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PubMed2004

Immunohistochemical analysis of soft tissues in implants with healthy and peri-implantitis condition, and aggressive periodontitis.

Today, implant-supported prostheses are widely accepted as a reliable treatment modality, but failures in longitudinal studies have been shown. In some cases, peri-implantitis with a progressive periodontal bone loss takes place, and mechanical or load factors and biological or plaque-induced lesions have been claimed as main etiologic factors. We compared five cases of peri-implantitis, with five cases of healthy peri-implant tissues and five cases of aggressive periodontitis in order to give new findings on the osseointegration loss process. Biopsy specimens from the peri-implant tissues including oral (O), sulcular, and junctional epithelium and the underlying and supracrestal connective tissue, were taken in all cases for histological and immunohistochemical analysis. T lymphocytes were the most prominent cell in the peri-implantitis (PG) and aggressive periodontitis (AG) groups, but not in the peri-implant healthy group (HG). CD1a-positive cells (Langerhans and immature dendritic cells) were observed more frequently in the O than in the sulcular-junctional (S-J) epithelium: they were located in the basal and parabasal layers, without any differences between the three groups. Vascular proliferation analysed by immunoreactivity for CD34, Factor VIII, and vascular endothelial growth factor was more prominent in the PG comparing with HG and AG in the S-J area. Apoptosis, analysed by bcl2 and p53 immunoreactivity, was similar in the three groups. In conclusion, we suggest that the osseointegration loss process is due to an inflammatory process similar to that observed in aggressive periodontitis according to the number of T lymphocytes, but not to the vascular proliferation.

Adolescent↗
PubMed2004

Relative proportions of T-cell subpopulations and cytokines that mediate and regulate the adaptive immune response in patients with aggressive periodontitis.

BACKGROUND: Both the virulence factors of periodontopathic bacteria and the immune response against them have been involved in tissue destruction observed in periodontal disease. Considering the regulatory role of cytokines produced by T cells, the purpose of this study was to compare the CD3+, CD4+, and CD8+ subpopulations of T cells, and to characterize the mRNA of cytokines involved in the adaptive immune response in a group of healthy/gingivitis 1 (HI/G1) individuals and aggressive periodontitis (AgP) patients. METHODS: The percentages of T-cell subpopulations were analyzed in 10 gingival samples of HI/G1 individuals and 10 gingival samples of AgP patients by immunohistochemistry. The presence of interleukin (IL)-2, interferon (IFN)-gamma, IL-4, IL-5, IL-10, IL- 13, and transforming growth factor (TGF)-beta was measured by reverse transcription polymerase chain reaction (RT-PCR) of mRNA extracted from complete gingival biopsies. RESULTS: Significant differences were found in CD3+ and CD4+ cell counts between both groups. The parameters were lower in the gingival biopsies from AgP patients while CD8+ counts were similar in both groups. The cytokine mRNA analysis showed constant expression of IL-2 and IFN-gamma in all cases. The mRNA of IL-5 and IL-10 was present in the majority of HI/G1 (N = 10, N = 9, respectively) but was not in the AgP group (N = 2, N = 1). IL-13 and TGF-beta were only detected in HI/G1 (N = 2, N = 3) and IL-4 was not detected in any of the individuals. CONCLUSIONS: These results indicate that the role of the CD8+ subpopulation in aggressive periodontitis lesions is limited. On the other hand, cytokines IL-2 and IFN-gamma may not be relevant in the progression of aggressive periodontitis.

Alveolar Bone Loss↗
PubMed2005

Implants in regenerated bone in patients treated for generalized aggressive periodontitis: a prospective longitudinal study.

