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PubMedDate not supplied

Platelet gel biotechnology applied to regenerative surgery of intrabony defects in patients with refractory generalized aggressive peridontitis. Case report.

Platelet gel biotechnology, a method which has all the components of "tissue engineering" techniques, potentiates the already known healing process of guided tissue regeneration procedures (GTR) by multiplying the number of molecules that activate the healing response and by grafting in the host site various cell types, among which stem cells. Here are reported cases of patients affected by refractory generalized aggressive periodontitis treated with the association GTR and platelet gel biotechnology to verify if the contribution of the gel would produce superior results than those obtained by surgery alone which had been previously applied to the same sites with negative results. Three patients in therapy from 4 to 11 years, already subjected to surgery (GTR) and antibiotic therapy, were reoperated with the adjunct of autologous platelet gel. At a distance of 15.2 months (range 11-17 months) the operated sites showed a reduction in probing pocket depth of 3.4 mm (range 2.8-4.8 mm) and a gain in clinical attachment level of 3.1 mm (range 3-3.5 mm). The association of platelet gel biotechnology with GTR in the surgical treatment of intrabony defects of refractory generalized aggressive periodontitis patients seems to produce results similar to those reported for patients with chronic adult periodontitis. The observations at 15.2 months indicate that there is a stability over time of the results in those sites where previous surgical therapy had shown relapse.

Adult↗
PubMed2006

Molecular epidemiology of oral treponemes in patients with periodontitis and in periodontitis-resistant subjects.

The etiologic role of oral treponemes in human periodontitis is still under debate. Although seen by dark-field microscopy in large numbers, their possible role is still unclear since they comprise some 60 different phylotypes, most of which are still uncultured. To determine their status as mere commensals or opportunistic pathogens, molecular epidemiological studies are required that include both cultured and as-yet-uncultured organisms. Here we present such data, comparing treponemal populations from chronic periodontitis (CP) or generalized aggressive periodontitis (GAP) patients. As a periodontitis-resistant (PR) control group, we included elderly volunteers with more than 20 natural teeth and no history of periodontal treatment and no or minimal clinical signs of periodontitis. Almost every treponemal phylotype was present in all three groups. For most treponemes, the proportion of subjects positive for a certain species or phylotype was higher in both periodontitis groups than in the PR group. This difference was pronounced for treponemes of the phylogenetic groups II and IV and for Treponema socranskii and Treponema lecithinolyticum. Between the periodontitis groups the only significant differences were seen for T. socranskii and T. lecithinolyticum, which were found more often in periodontal pockets of GAP patients than of CP patients. In contrast, no difference was found for Treponema denticola. Our findings, however, strengthen the hypothesis of treponemes being opportunistic pathogens. It appears that T. socranskii, T. lecithinolyticum and group II and IV treponemes may represent good indicators for periodontitis and suggest the value of the respective probes for microbiological diagnosis in periodontitis subjects.

Adult↗
PubMed1978

The natural history of periodontal disease in man. The rate of periodontal destruction before 40 years of age.

This longitudinal study of randomly selected Norwegian students and academicians has shown that 50% of the 17-year olds have lost no periodontal support, and the other 50% exhibited slight localized loss of attachment primarily on buccal surfaces of first molars and first bicuspids of both jaws. At 21 all students show one or more of these lesions as well as loss of attachment on interproximal surfaces. At 30 years of age the mean cumulative loss is still less than 1 mm. As they approach 40 years of age the mean individual loss of attachment is slightly above 1.5 mm or 10% of the total periodontal support, and the mean annual rate of attachment loss is 0.08 for interproximal surfaces and 0.1 mm for buccal surfaces. No case of juvenile periodontitis (periodontosis) or adult aggressive periodontitis were seen in this population. Seventy percent of the 15-year-old Sri Lankans have no or very little loss of periodontal support. However, approximately 30% exhibit localized lesions measuring between 2 and 9 mm and more than 1% have one or more root surfaces with 10 mm loss of attachment or more. In this age group the lesions occur at the interproximal and buccal aspects of lower central incisors and in first molars of both jaws. At 30 years of age the mean loss of attachment is 3.11 mm and approximately 25% of the tea laborers have lesions extending 10 mm or more below the cemento-enamel junction. As the Sri Lankan approaches 40 years of age the mean loss of attachment is 4.50 mm and the mean rate of progress of the lesion is 0.20 mm per year for buccal surfaces and 0.30 mm for interproximal surfaces. This study suggests that without interference the periodontal lesion progresses at a relatively even pace and that the progress is continuous.

