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PubMed1983

A longitudinal study of periodontal disease in patients with reduced immunocapacity.

The periodontal status of renal transplant patients on immunosuppressant drug therapy was compared with that of an age matched normal group over a period of 2 to 4 1/2 years. Gingival Index, Plaque Index, and Periodontal Destruction Index were used as measures of comparison. Over this period of time the Gingival Index of the immunosuppressed patients increased significantly when compared to the normals. There was a significant increase in the mean Plaque Index for both groups during the study period. The increase was greater in the immunosuppressed group. However, the difference in the Plaque Index for the two groups was not significant. There was little change in the Periodontal Destruction Index in both groups over time. The results of this study indicate that there is little difference in the rate of periodontal destruction between patients taking immunosuppressant drugs and normal patients. These findings, taken in conjunction with other recent reports, would seem to indicate that T cells play a minor role in the etiology of periodontal disease.

Adult↗
PubMed1998

Awareness of periodontal disease in a group of northern Canadian children.

Periodontal disease destroys the supporting structures of the teeth. The clinical signs start early in childhood as inflammation of the gingival tissues; if uncontrolled, it becomes the major cause of loss of teeth in adult life. The purpose of this survey was to determine the understanding that a group of 10- to 15-year-olds living in the Inuvialuit, Gwich'in, and Sahtu Districts of the Northwest Territories have regarding the recognition and prevention of periodontal-gingival disease. A total of 953 students, with a median age of 12.5 years, completed the survey. The data, which included rural and urban centers as well as rural and remote regions, were analyzed using the chi-square method. Ethnic and gender differences are reported. Results indicate that girls have a better awareness of good oral health. Non-Native children have a somewhat better understanding regarding the recognition and prevention of periodontal disease. Both Native and non-Native groups share uncertainties with respect to the rationale and reasons behind the disease process. Educators of oral health prevention should incorporate into their programs preventive measures that take into consideration Native culture and traditions.

Adolescent↗
PubMed1988

Detection of high-risk groups and individuals for periodontal diseases. Clinical assessment of the periodontium.

The fundamental concepts of measuring periodontal diseases and the interpretation of such information as an historical record of disease, rather than disease activity, emphasises the need for improved diagnostic and prognostic tests. Criteria for an indicator of disease activity were suggested and an index fulfilling these should allow sites to be categorised as "active", quiescent or healing, and enable one to predict the risk of future disease activity. The ability of current measurements and indices, routinely used during clinical assessments of periodontal diseases, to fulfill the suggested criteria was considered and rejected in all cases. It is concluded that clinical parameters are only capable of identifying disease retrospectively, indicating the need for longitudinal, rather than cross-sectional studies in the search for clinical and laboratory markers of disease activity and susceptibility.

Gingival Crevicular Fluid↗
PubMed2001

Insulin resistance and periodontal disease: an epidemiologic overview of research needs and future directions.

Poor periodontal health is known to be associated with Type 2 diabetes mellitus (DM). This relationship and underlying mechanisms are discussed elsewhere in this issue. Less is known concerning the link between the metabolic precursors to DM, including insulin resistance (IR), and its possible association with periodontitis. Indeed, there has been relatively little research to date in human populations concerning periodontal disease, IR, and the subsequent risk of chronic diseases, including DM. This paper will present an epidemiologist's view of how IR may link periodontal disease with DM and suggest several avenues of investigation to help clarify some of the outstanding issues.

Adipocytes↗
PubMed1996

Reflections on the development of a host-response diagnostic test for periodontal disease.

