Biomedical subjects

S S Socransky

Publications and source records attributed to S S Socransky.

At least 37 records · Page 2Linked to original sources

PubMed2001

Relationship of cigarette smoking to the subgingival microbiota.

BACKGROUND: The relationship of cigarette smoking to the composition of the subgingival microbiota is not clear. Some studies indicated higher levels of certain species in smokers, while other studies failed to detect differences in the microbiota between subjects with different smoking histories. Thus, the purpose of the present investigation was to examine the prevalence, proportions and levels of the subgingival species in adult subjects who were current, past or never smokers. METHOD: 272 adult subjects ranging in age from 20-86 years with at least 20 teeth were recruited for study. Smoking history was obtained using a questionnaire. Clinical measures were taken at 6 sites per tooth at all teeth excluding third molars at a baseline visit. Subgingival plaque samples were taken from the mesial surface of all teeth excluding third molars in each subject at baseline and assayed individually for counts of 29 subgingival species using checkerboard DNA-DNA hybridization. Subjects were subset according to smoking history into never (n=124), past (n=98) and current smokers (n=50). Uni-variate and multi-variate analyses were used to seek associations between smoking category and the counts, proportions and prevalence of subgingival species. RESULTS: Greater differences were observed for the prevalence (% of sites colonized) of the test species in the 3 smoking groups than were observed for counts or proportions of total counts. Members of the orange and red complexes including E. nodatum, F. nucleatum ss vincentii, P. intermedia, P. micros, P. nigrescens, B. forsythus, P. gingivalis and T. denticola were significantly more prevalent in current smokers than in the other 2 groups. The difference in prevalence between smokers and non-smokers was due to greater colonization at sites with pocket depth <4 mm. Stepwise multiple linear regression analysis indicated that combinations of the prevalence of 5 microbial species and pack years accounted for 44% of the variance for mean pocket depth (p<0.000001), while the prevalence of 3 microbial taxa along with age, pack years, current smoking and gender accounted for 31% of the variance in mean attachment level (p<0.000001). The difference in prevalence between current and never smokers of all members of the red complex and 8 of 12 members of the orange complex was significantly greater in the maxilla than in the mandible. CONCLUSIONS: The major difference between the subgingival microbiota in subjects with different smoking history was in the prevalence of species rather than counts or proportions. The greater extent of colonization in smokers appeared to be due to greater colonization at pocket depths <4 mm. Differences in colonization patterns between current and never smokers were greater in the maxilla than in the mandible.

Adult↗

PubMed2001

The effect of systemic antibiotics in the treatment of patients with recurrent periodontitis.

BACKGROUND: Subjects with periodontal disease exist who either (i) respond poorly to initial mechanical therapy ("refractory" periodontitis) or (ii) fail to adopt adequate self-performed plaque control techniques and hence develop recurrent disease ("recurrent" periodontitis) at multiple sites during the supportive treatment phase (SPT). Various systemic antibiotic regimens have been tried as adjuncts to the mechanical (re-) treatment of such "difficult to treat"-patients. While most studies indicated a positive outcome of the adjunctive therapy, some clinical investigators reported that this additional measure provided little or no benefit. AIM: The aim of the present investigation was to study the more long term effect of adjunctive antibiotic therapy in the re-treatment of patients with a well defined history of recurrent periodontitis. MATERIAL AND METHODS: 17 subjects with recurrent advanced periodontal disease were, following a baseline examination, subjected to non-surgical therapy including the use of systemic antibiotics (amoxicillin and metronidazole). They were placed in a careful SPT program and re-examined after 1, 3 and 5 years. The examinations included both clinical and microbiological assessments. RESULTS: It was demonstrated that in subjects with advanced and recurrent periodontitis, re-treatment including (i) comprehensive scaling and root planing (SRP), (ii) systemic administration of antibiotics and (iii) meticulous supragingival plaque control by both mechanical and chemical means established periodontal conditions that in the short term (3 years) and in the majority of subjects could be properly maintained by traditional SPT measures. Between 3 and 5 years, however, only 5 of the 17 subjects exhibited stable periodontal attachment levels. CONCLUSIONS: Some deep pockets and furcations were most likely inadequately instrumented during the active treatment phase. Microorganisms residing in biofilms left in such locations were probably not sufficiently affected by the 2 weeks of adjunctive antibiotic therapy. It is suggested that removal of certain subgingival deposits, therefore, may require surgical intervention.

Adult↗

PubMed2001

The long-term effect of systemic tetracycline used as an adjunct to non-surgical treatment of advanced periodontitis.

