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Biomedical subjects

S S Socransky

Publications and source records attributed to S S Socransky.

At least 127 records · Page 7Linked to original sources
PubMed1988

Microbiological and clinical effects of surgery plus doxycycline on juvenile periodontitis.

It was previously determined that surgery plus the antibiotic doxycycline were effective in eliminating or suppressing Actinobacillus actinomycetemcomitans (Aa), an organism strongly associated with disease in localized juvenile periodontitis (LJP). Eight patients with LJP participated in this surgical study. Patients were reexamined three and 12 months following therapy. The results of this study strongly suggest that surgery plus doxycycline effectively eliminate Aa from periodontal pockets. This elimination results in clinical improvement and attachment gain at three and 12 months following surgery. Further destruction was seen in individuals who continued to harbor high levels of Aa.

Actinobacillus↗
PubMed1987

Human serum antibody responses to oral microorganisms. IV. Correlation with homologous infection.

Recent microbiological studies of periodontal disease in humans have supported the concept of a specific bacterial etiology. While individual agents have not been unequivocally identified, numerous Gram-negative members of the subgingival microflora have been implicated. In addition, elevations in systemic antibody responses have been consistent with certain oral microorganisms being involved in an infectious process associated with the disease. This report delineates the relationship between elevated systemic antibody levels and oral colonization with the homologous microorganism at active disease sites. Thirty-four patients with various types of periodontal disease were examined. Using ELISA, each patient was shown to have an elevated antibody response to at least one organism from a battery of 18 oral microorganisms that were tested. Subsequently, subgingival plaque was cultured from disease-active and -inactive sites of each subject. The results demonstrated that the same microorganism to which the individual exhibited elevated serum antibody responses was detected in nearly 55% of the disease-active sites, while only 18% of the inactive sites showed the microorganism. Certain microorganisms including Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, Eikenella corrodens and Wolinella recta were primarily or exclusively correlated with active disease lesions. These findings support the hypothesis that elevated systemic antibodies to periodontopathic bacteria are reflective of subgingival colonization and exist as a response to a bacterial infection at disease-active sites.

Adolescent↗
PubMed1987

Clinical immunologic and microbiologic features of active disease sites in juvenile periodontitis.

Eight juvenile periodontitis (JP) patients with progressing disease were evaluated for clinical, immunologic, and microbiologic features. Clinically, bleeding on probing, pocket depth, and attachment level were unrelated to progressing disease. Only Actinobacillus actinomycetemcomitans was related to a marked increase in attachment loss when examined on both a site and patient basis. Eikenella corrodens was significantly elevated in progressing sites with A. actinomycetemcomitans as opposed to non-progressing sites harboring A. actinomycetemcomitans. Eikenella corrodens may function synergistically with A. actinomycetemcomitans to enhance disease in JP patients. Darkfield microscopy was of no value in distinguishing disease activity. All patients screened had elevated serum IgG levels to the same serotype of A. actinomycetemcomitans as that isolated from the subgingival flora. Other elevated serum IgG responses were noted to various organisms including F. nucleatum. B. intermedius, B. gracilus, B. gingivalis and E. corrodens.

Actinobacillus↗
PubMed1987

Difficulties encountered in the search for the etiologic agents of destructive periodontal diseases.

The present paper outlines some of the difficulties encountered in the search for the etiologic agents of destructive periodontal diseases. These include technical problems such as acquiring an appropriate microbial sample, as well as difficulties in the dispersion, cultivation and identification of isolates in that sample. Many of these difficulties are currently being successfully addressed. A second set of problems is more conceptual in nature. These include difficulties in distinguishing between periodontal diseases and determining the state of activity of periodontal lesions. In addition, complexes of organisms and/or sequences of species may be involved in the progress of lesions. A further problem is encountered in attempting to distinguish overgrowths of opportunistic species from increases in proportions of true pathogens. Finally, it appears likely that different infections occur at the same time in a single oral cavity. The technical and conceptual difficulties eventually filter down to the data analytical step and present numerous problems to the analyst. With all of these difficulties in mind, it is not surprising that the etiologic agents of destructive periodontal diseases are not clearly defined. However, improvement in technological assessments of the microbiota and clinical evaluation of the disease should permit reasoned approaches to be taken. The delineation of the etiologic agents of destructive periodontal diseases will be, of necessity, a multistage iterative process. Etiologic agents will be suggested by predominant cultivable studies and hypotheses concerning subsets of these agents tested using more specific procedures such as selective media, immunofluorescent techniques or DNA probes.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteria↗
PubMed1987

Development of a broth medium for Bacteroides forsythus.