This manuscript reviews the sequence of events surrounding the development of a proposed diagnostic test for periodontal disease based on analysis of a host mediator in gingival crevicular fluid (GCF). The mediator is lysosomal beta-glucuronidase (beta G), a marker of granule release from polymorphonuclear leukocytes. Preliminary studies were conducted to evaluate the most reproducible method of collecting GCF and analyzing the data. This was followed by analysis of the mediator in GCF in a variety of cross-sectional and short-term longitudinal studies, and eventually by a study of the relationship of beta G in GCF to disease progression (probing attachment loss) in a single center longitudinal trial. Development of an academic-industrial collaboration allowed the project to progress, as a rapid, practical assay system was developed, and a multi-center longitudinal trial was conducted. The multicenter trial indicated that patients with elevated beta G in GCF were at 6 to 14 times higher risk for experiencing probing attachment loss. The technical, regulatory, business and marketing issues surrounding the introduction of a diagnostic test for periodontal disease were considered. While technical and regulatory issues were not major impediments, business and marketing concerns contributed to a decision to halt development of the test. Specifically, there was concern about acceptance of the test by practitioners and third party reimbursement. Underlying these issues were the multifactorial nature of periodontal disease, and the lack of a direct cause and effect relationship of test results to disease outcome. While analysis of beta G in GCF is not currently available as a diagnostic test for periodontal disease, the development process has identified important issues for the introduction of diagnostic tests, including consideration of the relationship of test results to treatment, the need to integrate diagnostic tests into dental practice, and an appreciation of the financial and health care benefits derived by practitioners and patients with use of such tests.

Biomarkers↗
PubMed1988

Antimicrobial agents in the treatment of periodontal diseases: special aspects on tetracycline and doxycycline.

Increasing evidence for the involvement of specific microorganisms in the etiology of human periodontal diseases has appeared during the last few years. The microorganisms most likely to cause periodontal disease are Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, Bacteroides intermedius and Capnocytophaga species. Many of the strains are resistant to tetracycline and doxycycline. Recently penicillin-resistant B. gingivalis and B. intermedius have also been described. A. actinomycetemcomitans strains and capnocytophaga strains are sensitive to tetracycline and doxycycline. This has raised the question if periodontal diseases are possible to treat with antimicrobial agents alone or in combination with scaling of the teeth and surgery. Although numerous studies with different antimicrobial agents have been published it is still controversial if antimicrobials agents have a role in the treatment of human periodontal diseases. Comparative randomized long term studies are still needed to answer this question.

Anti-Bacterial Agents↗
PubMed2005

Periodontal disease among diabetics in Iraq.

BACKGROUND: It is generally accepted that diabetes increases the prevalence and severity of periodontitis, and is now considered the sixth "-opathy" of diabetes. The aim of this study was to determine the prevalence of periodontal disease in patients with type 2 diabetes mellitus and assess their severity in a single center in Basrah, Iraq. METHODS: This was a cross-sectional, case-control study. A total of 1593 patients were included (633 diabetic patients and 960 nondiabetics as controls). Patients with type 2 diabetes mellitus who were dentate persons aged 40 years and older and with = 6 remaining teeth were studied. RESULTS: Periodontal disease was seen in 95.9% of both diabetics and controls. Concerning mild and advanced disease, there was no difference between diabetics and controls, whereas moderate disease was more prevalent in those with diabetes. CONCLUSION: Of both the diabetics and controls, periodontal disease was seen in 95.9%. Moderate disease was significantly more common among diabetics. Larger studies, with pocket depth--attachment loss with radiologic evaluation for bone loss--are needed to assess the prevalence of periodontal disease among diabetics, other systemic disease, and the general population.

Case-Control Studies↗
PubMed1997

Relationship of serotype, leukotoxin gene type and lysogeny in Actinobacillus actinomycetemcomitans to periodontal disease status.

Actinobacillus actinomycetemcomitans has been associated with different forms of periodontitis, particularly with localized juvenile periodontitis (LJP). The bacterium possesses several virulence factors which have been shown to interact with the host immune system. Among these factors, leukotoxin, surface antigens (serotype) and bacteriophages have been suggested directly or indirectly to influence the course of infection. However, few studies have been able to show associations between these factors and periodontal disease, alone or in combination. Thus, the purpose of the present study was to investigate possible correlations between periodontal disease status and selected virulence factors (serotype, presence of bacteriophages, and the presence of a 530 bp deletion in the promoter region of the leukotoxin gene). 36 subjects took part in the study. Serotype c was the most frequently found serotype among periodontally affected subjects, although serotypes a and b were also present. 27 out of 36 strains harbored bacteriophages, and there was strong evidence that some of the bacteriophages were different from the previously characterized phi Aa phage. A. actinomycetemcomitans containing the F-fragment phage were more frequently associated with periodontal disease. Five strains, all serotype b, 3 from LJP patients and 2 from healthy subjects, showed a 530-bp deletion in the promoter region of the leukotoxin gene.