AIM: In the present study both the short- and the long-term effects were evaluated of a treatment that, during the phase of basic therapy, included administration of systemic tetracycline and non-surgical intervention. MATERIAL AND METHODS: 35 adult human subjects with advanced periodontitis, 19 females and 16 males, aged between 24 and 60 years, were included in a test group. 80 age- and sex-matched adult periodontitis subjects were recruited for a control group (42 females and 38 males). A baseline examination included assessment of the following parameters: number of teeth, plaque, bleeding on probing, probing attachment level, probing pocket depth. In radiographs, the distance between the cemento-enamel junction and the alveolar bone crest was determined at all interproximal sites. The subjects were given oral hygiene instruction. The members of the test group were provided with tablets with 250 mg of tetracycline hydrochloride and were instructed to take 1 tablet 4x per day for a period of 3 weeks. No antibiotic was given to the subjects in the control group. During the 3-week interval, all participants received 4-6 sessions of non-surgical periodontal therapy. All subjects were subsequently enrolled in a maintenance care program and were provided with supportive periodontal therapy (SPT) 3-4x per year. Clinical re-examinations were performed after 1, 3, 5 and 13 years. RESULTS: The present investigation demonstrated that tetracycline administered during a 3-week period concomitant with non-surgical treatment enhanced the outcome of mechanical therapy. At the re-examination 1 year after active therapy, there was in the test group an average gain in probing attachment that was almost 3x higher than the gain that occurred in an age and sex matched Control group. Re-examinations after 3, 5, and 13 years of SPT disclosed that this short-term benefit was not maintained in the longer perspective. CONCLUSION: The beneficial effect of systemically administered tetracycline on probing attachment level occurred in the first year post-therapy. Annual rates of probing attachment level change from 1 to 13 years did not differ between groups.

Adult↗

PubMed2001

Prevalence and risk indicators for destructive periodontal diseases in 3 urban American minority populations.

BACKGROUND, AIMS: Destructive periodontal diseases have been reported disproportionately more prevalent and severe in African-Americans relative to other American populations. Differences in subgingival microbiota and host immune response have also been reported for African-Americans, implying that risk factors for disease progression may also differ for these populations. Since it is not clear whether these differences are truly genetic or due to confounding variables such as social economic status, we examined a series of clinical, environmental, demographic, and microbiologic features associated with periodontal disease status in a group of 185 urban minority subjects resident within the greater New York metropolitan area. METHODS: The study population consisted of 56 Asian-American, 71 African-American and 58 Hispanic subjects. Clinical data recorded included pocket depth, attachment level, gingival erythema, bleeding upon probing, suppuration, and the presence of supragingival plaque. Environmental and demographic data recorded included smoking history, years resident in the United States, whether the subject reported a private dentist and occupational status. Subgingival plaque was sampled from the mesial aspect of all teeth exclusive of third molars and the levels of 40 subgingival species enumerated using checkerboard DNA-DNA hybridization. RESULTS: The African-American group had more missing teeth, deeper periodontal pocket depth and more attachment loss than the Asian-American or Hispanic groups. However, the African-American group were less likely to report having a private dentist, had a greater proportion of smokers and a greater proportion of unskilled individuals. The profile of subgingival species differed among the three ethnic/racial groups with A. actinomycetemcomitans, N. mucosa, S. noxia and T. socranskii significantly elevated in the Asian-American group and P. micros significantly elevated in the African-American group. When subset by occupational status, numbers of missing teeth, pocket depth, attachment level and prior disease activity were all found increased in the unskilled relative to the professional group. Local factors including the mean % of sites with plaque, marginal gingival erythema, bleeding upon probing and suppuration were also elevated in the unskilled group. The microbial profile differed among the 3 occupational groups with the unskilled group having elevated numbers of species associated with destructive periodontal diseases. CONCLUSIONS: Although greater destructive periodontal disease prevalence and severity were found in the African-American group, these results suggest that environmental and demographic variables, such as occupational status, may have a greater influence on risk indicators associated with disease prevalence and progression in these populations.

Adult↗

PubMed2001

Change in subgingival microbial profiles in adult periodontitis subjects receiving either systemically-administered amoxicillin or metronidazole.

