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Biomedical subjects

J Slots

Publications and source records attributed to J Slots.

At least 73 records · Page 4Linked to original sources

Clinical and microbiological evaluation of a bioabsorbable and a nonresorbable barrier membrane in the treatment of periodontal intraosseous lesions.

Clinical and microbiological features of periodontal healing in barrier membrane-treated sites were determined in a randomized clinical trial. The study included 10 patients with advanced adult periodontitis and a minimum of one set of similar 2 to 3 wall intraosseous periodontal lesions with no furcation involvement. In each patient, one periodontal lesion was treated with a biodegradable membrane and a contralateral lesion with a nonresorbable barrier membrane. Within the preceding 3 months of regenerative therapy, all patients received full mouth osseous surgery except for the sites for regeneration, were instructed in oral hygiene, and were prescribed systemic ciprofloxacin and metronidazole (250 mg of each, TID, 8 days), starting 7 days before membrane placement. At baseline and at 6 months postsurgery, probing depth and clinical attachment level were assessed in each study site. The subgingival presence of suspected periodontal pathogens was determined by non-selective and selective culture and by DNA probe analyses, and of human cytomegalovirus (HCMV) and Epstein-Barr virus type 1 (EBV-1) by a nested-polymerase chain reaction detection method. At baseline, the barrier-treated sites did not differ significantly in clinical and microbial parameters. Mean baseline probing depth was 7.8+/-1.1 mm for bioabsorbable and 7.9+/-1.3 mm for nonresorbable barrier-treated sites. At 6 months, sites treated with bioabsorbable barrier revealed 4.6+/-1.7 mm gain of clinical attachment (range: 1 to 7 mm) and sites treated with nonresorbable barrier 4.2+/-2.0 mm (range: 1 to 8 mm). The 11 barrier-treated sites that harbored 10% or less bacterial pathogens and were free of HCMV and EBV-1 averaged significantly more clinical attachment gain than the 9 sites that yielded more than 10% bacterial pathogens and/or test viruses (5.6 mm versus 3.0 mm; P=0.005). The present data suggest bioabsorbable and nonresorbable barriers provide similar clinical healing of 2 to 3 wall intraosseous periodontal lesions, emphasize the importance of controlling bacterial pathogens prior to and during periodontal healing, and point to the possible detrimental role of HCMV and EBV-1 in periodontal repair.

Adult↗

The utility of whole saliva to detect the oral presence of periodontopathic bacteria.

This study compared the presence of 6 periodontopathic bacteria in whole saliva and subgingival plaque of 202 subjects. The test bacteria were identified using a 16S rRNA-based PCR detection method. Each study subject contributed a whole saliva sample and a paper point sample pooled from the deepest periodontal pocket in each quadrant of the dentition. The kappa test revealed a fair agreement between the presence of Porphyromonas gingivalis, Prevotella intermedia, and Treponema denticola in whole saliva and periodontal pocket samples (kappa > 0.4). The McNemar test showed that the differences between sample types were due to a more frequent detection of the 3 organisms in whole saliva than in periodontal pocket samples (P < 0.01). Prevotella nigrescens also was detected more frequently in whole saliva than in periodontal pocket samples (P < 0.01; McNemar test). Although little agreement between samples was found for Actinobacillus actinomycetemcomitans and Bacteroides forsythus (kappa < or = 0.4), neither whole saliva nor pocket samples showed better detection for these 2 species (P < 0.01, McNemar test). The results indicate that whole saliva is superior to pooled periodontal pocket samples to detect P. gingivalis, P. intermedia, P. nigrescens, and T. denticola in the oral cavity. The detection of oral A. actinomycetemcomitans and B. forsythus with reasonably good accuracy may require both whole saliva and periodontal pocket samples.

Adult↗

Transmission and persistence of Actinobacillus actinomycetemcomitans in twins with advanced periodontitis.

The arbitrarily primed polymerase chain reaction technique (AP-PCR) was used to fingerprint Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis isolates in 44-year-old African American male and female twins who had not lived in the same household for 26 years. Both twins exhibited severe loss of periodontal attachment on several maxillary and mandibular teeth. All isolates of A. actinomycetemcomitans yielded the same AP-PCR banding pattern, whereas the P. gingivalis isolates from each twin showed different AP-PCR profiles. The finding of the same amplitype of A. actinomycetemcomitans in both twins suggests a single source of the organism and possibly a persistence of the organism in each twin for at least 26 years.