The aim of this prospective longitudinal study of patients treated for generalized aggressive periodontitis (GAP) was the clinical, microbiologic, and radiologic longitudinal evaluation of implants placed into bone regenerated by the guided bone regeneration (GBR) technique. Ten patients with GAP who had lost either one or two maxillary incisors or premolars through periodontal disease and whose alveolar bone was neither high nor wide enough for implant placement were enrolled in the study. GBR was carried out in a two-stage procedure using titanium-reinforced extended polytetrafluoroethylene membranes and titanium screws. No bone graft or bone substitute materials were used. After 6 to 8 months, the membranes and supporting screws were removed, and a total of 15 implants (Nobel Biocare) were placed. The control group comprised 10 periodontally healthy patients who had a total of II implants (Nobel Biocare) placed in the maxilla (incisor and premolar region) without GBR because of aplasia, trauma, or endodontic lesions. All patients were examined 2 to 4 weeks before extraction of the nonretainable teeth (baseline) and again immediately after placement of the superstructure. Further examinations were performed within the framework of a 3-month recall schedule over a 3-year period. At each session, clinical parameters (probing pocket depths, bleeding on probing, gingival recession, clinical attachment level, Gingival Index, and Plaque Index) were recorded at teeth and implants, and the composition of the subgingival microflora was determined by dark-field microscopy and DNA probe. Intraoral radiographs were taken for control purposes at baseline, immediately after insertion of the superstructure, and 1 and 3 years later. The GBR technique yielded a horizontal and vertical bone gain of 4.5 to 7.0 mm in the GAP patients. The clinical, microbiologic, and radiologic findings indicated healthy periodontal and periimplant conditions in both patient groups throughout the study. However, a slightly increased attachment loss (0.65 mm) and bone loss (1.78 mm) were recorded at the implants in the regenerated bone after 3 years of loading. The 3-year implant survival rate was 100% in both groups. The possibility of continuous attachment loss and bone loss occurring at teeth and implants in regenerated bone cannot be ruled out in patients treated for aggressive periodontitis. The prognosis for the retention of the teeth and implants is thus open to question.

Adult↗
PubMed2000

Parameter on aggressive periodontitis. American Academy of Periodontology.

The American Academy of Periodontology has developed the following parameter on the treatment of aggressive periodontitis. Patients should be informed of the disease process, therapeutic alternatives, potential complications, expected results, and their responsibility in treatment. Consequences of no treatment should be explained. Failure to treat aggressive periodontitis appropriately can result in progressive and often rapid loss of periodontal supporting tissues. This may have an adverse effect upon prognosis and could result in tooth loss. Given this information, patients (or their parents or guardians, as appropriate) should then be able to make informed decisions regarding their periodontal therapy.

Aggregatibacter actinomycetemcomitans↗
PubMed2006

Early colonization of non-submerged dental implants in patients with a history of advanced aggressive periodontitis.

The aim of the study was to evaluate the early colonization of non-submerged implants over a 6-month period in partially edentulous patients treated for advanced aggressive periodontal disease. In 22 patients treated for advanced aggressive periodontitis and in a supportive maintenance program for a period between 12 and 240 months at implant surgery, a total of 68 non-submerged dental implants were installed. Patients had a plaque score below 20%, and less than 20% of the pockets around the teeth were bleeding on probing (BOP). Using DNA-probes (micro-IDent), the presence and concentration of five periodontal pathogens (Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythensis (Tf) and Treponema denticola (Td)) were determined in the five deepest pockets of the rest dentition pre-operatively and after 6 months as well as five places around each implant 10 days, 1 month, 3 months and 6 months after surgery. In each patient, a test to determine the genotype interleukin-1 (IL-1) was performed (PST - micro-IDent). After 6 months, no difference in microbial composition as compared with baseline was found around the teeth in five patients, in 12 minute differences and in five patients important differences were observed. Ten days after surgery, three patients had a complete similar bacterial composition between teeth and implants. In 14 patients, the composition was fairly similar, while large differences in composition and concentration occurred in five patients. This microbiota around the implants remained almost unchanged over a 6-month period and did not hamper the clinical and radiographic osseointegration and did not lead to peri-implantitis, mucositis or initiation of bone destruction.

Adult↗
PubMed2006

Prognostic factors in the treatment of generalized aggressive periodontitis: II. Effects of smoking on initial outcome.

AIMS: The aim of this study was to investigate the effects of smoking on the response to non-surgical treatment for aggressive periodontitis. METHODS: Seventy-nine patients with generalized aggressive periodontitis were included in the study; 20 were smokers. All patients received a course of non-surgical periodontal therapy and outcomes assessed 10 weeks post-operatively. Non-responding patients were designated if they had 30% or more non-responding deep sites. RESULTS: At baseline, bleeding scores were lower in smokers. There was no difference in baseline plaque, pocket depth (PD), recession or clinical attachment levels (CALs); when sites were selected by equal levels of CAL, increased recession was seen in smokers. Outcomes were poorer in smokers (mean PD change 1.75+/-0.56 versus 2.23+/-0.87 mm). The odds ratio for 30% of sites not responding in smokers was 2.9; for 40% non-responding it was 5.9. Smoking altered the distribution of site-specific responses to increase specifically the number of non-responding sites. There was no significant difference in responses between ex-smokers and never-smokers. CONCLUSIONS: The results demonstrate that smoking is a major risk factor for poor response to initial treatment and emphasize the importance of smoking cessation in periodontal therapy.