AIM: The current investigation evaluated changes in levels and proportions of 40 bacterial species in subgingival plaque samples during, immediately after and up to 1 year after metronidazole or amoxicillin therapy combined with SRP. METHOD: After baseline clinical and microbiological monitoring, 17 adult periodontitis subjects received full mouth SRP and 14 days systemic administration of either metronidazole (250 mg, TID, n=8) or amoxicillin (500 mg, TID, n=9). Clinical measurements including % of sites with plaque, gingival redness, bleeding on probing and suppuration, pocket depth (PD) and attachment level (AL) were made at baseline, 90, 180 and 360 days. Subgingival plaque samples were taken from the mesial surface of all teeth in each subject at baseline, 90, 180 and 360 days and from 2 randomly selected posterior teeth at 3, 7, and 14 days during and after antibiotic administration. Counts of 40 subgingival species were determined using checkerboard DNA-DNA hybridization. Significance of differences over time was determined using the Quade test and between groups using ANCOVA. RESULTS: Mean PD was reduced from 3.22+/-0.12 at baseline to 2.81+/-0.16 (p<0.01) at 360 days and from 3.38+/-0.23 mm to 2.80+/-0.14 mm (p<0.01) in the amoxicillin and metronidazole treated subjects respectively. Corresponding values for mean AL were 3.21+/-0.30 to 2.76+/-0.32 (p<0.05) and 3.23+/-0.28 mm to 2.94+/-0.23 mm (p<0.01). Levels and proportions of Bacteroides forsythus, Porphyromonas gingivalis and Treponema denticola were markedly reduced during antibiotic administration and were lower than baseline levels at 360 days. Counts (x10(5), +/-SEM) of B. forsythus fell from baseline levels of 0.66+/-0.16 to 0.04+/-0.02, 0.13+/-0.04, 0.10+/-0.03 and 0.42+/-0.19 in the amoxicillin group at 14, 90, 180 and 360 days respectively (p<0.001). Corresponding values for metronidazole treated subjects were: 1.69+/-0.28 to 0.02+/-0.01, 0.20+/-0.08, 0.22+/-0.06 and 0.22+/-0.08 (p<0.001). Counts of Campylobacter species, Eubacterium nodatum, Fusobacterium nucleatum subspecies, F. periodonticum and Prevotella nigrescens were also detected at lower mean levels during and immediately after therapy, but gradually increased after withdrawal of the antibiotics. Members of the genera Actinomyces, Streptococcus and Capnocytophaga were minimally affected by metronidazole. However, amoxicillin decreased the counts and proportions of Actinomyces species during and after therapy. CONCLUSIONS: The data suggest that metronidazole and amoxicillin are useful in rapidly lowering counts of putative periodontal pathogens, but must be accompanied by other procedures to bring about periodontal stability.

Actinomyces↗

PubMed2001

Initial outcome and long-term effect of surgical and non-surgical treatment of advanced periodontal disease.

AIM: A clinical trial was performed to determine (i) the initial outcome of non-surgical and surgical access treatment in subjects with advanced periodontal disease and (ii) the incidence of recurrent disease during 12 years of maintenance following active therapy. MATERIAL AND METHODS: Each of the 64 subjects included in the trial showed signs of (i) generalized gingival inflammation, (ii) had a minimum of 12 non-molar teeth with deep pockets (> or =6 mm) and with > or =6 mm alveolar bone loss. They were randomly assigned to 2 treatment groups; one surgical (SU) and one non-surgical (SRP). Following a baseline examination, all patients were given a detailed case presentation which included oral hygiene instruction. The subjects in SU received surgical access therapy, while in SRP non-surgical treatment was provided. After this basic therapy, all subjects were enrolled in a maintenance care program and were provided with meticulous supportive periodontal therapy (SPT) 3-4 times per year. Sites that at a recall appointment bled on gentle probing and had a PPD value of > or =5 mm were exposed to renewed subgingival instrumentation. Comprehensive re-examinations were performed after 1, 3, 5 and 13 years of SPT. If a subject between annual examinations exhibited marked disease progression (i.e., additional PAL loss of > or =2 mm at > or =4 teeth), he/she was exited from the study and given additional treatment. RESULTS: It was observed that (i) surgical therapy (SU) was more effective than non-surgical scaling and root planing (SRP) in reducing the overall mean probing pocket depth and in eliminating deep pockets, (ii) more SRP-treated subjects exhibited signs of advanced disease progression in the 1-3 year period following active therapy than SU-treated subjects. CONCLUSION: In subjects with advanced periodontal disease, surgical therapy provides better short and long-term periodontal pocket reduction and may lead to fewer subjects requiring additional adjunctive therapy.

Adult↗

PubMed2001

Efficacy of manual and powered toothbrushes (I). Effect on clinical parameters.