Adolescent↗
PubMed2002

A telescopic crown concept for the restoration of partially edentulous patients with aggressive generalized periodontitis: two case reports.

Osseointegrated implants have been used with outstanding success in periodontally healthy patients in recent years and have thus become an established part of prosthetic treatment. Whereas initial reports were confined to their use in edentulous patients, in particular in the mandibular area, first results on their application in the oral rehabilitation of partially edentulous patients were published in the mid-1980s. Whether the positive results reported in periodontally healthy patients are also applicable to patients with progressive periodontal disease has yet to be clarified. As only a few controlled longitudinal studies dealing with the success of implants in periodontally involved patients have been published to date, detailed case reports are of great importance.

Adolescent↗
PubMed2002

Rationale for use of antibiotics in periodontics.

The purpose of this review is to provide the clinician with some practical rationale for the selection and use of antibiotics in the treatment of destructive periodontal diseases. We have attempted to integrate approximately 20 years of periodontal literature describing antibiotic therapy with personal experience and 21st century ideas. This article addresses antibiotic use during treatment of aggressive periodontitis with emphasis on juvenile disease and adult refractory diseases. The literature review revealed few large, controlled studies that compared efficacy of adjunctive antibiotic use to mechanical therapy alone. Even fewer studies evaluated the efficacy of one antibiotic relative to another. However, based on the evidence available, certain conclusions were drawn. Adjunctive use of an antibiotic along with mechanical debridement is recommended for the treatment of Actinobacillus actinomycetemcomitans-associated periodontitis as an acceptable therapeutic regimen. Due to the emergence of tetracycline-resistant A. actinomycetemcomitans, the combination of metronidazole and amoxicillin may be preferable. In aggressive refractory periodontitis, compelling evidence exists that the use of an appropriate adjunctive antibiotic frequently gives a more favorable clinical response than mechanical therapy alone. Unfortunately, the selection of antibiotic is not as clear and is probably case-dependent. Positive responses have been reported with amoxicillin/clavulanic acid, clindamycin, metronidazole, and the combination therapy metronidazole plus amoxicillin. The introduction of local delivery antibiotics specifically for the treatment of periodontitis offers a novel concept for the treatment of localized disease. The latter, in particular, may prove useful in the treatment of recurrent disease activity or where only a few individual sites are involved.

Adult↗
PubMed2002

Cytolethal distending toxin of Actinobacillus actinomycetemcomitans. Occurrence and association with periodontal disease.

The cytolethal distending toxin (Cdt) of Actinobacillus actinomycetemcomitans, a periodontal pathogen, is a newly described cytotoxin with immunosuppressive properties, capable of causing cell cycle arrest of lymphocytes. The objectives of this study were to investigate the occurrence of A. actinomycetemcomitans with the cdt genotype in the subgingival plaque of periodontitis patients and to determine the association of this bacterial genotype with periodontal disease. A total of 146 subgingival plaque samples from periodontitis patients were assayed by the PCR method using oligonucleotide primers targeting the cdt operon of A. actinomycetemcomitans. Primers targeting the leukotoxin gene A (ltxA) of A. actinomycetemcomitans was used to determine the occurrence of the bacteria in the plaque samples at baseline. At baseline, A. actinomycetemcomitans was detected in 106 out of 146 (73%) diseased sites studied. Among the 106 diseased sites found to harbor A. actinomycetemcomitans, 13 sites were positive for the bacteria with the cdt genotype (12%). Out of the 13 positive sites, 10 sites were obtained from patients diagnosed with aggressive periodontitis (77%). Thus, A. actinomycetemcomitans with the cdt genetic subtype has low occurrence in the subgingival plaque of periodontitis patients. However, a strong association was observed between the presence of the bacteria and aggressive forms of periodontitis. Thus, the cytotoxic and immunosuppressive properties of A. actinomycetemcomitans Cdt may function to cripple the host immunity and contribute to the pathogenesis of aggressive periodontitis.