Actinobacillus Infections↗
PubMed1989

Oral flora of mongrel and beagle dogs with periodontal disease.

The plaque flora was studied in adult mongrel and beagle dogs with periodontal disease. Gingival plaque from maxillary premolars was removed and cultured on various growth media. The flora in all dogs was composed of mostly anaerobic gram negative rods. Bacteroides asaccharolyticus was found in the highest proportion of plaque samples from mongrel dogs, and decomposed hydrogen peroxide suggesting catalase activity. Fusobacterium nucleatum was found in higher proportion in the plaque of beagle dogs as compared to B. asaccharolyticus. With the increasing numbers of obligative anaerobic gram negative organisms such as B. asaccharolyticus, the proportions of Streptococcus, Enterococcus and Staphylococcus decreased in the dogs with periodontal disease. The salivary flora was different from the plaque flora of the dogs with periodontal disease. It was constant regardless with the disease. The salivary flora of beagle dogs with the healthy gingiva was different from that of mongrel dogs. Enterococcus, Lactobacillus, Eubacterium and black-pigmented Bacteroides (BPB, mainly B. asaccharolyticus) were higher proportion in the flora of beagle dogs as compared to mongrel dogs, while Fusobacterium, Enterobacteriaceae, yeast and molds were lower in the flora. The results reveal that B. asaccharolyticus and F. nucleatum are common pathogens and uniquely contribute to the development of gingival inflammation in dog.

Animals↗
PubMed2002

Periodontal disease increases the risk of preterm delivery among preeclamptic women.

BACKGROUND: Preterm births are a major cause of neonatal morbidity and mortality, and represent an important public health issue. About 30% of preterm births are due to medical conditions of the mother or the fetus, among "which preeclampsia plays a major role. We have previously reported that maternal periodontal disease enhances the risk for preterm delivery and preeclampsia. Our current objective was to determine whether maternal periodontal disease increases the risk for preterm delivery among preeclamptic women. METHODS: Women were enrolled prior to their twenty-sixth week of gestation. Periodontal status was assessed at baseline and defined as healthy, mild, or moderate/severe. Repeat examinations were performed at delivery to assess changes in periodontal status. RESULTS: A cohort of 1,020 women was studied, 47 of whom had preeclampsia. A strong association between periodontal disease status at enrollment and rate of premature delivery was observed among preeclamptic women after adjusting for the major risk factors for preterm delivery, including maternal race; age; marital status; WIC (women, infants, children program) or food stamps; insurance; previous preterm delivery; and chorioamnionitis. Among preeclamptic women, 49.3% with mild periodontal disease and 82.6% with moderate to severe disease delivered preterm (hazard ratios [HR] 4.11 and 11.0, respectively). Periodontal disease worsening during pregnancy in preeclamptic women was also associated with an increased risk of preterm births (HR 8.44). CONCLUSION: These results suggest that mothers with preeclampsia may be at greater risk for preterm delivery if periodontal disease is present early in pregnancy or progresses during pregnancy.

Female↗
PubMed2000

[Epidemiology of dental caries and periodontal diseases in middle school students in Suzhou City].

OBJECTIVE: To assess the prevalence of dental caries and periodontal diseases in middle school students at the ages of 11 to 13 and 15 to 17. METHODS: Dental caries and periodontal diseases were assessed strictly by "national survey table of dental caries and periodontal diseases for school students". RESULTS: The study group consisted of 20 581 students. The percentage of dental caries, DMFT and DMFS in students 11 to 13 years of age were 23.6%,0.40 and 0.54, respectively. The corresponding results were 29.76%, 0.64 and 0.87 for students 15 to 17 years of age, respectively. The percentage of gingivitis and dental calculus in students 11 to 13 years were 75.33% and 35.86%, respectively. The corresponding values in students 15 to 17 years of age were 73.1% and 44.91%, respectively. Female students have significantly few gingivitis and dental calculus than male students in both groups. CONCLUSION: Compared with the students at the same ages in other cities, students in Suzhou city have low percentage of dental caries and periodontal diseases.