BACKGROUND/AIM: The purpose of the present investigation was to compare manual (Crest Complete) and powered toothbrushing (Braun Oral-B 3D Plaque Remover) for their ability to affect clinical parameters of periodontal diseases. METHODS: 48 periodontal maintenance subjects completed this single-blind 6-month longitudinal study. Subjects had a minimum of 20 natural teeth excluding third molars and >10% of sites (approximately 17 sites) with pocket depth > or =4 mm and/or >10% sites with attachment level >4 mm. At baseline, subjects received full mouth clinical measurements (168 sites) to determine mean Plaque Index, Gingival Index, pocket depth and attachment level and % of sites exhibiting BOP. Subjects were then randomly assigned to one of two groups. The control group (N=26) used a manual toothbrush while the test group (N=22) used a powered toothbrush. Subjects received instruction in oral hygiene and used their assigned toothbrush twice daily according to instruction. Follow-up clinical assessments were performed at 3 and 6 months. Significance of differences in clinical measures over time was determined using the Quade test and between brushing groups at each time point using the Mann-Whitney test. RESULTS: Mean pocket depth, mean plaque index and % of sites exhibiting BOP showed significant reductions from baseline to 3 and 6 months in both groups. Mean probing attachment level and mean Gingival Index were significantly reduced in the powered brushing group only. There was a significant positive correlation between plaque reduction and reduction in other clinical parameters in both brushing groups. The majority of subjects showed improvements in clinical parameters at 6 months, although a greater proportion of subjects in the powered group showed a reduction in Plaque Index (77% versus 65%) and in % sites exhibiting BOP (82% versus 69%). Mean pocket depth and mean attachment level showed significantly greater reductions between baseline and 6 months in lingual and mandibular areas in the powered group. CONCLUSIONS: Both manual and powered toothbrushes reduced pocket depth, plaque index and BOP. The powered toothbrush significantly reduced mean gingival index and probing attachment level. The greatest benefit of the powered brush was at mandibular and lingual surfaces.

Adult↗

PubMed2001

Efficacy of manual and powered toothbrushes (II). Effect on microbiological parameters.

BACKGROUND/AIM: The purpose of the present investigation was to determine the effect of self-performed supragingival plaque removal using either manual (Crest Complete) or power (Braun 3D Plaque Remover) toothbrushing on supra and subgingival plaque composition. METHODS: 47 periodontal maintenance subjects completed this single-blind 6 month longitudinal study. At baseline, samples of supra and separately subgingival plaque were taken from the mesial aspect of each tooth in each subject using sterile curettes and individually analyzed for their content of 18 bacterial taxa using checkerboard DNA-DNA hybridization. After random assignment to groups receiving either a manual (n=25) or power toothbrush (n=22), subjects received instruction in oral hygiene and used their assigned toothbrush 2x daily for 6 months. Clinical monitoring and microbiological sampling were repeated at 3 and 6 months. Significant differences in microbiological measures over time were sought using the Quade test and between brushing groups at each time point using the Mann-Whitney test. RESULTS: Mean total counts were significantly reduced for supra- and subgingival plaque samples in the manual group and subgingival samples in the powered brushing group. Actinomyces naeslundii and Actinomyces israelii/gerencseriae were the most numerous organisms detected at baseline and showed the greatest reductions in counts in both brushing groups. Streptococcus constellatus/intermedius was significantly reduced in both groups, while Streptococcus mitis/oralis/sanguis was significantly reduced in the manual toothbrushing group. Mean counts of species were more markedly altered in subgingival plaque. Major reductions occurred in both groups for A. naeslundii, A. israelii/gerencseriae, Peptostreptococcus micros, Veillonella parvula, Prevotella intermedia/nigrescens, S. mitis/oralis/sanguis and S. constellatus/intermedius. All taxa examined were reduced in prevalence (% of sites colonized) in the subgingival plaque samples for both brushing groups. The reductions in prevalence were greater for A. naeslundii, S. constellatus/intermedius, V. parvula, A. israelii/gerencseriae, S. mitis/oralis/sanguis, P. micros, Streptococcus mutans and P. intermedia/nigrescens. Mean prevalence was decreased more for Porphyromonas gingivalis, Campylobacter rectus/showae, Treponema denticola and Bacteroides forsythus in supragingival plaque than subgingival plaque. CONCLUSIONS: The major finding was the effect of supragingival plaque removal on the composition of the subgingival microbiota. Counts and prevalence of most taxa examined were markedly decreased in both toothbrushing groups. This reduction should translate to a decreased risk of periodontal disease initiation or recurrence. Further, the decreased prevalence of periodontal pathogens in supragingival plaque lowers potential reservoirs of these species.

Actinomyces↗

PubMed2001

The use of PVP-iodine as an adjunct to non-surgical treatment of chronic periodontitis.

