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PubMed1993

Ultrastructure of plaque associated with polytetrafluoroethylene (PTFE) membranes used for guided tissue regeneration.

The purpose of the study was to examine the ultrastructure of plaque contaminating polytetrafluoroethylene (PTFE) membranes used for guided periodontal tissue regeneration. 8 patients treated with Gore-Tex membranes received daily antibiotics (650 mg x 2 Femepen) and rinsed with 10 ml 0.2% chlorhexidine during a healing period of 30 days. Following retrieval, the membranes were processed for electron microscopy. External aspects of 12 portions from 4 partially exposed membranes were selected for detailed ultrastructural examination. The plaque-membrane interface was characterized by the presence of fibrin or discontinuous accumulation of intermicrobial matrix. Adjacent plaque-free areas of membrane surface exhibited no detectable electron-dense material. 3 structurally different groups of bacterial aggregations were observed on the strips: (i) dense layers of gram-positive cocci and rods dominated the external aspect of the open microstructure portion; (ii) cocci, rods and filamentous microorganisms embedded in fibrin filled the spaces of the open microstructure; (iii) a loosely arranged mixed microbiota consisting of gram-positive cocci and rods as well as of gram-negative microorganisms and spirochetes were present on the occlusive portion. Areas with morphologically intact bacteria alternated with areas with empty bacterial cell walls. One specimen also displayed degenerated Candida-like blastospores. This study shows that oral micro-organisms may colonize and extensively invade the open microstructure of PTFE material and that adhesion of plaque to the membrane surface is mediated either by fibrin or a discontinuous layer of intermicrobial matrix.

Adult↗
PubMed1993

The effect of sibling relationship on the periodontal condition.

The purpose of this investigation was to study clinically as well as microbiologically the effect of sibling relationship on the periodontal condition in a young population with a relatively high prevalence of periodontal disease and deprived from regular dental care. In this study, 23 family units consisting of 3 more siblings were evaluated. In all, 78 subjects aged 15 to 25 years were included in the study. The mean interproximal amount of loss of attachment in this population was 0.29 mm. The individual mean ranged from 0 to 1.27 mm. In 33% of the subjects, > or = 1 sites with a probing depth of 5 mm or more in conjunction with 2 mm of attachment loss were present. The results show a significant sibship effect for: plaque, calculus, loss of attachment, spirochetes on the tongue and in the pocket, Porphyromonas gingivalis on the gingiva and in the saliva and Prevotella intermedia in the saliva. These results support the hypothesis that periodontitis aggregates in families.

Adolescent↗
PubMed1994

Repeated subgingival oxygen irrigations in untreated periodontal patients.

The aim of this study was to assess the effect of repeated subgingival oxygen irrigations in previously untreated deep periodontal pockets. 112 pockets > or = 4 mm were selected in 14 subjects. Probing attachment level and bleeding on probing were recorded, as well as the presence of disease-associated micro-organisms within the pocket. Subsequently, the pockets were irrigated with gaseous oxygen 1 x a week during a continuous 8-week period. Irrigations with nitrogen served as control. The re-evaluation of all clinical and microbiological parameters at the end of study revealed that repeated oxygen insufflations resulted in a significant clinical improvement of the periodontal baseline conditions superior to the one found in the control.

Adult↗
PubMed1994

Prevalence of periodontitis and suspected periodontal pathogens in families of adult periodontitis patients.

