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PubMed1985

Clinical and microbiological evaluation of therapy for juvenile periodontitis.

Eight patients (mean age 15.6 yrs) with severe molar-incisor bone loss and pocket formation characteristic of juvenile periodontitis were entered into a clinical protocol of three sequential stages: scaling and root planing (S/RP); S/RP concurrent with systemic tetracycline therapy (1 gm/day for 28 days); periodontal surgery concurrent with systemic tetracycline therapy. Clinical and microbiological examinations were scheduled at baseline, at 1 to 2 months after Stage I, at 1 to 2 months after completion of tetracycline therapy in Stages II and III, and during recall. A decision to progress to the next stage or to place the patient on a 3-month recall was based solely on clinical findings (suppuration, bleeding upon probing and pocket depth) at the deepest site in each patient. Paperpoint subgingival plaque samples from representative affected sites were analyzed for percentage of total cultivable microflora composed of black-pigmented Bacteroides species (BPB), surface translocating bacteria (STB) and Actinobacillus actinomycetemcomitans (Aa). At baseline, all sites bled to probing, seven of eight sites showed suppuration, and deepest pocket depths averaged 8.0 mm. STB were detected in one and BPB in four sites, respectively, and all sites demonstrated Aa, which constituted approximately 40% of the total cultivable flora. S/RP alone had essentially no effect on either clinical or microbiological findings, and all patients progressed to Stage II. Five went on to Stage III. S/RP with tetracycline was clinically and microbiologically more effective at sites in which Aa was predominant. Surgery was required in all sites containing high levels of both BPB and Aa. These results suggest that microbiological diagnosis may be useful in selecting and monitoring treatment for juvenile periodontitis.

Actinobacillus↗

PubMed1990

Generalized juvenile periodontitis: report of a familial case followed for 5 years.

The case of a family, followed for 5 years and showing an exceptionally high prevalence of Generalized Juvenile Periodontitis (GJP), is presented. Two siblings were affected by a severe form of GJP meanwhile the dycorial twin of one was periodontally healthy. Both the affected siblings showed infection by Actinobacillus actinomycetemcomitans (Aa), but only one presented a reduced chemotaxis of the peripheral PMNs. The dycorial twin consistently displayed a freedom from Aa and a reduction in the peripheral PMNs chemotaxis. The extraction of the compromised teeth in the two affected siblings has been followed by colonization of new sites by Aa; only repeated administration of systemic tetracyclines seems to protect the subjects from colonization of other sites. These findings may contribute to the understanding of the etiology, pathogenesis, and therapy of juvenile periodontitis.

Actinobacillus↗

PubMed1991

Resolution of early lesions of juvenile periodontitis with tetracycline therapy alone: long-term observations of 4 cases.

Our previous studies have demonstrated that early-identified lesions of localized juvenile periodontitis (LJP) can be treated by the use of systemically administered tetracycline alone (1 gm/day for 6 weeks). This therapy results in arrest of disease progression, decreased pocket depths, gains in clinical attachment, and significant repair of alveolar defects. This paper reports on the long-term clinical and radiographic improvement in 4 subjects followed for 1 to 4 years after the completion of tetracycline therapy. Four patients (mean age 14 years) were examined 1 to 4 years following the completion of a single 6 week course of tetracycline. Mean pocket depth was reduced from the initial level of 7.1 mm to 3.6 mm. Mean attachment loss was reduced from 3.8 mm to 0.9 mm and angular bone defects had filled by an average of 72%. Pocket depths and attachment loss continued to decrease during the entire study period, while alveolar bone repair continued to increase. The findings support those of our previous investigation and confirm that: 1) early identified lesions of LJP can be effectively treated with 6 weeks of tetracycline therapy alone; 2) decreases in pocket depth, gains in clinical attachment, and repair of alveolar defects remain stable up to 4 years following antibiotic therapy; 3) clinical and radiographic improvement continues over time and may lead to complete resolution of some lesions; and 4) the reparative/regenerative potential of the periodontium in early onset disease in young individuals may exceed that observed in chronic adult periodontitis.

Adolescent↗

PubMed1997

Relationship between serum antibody levels and subgingival colonization of Porphyromonas gingivalis in patients with various types of periodontitis.

Porphyromonas gingivalis is considered to be an important pathogen in periodontitis. The present study investigates the relationship between serum anti-P. gingivalis IgG antibody levels and the subgingival distribution of P. gingivalis in patients with periodontitis. We examined subgingival plaque samples from 15 patients with adult periodontitis (AP), 8 patients with early-onset periodontitis (EOP), and 6 clinically healthy individuals. The samples were collected from periodontal pockets or gingival crevices of all remaining teeth in each subject. The total number of samples was 3,024, ranging from 76 to 120 per subject. Probing depth and bleeding at each sample site were recorded. P. gingivalis was detected using a non-radioactive whole genomic DNA probe. Serum samples were taken from the subjects, and the serum anti-P. gingivalis IgG antibody titer was determined by enzyme-linked immunosorbent assay (ELISA). P. gingivalis was recovered from all AP and EOP patients, and from 3 of the 6 healthy subjects. Two significant positive correlations were observed among the subjects. The serum anti-P. gingivalis IgG antibody titer correlated with detection frequency of P. gingivalis, and the antibody titer correlated with the amount of P. gingivalis detected. Higher levels of P. gingivalis were detected in the EOP group than in the AP group. However, no significant difference was found in the serum IgG titer levels between EOP and AP patients. These findings suggest a direct relationship between the serum anti-P. gingivalis IgG levels and subgingival P. gingivalis colonization; however, the functional capabilities of IgG antibodies may vary among the various types of periodontitis patients.

Adult↗

PubMed1992

Diagnostic studies on juvenile, rapidly progressive and adult periodontitis before and after periodontal therapy (II).

The use of antibody levels may identify subjects developing destructive periodontitis or provide markers of disease type. Clinical parameters can be used to group cases but they are incapable of detecting differences in host-susceptibility and host immune response. The validity of radial immunodiffusion (RID) as a laboratory screening method in diagnosis based on antibody quantitation has been evaluated in 36 patients before and after periodontal therapy. It was concluded that the serum IgA, IgG, IgM and parotid IgA concentration profiles, measured with RID have little value in determining the subgroups of early onset periodontitis patients but they can be used to differentiate these groups from slowly progressing adult periodontitis patients.

Adolescent↗

PubMed1989

[Characteristics of certain early periodontitis: apropos of two cases].

The study of early onset periodontitis led in the last years to important improvement in the etiopathogenic knowledge of periodontitis. The clinical and microbiological analysis of 2 early onset periodontitis cases gives a better understanding of the evolution of these 2 models of periodontal lesions. Hypothesis are presented concerning the transition between localized juvenile periodontitis and rapidly advanced periodontitis.

Actinobacillus↗

PubMed1951