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Results for “Aggressive Periodontitis”

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At least 433 records · Page 24Linked to original sources
PubMed1990

Repair potential in localized juvenile periodontitis. A case in point.

An aggressive form of localized juvenile periodontitis (LJP) in a 12-year old West African female is reported. The case was treated with scaling, root planing, debridement, and tetracycline therapy, which resulted in complete resolution of the disease, including elimination of periodontal inflammation, regeneration of lost periodontal structures, and spontaneous repositioning of teeth that had pathologically migrated. A hopelessly involved mandibular right first molar was successfully replaced by an incompletely developed maxillary third molar tooth bud whose roots and pulp structure continued to develop after autotransplantation. It is suggested, that LJP can be successfully treated without periodontal surgery and that the potential for repair in LJP cases is apparently greater than what one can anticipate in adult forms of periodontitis.

Aggressive Periodontitis↗
PubMed2001

Nonsurgical periodontal therapy.

Regular home care by the patient in addition to professional removal of subgingival plaque is generally very effective in controlling most inflammatory periodontal diseases. When disease does recur, despite frequent recall, it can usually be attributed to lack of sufficient supragingival and subgingival plaque control or to other risk factors that influence host response, such as diabetes or smoking. Causative factors contributing to recurrent disease include deep inaccessible pockets, overhangs, poor crown margins and plaque-retentive calculus. In most cases, simply performing a thorough periodontal debridement under local anesthesia will stop disease progression and result in improvement in the clinical signs and symptoms of active disease. If however, clinical signs of disease activity persist following thorough mechanical therapy, such as increased pocket depths, loss of attachment and bleeding on probing, other pharmacotherapeutic therapies should be considered. Augmenting scaling and root planing or maintenance visits with adjunctive chemotherapeutic agents for controlling plaque and gingivitis could be as simple as placing the patient on an antimicrobial mouthrinse and/or toothpaste with agents such as fluorides, chlorhexidine or triclosan, to name a few. Since supragingival plaque reappears within hours or days after its removal, it is important that patients have access to effective alternative chemotherapeutic products that could help them achieve adequate supragingival plaque control. Recent studies, for example, have documented the positive effect of triclosan toothpaste on the long-term maintenance of both gingivitis and periodontitis patients. Daily irrigation with a powered irrigation device, with or without an antimicrobial agent, is also useful for decreasing the inflammation associated with gingivitis and periodontitis. Clinically significant changes in probing depths and attachment levels are not usually expected with irrigation alone. Recent reports, however, would indicate that, when daily irrigation with water was added to a regular oral hygiene home regimen, a significant reduction in probing depth, bleeding on probing and Gingival Index was observed. A significant reduction in cytokine levels (interleukin-1beta and prostaglandin E2, which are associated with destructive changes in inflamed tissues and bone resorption also occurs. If patient-applied antimicrobial therapy is insufficient in preventing, arresting, or reversing the disease progression, then professionally applied antimicrobial agents should be considered including sustained local drug delivery products. Other, more broadly based pharmacotherapeutic agents may be indicated for multiple failing sites. Such agents would include systemic antibiotics or host modulating drugs used in conjunction with periodontal debridement. More aggressive types of juvenile periodontitis or severe rapidly advancing adult periodontitis usually require a combination of surgical intervention in conjunction with systemic antibiotics and generally are not controlled with nonsurgical anti-infective therapy alone. It should be noted, however, that, to date, no home care products or devices currently available can completely control or eliminate the pathogenic plaques associated with periodontal diseases for extended periods of time. Daily home care and frequent recall are still paramount for long-term success. Nonsurgical therapy remains the cornerstone of periodontal treatment. Attention to detail, patient compliance and proper selection of adjunctive antimicrobial agents for sustained plaque control are important elements in achieving successful long-term results. Frequent re-evaluation and careful monitoring allows the practitioner the opportunity to intervene early in the disease state, to reverse or arrest the progression of periodontal disease with meticulous nonsurgical anti-infective therapy.

Administration, Oral↗
PubMed1994

Neutrophil lysosomal nonoxidative microbicidal proteins in early-onset periodontitis.

The purpose of this study was to evaluate whether the reduced microbicidal activity of polymorphonuclear leukocytes (neutrophils) in patients with early-onset periodontitis is associated with a deficiency of nonoxidative microbicidal proteins. Neutrophils from 10 patients with early-onset periodontitis and 8 healthy control subjects were assessed for elastase isozymes 1 through 4, cathepsin G isozymes 1 through 4 and defensins (HNP-1, HNP-2 and HNP-3) using cationic and acid urea polyacrylamide gel electrophoresis. The results showed that both the total content and the relative distribution of elastase and cathepsin G isozymes was normal in neutrophils of patients with early-onset periodontitis. However, the HNP-3 content was significantly reduced in neutrophils from patients with generalized early-onset periodontitis. These findings indicate that the impaired microbicidal activities of neutrophils in patients with early-onset periodontitis does not appear to be based on an elastase or cathepsin G abnormality in neutrophils. Due to the high variability of HNP-1 + 2 and HNP-3 in neutrophils of control subjects, the reduced HNP-3 content in neutrophils probably plays a minor role in the pathogenesis of generalized early-onset periodontitis.

Adult↗
PubMed1998

Active cytomegalovirus infection in human periodontitis.

This study used the reverse transcription polymerase chain reaction method to determine mRNA transcription of subgingival human cytomegalovirus (HCMV) in six adult and three localized juvenile periodontitis patients. The oligonucleotide primers targeted the major capsid protein gene to determine active HCMV infection. HCMV major capsid protein transcript was detected in deep periodontal pockets of two adult and two localized juvenile periodontitis patients but not in any shallow periodontal sites. The findings suggest that active HCMV replication can occur in periodontal sites. Further studies are necessary to establish whether periodontal reactivation of HCMV correlates with the initiation or progression of destructive periodontal disease.

Adolescent↗
PubMed2005

Introns in the cytolethal distending toxin gene of Actinobacillus actinomycetemcomitans.

In eukaryotic cells, genes are interrupted by intervening sequences called introns. Introns are transcribed as part of a precursor RNA that is subsequently removed by splicing, giving rise to mature mRNA. However, introns are rarely found in bacteria. Actinobacillus actinomycetemcomitans is a periodontal pathogen implicated in aggressive forms of periodontal disease. This organism has been shown to produce cytolethal distending toxin (CDT), which causes sensitive eukaryotic cells to become irreversibly blocked at the G2/M phase of the cell cycle. In this study, we report the presence of introns within the cdt gene of A. actinomycetemcomitans. By use of reverse transcription-PCR, cdt transcripts of 2.123, 1.572, and 0.882 kb (RTA1, RTA2, and RTA3, respectively) were detected. In contrast, a single 2.123-kb amplicon was obtained by PCR with the genomic DNA. Similar results were obtained when a plasmid carrying cdt was cloned into Escherichia coli. Sequence analysis of RTA1, RTA2, and RTA3 revealed that RTA1 had undergone splicing, giving rise to RTA2 and RTA3. Two exon-intron boundaries, or splice sites, were identified at positions 863 to 868 and 1553 to 1558 of RTA1. Site-directed and deletion mutation studies of the splice site sequence indicated that sequence conservation was important in order for accurate splicing to occur. The catalytic region of the cdt RNA was located within the cdtC gene. This 0.56-kb RNA behaved independently as a catalytically active RNA molecule (a ribozyme) in vitro, capable of splicing heterologous RNA in both cis and trans configurations.

Aggregatibacter actinomycetemcomitans↗