The aim of the present study was to investigate the prevalence of periodontopathic microorganisms and periodontal destruction in the spouses and children of adult periodontitis patients. For this study, 24 families were selected on the basis of one parent with severe periodontal breakdown and the presence of Actinobacillus actinomycetemcomitans and/or Porphyromonas gingivalis and/or more than 30% Prevotella intermedia subgingivally. The clinical examination of both parents and children included pocket depth and clinical attachment loss (CAL) measurements. Samples for bacterial examination were obtained from the mucous membranes, the saliva and pockets. Pocket selection was based on the most advanced periodontitis situation found in a subject. The samples were cultured for the detection of A. actinomycetemcomitans, P. gingivalis and P. intermedia. By phase-contrast microscopy, the % of spirochetes and motile microorganisms was assessed. The number of children within each family varied between 1 and 3. In total 49 children were investigated with a range in age of 3 months to 15 years. Results showed that under the age of 5 years, none of the children had CAL, whereas in the age group of 5-15 years, 26.5% had 1-5 sites in the primary and/or permanent dentition with 1-3 mm CAL. 3 of the spouses had no interproximal CAL. 16 of the 24 spouses had a light to moderate form of periodontitis, with at least one site with 1 to 4 mm CAL and 5 spouses had severe periodontal breakdown with sites showing at least 8 mm CAL. Spirochetes, motile microorganisms and P. intermedia were frequently present in all family members. 18 out of the 24 probands were positive for P. gingivalis. This organism was found once only in a 5-year-old boy and in 11 of the spouses. A. actinomycetemcomitans was detected in 13 probands; 5 children and 5 of the spouses were also positive for this bacterium. If a child harboured one of the periodontopathogens, at least 1 of the parents was also positive for that bacterium. This phenomenon may be due to transmission of microorganisms between family members. Comparison of the clinical data reported in the present study with similar clinical parameters from epidemiological studies of the Dutch population suggest that the spouses and children of adult periodontitis patients might be at relatively high risk of developing periodontal breakdown.

Adolescent↗
PubMed1994

Evaluation of the efficacy of a redox agent in the treatment of chronic periodontitis.

A redox dye, methylene blue, was compared with subgingival root surface debridement and sterile water in the treatment of adult periodontitis. Plaque and gingival indices, bleeding on probing, and microbiological samples were obtained at baseline, and at 1, 4, 8 and 12 weeks following treatment. All subjects had matched pockets in each of the 4 quadrants, of 5 mm or more. One treatment consisted of 0.1% methylene blue gel irrigated professionally at 0, 1 and 4 weeks, and by subjects at days in between up to 4 weeks, at chosen sites within a randomly selected quadrant (split-mouth design). A 2nd treatment was sterile water irrigation as above. A 3rd quadrant received subgingival debridement, and sites in the 4th received methylene blue incorporated into a slow-release device of a biodegradable collagen alginate vicryl composite. All sites showed improvements in clinical and microbiological parameters. However, no statistically significant differences between treatment types were found for clinical measurements. Although plaque index tended to increase after week 1, gingival index was reduced, as was the papilla bleeding index. Probing depth reductions were approximately 1.2 mm for all treatments. Microbiological variables showed an increase in cocci and a decrease in motile organisms for all groups, the latter reaching statistical significance for subgingival debridement. The reductions in spirochaetes were significant for subgingival debridement and methylene blue by slow-release. Culture demonstrated an increase in the aerobe:anaerobe ratio for all groups, which was statistically significant initially (weeks 1 and 4) for subgingival debridement. Methylene blue was also effective statistically in improving this ratio, both by irrigation and slow-release (week 4). Methylene blue also significantly reduced the numbers of black-pigmented anaerobes during the trial period, both by irrigation and slow-release, which sterile water and subgingival debridement failed to do. No serious adverse experiences were seen, however, significantly greater morbidity was associated with subgingival debridement. These results clearly demonstrate that in altering the microflora to one that is more compatible with periodontal health, methylene blue treatment is comparable, or even better, than the currently standard treatment of subgingival debridement, and is better tolerated.

Adult↗
PubMed1995

The microbiota of osseointegrated implants in patients with a history of periodontal disease.

