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PubMed1985

Age-related expression of juvenile periodontitis.

To test the hypothesis that localized and generalized juvenile periodontitis is one disease entity, the localization of bone loss was measured from orthopantomograms of 88 patients with untreated juvenile periodontitis. Linear regression analysis showed a significant correlation between the age of the patient and the number of teeth with bone loss. Similarly, a correlation was found between the Gingival Bleeding Index scores, the age of the patient, and the number of affected teeth. It is concluded that juvenile periodontitis, known to be genetically controlled, is a disease entity which starts as a localized form with affected first molars and/or incisors and develops, if not treated, gradually to the generalized form of the same disease, which resembles the adult periodontitis.

Acute Disease↗
PubMed1995

Observations of root surfaces from patients with early-onset periodontitis and leukocyte adhesion deficiency.

The purpose of this investigation was to report observations of the root surfaces of teeth from 2 siblings with leukocyte adhesion deficiency (LAD). In previous publications, the clinical, radiographic and immunologic findings in the family were presented. 38 permanent teeth from the 2 siblings were prepared for microscopic examination, 11 for light microscopy (LM), and 27 for scanning electron microscopy (SEM). In addition, 8 healthy teeth obtained from 2 patients requiring extractions for orthodontic treatment served as controls. LM observations on healthy teeth revealed cementum with normal structural appearance which exhibited a mosaic or mogul-like pattern with SEM. In LAD specimens, cementum apical to the dentogingival junction exhibited resorption lacunae and areas of poor structural definition characterized by aplasia and hypoplasia (hypomineralization). Areas of hypoplasia presented as distinct irregular surfaces with a pebbly or globular-like appearance. Alteration in cementum formation and maturation may play a role in the etiology of early-onset periodontitis.

Adolescent↗
PubMed1986

Selective medium for the isolation of Haemophilus aphrophilus from the human periodontium and other oral sites and the low proportion of the organism in the oral flora.

We developed a medium for the selective recovery of Haemophilus aphrophilus. The medium, designated TSBVF, was composed of 4% tryptic soy agar, 10% heat-inactivated horse serum, 75 micrograms of bacitracin per ml, 5 micrograms of vancomycin per ml, and 50 micrograms of sodium fluoride per ml. TSBVF yielded a threefold higher recovery of oral H. aphrophilus than did chocolate agar with 75 micrograms of bacitracin per ml, which is a medium routinely used to diagnose human Haemophilus infections. H. aphrophilus and the few contaminating organisms on TSBVF were readily distinguished on the basis of colony morphology. The H. aphrophilus isolates exhibited variable fermentation of raffinose and dextrin but otherwise were biochemically similar. In a clinical study, H. aphrophilus was frequently recovered from supragingival plaque and saliva and occasionally from buccal mucosa and the tonsils. It was also isolated from 29 of 56 subgingival sites in 11 of 14 subjects. Its proportion of the subgingival microflora averaged 0.13% for healthy periodontal sites, 0.05% for adult periodontitis lesions, and 0.03% for localized juvenile periodontitis lesions. We concluded that H. aphrophilus is an indigenous bacterium of the human oral cavity. It occurs in low proportions in subgingival plaque and plays no apparent role in advanced periodontal disease in humans.

Adolescent↗
PubMed1990

Determination of pseudocholinesterase activity in the gingival crevicular fluid, saliva, and serum from patients with juvenile periodontitis and rapidly progressive periodontitis.

By use of a spectrophotometric method, pseudocholinesterase (PCE) activities were determined in gingival crevicular fluid (GCF), saliva, and serum from patients with juvenile periodontitis (JP) and rapidly progressive periodontitis (RPP) and from controls. The PCE activity in the GCF samples was 181 +/- 48 U/L in the JP group, 588 +/- 135 U/L in the RPP group, and 88.5 +/- 29.1 U/L in the control group. Saliva PCE activity levels were 9.1 +/- 1.7 U/L in the JP group, 21.8 +/- 4.5 U/L in the RPP group, and 12.7 +/- 0.8 U/L in the control group. GCF contained a higher PCE activity than saliva but a lower one than that of serum. The RPP group had a significantly higher PCE activity in both the GCF and saliva samples. No significant differences could be found regarding serum enzyme levels. Also, no significant correlations were present between biochemical values and the severity of periodontal disease. GCF may be an important source for the PCE content of saliva. It is suggested that the increased PCE activity seen in RPP patients might be caused by either the direct production of esterases by bacteria or the induction of esterases during periodontal destruction.

Adult↗
PubMed1988

Tetracycline therapy in patients with early juvenile periodontitis.