Adult↗
PubMed2006

Clinical and microbiological effects of different antimicrobials on generalized aggressive periodontitis.

AIM: To evaluate and compare the effects of adjunctive metronidazole plus amoxicillin, doxycycline and metronidazole on clinical and microbiological parameters in patients with generalized aggressive periodontitis. MATERIAL AND METHODS: Forty-three patients participated in this randomized clinical trial divided into four groups. Six weeks after scaling and root planning (SRP), groups 1-3 received adjunctive metronidazole, plus amoxicillin, doxycycline and metronidazole respectively, and group 4 acted as controls. Clinical recordings concerning probing depth, probing attachment level and bleeding on probing were performed at baseline, 6 weeks after SRP and 6 months from baseline. Subgingival samples were analysed using the 'checkerboard' DNA-DNA hybridization for Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Tannerella forsythia and Treponema denticola. RESULTS: All treatments resulted in improvement of clinical parameters (ANOVA p > 0.05). Systemic administration of metronidazole plus amoxicillin or metronidazole resulted in statistically significant greater reduction of the proportion of sites > 6 mm than SRP (z-test, p < 0.05). These antimicrobials yielded a significant effect on levels of important periodontal pathogens for 6 months. CONCLUSION: Adjunctive metronidazole plus amoxicillin or metronidazole alone (when A.actinomycetemcomitans is not involved) is effective in deep pockets of aggressive periodontitis patients.

Adult↗
PubMed2003

Localized aggressive periodontitis is linked to human chromosome 1q25.

Localized aggressive periodontitis (LAP; previously known as localized juvenile periodontitis) is one of the rapidly progressive periodontal diseases. Certain forms of familial LAP show a simple Mendelian pattern of transmission. However, no gene mutation has been identified to be responsible for the LAP phenotype. As an initial step to identify a gene mutation associated with LAP, we have performed genetic linkage analysis with four multigenerational families exhibiting the LAP phenotype. Affected individuals in the families were identified based on clinical and laboratory criteria in an attempt to define a homogeneous phenotype, since the clinical presentation of LAP may represent a manifestation of a heterogeneous group of diseases. The LAP phenotype is linked to a DNA marker, D1S492, with LOD score 3.48, theta=0.00. The haplotype analysis of the chromosome interval associated with D1S492 indicates that a LAP locus is located between D1S196 and D1S533 on chromosome 1, covering about 26 million DNA basepairs. We have also examined the DNA sequence of prostaglandin-endoperoxide synthase 2 (PTGS2 or cyclooxygenase 2, COX2) since prostaglandin 2 (PGE2), the product of COX2, is upregulated in LAP patients and COX2 is located between D1S196 and D1S533. No mutation in COX2 was identified in the patients.

Base Sequence↗
PubMed2003

Evaluation of human leukocyte N-formylpeptide receptor (FPR1) SNPs in aggressive periodontitis patients.

Polymorphonuclear neutrophils (PMNs) are attracted to sites of infection by N-formylpeptide (fMLP) chemoattractants. The high-affinity fMLP receptor (FPR1) of phagocytic cells interacts with bacterial fMLP and mediates chemotaxis, degranulation, and superoxide production. These cellular functions are disrupted in PMN from aggressive periodontitis (AP) patients. Two FPR1 gene single nucleotide polymorphisms (SNPs), c.329T>C and c.378C>G, have been associated with a localized form of AP in African-American patients. To evaluate the generality of these SNPs in AP patients, we sequenced a 363 bp interval of the FPR1 gene in an ethnically diverse group of patients (n=111) and controls (n=115). Neither c.329T>C nor c.378C>G were detected in the 452 alleles sequenced. Six SNPs were identified including two located in the FPR1 second extracellular loop that were significantly associated with the AP phenotype in African-American patients (p.R190W, P=0.0033; and p.N192K, P=0.0018). These two SNPs show three predominant haplotypes, each associated with a different disease risk in African-Americans. These data do not support the hypothesis that the FPR1 SNPs c.329T>C and c.378C>G play an etiologic role in aggressive periodontitis, but do suggest that SNPs in the second extracellular loop may be etiologically important.

Black or African American↗
PubMed2003

Bioabsorbable membrane and bioactive glass in the treatment of intrabony defects in patients with generalized aggressive periodontitis: results of a 12-month clinical and radiological study.

