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Bone loss following periodontal therapy in subjects without frequent periodontal maintenance.

The longitudinal effects of periodontal therapy in patients without a frequent periodontal maintenance program have been minimally documented. In this study we used Duckworth's modification of the Schei Ruler Technique to assess the difference in bone level around individual teeth treated for periodontal disease in subjects receiving infrequent posttherapy maintenance (less than or equal to 1 time/year). Crestal bone height differences were evaluated using the initial presenting series of long cone parallel radiographs of 23 subjects with their subsequent posttherapy analogous radiographic series taken 5.4 +/- 2.9 years later. Bone loss was defined as a reduction in the alveolar crest of greater than 50% of the radiographic crown height which corresponds to approximately 4 mm in posterior and 5 mm in anterior teeth. The loss for each tooth was expressed as a per cent of the measured height of the crown after conversion from millimeters using the mean crown-root ratio for each tooth. We found increased alveolar bone loss and tooth loss in subjects examined posttherapy when compared with conditions present when each subject initially presented for periodontal treatment. Our data suggest that molar teeth are more at risk than incisors and cuspids and that a lack of periodontal maintenance care and inadequate plaque control contribute to progressive bone loss following treatment.

Aged↗

Cathepsin B/L-, elastase-, tryptase-, trypsin- and dipeptidyl peptidase IV-like activities in gingival crevicular fluid: a comparison of levels before and after periodontal surgery in chronic periodontitis patients.

Gingival crevicular fluid (GCF) was collected from the deepest probing site of each tooth of 10 chronic periodontitis patients prior to treatment, after scaling and hygiene treatment, and after periodontal surgery. Surgery was carried out at sites which had persistent probing depths in excess of 5 mm. The patients were given a full periodontal examination, including measurements of probing depth, gingival index, bleeding index, and plaque index before each GCF collection. Cathepsin B/L-, elastase-, tryptase-, trypsin-, and dipeptidyl peptidase IV-like activities in the GCF samples were determined by fluorimetric assay with peptidyl derivatives of 7-amino-4-trifluoromethyl coumarin. There were reductions in all clinical parameters and all protease activities after scaling and hygiene treatment and further reductions after periodontal surgery. Decreases were recorded for both total enzyme activities and concentrations. The reductions were statistically significant in inter-patient comparisons using mean patient values and also in most intra-patient comparisons using site data from individual patients. GCF protease levels appear to reflect the clinical status of periodontal lesions and may prove to be of value in monitoring disease activity.

Adult↗

The effect of smoking and periodontal treatment on salivary composition in patients with established periodontitis.

BACKGROUND: The purpose of this study was to evaluate the effect of smoking on the periodontal status and the salivary composition in subjects with established periodontitis before and after periodontal therapy. METHODS: Our study group included 26 healthy subjects, 12 smokers and 14 non-smokers with established periodontitis. Clinical measurements and non-stimulated whole saliva were obtained and analyzed at baseline and after scaling and root planing. Smokers presented at baseline with significantly greater probing depth (4.16+/-0.26) compared to non-smokers (3.52+/-0.32) which was statistically significant (P = 0.0268); likewise, baseline clinical attachment level was greater in smokers (4.49+/-0.31 compared to non-smokers 3.87+/-0.13; P = 0.0620). Mean plaque index was also greater in smokers compared to non-smokers (0.86 and 0.65, respectively; P = 0.0834). Baseline pretreatment sodium values were significantly greater in non-smokers (14.36 mEq/l compared to 9.31 mEq/l in smokers; P = 0.0662); likewise non-smokers exhibited 50% greater salivary calcium levels (6.04 mg/100 ml compared to 4.32 mg/100 ml in smokers; P = 0.0133). RESULTS: Post-treatment probing depth and clinical attachment level were not different between smokers and non-smokers; this in spite of significant difference in plaque index in smokers (0.35 compared to 0.13 in non-smokers; P = 0.0135). Post-treatment, smokers had reduced calcium concentration (3.58 mg/100 ml compared to 5.11 mg/100 ml in non-smokers; P = 0.0438). Treatment affected albumin level in smokers only, consequently non-smokers had significantly greater salivary albumin concentration (1.1 mg/100 ml compared to 0.38 mg/100 ml in smokers; P = 0.0274). CONCLUSIONS: Subjects with established periodontitis exhibited elevated concentrations of salivary electrolytes and proteins. Within this study group, smokers exhibited greater disease level but reduced sodium, calcium, and magnesium concentrations. Smokers responded favorably to treatment. The clinical improvement eliminated the differences in salivary composition.

