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PubMed1990

Associations between six DNA probe-detected periodontal bacteria and alveolar bone loss and other clinical signs of periodontitis.

The purpose of the present study was to assess the associations between the presence and amounts of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, B. intermedius, Eikenella corrodens, Wolinella recta, and Fusobacterium nucleatum in the periodontal pocket and the degree of alveolar bone loss and other clinical signs of periodonitis, such as probing pocket depth, attachment level, and presence of bleeding on probing at the same site. The study material comprised 16 subjects with or without approximal sites showing longitudinal alveolar bone loss who were selected from a group of 142 subjects monitored radiographically over the past 4 years. In this group 105 sites were examined, of which 58 showed recent alveolar bone loss greater than or equal to 1 mm. Subgingival plaque was collected with absorbent paper points and hybridized with 32P-labeled DNA probes specific for the above-mentioned bacteria. The amount of each bacterial species was correlated with the degree of bone loss over time and the three clinical measurements by means of Spearman rank correlation. A. actinomycetemcomitans showed poor correlations with all three clinical signs of periodontal inflammation, whereas B. gingivalis and W. recta demonstrated significant positive correlations with the three clinical measurements and with attachment level and pocket depth, respectively. In addition, the amount of A. actinomycetemcomitans, B. gingivalis and W. recta showed significant positive correlation with the extent of alveolar bone loss at the site. In contrast, the amounts of B. intermedius, E. corrodens, and F. nucleatum showed negative correlations with all four measurements.(ABSTRACT TRUNCATED AT 250 WORDS)

Actinobacillus↗
PubMed1994

Implications of periodontal microbiology for the treatment of periodontal infections.

Studies have indicated the heterogeneity of periodontal diseases and have suggested several pathogens that may play important etiologic roles. The risk associated with individual pathogens or combinations of pathogens has been assessed, and diagnostic tests have been developed for their detection in clinical practice. Strategies are being devised to improve treatment by using appropriate agents to control different periodontal infections.

Aggregatibacter actinomycetemcomitans↗
PubMed2001

Untreated periodontal disease in Indonesian adolescents. Subgingival microbiota in relation to experienced progression of periodontitis.

BACKGROUND/AIMS: In an Indonesian population deprived of regular dental care, the experienced progression of disease between baseline (1987) and follow-up (1994) was investigated in relation to the composition of the subgingival microbiota at follow-up. At baseline the age ranged from 15 to 25 years. Clinical and microbiological evaluation was completed in 158 of the 167 subjects available at follow-up. METHODS: Plaque index (PI), pocket depth (PD), bleeding on probing (BOP), and attachment loss (AL) were scored at the approximal surfaces of all teeth and subgingival calculus on the approximal surfaces of the Ramfjord teeth only (number of sites with subgingival calculus: NSC). A pooled sample of the deepest pocket in each quadrant was evaluated using microbiological culture techniques. RESULTS: At baseline the mean values of the clinical parameters were AL=0.35 mm, PI=1.01, BOP=0.80 PD=3.25 mm and NSC=6.04 and at follow-up AL=0.75 mm, PI=1.16, BOP=1.19, PD=3.34 mm and NSC=5.85. All parameters except PD and NSC showed a statistically significant increase. At follow-up the prevalence of Actinobacillus actinomycetemcomitans was 40%, of Porphyromonas gingivalis 67%, of Prevotella intermedia 66%, of Fusobacterium nucleatum 79%, of Bacteroides forsythus 16%, of Campylobacter rectus 4%, and of P. micros 6%. No differences in clinical parameters were found between groups with or without these micro-organisms. In 129 subjects AL of > or =2 mm at > or =1 site was found. Logistic regression showed three significant odds-ratio's for experienced progressive periodontitis: Plaque index (12.2), gender (3.4) and Actinobacillus actinomycetemcomitans (2.9). CONCLUSIONS: The results of this retrospective study suggest that plaque is the most important parameter related to experienced disease progression, and that the presence of A. actinomycetemcomitans may be associated with increased chance of disease progression.

Adolescent↗
PubMed2005

Characteristics of periodontal ligament subpopulations obtained by sequential enzymatic digestion of rat molar periodontal ligament.

