to explore the experiences of students and personnel at a Chilean dental school during the COVID-19 pandemic. Materials and Methods This phenomenological descriptive qualitative study reported staff and students' experiences during the pandemic through in-depth, semi-structured interviews. These were recorded on audio and video with a digital platform. Three researchers then transcribed and analyzed the recordings and codified the answers into categories to determine the emerging topics until a saturation point was reached. Results The core emerging themes among the staff group were (1) change in the personal/professional life balance, (2) online learning through digital platforms, (3) staff perceptions of students' learning experiences, and (4) concerns about the future. For students, the themes were (1) changes in the learning process, (2) online learning through digital platforms, (3) interpersonal relationships, and (4) concerns about the future. Conclusion The COVID-19 pandemic has been a period of learning for our dental school staff and students. Even though online learning has been a useful tool for delivering didactic (theoretical) concepts, it has been unable to replace conventional education, including skills training. Students and teachers reported being overwhelmed at the beginning of the pandemic, but they have shown remarkable adaptability and resilience during this period.

Objective: To evaluate the accuracy of concentrations of gingival crevicular fluid (GCF) placental alkaline phosphatase (PLAP) during early pregnancy in identifying women at risk of subsequently developing preeclampsia (PE). Design: Prospective cohort study. Setting: Hospital Sotero del Rio, Santiago, Chile. Population: Pregnant women recruited at 11-14 weeks of gestation. Methods: Maternal obstetric and periodontal histories were obtained. GCF samples were collected for PLAP determination by ELISA assay. Multiple logistic regression models estimated the association between GCF-PLAP concentrations, maternal variables, and PE development. The accuracy performance of the prediction model was established. Results: 460 women were recruited into the study, and 412 completed their pregnancy follow–up visit. 18 (4.3%) women developed PE. GCF-PLAP concentrations and systolic blood pressure measurements were significantly higher in women who developed PE (p=0.015 and p<0.001, respectively). An association between first-trimester systolic blood pressure, GCF-PLAP, and PE were established. The predictive model had a sensitivity of 83%, specificity of 72%, a positive predictive value (PPV) of 12%, and a negative predictive value (NPV) of 99%. The positive and negative likelihood ratios were 2.9 and 0.3, respectively, thus classifying correctly 72% of women who subsequently developed PE. The area under the receiver operating characteristic curve was 0.77 for PE and 0.85 for preterm PE. Conclusions: An algorithm that includes PLAP concentrations in GCF and blood pressure during early pregnancy may aid in the identification of women at risk of developing PE. Funding: FONDEF IDeA: ID16I10452. NICHD/NIH/DHHS: HHSN275201300006C. Keywords: a cohort study, gestation, hypertension, placental biomarkers, risk prediction model.

BACKGROUND Gestational diabetes mellitus (GDM) is increasing worldwide and women with a history of GDM are at risk of developing type 2 diabetes which is a risk factor for periodontitis. AIM To explore the association between the concentrations of matrix metalloproteinase (MMP)-8 and -9 in gingival crevicular fluid (GCF) during early pregnancy with the periodontal diagnosis and the risk of GDM development. MATERIALS AND METHODS A prospective cohort study, including 314 women, enrolled at 11-14 weeks of pregnancy was conducted. A complete maternal/obstetric and periodontal exam was performed, and GCF samples were obtained for the MMP-8 and -9 determination by Multiplex Elisa Assays. Mann-Whitney test; Spearman's correlation and log-binomial regression model estimated the association between MMPs concentration in GCF and GDM. RESULTS 14% of the pregnancies were diagnosed with GDM. An increase in the concentration of MMP-8 and -9 in women with periodontitis stage III and IV compared to periodontitis stage I was observed (99.31 ng/ml [IQR: 85.32] v/s 71.95 ng/ml [IQR: 54.04], and 262.4 ng/ml [IQR: 312.55] v/s 114.1 ng/ml [IQR: 184.94], respectively). Women who developed GDM showed increased concentrations of MMP-8 and -9 in GCF since the beginning of pregnancy (p = 0.0381; p = 0.0302, respectively). MMP-8 concentration in GCF was associated with GDM (RR: 1.19; p = 0.045; CI 95% 1.00-1.40; and RR: 1.20; p = 0.063; CI 95% 0.99-1.45 in the adjusted model). CONCLUSION(S) GCF concentrations of MMP-8 and -9 at early of pregnancy are increased in women with severe periodontitis and associated with the GDM development. This article is protected by copyright. All rights reserved.