Adult↗

Effects of smoking and treatment status on periodontal bacteria: evidence that smoking influences control of periodontal bacteria at the mucosal surface of the gingival crevice.

BACKGROUND: We examined whether smoking status could influence growth of potentially pathogenic bacteria in the periodontal environment of treated and untreated periodontal patients. METHODS: We have previously reported effects of treatment status on marker bacteria in our patients. We established a history of any smoking during 6 months prior to microbiological sampling (F-ME, 16 smokers out of 64; MHM, 70 smokers out of 185). We used a commercial immunoassay to quantitate Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans in paper point samples from periodontal sites. RESULTS: Logistic regression showed that in smokers, neither P. gingivalis nor A. actinomycetemcomitans was quantitatively increased, while P intermedia was somewhat increased. Multiple regression demonstrated that smoking disrupts the positive relationship between increasing probing depth and increasing bacterial growth that is found in non-smokers. In smokers, growth of marker bacteria at shallow sites (< or =5 mm) was significantly increased to the levels found at deeper sites (>5 mm) in both smokers and non-smokers. Supragingival plaque biofilm was identified as a reservoir for marker bacteria; smokers and nonsmokers had equal ranges of oral cleanliness. CONCLUSIONS: Smoking-associated periodontitis is not simply a reflection of oral cleanliness. Smoking extends a favorable habitat for bacteria such as P. gingivalis, P. intermedia, and A. actinomycetemcomitans to shallow sites (< or =5 mm). Molecular byproducts of smoking interfere with mechanisms that normally contain growth of damaging bacteria at the surface of the oral mucosa in gingival crevices. In this way, smoking can promote early development of periodontal lesions.

Adult↗

The prognostic value of several periodontal factors measured as radiographic bone level variation: a 10-year retrospective multilevel analysis of treated and maintained periodontal patients.

BACKGROUND: Assigning a prognosis to a periodontal patient is one of the greatest challenges in clinical practice. Many different factors can affect the result of periodontal therapy. The purpose of this study was to evaluate the prognostic value of some clinical, genetic, and radiographic variables in predicting bone level variation in periodontal patients (aged 40 to 60) treated and maintained for 10 years. METHODS: Sixty consecutive non-smoking patients (mean age 46.77 +/- 4.96) with moderate to severe chronic periodontitis were treated with scaling and root planing (SRP). Some patients also underwent additional surgical treatments. All patients were maintained in the same private practice for 10 years. At baseline (T0) and at least 10 years later (T2), the following clinical variables were evaluated: probing depth (PD), tooth mobility (TM), presence of prosthetic restorations (PR), and molar teeth (MT). In addition, radiographic measurements were taken of the mesial and distal distances from the cemento-enamel junction (CEJ) to the bottom of the defect (BD), to the bone crest (BC), and to the root apex (RA). At T2, a genetic test to determine the IL-1 genotype and genetic susceptibility for severe periodontal disease was performed for all 60 patients. Based on the results of this assay, the patients were categorized as IL-1 genotype positive (G+) or negative (G-). The differences between the bone levels measured at T0 and T2 (ABD), indicating the bone level variation, was used as the outcome variable. Different predictor variables were then tested using a 3-level statistical model (multilevel statistical analysis; patient, tooth, and site level). At the patient level these were: age, gender, and interaction between mean bone loss and the IL-1 genotype (mean CEJ-BD(T0) x IL-1 genotype). At the tooth level the variables were: TM(T0), PR(T0), MT(T0); and at the site level the evaluated factors were: the infrabony component of the defect (CEJ-BD(T0) - CEJ-BC(T0), PD(T0), bone level (CEJ-BD(T0)), and the residual supporting bone (BD-RA(T0)). RESULTS: Among the considered predictor parameters, the following were significantly associated with the outcome variable: 1) mean CEJ-BD(T0) x IL-1 genotype (P = 0.0019); 2) TM(T0) (P < 0.0000); 3) CEJ-BD(T0) (P < 0.0000); 4) CEJ-BD(T0) - CEJ-BC(T0) (P < 0.0000); 5) PD(T0) (P = 0.0010). Deeper probing depths at a site and tooth mobility at baseline were associated with worst prognosis. Greater CEJ-BD(T0) distance and infrabony component at a site at baseline were associated with a better prognosis. The interaction between mean CEJ-BD measurement at baseline and IL-1 genotype was significantly associated both with a good or a poor prognosis. The other parameters evaluated - age, gender, presence of molars and prosthetic restorations, and residual supporting bone - were not significantly associated with bone level variation. CONCLUSIONS: Within the scope of this study design, many traditional prognostic factors were ineffective in predicting future bone level variation and therefore were of no prognostic value. Conversely, a few specific factors at each level emerged as valuable prognostic factors. At the patient level, the prognostic factor was initial mean bone level in conjunction with a positive IL-1 genotype. At the tooth level, the prognostic factor was tooth mobility. At the site level, the significant prognostic factors were initial bone level at a site, the infrabony component of a defect, and initial probing depth at a site. The use of these factors may be of value to clinicians as predictors of bone level variation when assigning a prognosis to a patient, a tooth, or a site.