English Abstract↗
PubMed2003

Vitamin D receptor alleles, periodontal disease progression, and tooth loss in the VA dental longitudinal study.

BACKGROUND: The relationship between the vitamin D receptor (VDR) genotype and periodontal disease is not known. This study compared periodontal disease progression among polymorphisms of 2 VDR genes in men in the VA Dental Longitudinal Study. METHODS: Subjects were 125 medically healthy, middle-aged men who had serial oral examinations over a mean 23-year period. Probing depth, gingival bleeding on probing, clinical attachment loss (CAL), and alveolar bone loss (ABL) from radiographs were measured at each examination. Progression of periodontal disease was defined as the percentage of teeth per decade that increased ABL by > or = 40%, and the percentage of teeth per decade that developed CAL > or = 5 mm. ApaI and TaqI polymorphisms were determined from buffy coat cells following polymerase chain reaction (PCR) amplification. Mean changes in oral status were adjusted for baseline values of smoking status, number of teeth present, and periodontal status by analysis of covariance. RESULTS: Genotype distributions were 41 AA, 58 Aa, 26 aa; and 53 TT, 46 Tt, 26 tt. The AA genotype showed the highest rates of progression of ABL (5 +/- 1% versus 1 +/- 1% and 2 +/- 1% teeth in Aa and aa, respectively; P = 0.03), CAL (37 +/- 4% versus 17 +/- 4% and 27 +/- 6% teeth; P = 0.004), and tooth loss (2 +/- 0.3 versus 1 +/- 0.3 and 1 +/- 0.4 teeth; P = 0.04). When genotype combinations were examined, progression of ABL, CAL, and tooth loss was highest in the AATT and AATt genotypes. CONCLUSIONS: The ApaI polymorphism of the VDR gene is associated with oral bone loss, clinical attachment loss, and tooth loss in older men. Analysis of the VDR alleles may prove useful for predicting periodontal disease.

Adult↗
PubMed1982

Tooth loss in 100 treated patients with periodontal disease. A long-term study.

A population of 100 patients with periodontal disease who had been treated and maintained for 15 years or longer was studied for tooth loss. The patients averaged 43.8 years of age and consisted of 59 females and 41 males. Patients were examined and their dental records were reviewed. On the basis of response to therapy and tooth loss, the patients were classified as Well-Maintained (77), Downhill (15), or Extreme Downhill (8). At the completion of initial treatment, 2,627 teeth were present. Of this number, during the maintenance period, 259 teeth (9.8%) were lost due to periodontal disease, while 40 teeth (1.5%) were lost due to other causes. Evaluation was made as to patterns of tooth loss, loss of questionable teeth, loss of teeth with furcations, surgical vs. nonsurgical therapy, and presence of fixed or removable prostheses. Considerable variation occurred between response groups. Periodontal disease appears to be bilaterally symmetrical and tooth loss response emulated this pattern with greatest loss of maxillary second molars and least loss of mandibular cuspids.

Adolescent↗
PubMed2003

Tobacco smoking and risk for periodontal disease.

OBJECTIVE: The magnitude of risk for periodontal disease associated with smoking was investigated by exploring the interrelationships between definition of disease, prevalence and relative risk in a population of dentally aware individuals. MATERIALS AND METHODS: A total of 133 smokers and 242 non-smokers in the age range 20-69 years served as the database. Criteria based on clinical probing of pocket depth and radiographic measurement of bone height were used for the purpose of disease definition. Various pocket frequency cutoff points for two probing depth levels, > or =5 and > or =6 mm, and, in addition, the 30th, 25th, and 20th percentiles of the bone height distribution were alternately selected as criteria. RESULTS: Disease definition had an impact on the prevalence, and the relative risk varied as a function of the prevalence. For a broad definition of disease such as 1% of pockets > or =5 mm, the prevalence for smokers was approximately twice the prevalence for non-smokers and the odds ratio (OR) was 3.0. A narrower definition such as 15% of pockets > or =5 mm resulted in decreased prevalences for both smokers and non-smokers and an OR of 12.1. Increasing exposures correlated with greater magnitudes of risk. Heavy exposure was associated with greater risk than light exposure. For the combination of a narrow disease definition and heavy exposure, the relative risk was considerable (OR 9.8-20.3). CONCLUSION: Smoking-associated relative risk is dependent on definition of disease and prevalence. Given other factors, a narrow definition will result in a low prevalence and a high risk and, vice versa, for a broader definition, prevalence will be high and the risk moderate.