Bacteriodes forsythus has been implicated as a possible pathogen in certain destructive periodontal diseases. This species has been extremely difficult to grow in broth, thus hampering its characterization and identification. A broth medium was developed consisting of 30 g of phytone, 10 g of NaCl, and 1 g of filter-sterilized L-cysteine per liter. The medium supported the growth of 23 fresh isolates of B. forsythus from six subjects to optical densities averaging 0.71 +/- 0.20 (standard deviation) at 550 nm after 48 to 72 h of anaerobic incubation.

Bacteroides↗
PubMed1986

Frequency distributions of periodontal attachment loss. Computer simulation.

3 patterns of attachment loss were described based on curve fitting the frequency distributions of baseline attachment level measurements of 61 subjects with destructive periodontal diseases. The frequency distributions of attachment level measurements of 30 group I individuals were satisfactorily fit by attachment level measurements of 30 group I individuals were satisfactorily fit by the sum of 2 normal curves, while those of 14 group II individuals were fit by the sum of 3 normal curves. Frequency distributions of 17 group III subjects were fit by a single normal curve. A computer algorithm was used to simulate attachment level loss frequency distributions by varying the "burst size" at active lesions and by imposing "immunity" for varying periods of time on sites which had been attacked. Frequency distributions of group I subjects could be simulated using burst sizes between 0.3 and 3.4 mm. These subjects could be divided into 2 groups: 14 subjects with localized minimal attachment loss required an average burst size of less than 1 mm, while 16 subjects with more destruction at diseased sites required an average burst size of greater than 1 mm to simulate their frequency distributions. Frequency distributions of 16 of 17 group III subjects could be simulated using an average burst size of less than 1 mm. However, the frequency distributions could also be simulated using larger burst sizes with the imposition of "immunity" for substantial periods of time at the attacked sites. The frequency distributions of group II subjects were more difficult to simulate.(ABSTRACT TRUNCATED AT 250 WORDS)

Computers↗
PubMed1986

Frequency distributions of periodontal attachment loss. Clinical and microbiological features.

The present investigation attempted to determine if the pattern of past periodontal destruction could be concisely summarized, and related to other clinical and microbiological parameters. 61 subjects between the ages of 12 and 61 years with destructive periodontal disease were evaluated at 6 sites per tooth for redness, plaque, suppuration, bleeding on probing, pocket depth, and attachment level. The frequency distribution of baseline attachment level measurements was computed for each individual. A curve fitting algorithm was used to fit the frequency distribution to 1-, 2-, and 3-term normal distributions. The parameters of the fit could be used to summarize concisely all of the frequency distributions. 3 major patterns of attachment loss could be distinguished. Pattern I required a two-term distribution with localized destruction at less than 34% of sites and was further divided into 3 groups, depending on average attachment loss at diseased sites. The means of the second peak for the subgroups were 2.7, 5.3, and 8.6 mm, respectively. Pattern II exhibited more widespread disease (greater than 33% of sites affected) with multiple peaks in the frequency distribution requiring a 3-term distribution for satisfactory fit. However, a significant proportion of sites was not affected. Pattern III exhibited a single-peaked normal distribution in which virtually all sites were affected. Mean attachment levels of the peaks in this group ranged from 2.7 to 8.4 mm. 23 of the 61 subjects showed significant attachment loss at 1 or more sites during the course of bi-monthly monitoring, as determined by the tolerance method of analysis. Subgingival plaque samples were taken from these active sites and matched with control sites prior to therapy. The proportions of Fusobacterium nucleatum, Streptococcus intermedius, and Eikenella corrodens were significantly elevated in active and control sites of subjects in groups II and III combined (the widespread disease groups), and proportions of Actinobacillus actinomycetemcomitans and Propionibacterium acnes were elevated in active and control sites of the more localized disease group I subjects. Group I subjects showed a 13- to 15-fold decrease in hazard rates of periodontal sites after Widman flap surgery and systemic tetracycline, whereas groups II and III subjects showed 2-to 6-fold decreases.