BACKGROUND: Guided tissue regeneration can be achieved using membranes. In recent years, some evidence has been provided that bioactive glass is also capable of supporting the regenerative healing of periodontal lesions. The aim of this clinical and radiological prospective study was to compare the effectiveness of a bioabsorbable membrane and a bioactive glass in the treatment of intrabony defects in patients with generalized aggressive periodontitis. METHODS: Twelve patients (9 females, 3 males) with generalized aggressive periodontitis were enrolled in the study. The investigations were confined to 1- to 3-walled intrabony defects with a depth > or = 4 mm and with preoperative probing depths > or = 7 mm. Teeth with furcation involvement were excluded. Fifteen of the total 30 defects were treated with the membrane (RXT group) and 15 with the bioactive glass (PG group). Allocation to the groups was randomized. The clinical parameters plaque index (PI), gingival index (GI), probing depth (PD), bleeding on probing (BOP), gingival recession (GR), clinical attachment level (CAL), and mobility were recorded prior to surgery as well as 6 and 12 months after surgery. Intraoral radiographs were taken in standardized paralleling technique at baseline and 12 months after the surgery. Following digitization, changes in the distances from the alveolar crest (xCA) to the defect base (xBD) and from the CEJ (xCEJ) to the xCA were determined. Statistical analysis was based on Kolmogorov-Smirnov test, Wilcoxon signed-ranks test, analysis of covariance, and Spearman's bivariate correlation analysis. RESULTS: After 12 months, a reduction in PD of 4.0 +/- 2.1 mm (P < 0.001) and a gain in CAL of 3.4 +/- 2.3 mm (P < 0.001) was registered in the RXT group. There was a slight increase in GR by 0.6 +/- 1.5 mm (P = 0.074). In the PG group, a reduction in PD of 3.8 +/- 1.9 mm (P < 0.001) and a gain in CAL of 2.8 +/- 1.9 mm (P < 0.001) was recorded, whereas GR increased by 1.0 +/- 1.4 mm (P = 0.007). The 6-month results did not differ significantly from the stated values. Radiographically, the defects (xCA to xBD) were found to be filled by 57.2 +/- 33.5% (P = 0.001) in the RXT group and by 50.5 +/- 22.8% (P = 0.001) in the PG group. Crestal resorption (xCEJ to xCA) was 6.1 +/- 34.5% (P = 0.910) in the RXT group and 15.1 +/- 39.7% (P = 0.433) in the PG group. Only the change in gingival recession after 12 months was significantly greater (P = 0.031) in the PG group, with -1.0 +/- 1.4 mm, compared to the RXT group, with -0.6 +/- 1.5 mm. Changes in the other clinical and radiological parameters showed no significant differences. The attachment gain correlated negatively with the preoperative PI (r = -0.574; P = 0.004) and with BOP after 6 months (r = -0.315; P = 0.021). CONCLUSIONS: Highly significant improvements in the parameters PD, CAL, and xCA-xBD were recorded after 6 and 12 months, respectively, with both regenerative materials. A good standard of oral hygiene and inflammation-free periodontal tissue in the postoperative phase improved the treatment outcome.

Absorbable Implants↗
PubMed2003

Prevalence of human herpesviruses in patients with aggressive periodontitis.

BACKGROUND: Recent studies have demonstrated that various human viruses, especially cytomegalovirus (HCMV) and Epstein-Barr virus type-1 (EBV-1), seem to play a part in the pathogenesis of human periodontitis. The aim of this investigation was to evaluate the subgingival presence of HCMV and EBV in patients with aggressive periodontitis (AgP) and healthy subjects and to examine the effect of treatment on the incidence of these viruses 3 months following surgery. METHODS: A polymerase chain reaction (PCR) method determined the presence of HCMV and EBV-1. Subgingival plaque samples from 17 consecutive AgP patients and 16 healthy controls were collected. The following indices were measured: plaque index (PI), gingival index (GI), probing depths (PD), and clinical attachment loss (CAL). Clinical parameters were assessed pretherapy and at 3 months following surgical and antimicrobial therapy. RESULTS: HCMV was detected in 64.7% of AgP patients but not detected in healthy subjects (P < 0.001) and EBV-1 in 70.6% of AgP patients and 6.3% of the healthy controls (P < 0.001). HCMV and EBV-1 coinfection was detected in 41.7% of AgP patients. A statistically significant decrease was found in all clinical parameters 3 months after treatment. There was a statistically significant decrease in HCMV and EBV-1 following therapy (P < 0.001; no HCMV; 1 patient with EBV-1). CONCLUSIONS: These findings indicate that subgingival presence of EBV-1 HCMV is strongly associated with aggressive periodontitis, and coinfection with HCMV and EBV-1 appears to be particularly deleterious to periodontal health.

