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Juvenile and rapidly progressive periodontitis. Peripheral blood lymphocyte subpopulations.

Juvenile and rapidly progressive periodontitis are grouped under the heading of early-onset periodontitis. In recent years, much attention has been devoted to studying immunologic factors in early-onset periodontitis. This study was designed to investigate peripheral blood lymphocyte subpopulations, natural killer cells and interleukin-2 receptor positive (IL-2R +) cells in patients with juvenile and rapidly progressive periodontitis. 38 patients with juvenile and 30 patients with rapidly progressive periodontitis, plus 30 normal healthy control subjects were included in the study. Peripheral blood T-lymphocytes, helper T-cells, suppressor T-cells, HLA-DR+ cells, and IL-2R + cells were determined using appropriate monoclonal antibodies and the indirect immunofluorescence method. B-lymphocytes were identified using the direct immunofluorescence technique. Both groups of patients had normal number of total CD3+ T-cells, CD4+ helper T-cells, CD8+ suppressor T-cells, HLA-DR+ cells and IL-2R+ cells. Natural killer cells were found to be significantly elevated in both groups. These findings could contribute to the immunopathogenesis of early-onset periodontitis.

Adolescent↗

Increased oxidative product formation by peripheral blood polymorphonuclear leukocytes in human periodontal diseases.

We examined the oxidative burst (hydrogen peroxide-dependent oxidative product formation) of polymorphonuclear leukocytes (PMNL) in the peripheral blood from the patients with various types of periodontal diseases including localized juvenile (LJP), generalized juvenile (GJP) and adult periodontitis (AP). Heparinized peripheral blood was obtained from 15 LJP, 13 GJP and 52 AP patients and from 30 healthy control subjects. The oxidative product (2',7'-dichlorofluorescein; DCF) formation of PMNL by stimulation with phorbol myristate acetate myristate acetate was evaluated by a rapid quantitative assay using flow cytometry. The results indicated that all patient groups contained variable populations with normal or increased DCF formation, while the control subjects exhibited DCF formation as a single population. No significant differences in average DCF formation were found among the three patient groups. Although individual patients gave various values, the average DCF formation of the three patient groups was much higher than that of the control group. Statistical analysis revealed a significant positive correlation between DCF formation and the clinical periodontal parameters on an individual basis. Furthermore, after initial periodontal treatment, DCF formation decreased to normal levels. These results suggest that the capacity of peripheral blood PMNL to mount oxidative burst reactions might reflect the inflammatory status of periodontal disease.

Adult↗

[Infection characters of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in immunodeficient guinea pigs].

OBJECTIVE: The aim of this study was to investigate effects of immunodeficiency on the periodontal infection characters of the specific pathogens of juvenile periodontitis. METHODS: A total of 36 immunodeficient guinea pigs produced by twice whole-body irradiation with 60Co were divided randomly into four groups, in which Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and A. actinomycetemcomitans with P. gingivalis were inoculated into the gingival sulcus of two mandibular incisors respectively. The pigs in the control group did not receive any inoculation. At 2, 3 and 6 weeks after inoculation, three animals in each group were sacrificed successively. Clinical and histological examinations were used to examine the changes in the periodontal tissues. The other 36 normal guinea pigs were divided into four groups and treated in a similar way described above. RESULTS: Significant periodontal damages were noted in immunodeficient pigs inoculated with A. actinomycetemcomitans, P. gingivalis or A. actinomycetemcomitans and P. gingivalis in 2 and 3 weeks after bacterial inoculation. The damages were more severe than in the normal groups. The immunodeficient groups demonstrated larger numbers of osteoclasts than the normal groups (P < 0.05). CONCLUSION: The loss of periodontal tissue in immunodeficient hosts is much serious than those with normal defence system, after they are infected with A. actinomycetemcomitans and P. gingivalis. Abnormal defence system in hosts may play an important role in onset and development of juvenile periodontitis.

Actinobacillus Infections↗

Prepubertal periodontitis: a report of 2 cases.

