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PubMed1989

Effects of subgingival irrigation on A. actinomycetemcomitans.

The effects of repeated subgingival irrigation on Actinobacillus actinomycetemcomitans was examined. 24 periodontal pockets harboring A. actinomycetemcomitans in 3 juvenile and 4 adult periodontitis patients were studied. The protocol included bi-weekly subgingival irrigation with hydrogen peroxide of the periodontal sites until the micro-organism was no longer detected by selective culture, or for 6 months. A. actinomycetemcomitans was gradually suppressed to below detection following the irrigation regime and could no longer be detected in 46% of the sites at completion of the irrigation protocol. The sites were microbiologically re-examined 5 months after cessation of the irrigation regime. A. actinomycetemcomitans re-occurred in only 2 of the sites from which it had originally been suppressed below detection. The results indicate: (1) that the irrigation regime tested has some potential to suppress A. actinomycetemcomitans in periodontal pockets; (2) that the effect of the irrigation protocol generally lasted for 5 months; (3) that the reduction rate of A. actinomycetemcomitans to below detectable levels seems related to the initial number of cultivable bacteria from the periodontal pocket.

Actinobacillus↗
PubMed1996

A double-blind trial of tetracycline in the management of early onset periodontitis.

The aim of the study was to evaluate the adjunctive effect of systemic tetracycline (250 mg qds for 14 days) in sequential root planing and surgical phases of treatment in a randomised, double-blind controlled trial. 38 patients who were under 26 years of age, in good general health and with localised (15 test/15 control) or generalised (4 test/4 control) early onset periodontitis completed the non-surgical phase. Data were analysed by ANOVA using baseline covariates and transformations where appropriate. Improvements in probing depth, probing attachment level and bleeding on probing were significantly better in the group treated with adjunctive tetracycline, at 3 months post-treatment. 26 patients (13 test/13 control) subsequently completed the surgical phase (modified Widman flap surgery with adjunctive tetracycline or placebo as before) and were re-examined at 6 months and 12 months. In the test group, 58% of the originally affected teeth required surgery compared to 75% in the control group. Surgery produced further reductions in mean probing depths but no further gains in probing attachment. There were no further statistically significant differences between test and control groups for any of the clinical measures, although the tetracycline group appeared to maintain an advantage. In conclusion, systemically administered tetracycline is a useful adjunct in the management of early onset periodontitis, particularly in non-surgical treatment.

Administration, Oral↗
PubMed2003

One of two human lactoferrin variants exhibits increased antibacterial and transcriptional activation activities and is associated with localized juvenile periodontitis.

The iron-binding protein lactoferrin is a ubiquitous and abundant constituent of human exocrine secretions. Lactoferrin inhibits bacterial growth by sequestering essential iron and also exhibits non-iron-dependent antibacterial, antifungal, antiviral, antitumor, anti-inflammatory, and immunoregulatory activities. All of these non-iron-dependent activities are mediated by the highly charged N terminus of lactoferrin. In this study we characterized a Lys/Arg polymorphism at position 29 in the N-terminal region of human lactoferrin that results from a single nucleotide polymorphism in exon 1 of the human lactoferrin gene. We expressed cDNAs encoding both lactoferrin variants in insect cells and purified the two proteins by ion exchange chromatography. The two lactoferrin variants exhibited nearly identical iron-binding and iron-releasing activities and equivalent bactericidal activities against a strain of the gram-negative bacterium Actinobacillus actinomycetemcomitans. When tested against the gram-positive species Streptococcus mutans and Streptococcus mitis, however, lactoferrin containing Lys at position 29 exhibited significantly greater bactericidal activity than did lactoferrin containing Arg. In addition, the Lys-containing lactoferrin stimulated bovine tracheal epithelial cells to synthesize much higher levels of tracheal antimicrobial peptide mRNA than did the Arg-containing variant. A genotyping assay that distinguished between the two alleles based on a polymorphic EarI restriction site showed that the Lys and Arg alleles had frequencies of 24% and 76%, respectively, among 17 healthy human subjects, and 72% and 28%, respectively, among nine patients with localized juvenile periodontitis. Our findings suggest that these two lactoferrin variants are functionally different and that these differences may contribute to the pathogenesis of localized juvenile periodontitis.

Aggregatibacter actinomycetemcomitans↗
PubMed1985

Rapid identification of periodontal pathogens in subgingival plaque: comparison of indirect immunofluorescence microscopy with bacterial culture for detection of Actinobacillus actinomycetemcomitans.