Adult↗
PubMed2005

Implants in patients treated for generalized aggressive and chronic periodontitis: a 3-year prospective longitudinal study.

BACKGROUND: The aim of the present prospective longitudinal study of periodontally diseased and periodontally healthy patients was a clinical, microbiological, and radiographic comparison of teeth and implants and an assessment of the implant success rate. METHODS: Thirty-nine partially edentulous patients provided with a total of 150 implants were enrolled in the study. Oral rehabilitation was undertaken in 15 patients treated for generalized aggressive periodontitis (GAgP), 12 patients treated for generalized chronic periodontitis (GCP), and 12 periodontally healthy patients. The examinations of the teeth and implants were carried out within the framework of a 3-month recall schedule over a 3-year period. At each session, clinical parameters for probing depth (PD), gingival recession (GR), attachment level (AL), gingival index (GI), and plaque index (PI) were recorded, and the composition of the subgingival microflora determined by dark-field microscopy. In the periodontally diseased patients, Actinobacillus actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.), and Prevotella intermedia (P.i.) were detected at teeth and implants by DNA analysis in the first and third years after insertion of the superstructure. Intraoral radiographs of the teeth and implants were taken at baseline, immediately after insertion of the superstructure, and then 1 and 3 years later. RESULTS: The GI and PI at implants and teeth remained below 0.25 and 0.6, respectively, in all patient groups throughout the study period. At the implants and teeth, a slight increase in PD and a continuous attachment loss was recorded in the GAgP patients. The attachment loss was greater at the implants than at the teeth in all groups. The morphological distribution of the microorganisms revealed virtually healthy conditions in all groups. A.a. was detected in two GAgP patients, whereas P.g. and P.i. were found more frequently both in the GAgP and in the GCP patients. Radiographically detected bone loss was higher after 3 years at implants and teeth in the GAgP patients than in the other two groups. The implant success rates recorded were 100% in the periodontally healthy and GCP patients, and 95.7% in the maxilla and 100% in the mandible of the GAgP patients. CONCLUSIONS: The results show that oral rehabilitation can be performed with implants in patients treated for generalized aggressive and chronic periodontitis. However, slight attachment loss and bone loss were registered at the implants and teeth in the patients with aggressive periodontitis.

Acute Disease↗
PubMed2005

Functional gene polymorphisms in aggressive and chronic periodontitis.

There is strong evidence that genetic as well as environmental factors affect the development of periodontitis, and some suggestion that aggressive and chronic forms of the disease share the same genetic predisposition. This study addresses the hypothesis that there are both shared and unique genetic associations in these forms of periodontitis. A sample of 51 patients with aggressive disease, 57 patients with chronic disease, and 100 healthy controls was recruited for this study. Ten functional polymorphisms in 7 candidate genes were genotyped. The results show statistically significant (p <or= 0.05) differences between genotype frequencies in aggressive and controls (IL-1B +3954 & IL-6 -174); chronic and controls (IL-6 -174 & VDR -1056); chronic and aggressive periodontitis (IL-1A -889); and periodontitis as a whole and controls (VDR -1056, TLR-4 399 & IL-6 -174). These results suggest that there are in fact both shared and unique genetic associations in aggressive and chronic periodontitis.

