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PubMed2006

Studies on periodontitis and analyses of individuals at risk for periodontal diseases.

Periodontal disease is an infectious disease initiated by microbial plaque, which accumulates on the tooth surface at the gingival margin and induces an inflammatory reaction. The function of the inflammatory process is to protect the host, however the process may also contribute to tissue destruction. Most individuals show gingival inflammation, but only a limited number suffer from periodontitis i.e. loss of attachment. Without treatment, periodontitis will result in tooth mobility and subsequent tooth mortality. Independent of ethnicity, 10%-15% of an adult population will develop severe periodontitis The aim of this thesis has been to analyse individuals at risk for periodontal disease. Four studies have been conducted in 2 different groups of individuals with: Recurrent periodontitis kept in a maintenance care program--studies I-III. Type 2 diabetes (T2D)--study IV. In study I, the clinicaleffect of local periodontitis treatment with an antibiotic gel was investigated. In study II, the microbiologicaleffect of periodontitis treatment with the same antibiotic gel as in study I was investigated. In study III, it was investigated whether the interleukin-l (IL-1alpha and beta) and interleukin-6 (IL-6) gene polymorphisms were associated with the susceptibility of chronic periodontitis. In study IV, the prevalence of periodontitis in individuals with T2D was investigated, together with the prevalence of diabetic complications in relation to periodontal disease. We also studied whether there was a difference in dental care habits and knowledge of oral health between T2D subjects with and without periodontal disease. In conclusion, this thesis did not find any significant clinical and microbiological differences between subjects with recurrent periodontal disease treated with a locally delivered metronidazole gel compared to a placebo gel. Neither could we find an association between genetic variants in the IL-lalpha, IL-beta and IL-6 genes in individuals with or without periodontal disease. The prevalence of severe periodontitis, according to radiographic criteria, was almost 20% in subjects with T2D. This was further confirmed by clinical parameters. T2D individuals with periodontal disease demonstrated a higher HbAlc level, a higher prevalence of cardiovascular complications and a higher proportion of smokers compared to periodontally healthy T2D subjects. Finally, T2D individuals seem to lack sufficient knowledge about oral health.

Adult↗
PubMed1989

[Research into actual conditions and preventive care in periodontal disease. Relationship between questionnaire results and periodontal disease in youth].

The purpose of this study was to determine the prevalence of periodontal disease and the relationship between the results of questionnaire concerning periodontal disease and the actual periodontal condition in youth. The examination was carried out in three parts. In the first part, a questionnaire was conducted on 3,886 junior and senior high school students (12 to 18 years of age) living in Kawagoe, Japan. The questionnaire was composed by of items concerning habits of oral hygiene, periodontal symptoms, understanding of periodontal disease and history of diagnosis by dentist of periodontal disease. Secondary, mass intraoral examination was carried out on all objects. The examination covered gingival inflammation, periodontal probing depth, calculus, dental plaque, dental caries and malalignment. Lastly, we examined the relationship between the results of periodontal examination and questionnaire with the original periodontal classification. The following results were obtained: 1. As an example of items in questionnaire, 83.1% brushed their teeth more than two times daily. The understanding of oral hygiene concerning dental caries was improved, but concerning periodontal disease was still poor. 2. The symptom most frequently reported was gingival bleeding during tooth brushing (18.4%). 3. The percentage of persons with periodontal disease (moderate gingival inflammation and periodontal pocket 4 mm or deeper) was of the highest frequency at 13 years old. The proportion of males increased with the advanced state of periodontal disease. 4. A significant correlation was found (chi 2-test: alpha less than 0.001) between advanced state of periodontal disease and a decrease in tooth brushing time per day. 5. A significant correlation was found between the advance of periodontal disease and gingival bleeding on tooth brushing (chi 2-test: alpha less than 0.001). Similarly, a correlation was found between the advance of periodontal disease and gingival swelling (chi 2-test: alpha less than 0.001). 6. A significant correlation was found (chi 2-test: alpha less than 0.001) between the advance of periodontal disease and aggravation of condition of dental plaque, calculus, dental caries and malalignment.

Adolescent↗
PubMed1995

Salivary levels of suspected periodontal pathogens in relation to periodontal status and treatment.