Actinobacillus Infections↗

Immune response to Fusobacterium nucleatum, Prevotella intermedia and other anaerobes in children with acute tonsillitis.

The number of aerobic and anaerobic bacteria was determined in the saliva of 20 children with acute group A beta-haemolytic streptococcal (GABHS) pharyngo-tonsillitis, and 20 with acute non-GABHS tonsillitis. Antibody titres to four Gram-negative anaerobic bacilli that reside in the oropharynx (Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas gingivalis, and Actinobacillus actinomycetemcomitans) were determined in these and 20 control patients. An average of 8.8 aerobic and anaerobic isolates per patient saliva specimens were found during the acute tonsillitis stage in both groups, and 6.9 (in GABHS tonsillitis) and 5.6 (in non-GABHS tonsillitis) 5-6 weeks later. There were 10- to 1000-fold more bacteria in the acute stages of the inflammation in both GABHS and non-GABHS groups. These bacteria were Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis, Peptostreptococcus spp., F. nucleatum, Prevotella spp. and Porphyromonas spp. Significantly higher antibodies levels to F. nucleatum and P. intermedia were found in the second serum sample of patients with non-GABHS pharyngo-tonsillitis (P < 0.001) and GABHS tonsillitis (P < 0.05), as compared with their first sample or the levels of antibodies in controls. The increase in the number of several aerobic and anaerobic bacteria during acute tonsillitis and the increase in antibody levels to F. nucleatum and P. intermedia, known oral pathogens, may suggest a possible pathogenic role for these organisms in acute non-GABHS and GABHS tonsillitis.

Acute Disease↗

Human Herpesviridae in acute necrotizing ulcerative gingivitis in children in Nigeria.

Herpesviruses have been implicated in the pathogenesis of human periodontitis. The present study investigated whether herpesviruses are present in the lesions of acute necrotizing ulcerative gingivitis. Sixty-two Nigerian children, aged 3-14 years, were studied. Twenty-two children had acute necrotizing ulcerative gingivitis and were also malnourished, 20 exhibited no acute necrotizing ulcerative gingivitis but were malnourished and 20 were free of acute necrotizing ulcerative gingivitis and in a good nutritional state. Polymerase chain reaction methods were used to determine the presence of human cytomegalovirus (HCMV), Epstein-Barr virus type 1 and type 2 (EBV-1, EBV-2), herpes simplex virus (HSV), human herpes virus 6 (HHV-6), human papilloma virus and human immunodeficiency virus type 1 in crevicular fluid specimens collected by paper points. Of the 22 acute necrotizing ulcerative gingivitis patients, 15 (68%) revealed viral infection and 8 (36%) viral coinfection. Thirteen (59%) acute necrotizing ulcerative gingivitis patients demonstrated HCMV, 6 (27%) EBV-1, 5 (23%) HSV and 1 (5%) HHV-6. Only 2 (10%) subjects from each group not affected by acute necrotizing ulcerative gingivitis showed viral presence, and no control subject revealed viral coinfection. These findings suggest that HCMV and possibly other herpesviruses contribute to the onset and/or progression of acute necrotizing ulcerative gingivitis in malnourished Nigerian children.

Acute Disease↗

Phenotypic and genotypic characterization of oral yeasts from Finland and the United States.

A total of 4-22 isolates of oral yeasts per subjects from 48 yeast-positive Finnish and American subjects (25 females and 23 males) were phenotyped and genotyped to determine the frequency of simultaneous oral carriage of multiple yeast taxa. An oral sample from either periodontal pockets, oral mucosa or saliva was obtained. All subjects yielded Candida albicans and 3 subjects an additional yeast species (Candida krusei, Candida glabrata or Saccharomyces cerevisiae). The API 20C Aux kit distinguished 9 different carbohydrate assimilation profiles among the C. albicans isolates. Thirty-eight of 46 C. albicans biotype I isolates were categorized in a single numerical profile. PCR analysis, using a random primer OPA-03 and a repetitive primer (GACA)4, detected 2 major genotypic groups among the C. albicans isolates; 44 subjects showing isolates with a "typical" PCR-profile and 4 subjects isolates with an "atypical" PCR-profile. The "atypical" PCR-profile was similar to that of Candida dubliniensis. All C. albicans isolates assimilated xylose, except 5, including the 4 with an "atypical" PCR-profile. No difference was found in distribution of oral yeast species, and of C. albicans phenotypes and genotypes between Finnish and American subjects. The present PCR method may offer a rapid and easy means of distinguishing oral Candida species.