Periodontal ligament (PDL) consists of different cell populations in various differentiation stages. In the present study, we isolated cell populations from rat molar PDL by sequential enzymatic digestion and characterized growth potential and mineralization activity of the PDL subpopulations (PDL-SP) to throw light on the mechanism of PDL remodeling and, in its turn, periodontal tissue regeneration. PDL attached to extracted rat molars was digested 2 mg/ml collagenase and 0.25% trypsin at 37 degrees C for 30 min. Then four consecutive digestions were performed for 20 min each in a fresh digestive solution. The solutions were centrifuged to collect released cells and 5 PDL subpopulations (30M-, 50M-, 70M-, 90M-and 110M-PDL-SP) were obtained. Light microscopic observation showed that about a half of PDL in width attached on the root surface of extracted teeth and 30M-PDL-SP was considered to contain cells mainly from middle portion of PDL. Scanning electron microscopic examination indicated that 110M-PDL-SP was enriched by root lining cementoblastic cells. 30M-PDL-SP showed a high level of proliferative activity. Although the growth potential of a subpopulation decreased in PDL-SP toward the root surface, 110M-PDL-SP had a high proliferative activity equivalent to that of 30M-PDL-SP. Analyses of alkaline phosphatase (ALP) and mineralization activities showed that higher activities in PDL-SP toward the surface of roots and that 110M-PDL-SP had the highest activity of ALP and the largest number of mineralization nodules. The present study shows as supposed by previous studies on cell kinetics in PDL that subpopulations with larger growth potential were generally located in the middle portion of PDL and those with higher mineralization activities toward the surface of the roots. It is suggested, however, that a possible pathway of PDL cell turnover may exist within the PDL-SP on the root surface in addition to the generally recognized pathway from the middle area of PDL to root surface.

Alkaline Phosphatase↗
PubMed1989

Periodontics in general practice: perspectives on periodontal diagnosis.

Standardized terminology does not exist to differentiate the conditions that constitute "response diagnosis" and "disease diagnosis" described in this review. Therefore, appropriate descriptive terminology is proposed for these two periodontic diagnoses. Diagnostic terms are needed to discern stages of disease. Periodontitis is a chronic disease prone to episodic recurrence that needs a "dynamic diagnosis" that can change with each reevaluation. In addition, the legal ramifications of failing to recognize or adequately described disease recurrence are discussed.

General Practice, Dental↗
PubMed2000

Sustained release of silver from periodontal wafers for treatment of periodontitis.

Periodontal wafers intended to treat the underlying infections in patients with periodontitis have been developed. The wafers consist of poly(lactic-co-glycolic acid) as a primary bioerodible polymeric component, poly(ethylene glycol) as a plasticizer and encapsulation aid, and silver nitrate as the antimicrobial agent. The wafers are capable of sustained in vitro release of bioactive silver for at least 4 weeks. The wafers exhibit silver release that follows erosion kinetics, confirming a bulk erosion/release mechanism. In clinical evaluation, sustained release of silver at bactericidal levels for at least 21 days is observed. Staining of hard and soft tissues due to the released silver is minimal and reversible.

Administration, Buccal↗
PubMed2001

Novel periodontal drug delivery system for treatment of periodontitis.

A conceptually novel periodontal drug delivery system (DDS) is described that is intended for treatment of microbial infections associated with periodontitis. The DDS is a composite wafer with surface layers possessing adhesive properties, while the bulk layer consists of antimicrobial agents, biodegradable polymers, and matrix polymers. The wafers contain poly(lactic-co-glycolic acid) as the main bioerodible component used in the bulk layer and ethyl cellulose applied as a matrix polymer enabling diffusion-controlled release. Starch and other polymers in combination with AgNO(3) serve as coatings adhesive to the teeth. In vitro experiments demonstrate that the wafers are capable of zero-order release of antimicrobial agents such as silver nitrate, benzylpenicillin, and tetracycline, for over 4 weeks.

Anti-Bacterial Agents↗
PubMedDate not supplied

Bacteriocin production by Actinobacillus actinomycetemcomitans isolated from the oral cavity of humans with periodontal disease, periodontally healthy subjects and marmosets.

The ability of Actinobacillus actinomycetemcomitans to produce bacteriocin has rarely been reported. Antagonistic substance production may confer an important ecological advantage for the producer microorganisms, especially in a competitive ecosystem such as the oral cavity. In the present study, 75 A. actinomycetemcomitans strains isolated from the oral cavity of human patients with periodontal disease, periodontally healthy subjects and marmosets, as well as two reference strains (A. actinomycetemcomitans ATCC 29523 and FDC Y4) were evaluated for auto-, iso-, and heteroantagonistic activity. Fifty-one (68.00%) strains exhibited antagonistic activity; heteroantagonism was observed more often than isoantagonism. Isolated strains antagonized 17 different species of gram-positive and gram-negative bacteria from the oral and nonoral microbiota. Sensitivity to heat and to proteolytic enzymes constituted strong evidence that the antagonistic substance has a proteic nature. Taken together, our data enabled us to confirm that the antagonistic substance detected was a bacteriocin. The wide spectrum of activity indicates the possibility that more than one antagonistic substance is produced and that these substances play an important role in the ecological balance of the oral ecosystem.