Alleles↗
PubMed2006

TGF-beta1 gene polymorphisms in periodontal diseases.

BACKGROUND: Genetic polymorphisms in the TGF-beta1 gene were shown to interfere with the transcriptional activity of the TGF-beta1 gene, and this influences the production, secretion or activity of the TGF-beta1 growth factor. Transforming growth factor-beta1 (TGF-beta1) gene polymorphism is associated with risk of inflammatory diseases. OBJECTIVES: The aim of this study was to evaluate TGF-beta1 gene polymorphisms in a Turkish population with different periodontal diseases and to investigate the association between TGF-beta1 genotype and clinical periodontal parameters. METHODS: A total of 134 subjects were included in this study. Genomic DNA was isolated from 51 patients with chronic periodontitis (CP), 43 with generalized aggressive periodontitis (G-AgP) and 40 healthy controls. Three TGF-beta1 gene polymorphisms were identified by PCR-RFLP and MS-PCR at positions +915G/C, Thr263Ile and 713/8delC. Probing pocket depth (PPD), clinical attachment loss (CAL), plaque accumulation (plaque %) and bleeding of probing were obtained. Chi-square, Mann-Whitney U test and logistic regression analysis were used. RESULTS: There was a slightly significant difference in +915C positive genotype distributions between CP and control groups (OR: 2.46, CI: 1.010-6.005, p = 0.047). No significant differences were present between G-AgP and controls in +915C positive genotype. Thr263Ile and -713/8delC genotype distributions were not different between study groups. There were significant differences in PPD and CAL scores between +915C positive and negative CP patients. CONCLUSION: These findings suggest that the TGF-beta1 (+915C) polymorphic allele might be associated with chronic periodontitis in the Turkish population.

Adult↗
PubMed2004

Estrogen receptor-alpha gene polymorphisms in patients with periodontitis.

BACKGROUND: Recent studies have shown that estrogen receptor-alpha (ER-alpha) gene polymorphisms are associated with alterations in bone mineral density and osteoporosis. It is unclear whether ER-alpha gene polymorphisms are associated with alveolar bone loss in patients with periodontitis. OBJECTIVE: The aim of this study was to investigate the relationship between ER-alpha gene polymorphisms and periodontitis. METHODS: Ninety patients with aggressive periodontitis, 34 patients with chronic periodontitis and 91 healthy controls were recruited in this study. All these subjects belonged to the Han Chinese race. DNA was extracted from peripheral blood of each subject. The ER-alpha gene was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) with PvuII and XbaI restriction endonucleases. RESULTS: The detection frequency of XX genotype was significantly higher in the chronic periodontitis patients than in the healthy controls (11.8% vs. 4.4%, p < 0.05). The difference between the female chronic periodontitis patients and healthy controls (26.7% vs. 2.1%, p < 0.01) was statistically significant, but no difference was found between the male patients and controls (p > 0.05). The detection frequency of PvuII ER genotypes was not statistically different among the three groups (p > 0.05). CONCLUSIONS: In female Han Chinese population, the XX genotype may be a risk indicator for chronic periodontitis.

Acute Disease↗
PubMed2005

Factors influencing the diagnosis and treatment of periodontal disease by dental practitioners in Victoria.