Adult↗

Absence of Porphyromonas asaccharolytica, Bacteroides fragilis and Chlamydia pneumoniae in human subgingival plaque.

Little is known about the presence of common medical pathogens in the human oral cavity. Using a 16S rRNA-based PCR identification method, this study determined the occurrence of Porphyromonas asaccharolytica, Bacteroides fragilis and Chlamydia pneumoniae in subgingival plaque from 50 adults with advanced periodontitis. Each patient contributed samples from 3 deep periodontal pockets collected by paper points. The PCR primers were for P. asaccharolytica 5'-CTC TAG CTA GAG TGT ACT GG-3' and 5'-ATA GGG TTT ATA GAT TAG CTC TCT-3', for B. fragilis 5'-AAT GAT TCC GCA TGG TTT CAT TA-3' and 5'-GCG GTG ATT GCT CAC TGA CA-3', and for C. pneumoniae 5'- TGA CAA CTG TAG AAA TAC AGC-3' and 5'-CGC CTC TCT CCT ATA AAT-3'. The primers yielded a single amplicon with the respective reference strains and produced no amplicon with colonies of 25 groups of oral organisms. None of the three test species were detected in any of the 50 pooled subgingival samples tested. P. asaccharyolytica, B. fragilis and C. pneumoniae do not seem to be part of the periodontopathic microbiota in humans.

Adult↗

Can one acquire periodontal bacteria and periodontitis from a family member?

Recent findings suggest that two major periodontal pathogenes, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis, are transmitted among family members. The authors discuss the evidence of person-to-person transmission of periodontal bacteria, the significance of saliva as a vehicle of transmission and the methods of verifying clonal similarity of bacterial strains obtained from family members. The authors also discuss the prophylactic and therapeutic implications of the person-to-person spread of periodontal bacteria.

Adult↗

Experimental peri-implant tissue breakdown around hydroxyapatite-coated implants.

This study monitored experimental peri-implant tissue breakdown around hydroxyapatite (HA)-coated titanium dental implants. Thirty-two HA-coated cylindrical implants, in groups of two, were bilaterally inserted in the posterior maxilla and mandible in 4 Macaca mulatta monkeys. Two months after healing-abutment connection, a 2-month plaque control program was initiated. Clinical and radiographic recordings and peri-implant submucosal microbial samples were then obtained (baseline). Cotton ligatures were next placed around the healing-abutments and plaque control measures were abandoned. Clinical and radiographic recordings were repeated at 5 and 10 months post-baseline. Microbial samples were repeated at 10 months post-baseline, and ligatures were removed. Clinical, radiographic, and microbial examinations were again repeated at 11 months post-baseline. Mean modified plaque index (mPI; P < 0.01), gingival index (G]; P < 0.01), and bleeding on probing (BOP; P < 0.05) scores increased over the plaque accumulation period. The mPI, and GI scores decreased after ligature removal (P < 0.001). Mean probing depth (PD) and clinical attachment level (AL) increased between baseline and the 5- and 10-month examinations (delta PD 3.0 mm; delta AL 2.7 mm; P < 0.05). PD values were reduced following ligature removal (P < 0.05). AL values and BP scores remained unchanged. A significant negative correlation was found between induced defect depth and width of keratinized mucosa at baseline (P = 0.03). At baseline, the submucosal microbiota was dominated by coccoid cells. Following ligature placement, the microbiota included a large proportion of Gram-negative anaerobic rods, predominantly Porphyromonas gingivalis, Bacteroides forsythus, and Fusobacterium species as well as beta-hemolytic streptococci. Ligature removal had a limited effect on the composition of the submucosal microbiota. This non-human primate study indicates that ligature-enhanced plaque accumulation is a precursor of progressive peri-implant tissue breakdown around HA-coated implants. The associated microbiota resembles that of peri-implantitis and destructive periodontal disease in humans. This preclinical model may be useful to study modalities aimed at arresting peri-implant tissue breakdown and at regeneration of bone in peri-implantitis defects.