Actinobacillus Infections↗
PubMed1999

Periodontal repair in dogs: effect of rhBMP-2 concentration on regeneration of alveolar bone and periodontal attachment.

The objective of this study was to evaluate the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) concentration on regeneration of alveolar bone and cementum, and on associated root resorption and ankylosis. Contralateral, critical size, supra-alveolar, periodontal defects were surgically produced and immediately implanted with rhBMP-2 in an absorbable collagen sponge (ACS) carrier in 8, young adult, male, beagle dogs. 6 animals received rhBMP-2/ACS (rhBMP-2 at 0.05, 0.10, or 0.20 mg/mL; total construct volume/defect approximately 4.0 mL) in contralateral defects following an incomplete block design. 2 animals received rhBMP-2/ACS (rhBMP-2 at 0 and 0.10 mg/mL) in contralateral defects (controls). The animals were euthanised at 8 weeks post-surgery and block sections of the defects were collected for histologic and histometric analysis. Supra-alveolar periodontal defects receiving rhBMP-2 at 0.05, 0.10, or 0.20 mg/ml exhibited extensive alveolar regeneration comprising 86%, 96%, and 88% of the defect height, respectively. Cementum regeneration encompassed 8%, 6%, and 8% of the defect height, respectively. Root resorption was observed for all rhBMP-2 concentrations. Ankylosis was observed in almost all teeth receiving rhBMP-2. Control defects without rhBMP-2 exhibited limited, if any, evidence of alveolar bone and cementum regeneration, root resorption, or ankylosis. Within the selected rhBMP-2 concentration and observation interval, there appear to be no meaningful differences in regeneration of alveolar bone and cementum. There also appear to be no significant differences in the incidence and extent of root resorption and ankylosis, though there may be a positive correlation with rhBMP-2 concentration.

Absorbable Implants↗
PubMed1989

Plasmids in Actinobacillus actinomycetemcomitans strains isolated from periodontal lesions of patients with rapidly destructive periodontitis.

Several strains of Actinobacillus actinomycetemcomitans newly isolated from periodontal lesions of patients with rapidly destructive periodontitis were all shown to possess identical plasmid profiles consisting of 4 plasmids. The largest plasmid, 20 MegaDalton (MDa), was also found in reference strains. Two different methods were used for isolation of the plasmids; the large 20 MDa plasmid (pHRP1) was found using the Kado and Liu method only. The 3 small plasmids of 7.0, 5.2 and 4.0 MDa (pHRP2, pHRP3, pHRP4), respectively, were seen using the Birnboim and Doly method. These plasmids are so far to be regarded as cryptic; no phenotypical characters have been linked to their presence. The large 20 MDa plasmid was found in all strains examined, and may be a genotypical marker for the A. actinomycetemcomitans species.

Actinobacillus↗
PubMed2005

Stress and the periodontal diseases: growth responses of periodontal bacteria to Escherichia coli stress-associated autoinducer and exogenous Fe.

Psychological stress is known to increase the circulating levels of the catecholamine hormones noradrenaline and adrenaline, which have been shown to influence the growth of a large number of bacterial species by acting in a siderophore-like manner or by inducing the production of novel autoinducers of growth. As we have previously demonstrated that periodontal organisms display differing growth responses to noradrenaline and adrenaline, the aim of this study was to determine whether these growth effects were based upon either siderophore-like or autoinducer mechanisms. Initial inocula of 43 microbial organisms normally found within the subgingival biofilm were established under anaerobic conditions (35 degrees C). Each strain was re-inoculated into a serum-based minimal medium and growth was assessed by optical density (OD(600 nm)) with test and control cultures performed in triplicate. Test cultures were supplemented with either 50 mum ferric nitrate or a previously described Escherichia coli autoinducer of growth. Significant growth effects for supplementation with ferric nitrate (13 species responding positively) and E. coli autoinducer (24 species responding positively) were observed, with differences in growth response within bacterial species and within microbial complexes. When data for all organisms were compared with published responses to catecholamines there were only weak correlations with Fe (r = 0.28) and E. coli autoinducer (r = 0.34) responses. However, large positive responses (> 25% increase) to free Fe and/or E. coli autoinducer were significantly more prevalent in the group of organisms (n = 12) known to exhibit similar responses to catecholamine hormones (P < 0.01; chi2 = 4.56). The results support the view that catecholamines may exert their effects on subgingival organisms by initiating autoinducer production, or simply by acting in a siderophore-like manner, scavenging bound iron from the local environment. It is possible that autoinducer mechanisms may play an important role in the response of oral microorganisms to stress hormones, thereby contributing to the clinical course of stress-associated periodontal diseases.