OBJECTIVE: The present study was performed to assess the effect of topically-applied PVP-iodine, used as an adjunct both during basic non-surgical therapy and at re-treatment during the long-term maintenance of patients with advanced periodontal disease. MATERIAL AND METHODS: 223 patients with advanced destructive periodontitis were recruited. The participants met the following inclusion criteria: (i) a minimum of 8 non-molar teeth, (ii) probing pocket depth of > or = 6 mm at > or = 2 teeth in each dentate quadrant, and radiographic bone loss exceeding 40% at the same teeth. A baseline I examination included assessment of plaque, gingivitis, probing pocket depth (PPD), probing attachment level (PAL) and radiographic bone height (RxBL). Following baseline I, the patients were stratified into 2 treatment groups; 2 subjects out of 3 were included in a control group and 1 in a test group. All participants, on an individual basis, received a case presentation and were instructed in proper self-performed plaque control measures. Non-surgical therapy was performed by the use of an ultrasonic device. The instrumentation in the test group was combined with the administration of 0.1% PVP-iodine. All subjects were recalled for comprehensive examinations 3, 6 and 12 months (baseline II) after baseline I and then after 3, 5 and 13 years of maintenance therapy. PAL determinations were performed annually. Subjects (losers) who at the re-examinations after 1, 2 and 3 years of maintenance demonstrated an annual further loss of PAL > or = 2 mm at > or = 4 teeth were exited from the study and referred for re-treatment. There were 9 losers in the test and 31 in the control group. In addition, 8 subjects in the test and 25 subjects in the control group withdrew from the trial for reasons unrelated to the study. These 73 subjects were not included in the data presentation from the various examinations. RESULTS: It was demonstrated that non-surgical periodontal therapy resulted in (i) improved gingival conditions, (ii) reduced PPD, (iii) gain in PAL. It was also documented that the topical application of 0.1% PVP-iodine in conjunction with the mechanical root debridement established conditions which further improved the outcome of therapy. This was evidenced by the fact that at the 3, 6, and 12 months re-examinations after baseline I, the test group had significantly lower mean PPD values and significantly more gain of PAL than the control group. During the 12 years of SPT, it was possible for most subjects in both groups to maintain shallow pockets and to avoid marked further loss of PAL. There were, however, a larger number of losers in the control than in the test group. CONCLUSION: PVP-iodine, topically applied during subgingival instrumentation, may improve the outcome of non-surgical periodontal therapy.

Administration, Topical↗

PubMed2001

Survival of Dicor glass-ceramic dental restorations over 16 years. Part III: effect of luting agent and tooth or tooth-substitute core structure.

STATEMENT OF PROBLEM: The influence of different types of restorative design features on the long-term survival of Dicor glass-ceramic restorations is only partially understood. PURPOSE: This study examined the effect of different types of luting agents and preparation core structures on the survival of Dicor glass-ceramic restorations functioning in vivo. MATERIAL AND METHODS: A total of 1444 Dicor glass-ceramic restorations were placed on the teeth of 417 adults. Failure was defined as a restoration that required remake because of material fracture. The survival of restorations of different types, with different luting agents and preparation core structures, was described with Kaplan-Meier survival functions. The significance of differences in survival between different tooth or tooth-substitute preparation core structures and different luting agents was determined with the log-rank test. RESULTS: The probability of survival of a typical acid-etched Dicor restoration luted to gold preparation core structures was 91% at 16 years compared with 75% for dentin preparation core structures (P<.01). The survival of acid-etched Dicor restorations luted to dentin preparations was significantly better than nonacid-etched restorations luted to dentin. Acid-etched Dicor restorations luted with resin composite exhibited a more favorable survival function than those luted with glass ionomer (P<.01) and zinc phosphate (P<.05). Differences between restorations luted with glass ionomer or zinc phosphate agents were not significant. CONCLUSION: Acid-etched Dicor restorations luted to gold preparation core structures exhibited significantly better intraoral survival than restorations luted to dentin. Acid-etched Dicor restorations survived better than nonacid-etched restorations when luted to dentin preparations. Acid-etched Dicor restorations luted with resin composite exhibited more favorable survivor functions than restorations luted with glass ionomer or zinc phosphate agents.

Acid Etching, Dental↗

PubMed2000

Photomechanical drug delivery into bacterial biofilms.

PURPOSE: To investigate whether photomechanical waves generated by lasers can increase the permeability of a biofilm of the oral pathogen Actinomyces viscosus. METHODS: Biofilms of Actinomyces viscosus were formed on bovine enamel surfaces. The photomechanical wave was generated by ablation of a target with a Q-switched ruby laser and launched into the biofilm in the presence of 50 microg/ml methylene blue. The penetration depth of methylene blue was measured by confocal scanning laser microscopy. Also, the exposed biofilms were irradiated with light at 666 nm. After illumination, adherent bacteria were scraped and spread over the surfaces of blood agar plates. Survival fractions were calculated by counting bacterial colonies. RESULTS: Confocal scanning laser microscopy revealed that a single photomechanical wave was sufficient to induce a 75% increase in the penetration depth of methylene blue into the biofilm. This significantly increased the concentration of methylene blue in the biofilm enabling its photodestruction. CONCLUSIONS: Photomechanical waves provide a potentially powerful tool for drug delivery that might be utilized for treatment of microbial infections.

Actinomyces viscosus↗

PubMed2000

The effect of scaling and root planing on the clinical and microbiological parameters of periodontal diseases: 12-month results.