The sensitivity of indirect immunofluorescence microscopy using specific polyclonal or monoclonal serodiagnostic reagents for Actinobacillus actinomycetemcomitans in subgingival dental plaque ranged from 82-100% as compared with culture on selective or non-selective media. This bacterium was found in 100% of the periodontally diseased sites examined in localized juvenile periodontitis patients and was statistically related to clinical indices of periodontal disease including the Gingival Index, Plaque Index, and Pocket Depth. Indirect immunofluorescence microscopy is a useful technique for the rapid and reliable determination of A. actinomycetemcomitans in human subgingival dental plaque which may be applied to the clinical diagnosis, treatment, and monitoring of periodontitis associated with A. actinomycetemcomitans.

Actinobacillus↗
PubMed1986

The effect of treatment on Actinobacillus actinomycetemcomitans in localized juvenile periodontitis.

Three treatment regimens including local tetracycline delivery, systemic doxycycline and surgery plus systemic doxycycline were investigated in a localized juvenile periodontitis (LJP) population. Of the investigated treatments only surgery plus systemic doxycycline for 14 days was effective in eliminating or suppressing Actinobacillus actinomycetemcomitans, an organism strongly associated with LJP lesions. While surgery plus antibiotics was the superior treatment, it appears that the possibility of reinfection or incomplete elimination of the organism exists. Careful long-term follow-up, including clinical and microbiological monitoring, is highly recommended in this periodontal population.

Actinobacillus↗
PubMed1990

Actinobacillus actinomycetemcomitans in families afflicted with periodontitis.

The purpose of this study was to determine the prevalence of Actinobacillus actinomycetemcomitans (Aa) in individuals from families where at least one individual has an early onset form of periodontitis. Twenty-three families with 73 subjects were evaluated in this study. Forty-seven early onset periodontitis subjects outside the 23 families were also studied. Prevalence of detection of Aa in family members ranged from 49% to 66% among groups constituted by clinical findings indicative of no loss of attachment, adult periodontitis, generalized severe juvenile periodontitis, or localized juvenile periodontitis. Whether the data were analyzed by subject or by site, no statistical differences could be found in prevalence (proportion of positive samples) among those clinical groups. The only significant difference was that localized juvenile periodontitis subjects had higher concentrations of Aa in their Aa-positive sites than did the other clinical groups. The prevalence of Aa-positive sites in subjects without attachment loss, but who are members of families in which early onset periodontitis is represented, was much higher than in other reports where periodontally healthy subjects were not related to early onset periodontitis cases. This suggests that Aa may be transmitted among members of families in which one or more members has an early onset form of periodontitis.

Actinobacillus↗
PubMed1992

Humoral antibody responses in periodontal disease.

Several forms of periodontal disease are considered to be infectious diseases with associated specific bacteria. This study examined the humoral antibody levels as assayed by ELISA to Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia in adult periodontitis (AP), localized juvenile periodontitis (LJP), rapidly progressive periodontitis (RPP), and in periodontally healthy subjects (HS). Sixty-two of the 64 (96.9%) patients had significantly elevated antibody levels to at least one of the three organisms. Elevated levels of antibodies to P. gingivalis occurred in 82.8% of the RPP, LJP, and AP patients with all 3 disease groups showing greater responses than HS controls. Antibodies to A. actinomycetemcomitans were found in 59.4% of the RPP, LJP, and AP patients and were significantly higher in both LJP and RPP patients. Only 21.9% of the RPP, LJP, and AP patients showed elevated levels to P. intermedia with only significantly higher levels in the RPP and LJP groups. Antibodies to A. actinomycetemcomitans and P. intermedia were rarely found alone (only 5.1% and 2.6% of the patients respectively) but were usually accompanied by P. gingivalis. These results suggest that one or more combinations of these 3 bacteria may play a role in the pathogenesis of these forms of periodontal disease.

Adolescent↗
PubMed1995

Lack of effect of oral hygiene training on periodontal disease progression over 3 years in adolescents.

A comprehensive new oral hygiene training program has lately been described and found effective in controlling dental plaque formation and in significantly reducing the incidence of approximal dental caries and gingivitis in adolescents. This study investigated the long-term effect of plaque control on the progression of periodontal diseases in adolescents. A group of 227 Brazilian schoolchildren were followed up over a period of 3 years. The children were divided randomly into 3 groups. The first group was given a needs-related intensive program which combined detailed information to parents and children pertaining to the etiology and prevention of dental diseases, instructions in self-diagnosis of plaque and gingivitis, and a detailed oral hygiene training based on individual needs, together with continued feedback and motivation during the entire 3 years. The second group was given a similar program, but through shorter sessions and with no motivation and feedback and no training in self-diagnosis. A control group received no motivation sessions or oral hygiene training. The 3 groups were examined radiographically at baseline and annually at 3 subsequent occasions. The data were analyzed with a multi-level variance analysis. The frequency of subjects showing sites with alveolar bone loss increased steadily during the entire period in all groups. Neither of the training programs had a significant effect on the alveolar bone level during 3 years compared to the control group. Generally, girls demonstrated higher proportions of approximal tooth surfaces showing radiographic bone loss, though not statistically significant. In this population the supragingival plaque control lacked any significant effect on periodontal disease progression.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1999

One stage full- versus partial-mouth disinfection in the treatment of chronic adult or generalized early-onset periodontitis. II. Long-term impact on microbial load.