Adult↗
PubMed1996

Epidemiology of periodontal diseases.

This review summarizes findings from 46 reports selected from over 130 epidemiologic studies published in 1993 and 1994. Recent findings from longitudinal studies are consistent with the concept that periodontal destruction proceeds in random bursts at specific sites and demonstrate that some individuals have an elevated risk of attachment loss. These and other studies provide further evidence that cigarette smoking is a significant risk factor. New studies have quantified the risk of tooth loss due to periodontal disease, and there is better knowledge about HIV-associated periodontal diseases. Familial studies suggest that both environmental and genetic factors contribute to individual variations in etiologic factors (such as plaque) and periodontal diseases. Several studies propose an intriguing link between periodontal diseases and coronary heart disease, which may be mediated through risk factors common to both diseases, and as a direct consequence of the contribution of periodontal bacteria and their products to atherosclerosis.

Arteriosclerosis↗
PubMed1975

Dental prophylaxis procedures in control of periodontal disease in Lucknow (rural) India.

Frequent professional scaling and regular tooth brushing are the main public health measures available for preventing and controlling periodontal disease but their frequency and efficacy are still incompletely understood. This investigation was carried out on 1,416 rural children and 189 factory workers in Lucknow area in the age groups 14 +/- 1, 17 +/- 1 and 28 +/- 2 years of age to evaluate the optimum requirement of these measures to the extent they will be economical and usable in the public health programs. The prevalence of gingivitis and periodontal disease in Lucknow children and adult samples was found to vary between 93 to 100%. Periodontal disease (including gingivitis and loss of attachment) and calculus accumulation showed considerable reduction (P less than 0.01) with any type of treatment. Scaling alone will not reduce the plaque formation for which regular tooth brushing is essential. Yearly and half-yearly scaling along with tooth brushing instructions will considerably improve and maintain the oral hygiene thereby reducing the prevalence and severity of periodontal disease, plaque, and calculus accumulations. However, more intensive measures (quarterly prophylaxis) will further improve the periodontal health and reduce calculus accumulation. The apical migration of the epithelial attachment can practically be stopped by rendering scaling half yearly, without any instructions in oral hygiene and elimination of dental plaque.

Adolescent↗
PubMedDate not supplied

[Double blind clinical study of local immunotherapy in treatment of periodontal diseases].

During a 3 weeks period, an immunotherapy by oral route was applied in patients presenting periodontal diseases (gingivitis and chronic adult periodontitis). This study, double blindly conducted, points out a statistically significative decrease of the main clinical symptoms of periodontal diseases (bleeding, erythema, oedema, pain, suppuration, fetidness) without any other local treatment and shows the interest of such a therapy in addition to the classical local treatments applied to patients presenting periodontal diseases.

Adjuvants, Immunologic↗
PubMed1989

Diabetes mellitus and periodontal disease in an Irish population.

The prevalence of periodontitis was studied in a population of 157 insulin dependent diabetes mellitus patients aged 8-78 years attending the outpatients diabetic clinic of a large general hospital in Cork, Ireland. Every third diabetic patient attending the clinic was selected for examination. The dental parameters measured were plaque index (PI), gingivitis index (GI), periodontal pocket depth (PD) and periodontal attachment loss (PAL). Diabetic control was measured by estimating percentage haemoglobin glycolysation (% Hb Alc) known duration of diabetes (KDD) and insulin dependence. It was found that none of the diabetic measurements showed any consistent pattern in relation to any of the periodontal measurements. The findings are in agreement with other studies which suggest that no significant correlation between diabetic parameters and periodontal disease can be demonstrated. When the diabetic patient suffered periodontitis it was due to factors (such as genetic predisposition) other than impaired glucose metabolism.

Adolescent↗