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PubMed2006

Autoantibodies directed to extracellular matrix components in patients with different clinical forms of periodontitis.

BACKGROUND: Periodontal disease occurs in different clinical forms, from mild and easily controllable to more aggressive inflammatory manifestations, with difficult clinical or surgical control. There is evidence that a local autoimmune reaction may participate in the onset and persistence of the aggressive forms of periodontal disease. As the underlying mechanism in this process is not fully understood, we decided to investigate whether patients bearing this form of disease presented higher levels of antibodies directed to extracellular matrix (ECM) components such as type I collagen, fibronectin, and laminin. METHODS: Three groups of patients were selected by clinical criteria: 22 subjects with aggressive periodontitis (AgP) = group A; 18 subjects with chronic periodontitis (CP) = group B; and 10 healthy (H) volunteers without periodontal disease = group C. Autoantibody levels were evaluated in the sera of these patients using the enzyme-linked immunosorbent assay (ELISA) method. RESULTS: The levels of autoantibodies directed to ECM components (type I collagen, fibronectin and laminin) in the sera of patients with AgP and CP were shown to be statistically different (P <0.05). CONCLUSIONS: Although the present findings suggest an involvement of autoantibodies directed to ECM components per se in the pathogeny of certain types of periodontal disease, the available data do not support the classification of the lesions as autoimmune. Nevertheless, the findings open a possibility for the development of an additional method for a differential diagnosis of the aggressive forms of periodontal disease.

Adolescent↗
PubMed1991

Immunologic mechanisms of pathogenesis in periodontal diseases: an assessment.

Principal lines of evidence that immune reactions are central to the pathogenesis of periodontitis are reviewed. Necessary components of immunologic reactions are present in gingiva in the periodontal diseases. Differences between healthy and periodontitis patients with respect to some measures of immune function further indicate that immune reactions do occur in the gingiva during periodontitis. They are probably responsible for at least some of the destruction of connective tissue and bone that occurs. Classical antibody-mediated hypersensitivity reactions probably do not provide the reasons. Mechanisms are more likely to be found in the pro-inflammatory and tissue-degrading effects of cytokines released in host-protective, antigen-specific and polyclonal responses to oral bacterial constituents or products. Some evidence suggests that limitation of clinical destruction in localized early onset periodontitis (JP) may in part be a function of a protective antibody response which develops after an initial rapidly progressive infection. A relatively deficient immune responsiveness may allow progression to more severe and generalized disease (RPP). Suggestions are made for studies needed to confirm suspected pathogenetic mechanisms, approach resultant targeted therapies, and test hypotheses for contrasting roles of immune reactions in different clinical expressions of periodontitis.

Aggressive Periodontitis↗
PubMed1992

[Do new diagnostic tests improve the differential diagnosis and therapy of periodontitis? A review].

New diagnostic tools give access to information that was previously not available by classical clinical means. This includes methods for the determination of the composition of the microbial flora or for monitoring specific reactions of host tissues to the accumulation of plaque. DNA-probes, monoclonal antibodies and enzyme assays have already been advertised and are sold to dentists. The practical value of new tests depends upon the possibility to improve the efficacy of treatment based on previously inaccessible information. This paper reviews frequently raised clinical questions, the possible answers coming from new diagnostica, and the potential impact of this knowledge on periodontal therapy.

Aggressive Periodontitis↗
PubMed1991

[Microbiology of periodontitis. 2. Microbiological diagnosis of periodontitis].

By common methods like scaling and root planing, flap procedures or surgical furcation treatment, a successful therapy of periodontal disease is possible in about 90% of the cases. The remaining 10%, mainly patients with juvenile or rapidly progressive periodontitis, are causing great problems, due to poor treatment response and frequent, local or general recidives. In the future, microbiological tests for a precise diagnosis of the pocket flora will be used in the dental office. They can provide better indications for additional antibiotic therapy. The present article reviews several microbiological investigation methods and their future use in the office during periodontal treatment.

Aggressive Periodontitis↗