BACKGROUND/AIMS: Previously, we reported that SRP resulted in a decrease in mean pocket depth and attachment level and reduced prevalence and levels of Bacteroidesforsythus, Porphyromonas gingivalis, and Treponema denticola at 3 and 6 months post-SRP in 57 subjects with adult periodontitis. 32 of the 57 subjects were monitored at 9 and 12 months. Thus, the purpose of the present investigation was to evaluate the microbial and clinical effects of SRP in 32 (mean age 48+/-11) subjects over a 12-month period. METHOD: Clinical assessments of plaque, gingival redness, suppuration, bleeding on probing, pocket depth and attachment level were made prior to SRP and at 3, 6, 9, and 12 months post-therapy. Subgingival plaque samples were taken at each visit and analyzed using the checkerboard DNA-DNA hybridization technique for the presence and levels of 40 subgingival species. Each subject also received maintenance scaling at each of the subsequent monitoring visits. Differences in clinical parameters and prevalence and levels of bacterial species were analyzed pre- and post-therapy using the Wilcoxon signed ranks test. The Quade test for related samples was used for analysis of multiple visits. RESULTS: Mean pocket depth (mm+/-SEM) decreased from 3.2+/-0.3 at baseline to 2.9+/-0.3 at 12 months (p<0.01). Mean attachment level showed significant reduction at 6 months, but did not diminish further. Bleeding on probing and plaque were significantly reduced at 12 months (p<0.001, p<0.05, respectively). P. gingivalis, B. forsythus and T. denticola decreased in prevalence and levels up to the 6-month visit and remained at these lower levels at 9 and 12 months. Significant increases in levels and prevalence were noted at 12 months for Actinomyces naeslundii genospecies 2, Actinomyces odontolyticus, Fusobacterium nucleatum ss polymorphum, Streptococcus mitis, Capnocytophaga sp, and Veillonella parvula. CONCLUSIONS: The data suggest that the maintenance phase of therapy may be essential in consolidating clinical and microbiological improvements achieved as a result of initial therapy.

Actinomyces↗

PubMed2000

The effect of repeated professional supragingival plaque removal on the composition of the supra- and subgingival microbiota.

BACKGROUND, AIMS: The purpose of the present investigation was to determine the effect of weekly professionally administered supragingival plaque removal on the composition of the supra and subgingival microbiota. METHODS: 18 adult subjects with periodontitis who had been treated and were in a maintenance phase of therapy were clinically and microbiologically monitored at baseline, 3, 6 and 12 months. After the baseline visit, the subjects received scaling and root planing followed by professional supragingival plaque removal every week for 3 months. Clinical measures of plaque accumulation, bleeding on probing (BOP), gingival redness, suppuration, pocket depth and attachment level were made at 6 sites per tooth at each visit. Separate supra (N = 1804) and subgingival (N = 1804) plaque samples were taken from the mesial aspect of all teeth excluding third molars in each subject at each time point and evaluated for their content of 40 bacterial taxa using checkerboard DNA-DNA hybridization. Significance of changes in mean counts, prevalence and proportions of bacterial species over time in both supra and subgingival samples were determined using the Quade test and adjusted for multiple comparisons. RESULTS: Mean % of sites exhibiting plaque, gingival redness and BOP were significantly reduced during the course of the study. Significant decreases in mean counts were observed in both supra and subgingival samples. Mean total DNA probe counts (x10(5), +/-SEM) at baseline, 3, 6 and 12 months were: 133+/-19, 95+/-25, 66+/-6, 41+/-6 (p<0.001) for supragingival samples and 105+/-22, 40+/-10, 19+/-4, 13+/-3 (p<0.001) for subgingival samples. Mean counts of 22 of 40 and 34 of 40 species tested were significantly reduced in the supra and subgingival samples respectively over the monitoring period. For example, mean counts of Porphyromonas gingivalis x10(5) at baseline, 3, 6 and 12 months in the subgingival plaque samples were 2.0+/-0.4, 0.5+/-0.2, 0.6+/-0.3, 0.3+/-0.1 (p<0.001); Bacteroides forsythus 2.0+/-0.6, 0.4+/-0.1, 0.4+/-0.2, 0.1+/-0.2 (p<0.001); Treponema denticola 3.4+/-1.1, 0.8+/-0.3, 0.4+/-0.2, 0.3+/-0.3 (p<0.01). Similar reductions were seen in supragingival plaque samples. While counts were markedly reduced by professional plaque removal, the proportion and prevalence of the 40 test species were marginally affected. CONCLUSIONS: Weekly professional supragingival plaque removal profoundly diminished counts of both supra- and subgingival species creating a microbial profile comparable to that observed in periodontal health. This profile was maintained at the final monitoring visit, 9 months after completion of therapy.

Adult↗

PubMed2000

Comparison of the microbiota of supra- and subgingival plaque in health and periodontitis.