BACKGROUND: Healthy periodontal tissues are essential to overall dental health. Therefore, the detection and management of periodontal disease is an integral part of general dental practice. The aim of this study was to investigate confidence in diagnosis and management of periodontal disease by general dental practitioners (GDPs), assess if the Dental Practice Board guidelines on periodontal record keeping are being addressed, and, if necessary, try to find ways of improving the periodontal knowledge of GDPs. METHODS: A survey assessing practitioner confidence in diagnosing and treating periodontal disease was sent to a random selection of 550 dental care providers registered with the Dental Practice Board of Victoria. RESULTS: Two hundred and eighty five (51.8 per cent) of questionnaires were returned completed. It was found that 79.7 per cent of the sampled population screened all new patients for periodontal disease. The majority of respondents felt confident to diagnose and treat gingivitis and initial periodontitis. However, only 61.9 per cent felt confident to diagnose aggressive/early onset periodontitis, and many were not confident in treating advanced periodontitis (36.3 per cent) or aggressive periodontitis (51.6 per cent). The majority of dentists reported that they provided most of the non surgical periodontal therapy to their patients, while most surgical treatments were referred to specialist periodontists. Factors deemed to be important in influencing the decision to provide periodontal treatment included level of training and ability to motivate patients to improve oral hygiene. Many responents requested periodontic continuing education (CE) courses be run. CONCLUSIONS: Most of the dentists surveyed were confident to diagnose periodontal disease and to treat the more common presentations of periodontal disease. There is some evidence to suggest that some practitioners are not following the minimum requirements set by the Dental Practice Board of Victoria in relation to periodontal record keeping. The results also indicate a need for more periodontic CE courses in Victoria.

Clinical Competence↗
PubMed2006

Risk of Porphyromonas gingivalis recolonization during the early period of periodontal maintenance in initially severe periodontitis sites.

BACKGROUND: Porphyromonas gingivalis is considered a critical pathogen of periodontal diseases including recurrent periodontitis. The profound effects of active periodontal treatment (APT) on P. gingivalis elimination were previously demonstrated and revealed that the subsequent P. gingivalis-free or -suppressed status seems to be maintained during early periodontal maintenance (PMT). The aim of the present study was to show the occurrence of microbial recolonization during this early PMT period. METHODS: In total, 128 sites from 11 generalized chronic periodontitis patients and one generalized aggressive periodontitis patient underwent clinical and microbiologic examination at baseline (Exam-I), after APT (Exam-II), and in PMT (Exam-III). Exam-III was carried out an average of 4.5 +/- 3.5 months after Exam-II. Detection and quantification of putative pathogens were performed using a polymerase chain reaction-based method. RESULTS: The PMT used was effective in maintaining the clinical conditions improved by APT. However, in microbiological examinations, Exam-III showed higher detection frequency and levels of P. gingivalis than Exam-II. This suggests that a P. gingivalis recolonization started in the early PMT period. P. gingivalis-increased sites then showed significantly more severe signs of periodontitis in Exam-I than P. gingivalis-stable sites (bleeding on probing frequency: 76.7% versus 56.5%; suppuration frequency: 41.9% versus 12.9%). On the other hand, in Exam-II, no significant differences of clinical parameters were noted between P. gingivalis-increased and -stable sites. CONCLUSION: Severe periodontitis sites before APT seemed to place them at risk of P. gingivalis recolonization in the early PMT period, and this microbial restoration could be a cause of recurrent periodontitis.

Acute Disease↗
PubMed2006

Endothelial nitric oxide synthase Glu298Asp gene polymorphism in periodontal diseases.

BACKGROUND: Endothelial nitric oxide synthase (eNOS) is involved in key steps of immune response. The aim of the present study was to evaluate genotype distribution and genotype-phenotype association in periodontal disease regarding Glu298Asp polymorphism of the eNOS gene. METHODS: A total of 272 subjects were included into the study. Genomic DNA was obtained from the peripheral blood of 51 chronic periodontitis (CP) patients, 48 generalized aggressive periodontitis (GAgP), and 173 reference controls. Polymerase chain reaction (PCR) amplification and subsequent BanII restriction fragment length polymorphism (RFLP) analysis were used to detect eNOS Glu298Asp polymorphism. Probing depth, clinical attachment loss, plaque accumulation, and bleeding on probing (BOP) were recorded. The data were analyzed by the chi2 test, logistic regression, and Mann-Whitney U test. RESULTS: The distributions of eNOS Glu298Asp genotypes and alleles were similar among study groups. Subjects with the Asp allele (Asp+) were statistically higher in the CP group compared to the control group (odds ratio [OR] = 1.957; 95% confidence interval [95% CI] = 1.038 to 3.689). In the GAgP group, BOP (%) was significantly higher in patients with the 298Asp allele (Asp+) compared to patients without the Asp allele (Asp-) (P = 0.015). CONCLUSIONS: The present study showed that eNOS Glu298Asp polymorphism is associated with BOP in GAgP patients. Moreover, the 298Asp allele of the eNOS gene might be related to CP in the Turkish population.