The purpose of this study was to determine the presence of suspected periodontal pathogens in the peri-implant microflora of osseointegrated implants exposed 3 and 6 months to the oral environment of patients previously treated for periodontal disease. Subgingival microbial samples were taken in the deepest residual pocket of each quadrant in 10 patients before placement of ITI implants and in 10 patients before abutment connection of Brånemark implants. The samples were cultured using continuous anaerobic techniques. 4 patients were positive for P. gingivalis, 13 for P. intermedia, 2 for A. actinomycetemcomitans, 16 for Fusobacterium, 7 for C. rectus and 12 showed microscopic evidence of spirochetes. After 3 and 6 months exposure of the implants to the oral environment, one sample was obtained from the peri-implant sulcus in each patient. P. gingivalis was found in 2 patients in the peri-implant samples after 3 and 6 months. 6 peri-implant samples were positive for P. intermedia after 3 months, 7 after 6 months. Fusobacterium was present in 13 peri-implant samples after 3, and in 12 samples after 6 months. 4 patients showed evidence of for C. rectus after 3 months, 2 after 6 months. Spirochetes were seen in 3 peri-implant samples after 3 and in 5 after 6 months. None of the implants were found to be colonized by A. actinomycetemcomitans, although the organism was detected on teeth in 1 individual. Similar distribution patterns were noted for ITI and Brånemark type implants.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Microscopic spirochete counts in untreated subjects with and without periodontal tissue destruction.

The purpose of the study was to determine microscopically the %s of spirochetes at sites without periodontal destruction in subjects with destructive periodontal diseases (cases) and in subjects free of it (controls), who had not received professional prophylaxis. From a sample of 164 individuals aged between 30-44 years living in rural and urban areas of Tanzania, cases and controls were selected. Cases (n = 25) were selected who exhibited at least 3 teeth with pocket depth of > 5 mm. The controls (n = 28) had no pockets deeper than 3 mm. From each subject, 1 subgingival plaque sample was taken at the mid point of the lingual surface of 1 of the upper premolars which showed bleeding on probing but no calculus and no pockets. In addition, one subgingival sample was obtained from a pocket. Pockets contained the highest %s of spirochetes, which confirms earlier findings. A significant difference in % of spirochetes between cases and controls was found at non-destructive sites, indicating a host effect on the subgingival microflora. However, the spirochete counts at non-destructive sites did not provide a reliable measure to identify subjects with destructive periodontal disease.

Adult↗
PubMed1995

Correlation of the periodontal status 6 years after puberty with clinical and microbiological conditions during puberty.

The purpose of this study was to assess the oral clinical and microbiological status of young adults 6 years after puberty and to compare these findings with the conditions observed during puberty. Clinical and microbiological parameters were monitored in 42 individuals 10 x between the ages of 11 and 14 years. 33 individuals were re-examined 10 years after the start of this monitoring. Microbiology included 2 subgingival samples per subject taken from the mesiobuccal aspects of the upper 1st molars. The samples were subject to continuous anaerobic culturing. Individuals with a marked and sustained increase in mean papillary bleeding scores during puberty (group A, n = 16) differed 6 years later from individuals without pronounced puberty gingivitis (group C, n = 8) in several aspects. Individuals in group A had a significantly higher gingival bleeding tendency and an increased number of sites with more than 3 mm attachment loss. The subjects in group C showed the lowest anaerobic total cultivable counts. Spirochetes were detected only in group A subjects (4 samples in 3 individuals). In all positive sites, spirochetes had been identified at least 8 out of 10 times during puberty. A. actinomycetemcomitans was present in only one individual of group A. P. gingivalis had not been detected during puberty; none of the samples were P. gingivalis positive 6 years later. P. intermedia was found in 27% of all samples, isolates belonging to the P. melaninogenica group of black pigmenting anaerobes had a frequency of 6%, 6 years after puberty.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Microbiological features of gingivitis in pubertal children.

The subgingival microflora of 42 pubertal children (aged 12-15 years) and 18 young adults (aged 21-25 years) was investigated by anaerobic culture and phase contrast microscopy. Motile rods, spirochetes and Prevotella intermedia were elevated proportionately in pubertal children with gingivitis (median GI > or = 1); however, no statistically significant differences in enumerated organisms on selective media were observed between pubertal children and young adults. These organisms were positively correlated with the index of bleeding on probing and the gingival index of pubertal children. Pubertal children were divided into 3 distinct subject clusters according to the similarity of subgingival microbial features, and the subjects who were then selected for the gingivitis group were distributed into clusters 1 and 2. The proportions of motile rods, P. intermedia and Eikenella corrodens were significantly higher in cluster 2 than in cluster 1. These results suggest that these 2 species and motile rods which differentiated features of clusters, are useful for screening of high-risk subjects for worsening of inflammation.