Tetracycline therapy, when used in conjunction with surgery or root planing, has been shown to be effective in controlling the progression of juvenile periodontitis. However, the ability of tetracycline alone to control the disease has not been assessed. The present study evaluated the effects of tetracycline therapy, with supragingival plaque control, on clinical attachment levels and radiographic bone height in patients with clinical and radiographic evidence of juvenile periodontitis. The four patients (mean age 15.2 +/- 0.3 yrs) each demonstrated loss of attachment of greater than or equal to 2 mm at one or more probing sites and had accompanying radiographic evidence of early localized bone loss. Following an initial clinical evaluation consisting of pocket depths, attachment levels and standardized radiographs, the patients received systemic tetracycline therapy (1 gm/day for three to six weeks) and oral hygiene instruction. At the completion of antibiotic therapy, patients received a supragingival professional prophylaxis every two weeks for three months, whereupon the initial evaluation was repeated. On comparing the initial and three-month clinical and radiographic data, there were significant decreases in clinical and radiographic measurements. For a total of 85 affected probing sites around 26 teeth, 79% decreased in pocket depth by greater than or equal to 2 mm (with no sites increasing in pocket depth) and 69% gained clinical attachment (with only one site losing attachment of 1 mm). Radiographic measurements revealed an increase in both the height and area of coronal alveolar bone. The findings indicated that six weeks of systemic tetracycline therapy combined with supragingival plaque control was effective in the initial control of early juvenile periodontitis.

Adolescent↗
PubMed1990

Histological differences between teeth with adult periodontitis and prepubertal periodontitis.

Thirty-nine permanent teeth from three siblings aged 11 to 14 years were extracted because of generalized prepubertal periodontitis (PP) and studied histologically with light microscopy. Twenty healthy teeth (HT) removed for orthodontic procedures from 10 children of similar ages and 22 teeth affected by adult periodontitis (AP) extracted from patients over 50 years old were used as controls. The cementum of the PP teeth was much thicker than that of the healthy teeth. A high percentage of resorption, unrelated to inflammation, was found in all the teeth studied. In 24 PP teeth the cementum was infiltrated by microorganisms and bacterial substances. All PP teeth showed a cuticle ranging from 10 to 80 microns in thickness on the diseased cementum. No similar structure was noted on the diseased cementum of the AP teeth. The PP teeth did not show any structural changes which could account for the severity of the periodontal lesions.

Adolescent↗
PubMed1992

Characteristics and utilization of antibody measurements in clinical studies of periodontal disease.

The detection and quantitation of immune responses to infections have long been used as a diagnostic tool in medical infections. Recently, increasing evidence has supported that active, specific antibody responses to selected members of the subgingival microbiota are noted in periodontitis patients. This report describes the various specificities of this antibody as they relate to periodontitis classification and prognosis. The functional aspects of the serum antibody have come under increasing scrutiny to understand better the potential immunologic mechanisms acting in the periodontium. Data are available that describe opsonizing potential, complement fixing ability, blocking functions, and anti-toxic capacity for the antibody. Longitudinal alterations in specific antibody levels are shown to relate to infection and accompany changes in the burden of a specific microorganism in the subgingival plaque. Thus, these antibody changes could be useful indicators of altered host-parasite interactions that presage a disease-active episode. Finally, studies were designed to examine the ability of antibody to reflect the effects of treatment on the disease. The results indicated that specific antibody levels change with mechanical, antimicrobial, and anti-inflammatory treatments. The findings described in this report suggest that evaluation of the level and specificity of serum antibody can be a beneficial adjunct in designing and implementing clinical studies delineating the initiation, progression, and treatment of periodontitis.

Aggregatibacter actinomycetemcomitans↗
PubMed1993

Clinical and laboratory studies of severe periodontal disease in an adolescent associated with hypophosphatasia. A case report.

Hypophosphatasia is a congenital disease characterized by defective bone mineralization, deficiency of alkaline phosphatase (ALP) activity, increased excretion of the phosphoethanolamine (PEA) in the urine, and premature loss of the deciduous teeth. A male hypophosphatasia patient (aged 15 years 6 months) with premature exfoliation of the deciduous teeth was referred to our hospital because of severe periodontal destruction in the permanent dentition. Blood and urine tests as well as oral and periodontal examinations were performed. Serum antibody titers against 7 periodontopathic bacteria by the enzyme-linked immunosorbent assay (ELISA), monocyte and neutrophil chemotaxis measurements, and cellular immunity tests were also performed. Low levels of ALP in serum and PEA in the urine were found. Monocyte and neutrophil chemotaxis exhibited normal values. Slightly depressed CD2+, CD3+, and CD4+ and slightly elevated activity of NK cells were found. An elevated level of serum antibody to Porphyromonas gingivalis was observed. Oral radiographic examination showed a mirror pattern of alveolar bone loss which is similar to that seen in localized juvenile periodontitis. Periodontal treatment of this patient was carried out for 4 years. The severely affected sites, the lower right and left first molars and the upper right first molar, had to be extracted. However, the other sites were well maintained. The serum IgG level against P. gingivalis was decreased after 4 years of periodontal treatment. Infection with P. gingivalis was suspected to be associated with the destruction of this patient's hypophosphatasia, but other dental abnormalities such as abnormal enamel, dentin, and cementum formation may also have contributed to the periodontal pathology.