Acute Disease↗
PubMed2005

Proinflammatory factors in saliva as possible markers for periodontal disease.

Studies have indicated that host inflammatory proteins, enzymes and indicators of bone metabolism present in saliva differ in different types of periodontal disease. However, the number of markers analyzed was limited and the effect of edentulousness was not examined. We measured the concentration of host inflammatory proteins: C-reactive protein (CRP), C3 and C4 complement components, alpha-2-macroglobulin (alpha-2M) and tumor-necrosis factor (TNF) in unstimulated saliva of 14 periodontally healthy (PH), 9 edentulous persons (EP), 10 patients with chronic periodontitis (CP) and 18 with aggressive periodontitis (AgP). TNF was below the level of detection in all samples except one. Edentulous persons and patients with CP had significantly reduced concentrations of CRP, C3 and alpha-2M. Edentulous persons and AgP patients had lower C4 concentrations. We can conclude that edentulous persons and CP patients have reduced salivary concentrations of host inflammatory proteins. These findings suggest that a reduction in host responsiveness might play a role in the pathogenesis of CP.

Adult↗
PubMed2006

[Blood lipids and glucose levels in patients with periodontitis].

OBJECTIVE: To determine the serum levels of lipid and glucose in patients with periodontitis. METHODS: The patients with aggressive periodontitis (AgP, n = 117) and chronic periodontitis (CP, n = 40) and healthy controls (n = 37) were recruited. Peripheral blood sample was obtained from each subject by venipuncture. Serum chemistry variables including total cholesterol, triglycerides, and fasting glucose were analyzed by biochemical analyzer. RESULTS: The average serum levels of triglycerides and glucose of the patients with AgP [(1.09 +/- 0.79) mmol/L and (5.07 +/- 0.66) mmol/L] were both significantly higher than those of the control group [(0.94 +/- 0.28) mmol/L and (4.62 +/- 0.64) mmol/L], P < 0.05. Higher serum levels of total cholesterol and glucose were also observed in patients with CP [(4.61 +/- 1.23) mmol/L and (5.40 +/- 1.01) mmol/L] compared with controls [(4.49 +/- 0.78) mmol/L and (4.62 +/- 0.64) mmol/L], P < 0.05. Serum level of total cholesterol in AgP group was positively associated with percentage of severe sites (r = 0.25, P < 0.01). CONCLUSIONS: Patients with periodontitis may have altered serum lipid and glucose levels compared with controls.

Adolescent↗
PubMed2003

Five-year maintenance follow-up of early-onset periodontitis patients.

OBJECTIVES: The purpose of this study was to evaluate the clinical and microbiological status of patients with early-onset or aggressive periodontitis (EOP) who had received supportive periodontal care (SPC) every 3-6 months for a period of 5 years, following active periodontal treatment. MATERIAL AND METHODS: The study population consisted of 25 individuals with early-onset periodontitis. Clinical examination and recordings of probing pocket depth (PPD) and clinical attachment level (CAL) were performed at baseline prior to treatment (T0), 3 months following the termination of active periodontal treatment (T1) and annually at the SPC appointments (T2,T3,T4,T5). Microbiological samples were obtained at the 5-year SPC (T5). Subgingival plaque samples for each individual were collected from one deep pocket (>5 mm), based on pretreatment measurements, randomly selected in each quadrant. The levels of Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Porphyromonas gingivalis and Treponema denticola were determined using oligonucleotide probe hybridization. RESULTS: During the 5-year period, the mean of SPC/patient was 12.7 sessions. A significant improvement was observed in PPD, CAL, gingival bleeding index and suppuration following treatment. However, between T1 and T5, 134 sites in 20 patients deteriorated with a CAL loss of> or =2 mm. Out of these 134 sites showing disease progression, microbial samples were randomly obtained in 13 sites (9.7%) from 8 patients. Among other factors, smoking and stress were found to have significant predictive value on the future attachment loss. P. gingivalis, T. denticola and total bacterial load were statistically significantly higher in patients who experienced disease progression during the 5-year maintenance period. CONCLUSIONS: For most EOP patients, regular SPC was effective in maintaining clinical and microbiological improvements attained after active periodontal therapy. However, a small percentage of sites was identified as progressive in 20 patients. Variables found to be related to periodontal progression were the presence of as well as the high bacterial counts of P. gingivalis, T. denticola and total bacterial load, number of acute episodes, number of teeth lost, smoking and stress.