Actinomyces↗
PubMed1995

Oral microbiota in subjects with a weak or strong response in experimental gingivitis.

The purpose of the present study was to examine the composition of the oral microbiota in subjects who had previously demonstrated to develop either a weak or strong response to experimental gingivitis. For this study, subjects were selected from a pool of 25 individuals who had participated twice in an experimental gingivitis trial. Out of these 25 panellists, 6 subjects were selected who had developed 2X a weak gingival inflammatory response and 7 subjects who had developed 2X a strong gingival inflammatory response. Approximately 9 months after the 2nd experimental gingivitis trial, we evaluated the clinical condition and the prevalence of a panel of selected oral micro-organisms in these subjects. The subjects were clinically examined for the presence of plaque, bleeding, pocket depth and loss of attachment. For the microbiological evaluation, samples were taken from the mucous membranes, subgingival sites and saliva. Samples were analyzed for the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Peptostreptococcus micros, Actinomyces spp., Fusobacterium nucleatum, Campylobacter rectus, spirochaetes and motile rods. Clinical evaluation showed that most subjects had a relatively healthy periodontal condition. No clinically significant differences could be detected between the weak and strong responding groups. The microbial evaluation showed absence of A. actinomycetemcomitans, P. gingivalis and P. micros in all subjects in either group. Analysis of the microbial data for the weak and strong responding group showed no differences between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Actinomyces↗
PubMed1995

Response to intracrevicular controlled delivery of 25% tetracycline from poly(lactide/glycolide) film strips in SPT patients.

Controlled local delivery of antibiotics has been shown to reduce periodontopathic micro-organisms with minimal side-effects. Clinical studies in our laboratory have shown that 25% tetracycline HCl delivered from poly(D,L-lactide/glycolide) film strips (25 TTC-PLGA) released therapeutic concentrations of tetracycline for 10 days. The present pilot study compared the intracrevicular delivery of 25% tetracycline HCl incorporated in these biodegradable film strips to scaling and root planing (SRP) in 10 adult periodontitis patients, who in spite of therapy and regular supportive periodontal treatment (SPT), continued to possess 5 bleeding periodontal pockets at least 5 mm deep. Sites were randomly selected to receive the following treatments: (1) 25 TTC-PLGA, (2) control strips without TTC (PLGA), (3) SRP, and (4) untreated control. Film-strip retention was augmented with a suture/cement technique, followed by strip removal after 2 weeks. Clinical parameters and subgingival bacterial morphotypes (darkfield analysis) were evaluated over time (0, 2.4, 8, 12, 26 weeks). Results indicated that, compared to baseline, 25 TTC-PLGA film strips caused significant (p < or = 0.01): (1) probing depth reduction for 26 weeks, (2) a clinical attachment level gain for 12 weeks, (3) lower %s of spirochetes for 4 weeks and motile rods for 8 weeks (p < or = 0.05), and (4) an accompanying increase in cocci for 4 weeks. In the scaled and root planed sites, probing depth was the only finding that demonstrated a significant change from baseline (p < or = 0.01). Controls and PLGA showed isolated reductions in probing depth and % of motile organisms. From these findings, applications of intracrevicular 25 TTC-PLGA, when compared to scaling and root planing, appears to have an enhanced antibacterial effect and a similar clinical effect in SPT patients. The results of this study indicate further investigation of 25 TTC-PLGA film strips should be undertaken using more subjects and sophisticated microbiological and clinical measurements.

Adult↗
PubMed1996

Full- versus partial-mouth disinfection in the treatment of periodontal infections. A pilot study: long-term microbiological observations.