Adolescent↗
PubMed1986

Attachment level changes in destructive periodontal diseases.

The present communication attempts to summarize some of the features of attachment loss which are of interest to the clinician and the statistician analyzing data from clinical trials. These include the measurements employed to detect changes in attachment level, the nature of the destructive disease process and the effects of therapy on the attachment level measurements. Although there are several difficulties associated with the attachment level measurement, at the present time it appears to be the best estimator of periodontal attachment available. The overall standard deviation of this measurement in greater than 46,000 replicate measurements at periodontal sites in 58 subjects was 0.78 mm (range 0.4 to 1.2 mm). In the periodontally healthy subject, the length of the attachment measured around 28 teeth is approximately 700 mm. Therefore, there are approximately 1400 adjacent points along the periodontal attachment where a measurement could be made using a periodontal probe with a 0.5 mm diameter tip. If 6 measurements were recorded per tooth, then approximately 12% of the possible probable points would be evaluated. Recent data indicate that destructive periodontal diseases progress with acute bursts of activity rather than as slowly progressive, continual processes. Such findings suggest new models of attachment loss progression. In one likely model, destructive periodontal diseases would progress by asynchronous bursts of activity at individual sites which occur with greater frequency during a finite period of time in an individual's life. 3 major patterns of attachment loss could be distinguished when frequency distributions of attachment level measurements were constructed for 61 destructive periodontal disease subjects. Pattern I (30 subjects) exhibited a bimodal distribution with localized destruction occurring at less than 34% of sites. Pattern II (14 subjects) exhibited more widespread disease (greater than 33% of sites affected) with a trimodal frequency distribution. Pattern III (17 subjects) exhibited a unimodal distribution in which virtually all sites were affected. The proportions of Fusobacterium nucleatum, Streptococcus intermedius and Eikenella corrodens in subgingival plaque samples were significantly elevated in sites of subjects with patterns II and III (the widespread disease groups). Bacteroides intermedius, Streptococcus uberis and Actinobacillus actinomycetemcomitans were elevated in sampled sites of localized disease subjects (pattern I). The effects of therapy by Widman flap surgery and systemic tetracycline were examined by several statistical analyses.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1986

The effect of treatment on Actinobacillus actinomycetemcomitans in localized juvenile periodontitis.

Three treatment regimens including local tetracycline delivery, systemic doxycycline and surgery plus systemic doxycycline were investigated in a localized juvenile periodontitis (LJP) population. Of the investigated treatments only surgery plus systemic doxycycline for 14 days was effective in eliminating or suppressing Actinobacillus actinomycetemcomitans, an organism strongly associated with LJP lesions. While surgery plus antibiotics was the superior treatment, it appears that the possibility of reinfection or incomplete elimination of the organism exists. Careful long-term follow-up, including clinical and microbiological monitoring, is highly recommended in this periodontal population.

Actinobacillus↗
PubMed1985

The relationships between streptococcal species and periodontopathic bacteria in human dental plaque.

The existence of antagonistic and commensal relationships between microorganisms was investigated. The predominant cultivable flora in 172 plaque samples from active and non-active sites in 32 human subjects with destructive periodontitis was determined. The presence of putative periodontopathic organisms (Bacteroides gingivalis, Bacteroides intermedius, Bacteroides forsythus, Wolinella recta, Actinobacillus actinomycetemcomitans, and Eikenella corrodens) in a site was correlated with the absence of certain viridans streptococci (Streptococcus sanguis, Streptococcus uberis and Streptococcus intermedius), and vice versa. A strong commensal relationship was found between B. gingivalis and Strep. intermedius. The second study involved 3 subjects with intractable periodontitis whose plaque harboured large numbers of one or more of these periodontopathic organisms. This plaque contained fewer organisms capable of inhibiting the growth of the periodontopathic strains in vitro when compared with a clinically-healthy control subject. Intermediate levels of inhibitors were found in plaque taken from non-active lesions. The majority of inhibitors in plaque from the healthy control were viridans streptococci. Hydrogen-peroxide production by these organisms appears to be the principal mechanism of growth inhibition for periodontopathic organisms. Bacterial interactions may thus be causally related to both periodontal health and disease.

Actinobacillus↗