Bacteria↗
PubMed1990

Effect of non-eugenol- and eugenol-containing periodontal dressings on the incidence and severity of pain after periodontal soft tissue surgery.

This study examines the incidence and severity of postoperative pain after gingivectomy using one non-eugenol-containing periodontal dressing, Coe-pak (n = 76) and 2 eugenol-containing periodontal dressings, Wondrpak (n = 64) and Nobetec (n = 86). All patients were subjected to gingivectomy using 1 type of local anaesthesia (lidocaine + adrenalin) only and covering the surgical areas with either of the 3 different dressings in a randomized study. Postoperative pain was assessed on 100 mm visual analogue scales over 5 days starting immediately after surgery. No pain was reported by 22.0% of the patients after Coe-pak, 23.4% after Wondrpak and 30.2% after Nobetec. 13.2% of the patients took analgesics after Coe-pak treatment, 3.1% after Wondrpak and 1.2% after Nobetec. Mean pain score after Coe-pak was higher (P less than 0.05) than after Nobetec 2 h after operation until the morning on the 3rd postoperative day. Mean pain score after Coe-pak was higher (P less than 0.05) than after Wondrpak 3 h to 9 h after operation. No statistically significant difference was found between Wondrpak and Nobetec regarding mean pain score.

Adult↗
PubMed1991

Healing of sites within the dog periodontal ligament after application of cold to the periodontal attachment apparatus.

The potential of periodontal ligament-derived tissues to regenerate periodontal attachment after cryosurgical trauma to the PDL in dogs was evaluated. The buccal alveolar plate of each canine tooth was exposed by a semi-lunar excision. A 3 mm thick cryoprobe, cooled to -81 degrees C, was placed on the bone 5 mm apical to the crest for 10 s. This induced cellular devitalization in the bone directly in contact with the probe and the PDL under it. The freezing-thawing cycle was repeated 3 times. Control sites were sham-operated at room temperature. Histologic sections from the center of the lesions were obtained from 1 h, 48 h and 30 d specimens. 1-h control and experimental histologic sections were similar. At 48 h post-surgery, the cellular component of the frozen PDL could not be identified and inflammatory response was minimal. The collagenous framework, however, appeared to form a continuum between the alveolar bone and cementum. Lacunae in the bone at the frozen segment were empty. The injured PDL was surrounded by normal PDL. Control specimens appeared normal. At 30 d, the PDL space in the frozen segments was populated by PDL-like tissue which did not differ significantly from the PDL coronal or apical to it. Collagen fibers appeared to be attached to the cementum on one side and to the alveolar bone on the other. Bone resorption or ankylosis was not observed in the experimental sites. It is suggested that the extracellular matrix in the devitalized area was preserved, supporting regeneration of the cryolesion.

Alveolar Process↗
PubMed1991

Periodontal repair in dogs. Healing patterns in large circumferential periodontal defects.

This report describes the healing patterns of large circumferential periodontal defects in the beagle dog. Approximately 5 mm large periodontal defects were created around the mandibular premolars (P2, P3 and P4) in 13 animals. The root surfaces were then instrumented to remove all cementum and the wounds immediately closed by replacing and suturing the flaps just coronal to the cemento-enamel junction. Block biopsies were harvested after 4 weeks. Most of the surgically denuded root surface healed with connective tissue repair. Cementum formation and regeneration of alveolar bone was limited and averaged approximately 30% and 20%, respectively, of the defect height. Almost all teeth exhibited root resorption. Ankylosis was observed in 1/3 of the teeth. There was no difference in the healing response between the 3 premolars or their buccal and lingual surfaces. The range of healing responses indicates that a biological potential exists which makes this model useful for testing the effect of various root and wound conditioners in (1) enhancing cementum formation on the root surface, (2) increasing regeneration of alveolar bone and (3) preventing aberrant healing events such as root resorption and ankylosis. Conversely, whether such agents may compromise wound healing and result in reduced connective tissue repair may concomitantly be tested.