A standard periodontal treatment consists of 4 to 6 scalings and rootplanings at a 1- to 2-week interval, which allows reinfection of a previously disinfected area before completion of the treatment. The present pilot study aims to examine the microbiological long-term effects of a full-mouth disinfection. 10 patients with advanced chronic periodontitis were randomly allocated to a test and control group. The patients from the control group received scaling and rootplaning and oral hygiene instructions at a 2-week interval. The full-mouth disinfection (test group) consisted of a full-mouth scaling and rootplaning in 2 visits within 24 h in combination with: tongue brushing with 1% chlorhexidine gel for 1 min, mouth rinsing with 0.2% chlorhexidine solution for 2 min and subgingival irrigation of all pockets (3x in 10 min) with 1% chlorhexidine gel. The patients of the test group were instructed to rinse 2x daily with 0.2% chlorhexidine. Plaque samples were taken at baseline and after 1, 2, 4 and 8 months. Differential phase-contrast microscopy showed a significantly larger reduction of spirochetes and motile organisms in the test group up to month 2 for the single-rooted and up to month 8 for the multi-rooted teeth. Furthermore, the culture data supported the effectiveness of the new treatment strategy. In both groups, the number of anaerobic CFU decreased 1 log around single- and 0.5 log around multi-rooted teeth. The number of anaerobic CFU remained low in the test group, in contrast to the control group. At 1 month, the test group harboured a significantly (p<0.01) lower proportion of pathogenic organisms, but this difference disappeared with time. Moreover, the test sites showed a significantly higher (p<0.02) increase in the proportion of beneficial micro-organisms up to 4 months. These findings suggest that a full-mouth disinfection leads to a significant microbiological improvement up to 2 months, which could be consolidated, although not significant, for the next 6 months.

Adult↗
PubMed1996

Azithromycin in the treatment of periodontal disease. Effect on microbial flora.

Azithromycin is an azalide antibiotic with excellent in vitro activity against a wide variety of oral bacteria. It has a long half-life, good tissue penetration and is preferentially taken up by phagocytes. We investigated the microbiological efficacy of azithromycin as an adjunct to the non-surgical treatment of adult chronic periodontitis; its clinical efficacy is dealt with in a separate paper. 46 patients were treated in a double-blind placebo controlled trial. Microbiological assessment of the same periodontal pocket (initially > 6 mm) was made at weeks 0, 2, 3, 6, 10 and 22. Either azithromycin 500 mg 1 x daily for 3 days or placebo was given at week 2. Particular attention was paid to the numbers of black pigmented anaerobes and spirochaetes present since these are the most commonly implicated pathogens in periodontal disease. Pigmented anaerobes were significantly reduced at weeks 3 and 6 in patients who received azithromycin compared to placebo and remained lower, although not significantly so, throughout the study. Counts of spirochaetes were significantly reduced throughout the study in patients who received azithromycin compared to placebo. Our microbiological study suggests that azithromycin may be useful as an adjunct in the treatment of periodontal disease.

Adult↗
PubMed1996

Dark field microscopy of the subgingival microflora in insulin-dependent diabetics.