Alveolar Bone Loss↗

Oral food consumption and subgingival microorganisms: subgingival microbiota of gastrostomy tube-fed children and healthy controls.

This study examined the effect of oral food consumption on the prevalence and levels of subgingival bacteria and yeasts in 20 gastrostomy tube-fed children and 24 healthy controls. Microbial identification was carried out using anaerobic culture and 16S rRNA-based PCR identification methods. Streptococcal and Actinomyces species were recovered from 100% and 76% of all subjects and averaged 66% and 11% of total cultivable organisms, respectively. In decreasing order of prevalence, Fusobacterium, enteric rods, Prevotella intermedia/Prevotella nigrescens, Capnocytophaga, Propionibacterium, yeasts, Actinobacillus actinomycetemcomitans, coagulase-negative Staphylococcus, Campylobacter rectus, Bacteroides forsythus, and Porphyromonas gingivalis were detected in 48% to 2% of the study subjects. The cultivable levels of these species varied widely among subjects. PCR detection showed C. rectus and Eikenella corrodens both to occur in 93% of the study subjects and to be the most prevalent putative periodontal pathogens examined. In decreasing order of prevalence, PCR identified Treponema denticola, A. actinomycetemcomitans, P. nigrescens, P. intermedia, B. forsythus, and P. gingivalis in 38% to 21% of the subjects studied. Tube-fed children and healthy controls exhibited similar subgingival microbial compositions. It appears from this study that oral food consumption is not a major determinant for the establishment of subgingival microbiota in children.

Actinomyces↗

Microbiological diagnostics in periodontics.

Microbiological tests in periodontics can be of great help in determining the characteristics of a pathogenic infection, prescribing the optimal antibiotic regimen, and monitoring the effectiveness of treatment. However, they are not without potential pitfalls. Current microbiological tests vary considerably in sensitivity and specificity. A false-positive test result may lead to unnecessary therapy and patient distress. A false-negative test result may prompt the withholding of necessary therapy and the subsequent progression of disease. Also, diagnostic tests can be relatively expensive and uncomfortable for patients. This article attempts to determine the usefulness of various microbiological testing systems for the management of periodontitis patients.

Adult↗

Polymerase chain reaction detection of 8 putative periodontal pathogens in subgingival plaque of gingivitis and advanced periodontitis lesions.

A 16S rRNA-based polymerase chain reaction (PCR) detection method was used to determine the prevalence of Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Campylobacter rectus, Eikenella corrodens, Porphyromonas gingivalis, Prevotella intermedia. Prevotella nigrescens and Treponema denticola in subgingival specimens of 50 advanced periodontitis, 50 adult gingivitis and 50 pediatric gingivitis subjects. The optimal PCR conditions were determined for each study species. Agarose gel electrophoresis of PCR products from each study species revealed a single band of the predicted size. Restriction enzyme digestion of amplicons confirmed the specificity of the amplification. PCR detection limits were in the range of 25-100 cells. No cross-reactivity with other oral micro-organisms or nonspecific amplification was observed. The prevalence by PCR in advanced periodontitis, adult gingivitis and pediatric gingivitis subjects was 30%, 14% and 14% for A. actinomycetemcomitans, 86%, 18% and 8% for B. forsythus, 74%, 52% and 78% for C. rectus, 80%, 70% and 66% for E. corrodens, 70%, 10% and 14% for P. gingivalis, 58%, 12% and 18% for P. intermedia, 52%, 20% and 22% for P. nigrescens, and 54%, 16% and 16% for T. denticola, respectively. The prevalence was higher in the advanced periodontitis group than in both adult gingivitis and pediatric gingivitis for A. actinomycetemcomitans, B. forsythus, P. gingivalis, P. intermedia, P. nigrescens and T. denticola at P < 0.01, and for E. corrodens at P < 0.05. The prevalence of C. rectus was significantly higher in the advanced periodontitis group than in the adult gingivitis group at P < 0.01. Matching results between PCR and culture occurred in 28% (B. forsythus) to 71% (A. actinomycetemcomitans) of the samples; the major discrepancy occurred in the PCR-positive/culture-negative category. Matching results between PCR and DNA probe methods were found in 84% of the subjects (B. forsythus) and 70% (P. gingivalis). Odds ratio analysis revealed statistically significant positive associations between 17 of the 28 possible combinations (P < 0.01). This study demonstrated the utility of a 16S rRNA-based PCR detection method for identifying important subgingival microorganisms. The results indicated a strong association between the study species and periodontitis. Several previously unreported symbiotic relationships were found between the 8 species tested.