Adult↗
PubMed2002

The presence of local and circulating autoreactive B cells in patients with advanced periodontitis.

AIM: The aim of the present investigation was to study the local (gingival) and systemic occurrence of autoreactive B cells (CD5+CD19 positive) in subjects with a high or low susceptibility to periodontitis. MATERIAL AND METHODS: 2 groups of subjects (Group A and B) susceptible to periodontitis were included. Group A consisted of 22 adult patients (7 females and 15 males, aged 24-66 years) with advanced and generalized chronic periodontitis and group B comprised 7 children (4 girls and 3 boys aged 9-13 years) with localized aggressive periodontitis. 26 periodontally healthy subjects, Group C (aged 23-80 years, mean 49.6+/-16.3), were also recruited. Assessment of clinical and radiographical characteristics of periodontal disease was performed. Gingival biopsies and peripheral blood samples were obtained and prepared for immunohistochemical analysis. Blood samples only were obtained from the periodontally healthy subjects (group C). RESULTS: The proportion of autoreactive B cells (CD5+CD19 positive) of peripheral blood lymphocytes was about 6 times higher in group A and 4 times higher in group B than in the samples from the control subjects (group C). About 40-50% of the B cells in the peripheral blood of the periodontitis susceptible individuals expressed markers for autoreactive features while less than 15% of the circulating B cells in the subjects of group C exhibited such markers. The periodontitis lesion in the adult periodontitis patients contained a substantial number of B cells out of which about 30% demonstrated autoreactive features. CONCLUSION: It is suggested that both circulating and local B cells in periodontitis susceptible individuals have a higher propensity to autoreactive properties than B cells of patients with a low susceptibility to periodontitis.

Adolescent↗
PubMedDate not supplied

Periodontitis as manifestation of Crohn's disease in primary dentition: a case report.

The purpose of this case report is to detail an initial periodontal manifestation of Crohn's disease in a 6-year-old boy. The first clinical diagnosis, localized aggressive periodontitis, was based on the microbiological isolation of Actinobacillus actinomycetemcomitans from subgingival sites. On examination, gingival lesions, together with bleeding on probing, edema, and erythema, were observed. Although an increased probing depth was detected, no radiographically visible alveolar bone loss was observed. According to these findings, periodontitis as a manifestation of a systemic disease was assumed. Furthermore, fissural ulcerations of the lips were noted. The patient also reported a swelling of the upper lip in the morning. Oral hygiene procedures, scaling, root planning, and the application of metronidazole and amoxicillin were not successful. Metabolic and several immunological tests, however, showed normal values. Two months after the first periodontal signs, the child suffered from severe malnutrition, accompanied by diarrhaea and abdominal pain. Active colitis with multiple granulomas was detected histopathologically from biopsies. Crohn's disease was then diagnosed by the internist. If in doubt, medical examinations in every case of childhood periodontitis are recommended to determine whether the findings speak for initial symptoms of a systemic disorder (eg, Crohn's disease).

Aggregatibacter actinomycetemcomitans↗