The subgingival microflora was assessed by means of dark field microscopy in 106 pockets of 47 subjects with long-term insulin-dependent diabetes mellitus (IDD). The microbiota of 55 healthy sulci (probing depth < 4 mm) and 51 periodontally diseased (probing depth > or = 4 and 6 mm) pockets were analyzed. The mean duration of the IDD of the diabetic subjects was 23.7 years (range from 10 to 41 years). The diabetic patients, aged 30-65 years, were under medical treatment at the III Department of Medicine, University of Helsinki Central Hospital, and at 2 clinics of the Helsinki Health Centre. Based upon their long-term medical records, 26 subjects were assessed to have poorly controlled insulin-dependent diabetes mellitus (PIDD) and 21 had controlled insulin-dependent diabetes (CIDD). The PIDD subjects exhibited higher mean blood glucose levels (12.9 +/- 4.6 mmol/l, mean +/- S.D.) than the CIDD subjects (7.9 +/- 3.6 mmol/l) (p < 0.001, t-test). The mean glycosylated hemoglobin HBA1 (HBA1c) levels were 11.2 +/- 4.6% (10.3 +/- 1.2%) and 8.8 +/- 1.8% (7.7 +/- 1.4%) for PIDD and CIDD subjects, respectively. These differences were statistically significant (p < 0.01 and p < 0.001, t-test). For each individual, site-specific recordings were made for plaque index and bleeding index scores, probing depth, loss of attachment and radiographic loss of alveolar bone. Dark field microscopy analysis of the presence of spirochetes, motile rods, cocci, non-motile rods, filaments and fusiforms was performed in the total of 106 pockets. According to the results of the dark field microscopy, the % of spirochetes and motile rods in the periodontally diseased pockets was significantly higher in the PIDD than in the CIDD subjects (9.2 +/- 13.4% and 10.8 +/- 14.3% versus 4.0 +/- 5.2% and 3.1 +/- 3.2%, p < 0.01 and p < 0.001, chi 2-test, respectively). Moreover, the PIDD subjects had lower mean %s of coccoid cells in periodontally diseased sites than the CIDD subjects (52.1 +/- 20.8% versus 60.7 +/- 9.0%, p < 0.001, chi 2-test).

Adult↗
PubMed1996

The effect of cyclosporin-A on the oral microflora at gingival sulcus of the ferret.

The effect of cyclosporin-A (CyA) on the dentogingival flora of ferrets with healthy and experimentally induced periodontal breakdown was studied. Five animals were given 10 mg/kg/d CyA. At the start of the experiments (day 0), ligatures were placed around 4 teeth in the right upper and lower jaws; corresponding contralateral teeth on the left side served as control. On days 0 and 28 (end of the experiment), microbiological samples were collected from the gingival sulcus of the experimental and the control teeth and from closely located gingival mucosa membrane. The samples were subjected to viable counts and to darkfield microscopic analyses. On day 0, facultative anaerobic rods, mainly Pasteurella spp, Alcaligenes spp, Corynebacterium spp. and Rothia spp dominated in the viable counts. No anaerobic bacteria were detected in the viable counts. On day 28 spirochetes increased in the experimental gingival sulcus samples and anaerobic bacteria appeared in most of the samples and constituted 40-60% of the total cultivable flora; Fusobacterium necrophorum and Eubacterium spp. predominated in the samples from the experimental sites. The results of the present study were compared with those of our previous investigation of ferrets not medicated with cyclosporin but also subject to experimental ligature periodontitis. Eubacterium spp. were absent in the animals not treated with cyclosporin, while this species was frequently present in the immunosuppressed ferrets. The results indicate that the presence of the large numbers of gram negative rods and of anaerobic bacteria may have enhanced the inflammatory process and further provoked the gingival overgrowth observed.

Actinomycetaceae↗
PubMed1997

Topical metronidazole application in recall patients. Long-term results.

The aim of this randomised study in split-mouth design, in which 24 patients from the recall programme of Marburg University Department of Periodontology were enrolled, was to compare topical application of a metronidazole 25% dental gel with subgingival scaling. The clinical parameters used were pocket probing depth (PPD) and bleeding on probing (BOP); these were recorded at baseline and 1, 3, 6, 14, 18 and 24 months after completion of treatment. In addition, plaque samples were taken from all mesial pockets for evaluation by dark-field microscopy. All patients had at least one tooth in each quadrant with a PPD of 5 mm or more showing BOP when they entered the study. The treatment consisted of 2 applications of dental gel in 2 randomly selected quadrants (on days 0 and 7) as well as subgingival scaling of the remaining quadrants. Statistical evaluation of all sites with a baseline PPD of 5 mm or more showed that both methods led to a significant reduction in PPD and BOP in the first 6 months. The average reduction in PPD was 1.3 mm in the gel group and 1.5 mm in the scaling group, with the tendency to bleeding being reduced by ca. 50% in both groups. After 24 months, improvements of 0.6 mm and 0.5 mm respectively were observed in PPD. The tendency to bleeding had undergone a slight increase but was still below baseline values. No statistically significant differences were observed between the two methods, although the results recorded with subgingival scaling were slightly better. Dark-field microscopy revealed a shift in the composition of the bacterial flora, suggesting a more physiological situation, which was maintained for 6 months before reverting consistently after 18 months to the baseline values of the plaque composition. Overall, application of a metronidazole 25% dental gel led in recall patients to an improvement in the investigated clinical and microbiological parameters comparable with subgingival scaling. After 24 months, the clinical parameters still displayed a very slight improvement over baseline values; after 18 months the microflora had reverted to its baseline composition.