BACKGROUND: Recent studies showed the clinical benefits of a one stage full-mouth disinfection, when compared to the worldwide standard treatment strategy of consecutive root planings per quadrant without proper disinfection of the remaining intraoral niches. The purpose of this study was to investigate the microbiological benefits of such a one stage full-mouth disinfection with special attention to all intraoral niches for periodontopathogens and to evaluate the perception by the patients of the new treatment strategy. METHODS: Sixteen patients with early-onset periodontitis and 24 patients with severe adult periodontitis were randomly assigned to test and control groups. The control group was scaled and root planed, per quadrant, at 2-week intervals and given oral hygiene instructions. The test group received the one stage full-mouth disinfection treatment. At baseline and after 1, 2, 4, and 8 months, microbiological samples were taken from all niches (tongue, mucosa, saliva, and pooled samples from single- and multi-rooted teeth). The samples were cultured on selective and non-selective media. Patient perception of the treatment was evaluated using a questionnaire. RESULTS: In comparison to the standard therapy, the one stage full-mouth disinfection resulted in significant additional microbial improvements. The test group showed larger reductions in the proportions of spirochetes and motile organisms in the subgingival flora, and more significant reductions in the density of key pathogens, with even the eradication of P. gingivalis. The beneficial effects in the other niches were primarily restricted to the number of colony-forming units/ml of black-pigmented bacteria, especially on the mucosa and in the saliva and to a lesser extent on the tongue. Both treatments were well tolerated by the patients and the overall severity rating for both therapies was comparable, although 4 quadrants were treated within 24 hours in the test group versus only 1 in the control group. The full-mouth disinfection approach resulted more frequently in a slight increase of body temperature, especially after the second day. CONCLUSIONS: These findings support the benefit of a one stage full-mouth disinfection in the treatment of patients with either chronic adult or early-onset periodontitis.

Adult↗
PubMed2000

The clinical and microbiological effects of systemic ornidazole in sites with and without subgingival debridement in early-onset periodontitis patients.

BACKGROUND: The purpose of this study was to evaluate the clinical and microbiological effects of systemic ornidazole (ORN) in sites with or without subgingival debridement in early-onset periodontitis (EOP) patients. METHODS: Two pooled bacterial samples consisting of 4 sites each (scaled and non-scaled sites) were obtained from 30 individuals exhibiting EOP. All patients received oral hygiene instruction (OHI), supragingival scaling and ORN. Subgingival scaling and root planing (SRP) was carried out only in scaled sites. Bacterial samples were taken at baseline (BL) and 1 week and 2, 6, and 12 months after systemic ornidazole administration (500 mg/bid for 7 days). One more sample was taken at scaled sites, one week after SRP. RESULTS: One week following SRP (scaled sites) Gram-negative facultative and anaerobic rods were significantly reduced while Gram-positive facultative cocci were significantly increased. After ORN administration, P. gingivalis, P. denticola, P. intermedia, B. forsythus, C. rectus, and S. sputigena were no longer detectable in either scaled or non-scaled sites. A statistically significant long-term (2, 6, and 12 months) reduction of P. gingivalis, P. intermedia, P. loescheii, B. forsythus, and C. rectus and a pronounced increase of S. milleri, S. oralis, and S. sanguis counts in both scaled and non-scaled sites were detected in comparison to baseline. A sustained reduction of bleeding tendency and of probing depth was also observed in both scaled and non-scaled sites. CONCLUSIONS: ORN combined with SRP effects beneficial shifts in the bacterial population associated with substantial clinical improvement, thereby indicating that ORN is effective adjunct in the treatment of EOP deep periodontal pockets where anaerobic bacteria are predominant.

Administration, Oral↗
PubMed2001

Molecular analysis of Peptostreptococcus micros isolates from patients with periodontitis.