Adult↗

Bone apposition in surgical bony defects following orthodontic movement: a comparative histomorphometric study between root- and periodontal ligament-damaged and periodontally intact rat molars.

BACKGROUND: The influence of orthodontic tooth movement with diminished periodontal support is unclear. The aim of the present study was to evaluate bone healing in surgical defects following orthodontic tooth movement with and without periodontal ligament (PDL) and root surface damage. METHODS: The study comprised 33 adult male Wistar rats, divided into two groups: group 1 (n = 14) with bony defect and no root damage and group 2 (n = 19) with periodontal bony defect including root/PDL damage on the mesial root of the maxillary first molar. One week after a surgical defect was created, orthodontic protraction of the right maxillary first molar was initiated in both groups. After 2 weeks of protraction, retention of 1 week was established; at the end of this period block sections were made. Histomorphometric analysis through light microscopy of decalcified tissue was performed. Results were statistically analyzed using independent samples t test and analysis of variance (ANOVA) with repeated measures. RESULTS: Differences between groups in total area of bone defect and bone apposition were not statistically significant. Bone apposition calculated as percentage of the bone defect was significantly (t-test) greater (P = 0.002) in group 2 (46.21%) than in group 1 (24.95%). Within each group, area of bone apposition was significantly (ANOVA) greater in the distal than in the mesial quadrants of the bony defect (P = 0.006) and in the apical than the occlusal ones (P = 0.021). CONCLUSION: Following orthodontic tooth movement, periodontal bony defects showed enhanced bony healing compared with alveolar bone defects with no direct association with the periodontal attachment apparatus.

Alveolar Bone Loss↗

Sampling strategy for intraoral detection of periodontal pathogens before and following periodontal therapy.

BACKGROUND: The aim of this study was to identify a sampling strategy with high probability for detecting oral colonization by Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Eikenella corrodens, Tannerella forsythensis, Prevotella intermedia, Prevotella nigrescens, and Treponema denticola before and following mechanical periodontal therapy. METHODS: Samples were taken from the following intraoral sites in 35 patients with untreated chronic periodontitis before and 1.5, 3, and 6 months after non-surgical periodontal therapy: supra- and subgingival plaque from the deepest pockets in each sextant; pooled supra- and subgingival plaque from another six randomly selected, less affected teeth; mucosal swab samples from the tongue, tonsils, throat, and buccal mucosa; and stimulated and unstimulated saliva. Microbial species were identified by polymerase chain reaction (PCR). RESULTS: Of the sampling of all assessed sites, the highest probability for simultaneously detecting the tested pathogens was found in respect to the combination of supra- and subgingival plaque samples taken from the most affected tooth in each sextant in untreated patients (probability: 83% to 95% for the assessed bacteria). These results were consistently observed throughout the study period. CONCLUSIONS: For determining the intraoral carrier state of patients with periodontitis, a combined sample of supra- and subgingival plaque taken from the deepest periodontal pocket in each sextant may yield the most reliable result. This sampling strategy may be used in routine microbial testing and clinical research.

Bacteria, Anaerobic↗

The effect of limited drying or removal of the periodontal ligament. Periodontal healing after replantation of mature permanent incisors in monkeys.