Administration, Topical↗
PubMed1998

Untreated periodontal disease in Indonesian adolescents. Clinical and microbiological baseline data.

At present, several risk factors for the initiation and progression of periodontitis have been identified. In order to investigate the rôle of various potential clinical and microbiological risk factors and indicators, a longitudinal study was initiated in a young population deprived from regular dental care. The present communication describes the baseline cross-sectional data obtained in 1987 in terms of the clinical periodontal condition and prevalence of periodontal bacteria in the oral cavity. All inhabitants in the age range 15-25 years of a village with approximately 2000 inhabitants at a tea estate on Western Java, Indonesia, were examined clinically and microbiologically. In total, 255 adolescents, comprising 130 males and 125 females participated in the study. Samples for bacteriological examination were taken from the gingiva, the dorsum of the tongue, and the saliva. Plaque index, bleeding upon probing, pocket depth, and attachment loss (AL) were scored on the approximal surfaces from the vestibular aspect of all teeth as well as the mid-vestibular and mid-lingual aspects of the Ramfjord teeth. Calculus was scored only on the 4 surfaces of the Ramfjord teeth. Following the clinical measurements, the deepest bleeding pocket with no clinical loss of attachment was sampled for microbiological examination. In addition, in 37 subjects a deep bleeding (> or = 4 mm) with at least 4 mm of attachment loss was sampled. Moderate periodontitis (max. AL 3-4 mm) was found in 26% of the population, advanced periodontitis (max. AL > or = 5 mm) in 8%, whereas 66% of the population showed no or minor periodontitis (max. AL 0-2 mm). Actinobacillus actinomycetemcomitans was found in 57% of the population, Porphyromonas gingivalis in 87%, Prevotella intermedia and motile rods in all cases and spirochetes in 89%. P. gingivalis (66%), A. actinomycetemcomitans (37%) and spirochetes (63%) were, of all the sampled sites of the oral cavity, most frequently detected in pockets without attachment loss. Motile rods were most prevalent on the tongue and in the saliva (92% and 89%, respectively). A high prevalence of the investigated periodontal bacteria was detected both in the pockets without and with attachment loss. No significant association between the clinical periodontal parameters and the prevalence of the microorganisms was observed at a patient level. At a site level, both P. gingivalis and spirochetes were more prevalent in sites with attachment loss. The actual rôle of these putative periodontal pathogens may be elucidated more extensively, when longitudinal data on the present population become available.

Adolescent↗
PubMed1998

Semi-automated measurement of motility of human subgingival microflora by image analysis.

The purpose of this investigation was to quantitatively estimate bacterial motility by image analysis, and to apply this method for the measurement of motility of human subgingival microflora. We developed a semi-automated method for the quantification of bacterial motility using video microscopy, digitization and image processing. Moving images of both authentic bacterial samples and clinical samples were recorded using a phase contrast microscope with a high speed (1/100 s) shutter camera. The motility was evaluated by measuring the total number of pixels remaining after the subtraction of 2 serial video images. The total number of pixels was significantly correlated with both the sum of the velocity of each bacterial cell and the number of motile bacteria on the same original images. Motility of subgingival microflora from 140 clinical samples tested was measured at 0 pixels to 3600 pixels, whereas the effect of Brownian movement was less than 150 pixels. The motility of subgingival microflora estimated with this image analysis system did not differ much from objective judgments by the naked eyes of experts. These results suggest that a semi-automated image analysis system may be useful in the evaluation of the motility of human subgingival microflora.

Adolescent↗