“…1,2,3,4,5,6 Several factors have been investigated during research on periodontal disease in pregnancy, including hormone levels, 7,8 virulence factors of microorganisms, 9,10 changes in immunologic responses, 5,11 and microbiota. 12,13,14,15,16,17,18 Various types of analysis and models have proven helpful in understanding the multi-factorial causes of periodontal disease. 7,8,19,20,21 Of these, bacterial challenge studies have provided a valuable contribution to understanding the complex pathogenesis of periodontal disease.…”