BACKGROUND: Recent studies provide strong evidence implicating Peptostreptococcus micros in the pathogenesis of various oral infections, including oropharyngeal abscesses and periodontal disease. To date, very little is known regarding the role of P. micros in periodontal disease. Therefore, a genetic analysis was initiated to differentiate among strains of P. micros infecting periodontal patients. METHODS: Sixty DNA samples of P. micros isolated from 15 patients with periodontal disease were evaluated. Arbitrarily primed polymerase chain reactions (AP-PCR) were performed using primer 3 (AGTCAGCCAC) and primer 13 (CAGCACCCAC). The PCR products were analyzed by gel electrophoresis. RESULTS: The primers produced several unique patterns among the strains tested. Primer 3 resulted in 30 different patterns, whereas primer 13 resulted in 31 different patterns, which were distinct from those seen with primer 3. In 8 of 15 patients, the PCR profile was identical for all isolates cultured from that patient, indicating a clonal infection. In 4 of 15 patients, 2 different genotypes were identified. In the remaining 3 patients, all isolates cultured from these patients exhibited a unique genotype. CONCLUSIONS: While P. micros appears to be heterogeneous throughout a population of periodontal patients, each patient is, for the most part, infected with a limited number of genotypes. These results demonstrate the genetic diversity of P. micros and the usefulness of AP-PCR for future epidemiological studies in understanding the role P. micros plays in periodontal disease pathogenesis.

Adolescent↗
PubMed2000

Periodontal diseases in children and adolescents.

The predominant form of periodontal disease in children and adolescents is gingivitis, which is a nonspecific inflammatory reaction of the marginal gingiva. The inflammatory reaction in the tissue, initiated by dental plaque accumulation, starts early during infancy and reflects the bacterial challenge to the host. In most children, the process of gingival inflammation remains superficial. In some cases, however, the balance between the microbial challenge and the host response is disrupted, leading to an inflammatory process that may result in loss of attachment. Genetic factors that modify the host response to the bacterial challenge are major determinants of susceptibility to the development of EOP, and many systemic diseases have been reported to predispose children and adolescents to periodontal disease. It is important to take a complete medical history of the patient and assess if there is a hereditary trend for periodontitis within the family. Dental professionals should rely on clinical and radiographic criteria of the disease for early identification of children at risk, with special focus on the presence of subgingival calculus. Children with overt gingival inflammation, subgingival calculus, or early signs of alveolar bone loss should be considered as periodontitis-risk patients and should be included in a preventive program as early as possible.

Adolescent↗
PubMedDate not supplied

Periodontal diseases, caries, and microbial composition of the subgingival plaque in children: a longitudinal study.

The present study compares periodontal parameters, caries, and levels of colony forming units (CFU) of bacteria from subgingival plaque of permanent teeth, to those of primary teeth examined 4 years previously. Six children who had periodontitis and 5 who had no periodontitis in primary teeth (groups A and B respectively) were examined. The microbial examination included the number of CFU of the total anaerobic count, Actinobacillus actinomycetemcomitans, Streptococcus mutans and Porphyromonas gingivalis. The differences in CFU values for the permanent teeth between groups A and B were not significant. Group A had significantly higher gingival inflammation values in the permanent teeth than group B. Permanent teeth had significantly higher CFU values of P. gingivalis than the primary teeth. Based on the present limited sample, the number of CFU from bacteria of the subgingival plaque of primary teeth are not an adequate predictor of periodontal disease or caries in the permanent teeth.

Adolescent↗
PubMed1996

Periodontal diseases in children and adolescents: classification, aetiology and management.

The human periodontal diseases are a complex group of disorders that span the entire length of the human life cycle. They are infective in nature, but are mediated by host parasite interactions that are influenced not only by the nature of the pathogens present but also by a variety of underlying immunological and connective tissue anomalies. Thus, on occasion they may reflect systemic disorders that have previously been undiagnosed. As such abnormalities frequently present in childhood or adolescence, knowledge of the potential implications of this broad group of diseases is important. This paper reviews the current classification of childhood periodontal disease and outlines the clinical presentation and management of the more common disorders.

Acute Disease↗
PubMed1996

A regenerative approach to the treatment of severe osseous defects: report of an early onset periodontitis case.

The biological principles of guided tissue regeneration (GTR) and graft materials have become widely used as methods for the treatment of severe osseous defects. An early-onset periodontitis case which includes a 3-year follow-up is presented in this case report, which demonstrates the successful use of an expanded polytetrafluoroethylene barrier membrane (ePTFE; Goretex Periodontal Material) in conjunction with natural coral bone graft (Biocoral 450). The results after 3 years illustrate the potential for regenerative periodontal therapy in combination with appropriate prosthetic procedures where limited success might have been expected.

Adolescent↗