Adolescent↗
PubMed1998

Periodontal diseases in the United States population.

Recent epidemiologic surveys and studies have provided important information on the prevalence, extent, and severity of periodontal diseases in the United States. Over 50% of adults had gingivitis on an average of 3 to 4 teeth. Subgingival calculus was present in 67% of the population. Adult periodontitis, measured by the presence of periodontal pockets > or = 4 mm, was found in about 30% of the population on an average of 3 to 4 teeth. Severe pockets > or = 6 mm were found in less than 5% of the population. Attachment loss > or = 3 mm was found in 40% of the population. Gingival recession accounted for a significant amount of attachment loss. The prevalence of early-onset periodontitis ranged from less than 1% in 14- to 17-year-olds to 3.6% in young adults aged 18 to 34. Extensive and severe periodontitis was much more prevalent in minorities, people with less than a high school education, and those who had seen a dentist infrequently and had subgingival calculus. Smoking and diabetes have been identified as risk factors, especially diabetics with poor metabolic control, a long duration of the disease, and extensive subgingival calculus. Under managed care, there has been an expansion of soft tissue management programs in the offices of general dentists and referral guidelines which limit referral of patients with moderate periodontitis. Quality-assurance mechanisms will be essential for the diagnosis and treatment of persons with periodontitis.

Adolescent↗
PubMedDate not supplied

Clinical and microbiological changes in a child with rapid alveolar bone loss and refill.

A 10-year-old Japanese girl with severe tooth mobility in her lower permanent incisors was examined clinically, as well as radiographic and microbiological means. The incisors had severe alveolar bond loss and pocket depths exceeding 7 mm at the first visit, however, 10 periodontal bacteria were not detected in subgingival plaque samples taken from the lower central incisors using a 16S rRNA-based polymerase chain reaction method. Periodontal treatment consisting of mechanical debridement and antibiltic medication resulted in a significant improvement of the clinical parameters. Three months after the first examination, dental radiographs showed refilling of alveolar bone in the region. Further, microbiological examinations after remission detected only oral microflora commonly found in health children including A. actinomycetemcomitans. Based on the clinical, readiographic, and microbiological findings, the present case was diagnosed as acute periodontitis.

Acute Disease↗
PubMedDate not supplied

Seven-year follow-up of 10 children with periodontitis.

The present manuscript reports a 7-year follow-up of a kindred in which 10 children (siblings and cousins) had moderate to severe periodontal diseases in primary (9 children) and permanent teeth (1 child). No systemic condition was related to the periodontal diseases. The number of affected teeth per child varied from 1 to 12. Treatments involved local therapy and systemic antibiotics. Treatment of periodontitis in primary teeth led to alveolar bone regeneration and periodontally healthy permanent teeth. Recurrence was suspected only in 1 case. The different aspects related to prevention, diagnosis, and treatments of families with periodontal diseases are discussed. From this manuscript, it is concluded that (1) susceptible families develop a high prevalence of periodontitis; (2) these families should be carefully monitored to provide early treatment to new cases; and (3) treatment of children with periodontitis in the primary dentition may be successful, with no periodontitis developing in the permanent dentition in adolescence.

Adolescent↗
PubMed1990

[Clinical and ultrastructural observations of juvenile periodontitis].

In this study, clinical data of 7 cases of juvenile periodontitis were analyzed in company with electron microscopic observations. It consisted of 6 females, and 1 male, aged from 12 to 18 years old. TEM showed chronic inflammation of the pocket walls, marked plasma cell and lymphocyte infiltration. Plasma cells revealed abundant dilated rough endoplasmic reticulum and were classified into three types. Numerous bacteria were found in lamina propria in one case, without any signs of phagocytosis. The collagen fibers were fragmented, dissolved and arranged out of order. The characteristics of clinical history, and the ultrastructural changes of the periodontal pocket were analyzed and discussed.

Adolescent↗
PubMed1986

The role of the orthodontist in the multidisciplinary approach to periodontal therapy.

The effects of orthodontic tooth movement upon the supporting tissues of teeth with periodontal breakdown are conflictingly reported. Recent studies in beagle dogs have, however, enlarged our understanding of the effects of tipping and bodily movements of teeth and of factors important in retention after orthodontic treatment. Such treatment should always be preceded by the treatment of periodontal inflammation and the elimination of deep pockets.

Adult↗