The primary ecological niche for suspected periodontal pathogens seems to be the subgingival area, even though periodontal pathogens are also frequently recovered from saliva. The interrelationship of different periodontal conditions and the salivary levels of suspected periodontal pathogens is not known. In the present study, salivary levels of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Campylobacter rectus, and Peptostreptococcus micros were determined by bacterial culture and related to clinical periodontal status in 40 subjects with either advanced, moderate, or initial/no periodontitis. Culture-positive subjects harbored the 5 bacterial species in mean numbers ranging from 2 x 10(5) to 6 x 10(7) colony-forming units (CFU)/mL saliva. A. actinomycetemcomitans was found in none and P. gingivalis in one of the subjects with initial periodontitis, whereas both species were found in 33% and 44%, respectively, of the subjects with moderate periodontitis and in 60% and 40%, respectively, of the subjects with advanced periodontitis. The mean numbers of CFU/mL of P. intermedia, C. rectus and P. micros were significantly higher in subjects with advanced periodontitis than in subjects with initial/no periodontitis. Ten patients with advanced periodontitis were treated mechanically and with adjunctive systemic metronidazole, and were re-examined 1 and 6 months after treatment. Periodontal treatment eradicated or significantly reduced the levels of salivary periodontal pathogens for half a year, whereas in untreated subjects, the levels and the detection frequencies generally remained fairly stable. In conclusion, the results showed that the salivary levels of periodontal pathogens reflect the periodontal status of the patient.

Adult↗
PubMed2005

[Markers of periodontal destruction in saliva of periodontitis patients].

UNLABELLED: Periodontal diseases result from interactions between periodontal microflora and the multifaceted response of the host. Markers of this interrelationship can be found in gingival crevicular fluid and saliva samples indicating early periodontal disease activity. Studies of host defense mediators in saliva of patients with periodontal diseases are very scarce. AIM: The goal of this study was therefore to investigate interrelationships between mediators of local immunity in host saliva and clinical parameters of periodontal destruction in persons with chronic and aggressive periodontitis. METHODS AND SUBJECTS: Host defense indicators were measured using enzyme-immunochemistry tests in unstimulated saliva samples of persons with periodontitis. The degree of periodontal destruction was determined by measuring attachment loss. Subjects were divided into two groups: persons with mild signs of chronic periodontitis and persons with severe signs of aggressive periodontitis. Hypotheses about the structure of those samples and their interrelationship were tested using non-parametric methods. RESULTS: Results indicated that C-reactive protein, C3 component of the complement, alfa 2-macroglobulin and interleukin-6 levels differ significantly between patients with chronic and aggressive periodontitis. Interleukin-6, influencing cells with osteoblastic phenotype, is present at a high level in patients with aggressive periodontitis. Calcium was much lower than in healthy persons. Trypsin levels were lower in patients with periodontitis than in healthy persons. We found a significant interrelationship between host response mediators as measured in saliva and periodontal destruction measured by clinical attachment loss. CONCLUSION: The levels of host defense mediators in saliva are different for chronic and aggressive periodontitis. This findings might help in estimating the course and progression of periodontal destruction, thus providing clinical benefits in treatment planning.

Adult↗
PubMed2006

The relation between apical periodontitis and root-filled teeth in patients with periodontal treatment need.

AIM: To investigate a number of clinical and treatment variables that might have influenced the prevalence of apical periodontitis in root-filled teeth in a population of periodontally compromised patients. METHODOLOGY: This investigation was a retrospective cross-sectional study on data collected from periodontal charts in addition to intra-oral full-mouth radiographs from patients attending the Department of Periodontology of the Dental School of the Ghent University Hospital. Periodontal parameters (clinical attachment loss and the lowest marginal bone level, the history of periodontal treatment), endodontic treatment (length, homogeneity and overall quality of the root filling) and the quality of coronal restorations were related to the prevalence of apical periodontitis. A total of 272 root-filled teeth in 94 patients were evaluated. RESULTS: The periapical condition was significantly influenced by the quality of the root filling and the coronal filling (P < 0.05). More apical periodontitis was seen when the coronal level of the root filling exceeded the marginal bone level (P < 0.005). The marginal periodontal condition seemed to influence the periapical status. Teeth with apical periodontitis were associated with significantly more extended marginal bone loss (P < 0.001). Significantly less apical periodontitis was seen in patients that had received marginal periodontal treatment (P < 0.005), compared with untreated periodontal patients. CONCLUSIONS: Signs of periodontal disease, as reflected by marginal bone loss, are of importance for the periapical condition of root-filled teeth. Efforts should be taken in preventing spread of infection through the periodontal-endodontic pathway by periodontal infection control and a high quality of root filling and coronal filling. Care should also be taken to seal the coronal cavity up to the level of the root filling, where it is advisable to reduce the coronal level of the root filling below or at least at the level of the surrounding marginal bone.