BACKGROUND, AIMS: The purpose of the present investigation was to compare the microbial composition of supra and subgingival plaque in 22 periodontally healthy (mean age 32+/-16 years) and 23 adult periodontitis subjects (mean age 51+/-14 years). METHODS: A total of 2358 supra and separately subgingival plaque samples were collected from the mesial aspect of all teeth excluding 3rd molars in each subject. Samples were examined for the presence and levels of 40 bacterial taxa using whole genomic DNA probes and checkerboard DNA-DNA hybridization. Clinical assessments including dichotomous measures of gingival redness, bleeding on probing, plaque accumulation and suppuration, as well as duplicate measures of pocket depth and attachment level, were made at 6 sites per tooth. Mean counts (x10(5), % DNA probe count and % sites colonized for each species were determined separately for supra and subgingival samples in each subject and then averaged across subjects in the 2 clinical groups. Significance of differences between healthy and periodontitis subjects was determined using the Mann-Whitney test and adjusted for multiple comparisons. RESULTS: Mean total DNA probe counts (x10(5), +/-SEM) for healthy and periodontitis subjects in supragingival plaque were 72.1+/-11 and 132+/-17.5, respectively (p<0.01), and in subgingival plaque 22.1+/-6.6 and 100.3+/-18.4, (p<0.001). Porphyromonas gingivalis, Bacteroides forsythus and Treponema denticola could be detected in supragingival plaque samples of both healthy and periodontitis subjects. Actinomyces species were the dominant taxa in both supra- and subgingival plaque from healthy and periodontitis subjects. 4 Actinomyces species accounted for 63.2%, of supragingival and 47.2% of subgingival plaque in healthy subjects and 48.% and 37.8% in periodontitis subjects respectively. Increased proportions of P. gingivalis, B. forsythus, and species of Prevotella, Fusobacterium, Campylobacter and Treponema were detected subgingivally in the periodontitis subjects. P. gingivalis, B. forsythus and T. denticola were significantly more prevalent in both supra- and subgingival plaque samples from periodontitis subjects. CONCLUSIONS: The main differences between supra and subgingival plaque as well as between health and disease were in the proportions and to some extent levels of Actinomyces, "orange" and "red" complex species.

Adult↗

PubMed2000

Microbial composition of supra- and subgingival plaque in subjects with adult periodontitis.

BACKGROUND, AIMS: The purpose of the present study was to compare and relate the microbial composition of supra and subgingival plaque in 23 adult periodontitis subjects (mean age 51 +/- 14 years). METHODS: A total of 1,170 samples of supra and subgingival plaque were collected from the mesial aspect of every tooth (up to 28 supra and 28 subgingival samples) from each subject and evaluated for the presence and levels of 40 bacterial taxa using whole genomic DNA probes and checkerboard DNA-DNA hybridization. Clinical assessments including dichotomous measures of gingival redness, bleeding on probing, plaque accumulation and suppuration, as well as duplicate measures of pocket depth and attachment level, were made at 6 sites per tooth. The counts (levels), % DNA probe count (proportion) and % of sites colonized (prevalence) of each species in supra and separately in subgingival plaque were computed for each subject. Significance of differences between supra and subgingival plaque for each species was sought using the Wilcoxon signed ranks test and adjusted for multiple comparisons. RESULTS: All 40 taxa were detected in both supra and subgingival plaque. Actinomyces species were the most prevalent taxa in both habitats. 75 to 100% of supra and 62 to 100% of subgingival sites were colonized by at least one of the 5 Actinomyces species. Supragingival samples exhibited significantly higher counts of Actinomyces naeslundii genospecies 1, Actinomyces israelii, Actinomyces odontolyticus, Neisseria mucosa, Streptococcus gordonii, Capnocytophaga ochracea and Capnocytophaga sputigena when compared with mean counts in subgingival samples taken from the same tooth surfaces. Subgingival plaque samples presented significantly higher counts of Prevotella nigrescens, Prevotella intermedia, Bacteroides forsythus and Porphykromonas gingivalis. Subgingival samples exhibited a significantly higher proportion of "red" and "orange complex" species, while supragingival plaque exhibited higher proportions of "green" and "purple" complex species as well as Actinomyces species. Suspected periodontal pathogens could be detected in supragingival plaque from sites where subgingival samples were negative for the same species. CONCLUSIONS: The data indicate that supragingival plaque can harbor putative periodontal pathogens, suggesting a possible rôle of this environment as a reservoir of such species for the spread or reinfection of subgingival sites.

Actinomyces↗

PubMed2000

Microbiological parameters associated with IL-1 gene polymorphisms in periodontitis patients.