The effect of limited drying or removal of the periodontal ligament upon periodontal healing after replantation of incisors was studied in green Vervet monkeys. All teeth were examined histologically either 2-, 4- or 8 weeks after replantation. The drying experiment demonstrated that an area of ankylosis was established after 2 weeks corresponding to the dried portion of the root and was removed by a resorptive process in the majority of cases after 8 weeks. The removal of the periodontal ligament led to development of surface-, inflammatory- and replacement resorption. Furthermore, 1 mm2 and 4 mm2 lesions on the root surface developed transient ankylosis which disappeared after 8 weeks while lesions of 9 mm2 or 16 mm2 in size resulted in an ankylosis which, in most cases, persisted after 8 weeks. Based on these findings, it is postulated that physical removal or extended drying of the periodontal ligament initiates a rapid osteogenesis in the alveolus which establishes an ankylosis. If the damaged area is placed next to a zone on the root surface with a vital periodontal ligament, a later resorptive process is established from this zone, whereby the ankylosis area is gradually resorbed. It is estimated that the extent of this process in this experiment amounted to possibly 1 -- 1.5 mm.

Animals↗

Mandibular dysfunction and periodontitis. A comparative study of patients with periodontal disease and occlusal parafunctions.

Fifty-one patients (mean age, 47.3 years) with moderate to severe periodontal disease and 40 patients (mean age, 48.9 years) with symptoms related to bruxism (occlusal parafunctions such as grinding and/or clenching of the teeth) were compared with regard to periodontal conditions and signs and symptoms of mandibular dysfunction. The bruxists reported more symptoms of pain and dysfunction of the masticatory system than the periodontal patients. The clinical dysfunction index was significantly higher among the bruxists, while there was a similarity between the groups in the variation of occlusal conditions, except for occlusal wear, which was more pronounced in the bruxist group. Attrition was in general positively correlated to alveolar bone height. This correlation was stronger (and statistically significant) for the canines than for other teeth. Attrition was negatively correlated to tooth mobility. It is concluded that patients with moderate to severe periodontal disease and patients with bruxism/occlusal parafunctions are distinctly different with regard to signs and symptoms of mandibular dysfunction. The results support the opinions that there is no or only weak correlation between periodontal disease and bruxism, and between bruxism and occlusal status.

Adult↗

Periodontitis in a 13-year old: an illustration of a new periodontal classification.

This report describes a periodontal abscess and bone loss in a 13-year-old boy being treated as a patient in the Dental Benefit Scheme, a year after his entry to the Scheme. His condition illustrates well the rationale of a new classification for periodontitis. We suggest that periodontal screening is important so that instances such as this can be identified earlier; a small number of young patients require conventional, conservative periodontal treatment and ongoing monitoring of periodontal disease.

Adolescent↗

[Gingival crevicular aspartate aminotransferase levels in periodontitis patients before and after periodontal treatment].

Gingival crevicular fluid samples were collected from 296 teeth from 40 subjects, including 19 rapidly progressive periodontitis (RPP), 8 chronic adult periodontitis (CAP), 7 marginal gingivitis (MG) and 6 healthy subjects (H). The activities of aspartate aminotransferase (AST) in each sample were tested. The results were as follows: (1) The two groups with destructive periodontal disease (RPP and CAP) had greater GCF-AST levels than that from the two non-destructive groups (MG and H). (2) The GCF-AST activities showed significant positive correlations with clinical periodontal parameters, such as probing depth, attachment loss, bleeding index and suppuration. (3) Four weeks after thorough full-mouth root planing, both clinical parameters and GCF-AST levels decreased significantly. The present study suggests that GCF-AST activity might be a sensitive and objective marker for detection of periodontal tissue destruction and inflammation.

Adult↗

[Ultrastructural and cytochemical studies of clonal cell lines in fibroblasts derived from human periodontal ligaments--establishment of clonal cell lines in fibroblasts from periodontal ligaments].

It has recently been suggested that fibroblasts in periodontal ligaments have cytochemical characteristics similar to those of osteoblasts and different from those of other connective tissues. The authors isolated clonal cell lines of fibroblast-like cells from human periodontal ligaments in order to clarify their nature. Digestion with collagenase and hyaluronidase was used to isolate the cells from a human periodontal ligament. The cells were then plated in a 96-hole microplate. A single cell in a conditioned medium containing 20%FBS was placed in each hole. From these single cells large colonies ware subcultured. Subculturing was done every 8 days until more than 20 successive generations had been produced. The method developed by Lowry et al. was used to determine the ALPase activity of the cultured cells. From the 768 cells cultured from human periodontal ligament, 7 clonal cell lines were isolated in vitro. Cultures of these clonal cell lines resulted in typical, spindle-shaped, fibroblast-like cells, all of which were homogeneous. Very high ALPase activity was observed in 4 of the 7 cell lines. Enzyme reaction products occurred mainly along cell membranes. These stable clonal cell lines provide suitable systems for in vitro studies related to morphological and functional analysis of fibroblasts in the periodontal ligament.