Alveolar Bone Loss↗
PubMed2000

Levels of interleukin-1 beta, -8, and -10 and RANTES in gingival crevicular fluid and cell populations in adult periodontitis patients and the effect of periodontal treatment.

BACKGROUND: Various cytokines have been identified at sites of chronic inflammation such as periodontitis. Cytokines are synthesized in response to bacteria and their products, inducing and maintaining an inflammatory response in the periodontium. The purpose of the present study was to investigate the involvement of interleukin-1 beta (IL-1 beta), IL-8, and IL-10 and RANTES (regulated on activation, normally T cell expressed and secreted) and the cell populations associated with the immune response in destructive periodontitis, as well as the effect of periodontal therapy on cytokine levels in gingival crevicular fluid (GCF). METHODS: Data were obtained from 12 patients with moderate to advanced periodontitis and 6 healthy controls. Patients presenting at least 2 sites with > or =2 mm clinical attachment loss were included in the destructive periodontitis group. After monitoring for 4 months, only 6 patients showed destructive periodontitis and GCF samples and soft tissues biopsies were collected from these patients. GCF samples and biopsies were collected both from active (12 CGF samples and 6 biopsies) and inactive (12 CGF samples and 6 biopsies) sites. The comparison with healthy controls was carried out by collecting GCF samples from 6 healthy volunteers (12 samples) and biopsies during the surgical removal of wisdom teeth. In periodontal patients, clinical data and GCF samples were obtained prior to periodontal treatment (72 samples) and 2 months after periodontal therapy (72 samples). GCF was collected using a paper strip; eluted and enzyme-linked immunoabsorbent assays (ELISA) were performed to determine cytokine levels. The inflammatory infiltrate was analyzed by immunohistochemistry of gingival biopsy samples with monoclonal antibodies against CD3, CD8, CD4, CD11c, and CD19 antigens. RESULTS: Cellular components of the inflammatory infiltrate include B and T lymphocytes and monocyte/macrophages. Active sites contained a higher number of B lymphocytes and macrophages. IL-8 and IL-1 beta and RANTES in GCF were detected in the majority of sites from periodontal patients (100%, 94% and 87%, respectively); IL-10 was found in only 43%. IL-8 was the only cytokine detected in the GCF (75%) of the control group. Moreover, IL-1 beta levels were significantly higher in active sites versus inactive sites (P <0.05). IL-8 and IL-10 and RANTES were increased in active sites; however, differences were not significant (P>0.05). A positive correlation between the IL-8 and RANTES (r = 0.677, P<0.05) was observed in periodontitis patients. Periodontal therapy reduced the total amount of IL-1 beta, IL-8, and IL-10 and RANTES. Data showed a weak correlation between the clinical parameters and the total amount of cytokines in periodontitis. CONCLUSIONS: These data suggest that the amount of crevicular IL-1 beta, IL-8, and IL-10 and RANTES is associated with periodontal status. Removal of the bacterial plaque reduces the antigenic stimuli and consequently could modulate the chemokines present in GCF. We propose that the dynamic interactions between cytokines, their production rates, and their quantity could represent factors controlling the induction, perpetuation, and collapse of the cytokine network present in the periodontal disease.

Adult↗
PubMed1989

Periodontal implications of orthodontic treatment in adults with reduced or normal periodontal tissues versus those of adolescents.

This longitudinal study monitored periodontal status in 20 adults and 20 adolescents undergoing fixed orthodontic treatment. Ten adults had generalized periodontitis and received periodontal treatment, including periodontal surgery, before orthodontic treatment. They also received periodontal maintenance at 3-month intervals during orthodontic treatment. The other 10 adults had normal periodontal tissues. Neither these latter adults nor the adolescents received periodontal maintenance during orthodontic treatment. Periodontal status was determined (1) at six standard sites before fixed appliances were placed (baseline), (2) at 1, 3, 6, 9, 12, and 18 months after appliances had been placed, and (3) 1, 3, 6, and 12 months after appliances had been removed. At each of these visits, these sites were assessed for plaque index, gingival index, bleeding tendency, and pocket depth. Loss of attachment between baseline and 3 months after appliances were removed and tooth loss were also determined. Complete data were obtained for 15 adolescents and 14 adults. During orthodontic treatment the adolescent group showed significantly more (p less than 0.05) periodontal inflammation and supragingival plaque than the adults; after appliances were removed, this pattern was no longer statistically significant. For loss of attachment, there were no significant differences among adolescents, adults with normal periodontal tissues, or adults with reduced but healthy periodontal tissues who had undergone treatment for periodontal disease. For tooth loss, three nonstudy site teeth with pockets deeper than 6 mm and/or furcation involvements were lost because of periodontal abscesses in the adult group treated for periodontal disease.