PURPOSE: Prepubertal periodontitis is a term suggested for a form of periodontitis that starts soon after the eruption of primary teeth. There is increased awareness that the disease entity known as "periodontitis" is in all probability a family of related but reasonably discrete diseases. The purpose of this report is to describe the clinical, radiographic, and laboratory findings in 2 patients, as well as treatment of prepubertal periodontitis. METHODS: This study presents 2 cases of generalized prepubertal periodontitis: a 5-year-old girl and a 13-year-old girl. RESULTS: Case 1 presented to the clinic because of parental concern for the early exfoliation of her teeth. All of her teeth with Grade III mobility, ie, 8.5, were extracted and the rest were scaled and root planed with subgingival irrigation of 0.2% chlorhexidine. She received a program of 3-month maintenance scaling and 6 months later, there was no further progression of periodontal lesions. Case 2 demonstrated the destruction of tooth roots along with extensive loss of tooth roots and alveolar bone. Since all the permanent teeth were Grade II mobile, the patient was advised to have total extraction with replacement of teeth by complete denture prosthesis at a later date. CONCLUSIONS: In case 2 premature root resorption was occurring concurrently with unexplained extensive alveolar bone loss. In Case 1, the elimination of the pathogenic microflora during primary dentition by early extraction of the teeth involved, plus daily local, mechanical and chemical control of the irritant factors may have prevented subsequent damage to remaining teeth in prepubertal periodontitis.

Adolescent↗

Leukocyte esterase and protein levels in saliva, as indicators of gingival and periodontal diseases in children.

PURPOSE: This study was to determine if dip stick assays of children's saliva for leukocyte esterase or protein (Serim Research Corporation, Elkhart, Ind) reflect the presence or severity of gingival or periodontal diseases in children. METHODS: The study included 13 children with periodontitis [study group] and a control group of 17 children without periodontitis. The saliva leukocyte esterase and protein values (scales from 1 to 4) were tested with dip stick analyses. The gingival (GI) and plaque indices (PI) presence and number of sites with periodontitis, demographic data, systemic condition, caries prevalence, and the presence of dental restorations were recorded and their relationship to leukocyte esterase or protein values were analyzed. RESULTS: Most children had a protein value of 2 or 3 or a leukocyte esterase value of > or = 3. Significant differences in the distribution of protein values by the presence/absence of periodontitis (chi-square, P<0.001), or the number of sites with periodontitis by protein value (chi-square, P=.005; ANOVA, P=.03) were evident; No. 4 protein values were found only in children with periodontitis, and No. 2 and No. 3 protein values were mostly found in children without it. CONCLUSIONS: Dip stick protein analysis of saliva of children has the potential to differentiate children with periodontitis or with fewer periodontal lesions.

Aggressive Periodontitis↗

[Periodontal diagnosis based on an immunohistochemical-morphometric analysis].

What is the correlation between immunoreactive blood cells, clinical parameters and the presence of special subclasses of bacteria in the subgingival microflora? To answer this question, patients suffering from juvenile and rapid progressive periodontitis were examined and compared with a control group without any periodontal disease. Cryostat sections from gingiva biopsies were marked immunohistochemically. Using the Kruskall-Wallis test, highly significant differences could be shown between the groups of disease in terms of immunoreactive cells such as leukocytes and monocytes, as well as in terms of the clinical parameters pocket depth, plaque index, gingival index and sulcus fluid and in terms of the microbiological subclasses coccoid cells, curved and motile rods and spirochetes. The results showed that immunohistochemical and morphometric methods of characterizing immunoreactive white blood cells might be used as an aid in diagnosis and understanding of periodontal diseases.

Aggressive Periodontitis↗

Expression of complement receptors CR1 and CR3 in patients with juvenile periodontitis.

The expression of two complement receptors, CR1 and CR3, was investigated in a group of 11 patients with localized juvenile periodontitis (LJP) before and after stimulation of their peripheral blood neutrophils and monocytes with a chemotactic factor. A total deficiency of CR1 or CR3 was not observed in any patient. Abnormally high or low values were seen in some individuals; however, tests repeated a few months later suggested that the abnormal expression of CR1 and CR3 were not causing the disease, but were probably the result of the inflammation and infection usually associated with untreated juvenile periodontitis.

Adolescent↗

[Langerhans cells in the gingival epithelium].

Langerhans cells (LCs) were specifically demonstrated by monoclonal antibody OKT 6. In healthy gingival tissue LCs were mainly seen in stratum spinosum of the surface epithelium. They had small nuclei and with long cell processes. The LCs of oral epithelium in marginal gingivitis and adult periodontitis tissue were more in numbers than in healthy tissue. In juvenile periodontitis tissue LCs numbers seemed to be increased obviously in comparison to the healthy tissue. The LCs were round and often located in both deep spinous and basal layers. These results demonstrate that LCs play an important role in the local immune response of the periodontal tissues.

Adult↗