Adolescent↗

Detection of human viruses in periodontal pockets using polymerase chain reaction.

Even though viruses have been implicated in the etiology of several medical and dental disorders, little or no data are available on the possible involvement of human viruses in the pathogenesis of human periodontal disease. This study investigated the presence of human cytomegalovirus, Epstein-Barr virus, herpes simplex virus, human papillomavirus and human immunodeficiency virus (HIV) in crevicular fluid samples from 30 patients with advanced periodontitis and 26 subjects with gingivitis. Viral identification was performed on direct subgingival samples from 3 diseased sites in each patient using the polymerase chain reaction technique. Seventy-eight percent of advanced periodontitis patients were positive for at least one of the five test viruses. Cytomegalovirus was detected in 60% of the periodontitis patients, Epstein-Barr virus in 30%, herpes simplex virus in 20%, human papillomavirus in 17% and HIV in 7%. Forty percent of the periodontitis patients revealed coinfection by 2 to 5 viruses. Only 31% of the gingivitis subjects showed a positive viral identification in crevicular fluid, and infected individuals only revealed human cytomegalovirus. This study demonstrated that human viruses may occur in periodontitis lesions with relatively high prevalence. The pathogenetic significance of human viruses in destructive periodontal disease needs to be determined.

Adult↗

Tetracycline resistance in Prevotella isolates from periodontally diseased patients is due to the tet(Q) gene.

Tetracycline-resistance in gram-negative periodontal bacteria is often due to the presence of the tet(Q) gene. In the present study the polymerase chain reaction (PCR) was used to examine 54 isolates of gram-negative anaerobic rods (Prevotella intermedia, Prevotella nigrescens and related or Bacteroides-like species) for the presence of the tet(Q) gene. The isolates were recovered from 42 patients with periodontal disease living in northern Europe and North America. An 814 base-pair segment of the tet(Q) gene was amplified from all 41 isolates resistant to tetracycline with minimal inhibitory concentrations of 4 micrograms/ml and above. The presence of the tet(Q) gene was verified using hybridization with a specific oligonucleotide internal to the amplified region and restriction endonuclease digestion with DdeI. A PCR product of the same size was also amplified from one tetracycline susceptible isolate (minimal inhibitory concentration = 0.5 microgram/ml). However, this isolate and the one isolate that was resistant to tetracycline at 4 micrograms/ml showed a weaker signal than the remaining isolates when hybridized with the internal probe. Typing of the PCR products using restriction endonuclease digests with AluI and HpaII revealed two clusters of distinct electrophoresis patterns, indicating that two different subtypes of the tet(Q) gene were present in this material. A control strain containing the tet(Q) gene from Bacteroides thetaiotaomicron had a different electrophoresis pattern for AluI. This study indicated that subtypes of the tet(Q) gene in tetracycline-resistant gram-negative periodontal bacteria exist both within the same patient and within the same species.

Base Sequence↗

Mammalian viruses in human periodontitis.

A prior investigation has demonstrated a higher prevalence of human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) in subgingival specimens from periodontitis patients than from gingivitis patients. This study aimed to determine the frequency of HCMV, EBV-1, EBV-2, herpes simplex virus (HSV) and human immunodeficiency virus (HIV) in subgingival samples from 27 adults who each contributed both a periodontitis and a gingivitis site. Viral detection was performed using a nested-polymerase chain reaction method. Twenty-four subjects (89%) yielded at least one of the five test viruses from deep periodontal pockets, whereas only 15 (56%) showed viruses from shallow periodontal sites (P = 0.015; chi-square test). Viral co-infection occurred more frequently in deep than in shallow periodontal sites (P = 0.015). HCMV was detected with higher frequency in deep than in shallow periodontal sites (P = 0.023). The possible periodontopathogenic mechanisms of mammalian viruses in human periodontitis are discussed. The role and importance of HCMV and other mammalian viruses in the initiation and progression of destructive periodontal disease merits further investigation.

Adult↗