Adolescent↗
PubMed1996

Utility of 5 major putative periodontal pathogens and selected clinical parameters to predict periodontal breakdown in patients on maintenance care.

The predictive utility of 5 major putative periodontopathic microbial species, "superinfecting" organisms, and several clinical periodontal parameters were assessed relative to periodontitis recurrence over a 12-month period in 78 treated adult patients participating in a 3-month maintenance care program. At baseline, pooled subgingival microbial samples were collected from each patient, and whole-mouth evaluations of probing depth, relative periodontal attachment level, furcation involvement, and indices of plaque and gingival inflammation were carried out. 67 (85.9%) subjects were culture-positive at baseline for presence of either Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Campylobacter rectus or Peptostreptococcus micros, with 48 (61.5%) subjects yielding one or more of these species at or above designated threshold proportions of > or = 0.01% for A. actinomycetemcomitans, > or = 0.1% for P. gingivalis, > or = 2.5% for P. intermedia, > or = 2.0% for C. rectus, and > or = 3.0% for P. micros. Subgingival yeasts were recovered from 12 subjects, staphylococci from 7, and enteric rods/pseudomonads from 6; however, no subjects revealed > or = 1.0% baseline proportions of these "superinfecting" organisms in subgingival specimens. Periodontitis recurrence in subjects was defined as any periodontal site exhibiting either a probing depth increase of > or = 3 mm from baseline, or a probing depth increase of > or = 2 mm from baseline together with a loss in relative periodontal attachment of > or = 2 mm from baseline. 15 (19.2%) study subjects showed periodontitis recurrence within 6 months of baseline, and 25 (32.1%) within 12 months. The mere baseline presence of the 5 major test species and "superinfecting" organisms were not significant predictors of periodontitis recurrence over 12 months. However, a 2.5 relative risk for periodontitis recurrence over 12 months was found for subjects yielding one or more of the 5 major test species at or above the designated baseline threshold proportions (p = 0.022, Mantel-Haenszel chi 2 test). The positive predictive value for periodontitis recurrence of a microbiologic analysis encompassing the 5 major test species at or above the designated threshold proportions improved with increasing time from baseline, up to approximately 42% at 12 months. Baseline variables jointly providing in multiple regression analysis the best predictive capability for periodontitis recurrence in subjects over a 12-month period were recovery of one or more of the 5 major test species at or above designated threshold proportions, the proportion of sites per subject with > or = 5 mm probing depth, and the mean whole-mouth probing depth. These findings indicate that one or more of 5 major putative periodontal pathogens in elevated subgingival proportions together with increased probing depth predispose adults on maintenance care to recurrent periodontitis.

Adult↗
PubMed1993

Salivary collagenase, elastase- and trypsin-like proteases as biochemical markers of periodontal tissue destruction in adult and localized juvenile periodontitis.

The profile of salivary proteases and their cellular origin, with special reference to polymorphonuclear leukocytes and bacteria, was studied in localized juvenile periodontitis and compared with adult periodontitis and healthy controls. General proteolytic activity in saliva as well as collagenase, elastase-like and trypsin-like activity was measured. In addition, the sensitivity of salivary collagenase of patients with localized juvenile periodontitis to doxycycline inhibition was studied. The saliva of localized juvenile periodontitis patients contained low amounts of collagenase compared with adult periodontitis saliva, and almost all salivary collagenase was found to exist in endogenously active form, as was found to be the case also in adult periodontitis patients and healthy controls. The salivary collagenase of localized juvenile periodontitis patients was relatively insensitive to 100 mumol/l doxycycline but was completely inhibited by 600 mumol/l doxycycline, reflecting rather matrix metalloproteinase-1 (fibroblast-type) than matrix metalloproteinase-8 (polymorphonuclear leukocyte) enzyme. The saliva of localized juvenile periodontitis patients also contained low amounts of elastase-like activity compared with the saliva of untreated adult periodontitis patients. Scaling and root planing caused a significant decrease in elastase-like activity in the saliva of adult periodontitis patients. General proteolytic and trypsin-like activities were also low in the saliva of localized juvenile periodontitis patients. Furthermore, the reducing agent beta-mercaptoethanol did not activate or inhibit the salivary trypsin-like activity of localized juvenile periodontitis or adult periodontitis patients, although the reductant readily activated partially purified Porphyromonas gingivalis trypsin-like protease in a characteristic manner.(ABSTRACT TRUNCATED AT 250 WORDS)

