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Expression of T-cell receptor Vbeta2, 6 and 8 gene families in chronic adult periodontal disease.

Substantial evidence exists to suggest a role for T-cells in periodontal disease. As yet, however, the T-cell receptors remain to be characterised at the molecular level. The expression and the nucleotide sequence of genes from the T-cell receptor beta variable (TCRBV) gene families 2, 6 and 8 were analyzed in periodontal tissue from 24 patients with chronic adult periodontal disease (CAPD) and peripheral blood lymphocytes (PBL) of 16 of these patients. A restriction in the expression of these TCRBV gene families was detected in periodontal tissue from 14/24 patients with CAPD, and the pattern of gene expression was often different between individual patients; however there was no restriction in TCRBV gene expression in matched PBL samples from 8 of these 14 patients. Quantitative RT PCR analysis of samples from 5 CAPD patients who expressed all 3 TCRBV gene families in their periodontal tissues did not reveal any significant differences in the levels of gene expression in periodontal tissue and PBL. In contrast to the findings with some CAPD patients, genes from all 3 TCRBV families were always expressed in periodontal tissue and PBL from disease-free control subjects. PCR products from both the PBL and periodontal tissue of CAPD patients were cloned and sequenced; analysis of the nucleotide sequence revealed diversity with respect to the expression of TCRB joining (TCRBJ) and TCRB diversity (TCRBD) genes and the sequence of the junctional region in all samples analysed. In conclusion, in CAPD, the pattern of TCRBV gene expression in periodontal tissue is often but not always different from that in PBL and healthy periodontal tissue, which may indicate, in some cases, a local influence on particular T-cell subsets which is relevant to the pathogenesis of periodontal disease. However, the expressed TCRB genes are heterogeneous at the nucleotide level, emphasising the underlying complexity at the molecular level in the local T-cell response in CAPD.

Adult↗

Periodontal status and bruxism. A comparative study of patients with periodontal disease and occlusal parafunctions.

This study investigated a possible association between bruxism and severity of periodontal disease. Subjects consisted of 51 patients (mean age 47.3 years) referred to the Department of Periodontology for treatment of moderate to severe periodontal disease (Perio-group) and 40 patients (mean age 48.9 years) referred to the Department of Stomatognathic Physiology for treatment of symptoms related to bruxism (Bruxism-group). Examination of the two groups included measurements of the alveolar bone height, probing attachment level, tooth mobility, and attrition of teeth. A questionnaire was also used to gain information on the patient's awareness of bruxism and tooth mobility. Awareness of clenching and/or grinding was reported by 57% of patients in the Bruxism-group and 24% of patients in the Perio-group. The perio-patients reported significantly higher frequency of tooth mobility than did the bruxism-patients. Alveolar bone loss, attachment loss, and tooth mobility were significantly more pronounced in the Perio-group than in the Bruxism-group. The Bruxism-group showed a higher frequency of tooth attrition than the Perio-group. Periodontal disease and bruxism seldom occurred in the same individual, and the results indicate that the two phenomena are in general not closely associated.

Adult↗

[Is it possible for periodontal patients to recognize periodontal disease].

The purpose of this study was the evaluation of clinical symptoms of periodontal disease in a sample of adult periodontal patients, that were presented for periodontal treatment in the private clinics of the authors during a period of ten years. A questionnaire was designed for this reason which included questions related to gingival bleeding, gingival enlargement, tooth migration and tooth mobility. 330 questionnaires were evaluated from a total of 1175 consisting a representative sample. The results have showed that the clinical symptoms that directed patients to look for periodontal treatment were (a) gingival bleeding when brushing or spontaneously (74.78%), (b) tooth mobility (65.65%), (c) presence of gingival enlargement (60%) and (d) tooth migration (36.96%). Comparison between positive answers, in all questions in relation with the presence of the clinical symptoms of periodontal disease showed significant differences between men and women. Furthermore, women were presented for appropriate periodontal treatment with the presence of two symptoms while men with the presence of three. In conclusion gingival bleeding when brushing or spontaneously is a symptom that is easily evaluated by the patient--as the results of this study indicated--provided he knows its significance. Therefore, emphasis must be given in informing the patients regarding its significance.