Alveolar Bone Loss↗
PubMed1995

Putative periodontal pathogens colonizing oral mucous membranes in denture-wearing subjects with a past history of periodontitis.

The prevalence of selected putative periodontal pathogens colonizing oral mucous membranes was investigated in 26 denture-wearing subjects with a history of periodontitis. The microbiota of the oral cavity of these subjects was examined on average 9.3 years after extraction (range: 1-40 years). Samples were taken from several locations on the oral mucous membranes, from saliva and from plaque attached to the upper and lower denture. Actinobacillus actinomycetemcomitans was not detected in any of the 26 edentulous subjects. Porphyromonas gingivalis was detected in 2 subjects (proportion of cultivable flora: 0.002% and 12.5%). Prevotella intermedia was recovered from 7 subjects with a mean proportion of 0.5% (range < 0.001%-6.3%). Analysis showed that subjects harbouring P. intermedia were wearing full dentures for a longer period of time (mean: 20.2 years) than subjects in which P. intermedia could not be detected (mean: 6.6 years). This result suggests that the absence of P. intermedia shortly after extraction may reflect only a temporary event. Other Prevotella species were found in 22 subjects, constituting < 2% of the total cultivable flora (range 0.01%-10.5%). In conclusion, the low prevalence of P. gingivalis and the absence of A. actinomycetemcomitans, suggest that the oral cavity of edentulous subjects may not be regarded as a habitat for these species. The preferable habitat of the Prevotella spp. seems to be the oral mucous membranes, possibly with the exception of P. intermedia.

Adult↗
PubMed1998

Crevicular fluid prostaglandin E2 levels in periodontitis-resistant and periodontitis-susceptible adults.

The aim of this cross-sectional study was to determine concentrations of prostaglandin E2 (PGE2) in gingival crevicular fluid (GCF) in a cohort of periodontal disease-resistant (PDR) adults with chronic gingivitis but with minimal evidence of bone loss, and to compare these data with GCF-PGE2 levels in patients with untreated chronic adult periodontal disease (CAPD). 20 PDR and 35 CAPD subjects with mean (+/-se) ages 52.4 (+/-2.9) and 43.7 (+/-1.2) years respectively, were recruited. GCF was sampled from 6 sites in each PDR subject and 4 sites in each CAPD subject. The GCF-PGE2 concentrations were determined by enzyme immunoassay (Assay Designs). Whole mouth medians of site-specific GCF-PGE2 concentrations were calculated for each subject. The means of the median GCF-PGE2 concentrations were: PDR 54.94+/-4.06 ng/ml; CAPD 41.57+/-2.91 ng/ml (p=0.009). We hypothesise that the higher concentrations of PGE2 in the PDR group may be associated with the proliferating pocket epithelia of the chronic gingivitis. In the CAPD cohort, there were no differences in GCF-PGE2 concentrations between subgroups of smokers (n=13), ex-smokers (n=11) and non smokers (n=11). In the PDR cohort, 19/20 subjects were non-smokers.

Adult↗
PubMed1978

A comparison of WHO periodontal status index with the periodontal and oral hygiene indices.

Examination of 2,138 subjects, aged 15-65+ years, was carried out by calibrated examiners using mirrors and fibre optic illumination. Each subject was scored by the Periodontal Status Index, PSI (WHO Oral Health Surveys), Periodontal Index, PI (Russell) and the Oral Hygiene Index, OHI (Greene & Vermillion). For the PSI, PI and OHI all scores were age-dependent with the exception of soft deposits in PSI and OHI, which were age-independent. The advantages of the PSI system were considered to be the ease of scoring and the opportunity to assess treatment requirements, in terms of time, at the public health service level. Disadvantages were lack of quantitation, difficulties of diagnosis of intense gingivitis, and localized and general conditions. The PI and OHI systems provided a more objective, quantitative and sensitive basis of scoring than the PSI. Statistical tests showed the respective indices are associated and measuring the same kind of criteria. Examiner calibration and consistency were similar for both scoring systems.

Adolescent↗
PubMed1998

Practical periodontics. Awareness of periodontal disease--the patient.

This paper looks at awareness by the public and our patients' knowledge of the health of their gums and the tooth supporting tissues, what it means to them, how they interpret this information and whether they seek care as a result of such knowledge. The way a dentist and a patient interact with and without such knowledge is considered. It is contended that knowledge of the periodontal disease processes and of how to treat, manage, control, and even prevent must be accompanied by an awareness by the patient, the profession and industry. This recognises that the dentist and patient are in a partnership, especially in management of periodontal diseases.

Adult↗