Aggressive Periodontitis↗
PubMed2004

Tooth loss during maintenance following periodontal treatment in a periodontal practice in Norway.

BACKGROUND: Periodontal therapy coupled with careful maintenance has been shown to be effective in maintaining periodontal health; however, a small number of teeth are still lost because of progressive periodontitis. AIM: To investigate factors associated with tooth loss due to periodontal reasons during maintenance following periodontal treatment in patients in a Norwegian specialist periodontal practice. The study also examined how initial prognosis related to actual outcome as measured by periodontal tooth loss. METHODS: Hundred consecutive patients (68 females, 32 males) who had comprehensive periodontal treatment and attended for 9.8 (SD: 0.7), range: 9-11 years of maintenance care, were studied. All teeth classified as being lost due to periodontal disease over the period were identified. RESULTS: Only 36 (1.5%) of the 2436 teeth present at baseline were subsequently lost due to periodontal disease. There were 26 patients who lost at least one tooth. Logistic regression analysis showed that tooth loss was significantly related to male gender (p=0.049; adjusted odds ratio: 2.8; confidence interval (c.i.): 1.0-8.1), older age, i.e.>60 years (p=0.012; adjusted odds ratio: 4.0; c.i.: 1.3-12.0) and smoking (p=0.019; adjusted odds ratio: 4.2; c.i.: 1.4-13.8). The majority 27 (75%) of the teeth lost due to periodontal disease had been assigned an uncertain, poor or hopeless initial prognosis; however, nine teeth (25%) lost had been assigned a good prognosis at baseline. The prognosis for 202 teeth was judged to have worsened over the period of the study. CONCLUSION: Compliance with maintenance following periodontal treatment was associated with very low levels of tooth loss in a referral practice in rural Norway. Male gender, older age (>60 years) and smoking were predictors of tooth loss due to progressive periodontitis.

Adult↗
PubMed2005

[Infection frequency of Epstein-Barr virus in subgingival samples from patients with different periodontal status and its correlation with severity of periodontal lesion].

OBJECTIVE: To detect the infection frequencies of different Epstein-Barr virus (EBV) genotypes in subgingival samples of chronic periodontitis, and the correlation among infection with different genotypes and the severity of periodontal lesion. METHODS: Nested PCR (nPCR) with EBV-1 or EBV-2 specific primers was used to detect EBV-1 and EBV-2 in the subgingival samples from 65 chronic periodontitis patients, 65 gingivitis patients and 24 periodontal healthy individuals. The amplicons were further identified by RFLP with endonucleases Afa I and Stu I. By using periodontal attachment loss (AL) and gingival index (GI) as the observing in, the correlation of infection with different EBV genotypes and the severity of periodontal lesion were analyzed. RESULTS: 0.01 ng of EBV-1 DNA could be detectable by the established nPCR. All the samples showed the same detection results by two separated nPCR. All the EBV-1 amplification products (497 bp) by using endonuclease Afa I digestion could be divided into two fragments with 355 bp and 142 bp respectively. After endonuclease Stu I digestion, all the EBV-2 amplification products (165 bp) displayed two fragments with 118 bp and 47 bp respectively. In the samples of chronic periodontitis patients, gingivitis patients, and healthy periodontal tissues, the positive rates were 28.5% (74/260), 16.9% (44/260), and 14.6% (14/96) for EBV-1; and were 8.1% (21/260), 3.1% (8/260), and 0% for EBV-2 respectively, and the total EBV positive rates were 36.5% (95/260), 20.0% (52/260) and 14.6% (14/96) respectively. None of the positive samples was detectable for both the EBV-1 and EBV-2. The positive rates of EBV-1, EBV-2 and the total EBV positive rates in the chronic periodontitis samples were all higher than those in the gingivitis samples (all P < 0.05) and healthy periodontal tissue samples (all P < 0.01), without a significant difference between the gingivitis samples and healthy periodontal tissue samples (P > 0.05). Infection of EBV or EBV-1 or EBV-2 in CP patients could not be associated with AL or GI. CONCLUSION: Subgingival infection with either EBV-1 or EBV-2 is closely associated with chronic periodontitis. Infection of EBV may not correlate directly with severity of periodontitis.