Adult↗

Nucleoli of lymphocytes in the peripheral blood of patients with periodontal disease (preliminary report).

A group of 104 patients with various grades of severity of the periodontal disease and a control group of healthy volunteers were examined. On the basis of an examination of the nucleoli, the activity of the RNA synthesis in the lymphocytes of peripheral blood was established. Patients with a very advanced periodontal disease showed a statistically highly significant increase in the ratio of active and reversibly inactivated lymphocytes. Thus, the significance of immune factors in the development of the periodontal disease was confirmed.

Adolescent↗

Effect of periodic preventive care on the progression of periodontal disease in young adults with Down's syndrome.

OBJECTIVES: To examine the effect of periodic preventive care on the progression of periodontal disease in 24 young adults with Down's syndrome (DS) (mean age+/-SD: 20.8+/-5.6 years) MATERIAL AND METHODS: Subjects were divided into two groups: 13 subjects who had frequently visited our clinic (mean interval between visits: 3.7+/-1.3 months; managed group) and 11 subjects who had not visited our clinic for more than 1 year (mean duration of no visits: 27.5+/-10.1 months; interrupted group). The progression of periodontal disease in the subjects was evaluated clinically, microbiologically and roentgenologically. RESULTS: Clinical parameters (probing depth, frequency of the presence of a pathological periodontal pocket, alveolar bone loss, frequency of the incidence of pathological bone loss, and modified total PMA (M-PMA)) and benzoyl-DL-arginine-naphthylamide (BANA) scores in the interrupted group were significantly higher than those in the managed group. Subject age showed significant positive correlations with probing depth and alveolar bone loss. BANA scores showed significant positive correlations with probing depth, alveolar bone loss and M-PMA in the interrupted group. CONCLUSIONS: The results suggest that periodic preventive care is effective for suppressing the progression of periodontal disease in young adults with DS.

Adolescent↗

[The relationship between periodontal disease and osteoporosis in animals].

Osteoporosis is suspected as a potential risk factor in periodontal disease. However, the detailed relationship between these diseases is unclear. The particular models of laboratory animals for the both diseases are needed to clarify the interactive influence route. In this article, we introduce the animal models for both diseases, review the relationship between osteoporosis and periodontal disease in animals and report our laboratory study. The purpose of our study was to investigate the effect of an ovariectomy on the progression of experimental periodontitis in rats. Thirty female Sprague-Dawley rats as control, 30 sham-operated rats and 30 ovariectomized rats (OVX group) were included. In the maxillary molars of every rat, a nylon thread was ligated to induce experimental periodontitis. The results were as follows : at 6 and 12 weeks in the OVX group, the levels of bone mineral density (BMD) had decreased more significantly. The periodontal tissues in the OVX group showed a severer inflammation and alveolar bone resorption. From these results, it is suggested that the osteoporotic conditions may affect the progression of periodontal lesions in rats. It will be necessary to clarify with a molecular mechanism with the establishment of animal models in both diseases in the future.

Animals↗

[Early diagnosis of periodontal disease].

Early diagnosis is necessary if the prevalence of periodontal disease is to be brought under control. For periodontal screening in dental practice we propose to employ the C.P.I.T.N. system, combined with examination of two or four dental bite-wing radiographs. Both of these procedures can be accurately applied in general dental practice conditions. The screening is not time consuming and can yield very important diagnostic data.

Adult↗

Relationship between tooth irregularity and periodontal disease in children with regular dental visits.