Alkaline Phosphatase↗

[Plaque--gingivitis--periodontitis. (2) Microbiology and pathogenesis of periodontitis].

In a survey, current conceptions regarding the origin of gingivitis and periodontitis, as well as their clinical picture, are described. After the build-up of the bacterial plaque in several phases to form a periodontal pathogenic plaque, following a short, acute stage, a chronic gingivitis soon establishes itself in the neighbouring soft gingival tissue, from which, not inevitably, however, a periodontitis can develop after some years, the osseous parts now also being involved in the periodontal destruction, in which the polymorphonuclear neutrophilic granulocytes appear to have a major share. Depending on the age of the patient, progress of the disease, and the composition of the subgingival plaque, endeavours are made to classify the periodontal diseases into four subgroups. In recent years, however, doubt has increased as to whether gingivitis and even the periodontitides can be considered as comprising a single disease. However, this does not affect therapeutic concepts developed on the basis of opinions to date and which, as a rule, are successful, so that, for the time being, there is no reason for a change in this sphere.

Dental Plaque↗

Regeneration of periodontal tissues following experimentally induced periodontitis in rats: a comparison of sucrose-rich and conventional diets.

The purpose of the present study is to elucidate influences of diet on periodontal regeneration following experimental periodontitis in rats. S-D rats were divided into two groups, which were fed either a conventional diet (group A) or a sucrose-rich diet (group B). Experimental periodontitis was produced by placement of elastic bands between maxillary molar teeth. After one week, the elastic bands were removed and the animals were sacrified by perfusion fixation with formalin immediately, 1, 3, or 5 days, or 1, 2, 3, 4, 6, or 8 weeks after the removal. Sections of the teeth and surrounding tissue were examined by light microscopy. Three days after the removal, in both groups, granulation tissues with many inflammatory cells were covered by epithelial cells; the attachment site to the root surface was located more apically than the cemento-enamel junction. Distinct periodontal pockets were formed by five days after the removal in group A. In group B, the infiltrations of inflammatory cells were more prominent than in group A. Six weeks after the removal in both groups, an epithelium which resembled long junctional epithelium rather than pocket epithelium became thicker. Eight weeks after the removal, the findings were similar to those of six weeks in group A. However, a severe inflammatory cell concentration was found in group B. These results suggest that periodontal wound healing is markedly influenced by diet, and that this experimental system is useful for studying dynamic changes in both pocket and long junctional epithelia.

Animals↗

[Alkaline phosphatase levels in gingival crevicular fluid of periodontitis before and after periodontal treatment].

Gingival crevicular fluid (GCF) samples were collected from 204 teeth from 35 subjects, including 8 rapidly progressive periodontitis (RPP), 14 chronic adult periodontitis (CAP), 7 marginal gingivitis (MG) and 6 healthy subjects (H). The results of alkaline phosphatase (ALP) examination indicated that the ALP levels from CAP and RPP patients were significantly higher than those from H subjects and MG patients. The ALP levels were closely related to the amount of GCF flow and various clinical periodontal parameters, especially to probing depth and attachment loss. The ALP levels and the various clinical parameters decreased significantly after periodontal therapy. The present study suggests that the measurement of GCF--ALP could be an useful adjuctive criterion for detection of periodontal inflammatory status and extent of tissue destruction.

Adult↗

[Microflora of periodontal pockets in advanced periodontitis].

The aim of study was the evaluation of periodontal pockets microflora in patients with advanced periodontitis. From each subject 16-20 samples were taken using paper points. Pooled sample after 60 s. mixing was serially diluted in reduced BHI. For total cell counts and for the isolation of black pigmented anaerobes Brucella agar supplemented with 5% sheep blood, hemin, menadione, with and without Kanamycin-Vancomycin mixture and BM agar plates were used. For isolation of A. actinomycetemcomitans TSBV agar plates were used. Cultures were incubated in anaerobic chamber at 37 degrees C for 7 days and TSBV agar plates in an atmosphere of 95% air-5% CO2 at 37 degrees C for 5 days. Microorganisms were identified by Gram staining, colony morphology, fluorescence in UV-light, haemagglutination of 3% sheep erythrocytes, fermentation of sugars, production of indole, urease (API 20A), specific enzymes (Rapid ID 32A). Twenty seven subjects with clinically recognized periodontitis were examined. Microorganisms important in periodontitis were isolated from periodontal pockets of almost all examined subjects. The number of bacteria obtained from the sample of one patient ranged from 1 x 10(4) CFU/ml to 3,6 x 10(6) CFU/ml. Porphyromonas gingivalis was identified in the samples taken from 17 patients, Prevotella intermedia-19, Actinobacillus actinomycetemcomitans -11, Fusobacterium nucleatum-9, Peptostreptococcus spp.-22.