Adolescent↗
PubMed2002

Periodontal pathogen detection in gingiva/tooth and tongue flora samples from 18- to 48-month-old children and periodontal status of their mothers.

Few studies have detected periodontal pathogens in young children, and when detected the prevalence has been relatively low. In this epidemiological study, we determined the prevalence of periodontal pathogen colonization in young children and examined the relationship between periodontitis in mothers and detection of periodontal pathogens in their children aged 18-48 months. Children were selected and enrolled randomly into the study; tongue and gingival/tooth plaque samples were harvested and analyzed by DNA probe checkerboard assay for Porphyromonas gingivalis and Bacteroides forsythus. Clinical measurements included a gingival bleeding score in the children and a periodontal screening and recording (PSR) score in the mothers. Mothers having one or more periodontal sites with probing depths > 5.5 mm were classified as having periodontitis. In this population, 71% (66/93) of the 18- to 48-month-old children were infected with at least one periodontal pathogen. Detection rates for children were 68.8% for P. gingivalis and 29.0% for B. forsythus. About 13.8% (11/80) of children had gingival bleeding in response to a toothpick inserted interproximally. Children in whom B. forsythus was detected were about 6 times more likely to have gingival bleeding than other children. There was no relationship between bleeding and detection of P. gingivalis. 17.0% (16/94) of the mothers had periodontitis. When all mother-child pairs were considered, the periodontal status of the mother was found not to be a determinant for detection of periodontal pathogens in the floral samples from the children. However, the odds ratio that a daughter of a mother with periodontitis would be colonized was 5.2 for B. forsythus. A much higher proportion of children in this population were colonized by P. gingivalis and/or B. forsythus than has been previously reported for other populations. A modest level of association between manifestations of periodontitis in mothers and detection of B. forsythus in their daughters was observed.

Adult↗
PubMed2006

[Mechanical periodontal treatment combined with tetracycline for aggressive periodontitis].

OBJECTIVE: To evaluate the effect of mechanical periodontal treatment combined with tetracycline on periodontal attachment, distances of cementum-enamel junction (CEJ) to the bone defect bottom and to the alveolar crest, and avidity of serum IgG against Porphyromonas gingivalis (Pg) lipopolysaccharide (LPS) in patients with aggressive periodontitis. METHODS: Twenty-six patients with aggressive periodontitis were divided equally into two groups to receive mechanical periodontal treatment combined with tetracycline or exclusive mechanical periodontal treatment, with another 20 periodontally healthy subjects serving as the control group. In the two patient groups, routine clinical examination of the subjects was performed to record periodontal attachment level and distances of CEJ to the bottom of the bone defects and to the alveolar crest before and 3 and 6 months after the treatment. The avidity of serum IgG against Pg LPS was measured by ELISA with thiocyanate elution before and after periodontal treatment. RESULTS: Compared with patients with exclusive mechanical periodontal treatment, patients with combined treatments showed significant improvement in periodontal attachment level and the distance of CEJ to the bone defect bottom after the treatment (P<0.01 and P<0.05, respectively) with also significantly reduced avidity of serum IgG against Pg LPS (P<0.01). CONCLUSION: Mechanical periodontal treatment combined with tetracycline produces favorable effects in patients with aggressive periodontitis.

Adult↗
PubMed1981

Histologic evaluation of probe penetration during clinical assessment of periodontal attachment levels. An investigation of experimentally induced periodontal lesions in beagle dogs.