OBJECTIVES: The aim of this study was to investigate any association between irregular teeth and periodontal breakdown among children who attend dental clinics regularly. METHODS: The subjects were 80 children (39 females and 41 males) with a mean age of 12.38 +/- 0.75 years. Each subject had an alginate impression in the mandibular arch, periapical radiographs for the lower incisor teeth and clinical examination for periodontal health. Plaque accumulation, gingival condition and probing depth, bone level and status of lower incisor teeth contact areas were recorded. Spearman correlation test was used to observe any relationship between the clinical variables. RESULTS: The average probing depth, gingival index and plaque index scores in the subjects studied were 1.3 +/- 0.25, 0.99 +/- 0.28 and 1.17 +/- 0.52 respectively. The average number of sites with labiolingual displacement with mesiodistal overlap was 1.81 +/- 1.30 and those without mesiodistal overlap was 1.39 +/- 1.10. The average number of contact areas with spacing was 0.59 +/- 1.23. The correlation observed between irregularity and periodontal health indicated no association between the number and type of displacement and plaque accumulation, gingivitis, attachment loss and alveolar bone level. CONCLUSION: There was no association between irregularity of teeth and periodontal diseases in presence of good oral hygiene.

Alveolar Bone Loss↗

Endocrinological status of patients with periodontal disease.

The aim of the present study was to determine whether changes in the endocrinologic status occur in patients with progressive forms of periodontal disease and, if so, what their role is. For this purpose the function of hypophysis, concentration of pituitary and accessory gland hormones, parathormone, calcium, phosphorous, glucose and lipids in blood were determined. The study was carried out in 77 subjects, 37 patients with advanced periodontal disease, and 40 control subjects with normal periodontium. Blood glucose was significantly lower in the study group (p < 0.01%) which was surprising, since increased glucose values are known to favor the development of periodontal disease. Growth hormone was significantly lower in the study group (p < 0.01%). Concentrations of parathormone calcium and phosphorous were also lower in the study group. Among sex hormones, only estradiol was found to have a significantly lower value in the study group (p = 0.92%). Although the values of nearly all hormones were within the reference range, the within-group analysis showed significant differences for some hormones. In general, these results were lower in subjects with advanced periodontal disease.

Adult↗

Natural history of periodontal disease in man. Rapid, moderate and no loss of attachment in Sri Lankan laborers 14 to 46 years of age.

This paper describes the initiation, rate of progress of periodontal disease and consequent tooth loss in a population never exposed to any programs or incidents relative to prevention and treatment of dental diseases. The group consisted of 480 male laborers at two tea plantations in Sri Lanka. The study design and baseline data have been published. At the initial examination in 1970, the age of the participants ranged between 14 and 31 years. Subsequent examinations occurred in 1971, 1973, 1977, 1982 and 1985. Thus, the study covers the age range 14-46 years. Throughout the study, the clinical indices were scored by the same two examiners, both well-trained and experienced periodontitis. Intra-examiner reproducibility for each index was tested at baseline and repeated periodically during the study. The data for each examination were computerized and updated on an ongoing basis. At the last examination in 1985, there were 161 individuals who had participated in the first survey. This population did not perform any conventional oral hygiene measures and consequently displayed quite uniformly large aggregates of plaque, calculus and stain on their teeth. Virtually all gingival units exhibited inflammation. Based on interproximal loss of attachment and tooth mortality rates, three subpopulations were identified: (1) individuals (approximately 8%) with rapid progression of periodontal disease (RP), those (approximately 81%) with moderate progression (MP), and a group (approximately 11%) who exhibited no progression (NP) of periodontal disease beyond gingivitis. At 35 years of age, the mean loss of attachment in the RP group was approximately 9 mm, the MP group had approximately 4 mm and the NP group had less than 1 mm loss of attachment. At the age of 45 years, the mean loss of attachment in the RP group was approximately 13 mm and the MP group approximately 7 mm. The annual rate of destruction in the RP group varied between 0.1 and 1.0 mm, in the MP group between 0.05 and 0.5 mm, and in the NP group between 0.05 and 0.09 mm. Since this population was virtually caries free, essentially all missing teeth were lost due to periodontal disease. In the RP group, tooth loss already occurred at 20 years of age and increased throughout the next 25 years. At 35 years of age, 12 teeth had been lost, at 40 years of age 20 teeth were missing and at 45 all teeth were lost. In the MP groups, tooth mortality started after 30 years of age and increased throughout the decade.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Salivary matrix metalloproteinase-8 in patients with and without coronary heart disease may indicate an increased susceptibility to periodontal disease.