BACKGROUND, AIMS: Polymorphisms in the cluster of IL-1 genes have been significantly associated with the severity of adult periodontitis. The purpose of this study was to compare microbiological parameters in IL-1 genotype negative and positive adult subjects with a range of periodontitis severities. METHOD: The study included 108 subjects in good general health. Clinical parameters were recorded at 6 sites/tooth excluding 3rd molars and included: plaque accumulation, gingival erythema, bleeding on probing, suppuration, pocket depth and attachment level. Subgingival plaque samples were collected from the mesiobuccal surface of up to 28 teeth in each subject (mean 25.3) providing a total of 2736 samples. The levels of 40 subgingival taxa were determined in each sample using checkerboard DNA-DNA hybridization. Fingerstick blood samples were collected for IL-1A (+4845) and IL-1B (+3954) genotyping using PCR-based methods. RESULTS: The proportion of IL-1 genotype positive subjects that exhibited mean counts of specific subgingival species above selected thresholds was significantly higher than the proportion of genotype negative subjects. Prominent among species that were detected at higher levels in genotype positive subjects were members of the "red" and "orange" complexes and included: Bacteroides forsythus, Treponema denticola, the Fusobacterium nucleatum subspecies, Fusobacterium periodonticum, Campylobacter gracilis, Campylobacter showae and Streptococcus constellatus. Streptococcus intermedius, Streptococcus gordonii and 3 Capnocytophaga species were also detected more frequently at high numbers in genotype positive subjects. Significantly higher mean counts of B. forsythus, Porphyromonas gingivalis, T. denticola, the F. nucleatum subspecies, F. periodonticum, Campylobacter rectus, C. showae, Eubacterium nodatum, S. constellatus, S. gordonii, and S. intermedius were detected at periodontal pockets >6 mm in subjects who were genotype positive when compared with genotype negative subjects. The increase was due to increased numbers of cells of these species rather than a major shift in proportion. CONCLUSION: The data suggest that genotype positive subjects more frequently had higher levels of "red" and "orange" complex species that are known to be strongly associated with measures of periodontal inflammation.

Adult↗

PubMed2000

Effect of the interleukin-1 genotype on monocyte IL-1beta expression in subjects with adult periodontitis.

An association has been reported between polymorphisms in the genes encoding IL-1alpha (-889) and IL-1beta (+3953) (periodontitis susceptibility trait, PST), and an increased severity of periodontitis (18). The IL-1beta polymorphism was reported to correlate with increased IL-1beta expression by monocytes in response to bacterial stimulants. In the present study, we determined if PST positive subjects with periodontitis exhibit elevated production of IL-1beta, compared to PST negative periodontitis patients. Peripheral blood monocytes were obtained from 10 PST+ and 10 PST- age- and disease-balanced subjects with adult forms of periodontitis. Monocytes were cultured with a panel of bacterial stimulants, including Escherichia coli and Porphyromonas gingivalis LPS, and whole formalinized periodontal pathogens P. gingivalis, Bacteroides forsythus and Prevotella intermedia, and health-associated organisms Veillonella parvula and Streptococcus sanguis. Our results demonstrate that monocytes from PST+ and PST- patients showed no significant differences in IL-1beta production in response to any stimulant tested. In addition, the periodontal pathogens P. gingivalis, B. forsythus and P. intermedia failed to stimulate higher IL-1beta responses compared to health-associated species V. parvula and S. sanguis. A marked interindividual variation in production of IL-1beta was seen, with high, low and intermediate responders present in both PST+ and PST- groups. We conclude that genetic loci other than the PST polymorphisms are also important regulators of monocyte IL-1 responses.

Adult↗

PubMed2000

Bacteria of asymptomatic periradicular endodontic lesions identified by DNA-DNA hybridization.

Possible inclusion of contaminant bacteria during surgery has been problematic in studies of periradicular lesions of endodontic origin. Therefore, in this study, two different surgical techniques were compared. A second problem is that some difficult to cultivate species may not be detected using bacteriological methods. Molecular techniques may resolve this problem. DNA-DNA hybridization technology has the additional advantage that DNA is not amplified. The purpose of this investigation was to determine if bacteria from periradicular endodontic lesions could be identified using DNA-DNA hybridization. A full thickness intrasulcular mucoperiosteal (IS) flap (n = 20) or a submarginal (SM) flap (n = 16) was reflected in patients with asymptomatic apical periodontitis. DNA was extracted and incubated with 40 digoxigenin-labeled whole genomic probes. Bacterial DNA was detected in all 36 lesions. Seven probes were negative for all lesions. In patients with sinus tract communication, in teeth lacking intact full coverage crowns, and in patients with a history of trauma 4-13 probes provided positive signals. Seven probes were positive in lesions obtained by the IS, but not the SM technique. Two probes were in samples obtained with the SM technique, but not the IS. Only Bacteroides forsythus and Actinomyces naeslundii genospecies 2 were present in large numbers using either the IS or the SM technique. The SM flap technique, in combination with DNA-DNA hybridization, appeared to provide excellent data pertaining to periradicular bacteria. These results supported other studies that provide evidence of a bacterial presence and persistence in periradicular lesions.

Actinomyces↗