The purpose of this study was to evaluate histologically the extent and characteristics of the penetration of a periodontal probe during clinical assessment of loss of periodontal attachment in three different situations: (1) experimental mild gingivitis, (2) experimental severe periodontal inflammation and (3) experimental moderate periodontal inflammation. Mild gingivitis was obtained by merely allowing plaque to accumulate on the teeth. Severe periodontal inflammation was created using copper bands for a period of 3 weeks followed by placement of cotton ligatures for another 11 weeks. Moderate periodontal inflammation group was obtained by allowing the experimental defects to recover for a period of 3 to 31 weeks. At different times gutta percha imitations of a thin periodontal probe were inserted into the pockets using a gentle but unknown force. Histologic observation in 30 specimens showed that epithelium was always present around the probe tip, in most instances forming a continuous layer of epithelial cells. Histometrical analysis showed that in mild gingivitis the probe tip failed to reach the apical termination of the junctional epithelium (mean = -0.84 mm). In severe periodontal inflammation the tip of the probe went past this point (mean = +0.50 mm), while in moderate periodontal inflammation the probe tip came closest to the apical termination of the junctional epithelium (mean = -0.05 mm). It is concluded that the epithelial lining of a pocket stays intact, even in severe periodontal inflammation where the probe tip is situated apical to the apical termination of the junctional epithelium, indicating that during clinical probing the periodontal tissues are compressed and displaced but not perforated. It is also concluded that in beagle dogs the extent of probe penetration in experimentally inflamed periodontal tissues is dependent upon the degree of inflammation.

Animals↗
PubMed1999

beta-Hemolytic streptococci and other beta-hemolytic organisms in apical periodontitis and severe marginal periodontitis.

Thirteen teeth with necrotic pulps and apical periodontitis and nine severe periodontal pockets were cultured for presence of beta-hemolytic streptococci and other beta-hemolytic organisms. Samples were dispersed and plated on two non-selective and one selective growth media and incubated anaerobically and in 10% CO2 in air. A total of 59 beta-hemolytic colonies were purified and identified. Eight beta-hemolytic streptococcal isolates were obtained from three of the severe marginal periodontitis sites. All were identified as belonging to the Streptococcus sanguis group. No beta-hemolytic streptococci were detected in apical periodontitis samples. Twenty obligately anaerobic isolates were detected, all of which were known periodontal and endodontic pathogens. Isolates from apical periodontitis sites were identified as Propionibacterium acnes, Actinomyces naeslundii, Actionomyces odontolyticus and Peptostreptococcus micros, while severe marginal periodontal sites contained the same species with the addition of Actinomyces viscosus and Actinomyces meyeri. Of 19 staphylococci and micrococci, Staphylococcus epidermidis was the predominant isolate in both apical periodontitis and severe marginal periodontitis sites. However, less commonly known organisms such as Staphylococcus cohnii and Micrococcus sp. were identified in severe marginal periodontitis sites. The isolation of Bacillus sp. (12 isolates) in one severe marginal periodontitis and two apical periodontitis subjects was especially interesting, warranting consideration of this organism as a legitimate isolate and potential pathogen in oral disease.

Bacillus↗
PubMed1996

Periodontal status and detection frequency of bacteria at sites of periodontal health and gingivitis.

It is generally recognized that bacteria in dental plaque at sites of periodontal diseases are not commonly found at sites of periodontal health. One hypothesis to explain the etiology of periodontitis is that pathogenic bacteria from diseased sites infect healthy sites. It has been suggested that gingival inflammation may predispose sites to colonization by bacteria associated with periodontal diseases. The purpose of this cross-sectional study was to determine whether the detection frequency of selected bacteria at sites of periodontal health or gingivitis differed between subjects who were in good periodontal health, subjects who had gingivitis, or subjects with periodontitis. The clinical status of every tooth (except third molars) from 106 subjects was characterized by means of clinical attachment level, probing depth and by signs of inflammation. Subgingival plaque was collected from mesio-facial and disto-lingual surfaces. Specific monoclonal antibodies were used in an immunocytochemical assay to identify Campylobacter rectus, Eikenella corrodens, Porphyromonas gingivalis, pathogen-related oral spirochetes (PROS, using Treponema pallidum subspecies pallidum monoclonal antibodies), T. denticola (serotypes A-D), T. socranskii subspecies buccale and T. socranskii subspecies socranskii. Differences in detection of bacteria between groups of subjects were measured using odds ratios (OR). Results of this study indicate that PROS was the only identified bacterium at sites of both health and gingivitis that demonstrated a significant positive relationship with the presence of periodontitis. These findings do not prove that bacteria spread from periodontitis sites, nor do they imply that disease necessarily results from infection. However, these data do suggest that some bacteria associated with periodontitis are more likely than others to tolerate conditions at healthy sites and that the presence of periodontitis increases risk of infection at healthy sites.

Adult↗