Adult↗

HLA-A, B, Cw, DRB1, DRB3/4/5, DQB1 in German patients suffering from rapidly progressive periodontitis (RPP) and adult periodontitis (AP).

BACKGROUND/AIM: There is growing indication that differences in host response determine susceptibility and resistance to periodontal disease. Particularly, the effect of histocompatibility antigens (HLA) on early onset periodontitis (EOP) has been studied. As most of the results are not conclusive and to date no report has been done on German patients, the aim of this study was to investigate the distribution of HLA alleles in a group of 50 German RPP patients and 102 German AP patients and to compare them to 102 control probands without periodontitis. METHODS: Diagnosis was established according to standardised clinical criteria. HLA typing was performed using serologic and molecular biologic (PCR-SSP) techniques. RESULTS: Compared to the controls, RPP patients had a significantly higher frequency of HLA-DRB1*13 and a significantly lower frequency of HLA-DRBblank*(non-DRB3/4/5). AP patients showed a significantly increased occurrence of HLA-B*14 and -Cw*08 as well as a significantly decreased frequency of HLA-A*03. In both patient groups HLA-A*11 and -A*29 had an increased frequency and HLA-A*31 and -A*30/31 were decreased. These differences were statistical significant in the whole patient group (RPP + AP). CONCLUSIONS: Based on modern DNA techniques the present study shows an association of HLA to both RPP and AP. Certain HLA alleles seem to be associated with susceptibility or resistance to periodontitis in general. However, before this knowledge can be used for differential diagnosis or prognosis, further investigations are necessary.

Adult↗

Serum IgG antibody response to periodontal pathogens in minority populations: relationship to periodontal disease status and progression.

Differences in periodontal disease prevalence, severity, subgingival microflora and host immune response have been reported for various ethnic/racial groups, which implies that risk factors for destructive periodontal disease progression may also vary in these populations. As it is possible that these differences may be due to confounding variables other than ethnicity/race, we have measured serum IgG antibody response to six periodontal pathogens, and compared these data with microbiological, clinical and demographic parameters in three urban minority populations. The study population consisted of 23 Asiatic, 48 African-American and 37 Hispanic subjects, who were resident in the greater New York region. Clinical indices that were recorded included pocket depth, attachment level, gingival erythema, bleeding upon probing, suppuration and supragingival plaque. Attachment level measurements were taken twice at each visit, and the difference between the means of pairs of measurements taken at baseline and two months later was used to determine disease progression. Subgingival microbiological species were identified and enumerated using DNA-DNA checkerboard hybridization. Serum IgG antibody levels to Actinobacillus actinomycetemcomitans serotyopes a and b, Bacteroides forsythus, Campylobacter rectus, Porphyromonas gingivalis and Prevotella intermedia were measured by enzyme-linked immunosorbant assay (ELISA). Mean serum IgG antibody to P. gingivalis was found to be higher in the African-American group, while IgG antibody to B. forsythus was lower in the Hispanic group. However, the African-American group also had greater mean probing depth, attachment loss, number of missing teeth and numbers of individuals within the unskilled occupational group. When the data were analyzed by occupational status, mean serum IgG antibody to P. gingivalis increased from professional to skilled to unskilled groups. For the entire study population, prior disease and subsequent attachment loss were associated with elevated serum IgG antibody to P. gingivalis. Increasing pocket depth, attachment level, gingival erythema and age were also positively correlated with serum IgG antibody to P. gingivalis, but not with serum IgG antibody to the other five subgingival species. No correlation was found between whole-mouth bacterial levels and homologous serum IgG antibody levels. These results suggest that elevated serum IgG antibody to P. gingivalis reflects destructive periodontal disease status, and may be considered a risk factor for disease progression in these ethnic/racial populations. In addition, although differences in serum IgG antibody profiles to subgingival species were found among the three ethnic/racial groups, environmental and socioeconomic variables may have a greater influence on serum IgG antibody levels in these populations.

Adult↗