BACKGROUND AND OBJECTIVE: Tissue destruction caused by periodontitis may increase the number of cytokines implicated in the pathogenesis of cardiovascular diseases. We measured the concentration of the leukocyte-derived proteolytic enzyme, salivary neutrophil collagenase-2 [matrix metalloproteinase-8 (MMP-8)], as a marker of periodontal disease and assessed its relationship to coronary heart disease (CHD). Our aim was to study whether salivary MMP-8 levels were different among patients with and without CHD. The hypothesis was that patients with heart disease might present higher salivary MMP-8 levels than cardiologically healthy controls. MATERIAL AND METHODS: Saliva samples were taken from 256 patients with CHD and from 250 matched controls with known oral and general health status. The MMP-8 levels in saliva were analyzed by immunofluorometric assay, salivary albumin was assessed by enzyme-linked immunosorbent assay (ELISA) and total protein was determined using the colorimetric method. We further investigated the molecular forms and isoform distribution of salivary MMP-8 by western immunoblotting. The MMP-8 results were adjusted for the number of teeth and salivary protein concentrations. RESULTS: The adjusted logarithmic MMP-8 values were 0.145 +/- 0.245 microg/l in patients with CHD and 0.088 +/- 0.115 microg/l in controls (p < 0.01). The respective MMP-8 : total protein and MMP-8 : albumin ratios were also significantly higher in CHD patients than in non-CHD subjects. CONCLUSION: Elevated salivary MMP-8 levels seemed to associate with CHD, suggesting more tissue breakdown as a result of periodontitis among the patients with heart disease.

Analysis of Variance↗

An investigation into the association among preterm birth, cytokine gene polymorphisms and periodontal disease.

OBJECTIVE: To investigate a putative relationship between preterm delivery and the carriage of polymorphic genes that code for the cytokines interleukin-1beta (IL-1beta) at codon +3953 and tumour necrosis factor-alpha (TNF-alpha) at codon -308 in a group of postpartum women and to elucidate if the concurrent presence of periodontal disease increased the risk of preterm delivery in this group. DESIGN: Case-control study SETTING: Postnatal wards at Guy's and St Thomas' Hospital Trust. POPULATION: Postpartum women from southeast London, UK. METHODS: Case subjects were defined as those who experienced a birth at less than 37 weeks of gestation. Control subjects gave birth at term. Demographic data were collected and a periodontal examination was performed. Blood samples were collected and analysed by restriction fragment length polymerase techniques for the presence of each of the allelic variants. MAIN OUTCOME MEASURES: The level of periodontal disease and the carriage of allelic variants of IL-1beta+3953 and TNF-alpha-308 genes. RESULTS: Forty-eight case subjects and 82 control subjects were assessed. There was no statistically significant difference in the carriage of the IL-1beta+3953 allelic variant between cases and controls (29%versus 18%, P= 0.112). However, 23 (48%) of the case subjects and 24 (29%) of controls were heterozygous or homozygous for the variant TNF-alpha-308 gene (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.0-5.0, P= 0.026). There was no association between the carriage of either the polymorphic IL-1beta+3953 or TNF-alpha-308 variant and the severity of periodontal disease. The combination of periodontal disease and the allelic variant did not increase the risk of preterm delivery. CONCLUSIONS: In this study, a higher proportion of women who delivered preterm carried the polymorphic TNF-alpha-308 gene. There did not appear to be any interaction between either of the genotypes and periodontal disease with preterm delivery as has been reported for bacterial vaginosis and the TNF-alpha-308 polymorphic gene.

Adult↗

Systemic disorders in patients with periodontal disease.

BACKGROUND, AIMS: Over the past 10 years several studies have been published pointing towards a relationship between periodontal disease and various systemic disorders or diseases. The purpose of this retrospective study was to investigate the occurrence of self-reported systemic disorders in patients referred to a specialist clinic for periodontal treatment and to explore possible relationships between general health and periodontal disease severity in this population. MATERIAL AND METHODS: Data were collected from the dental records and the health questionnaires of 1006 subjects. Stepwise multiple linear regression analyses were adopted to calculate correlations between systemic disorders as independent variables and number of remaining teeth and the relative frequency of periodontal pockets of 5 mm or more, respectively, as the dependent variable. RESULTS: The number of remaining teeth was significantly and positively correlated to the presence of cardiovascular disease, diabetes and rheumatoid disease after adjustment for age, sex and smoking. The relative frequency of diseased sites, however, was not significantly correlated to any one of the investigated systemic health disorders. CONCLUSION: No significant associations between investigated systemic disorders and periodontal disease severity were found if the relative frequency of deep periodontal pockets was used as the clinical parameter for periodontal disease severity. However, cardiovascular disease, diabetes and rheumatoid disease were found to be significantly correlated to number of lost teeth, which may represent one aspect of periodontal health. This result held true in nonsmokers only.

Adult↗

Multifactorial assessment of predictors for prevention of periodontal disease progression.

Univariate approaches have identified single factors influencing periodontal disease progression. The aim of this explorative approach was to assess the influence of various predictive factors responsible for the prevention of periodontal disease progression in the same patient sample. Patients with untreated chronic periodontitis underwent subgingival debridement alone or in combination with adjunctive antimicrobial therapy (systemic amoxicillin and metronidazole/7 days plus supragingival CHX irrigation). Supportive periodontal therapy was performed over a 24-month period. As predictors, clinical, microbial, immunological, and genetic parameters were assessed. The primary outcome variable was the percentage of teeth without attachment loss >/=2 mm over the study period (stability of attachment). At 24 months, multiple regression analysis identified adjunctive antimicrobial therapy for teeth with initially at least one site showing a pocket probing depth of >/=7 mm and IgG(4) reactivity against a 110-kDa protein of A. actinomycetemcomitans at teeth with initial pocket probing depths </=6 mm as main predictors of long-term attachment stability ( p<0.05). Other parameters failed to influence treatment outcome. Adjunctive antimicrobial therapy and antibody reactivity may be dominant factors influencing the prevention of attachment loss in patients receiving periodontal therapy.

Adult↗

The periodontal disease problem. A comparison between industrialised and developing countries.

There is no reason to believe that periodontal diseases in industrialised and developing countries are in principle different. That is, not in the sense that the problem is caused by a different set of periodontal diseases, with different micro-organisms and a different natural history, needing a different approach towards prevention and treatment. Indeed, from a public health perspective the relative similarities in periodontal conditions around the world are far more striking than the differences. The view that periodontal diseases are a much more prevalent and a severe problem in the developing countries seems to be true only in terms of poorer oral hygiene and considerably greater calculus retention, already at a young age, but not so clear for periodontal destruction in adults.

Adolescent↗

Tumour necrosis factor alpha in gingival crevicular fluid as a possible indicator of periodontal disease in humans.

The suitability of using the cytokine TNF as an indicator of periodontal disease was assessed. Gingival crevicular fluid was collected from 162 sites on filter strips and analysed for TNF by ELISA. About 21% of the sites contained TNF: the amount recovered per site ranged from 0.2 to 998.8 fmol with a median value of 3.7 fmol. The periodontal disease status of each site was documented by recording the gingival and plaque indices, and by measuring pocket depth. About 62% of TNF-containing sites had a gingival index of 1, 76% had a plaque index of 0 or 1, and 47% had pockets of 3 mm or less. When the periodontal status of sites with and without TNF was compared by chi 2 analysis, no significant differences were found. These findings suggest that TNF may be found in sites prior to clinically observable disease and therefore may prove to be a suitable indicator for periodontal disease.

Enzyme-Linked Immunosorbent Assay↗