Adolescent↗
PubMed2006

Bioabsorbable membrane and bioactive glass in the treatment of intrabony defects in patients with generalized aggressive periodontitis: results of a 5-year clinical and radiological study.

BACKGROUND: The aim of this clinical and radiological prospective 5-year study was to compare the long-term effectiveness of a bioabsorbable membrane and a bioactive glass in the treatment of intrabony defects in patients with generalized aggressive periodontitis. METHODS: Sixteen patients (11 women and five men) with generalized aggressive periodontitis were enrolled in the study. The investigations were confined to 1- to 3-walled intrabony defects with a depth >/=4 mm and with preoperative probing depths (PDs) >/=7 mm. Teeth with furcation involvement were excluded. Twenty-two of the defects were treated with the membrane (RXT group) and 20 with the bioactive glass (PG group). Allocation to the two groups was randomized. The clinical parameters plaque index (PI), gingival index (GI), PD, bleeding on probing (BOP), gingival recession (GR), clinical attachment level (CAL), and tooth mobility were recorded before surgery and at 6 months and every year for 5 years after surgery. Intraoral radiographs were taken using a standardized paralleling technique at baseline and every year for 5 years. Statistical analysis was based on Kolmogorov-Smirnov and Wilcoxon signed-rank tests, analysis of covariance, and Spearman's bivariate correlation analysis. RESULTS: After 5 years, a reduction in PD of 3.6 +/- 0.8 mm (P = 0.016) and a gain in CAL of 3.0 +/- 2.0 mm (P = 0.01) were registered in the RXT group. There was a slight increase in GR by 0.6 +/- 1.4 mm (P = 0.334). In the PG group, a reduction in PD of 3.5 +/- 1.4 mm (P = 0.01) and a gain in CAL of 3.3 +/- 2.1 mm (P = 0.01) were recorded, whereas GR increased by 0.2 +/- 1.7 mm (P = 0.525). The 1-, 2-, 3-, and 4-year results did not differ significantly from the 5-year results. Radiographically, the defects (the point on the proximal surface of the defective tooth at which the projected alveolar crest intersected the root surface [xCA] to the most coronally located point at the proximal surface of the tooth on the defect side up to which the periodontal ligament space still displayed a uniform width [xBD]) were found to be filled by 47.5% +/- 38.3% (P = 0.001) in the RXT group and by 65.0% +/- 50.5% (P = 0.001) in the PG group. Crestal resorption (the most apical point of the enamel at the proximal surface of the tooth on the defect side [xCEJ] to the xCA) was 19.0% +/- 30.2% (P = 0.374) in the RXT group and 12.3% +/- 38.6% (P = 0.647) in the PG group. The xCEJ to the xBD was significantly more in the PG group (28.4 +/- 24.6 versus 7.3 +/- 21.8, P = 0.048). A good standard of oral hygiene and inflammation-free periodontal tissue in the postoperative phase improved the treatment outcome. No dependence of attachment gain was found on the tooth type, number of walls involved in the defects (r = 0.075; P = 0.319), or intraoperative depth (r = 0.114; P = 0.307). CONCLUSIONS: Highly significant improvements in the parameters PD and CAL were recorded after 5 years with both regenerative materials. Radiographically, the defects (the xCED to the xBD) were found to be filled significantly more in the bioactive glass group. A good standard of oral hygiene and inflammation-free periodontal tissue in the postoperative phase improved the treatment outcome.

Absorbable Implants↗
PubMed2003

The use of tetracycline fibres in the treatment of generalised aggressive periodontitis: clinical and microbiological findings.

The purpose of the present study was to evaluate the effects of tetracycline fibres (TCF) as an adjunct to scaling in the treatment of generalised aggressive periodontitis and to compare the effects with mechanical treatment only. Ten patients, 24-39 years old referred for treatment to the Department of Preventive Dentistry, Periodontology and Implant Biology, Aristotle University of Thessaloniki took part in the study. A split-mouth experimental design was used. Measurements referring to bleeding on probing (BOP), pocket depth (PD) and clinical attachment level (CAL) were performed at 12 sites randomly selected. Clinical recordings were made at baseline, 2 and 6 months, after treatment. Subgingival plaque samples were taken for microbiological analysis using the 'checkerboard' DNA-DNA hybridisation technique at baseline, immediately after treatment and at 2 and 6 months. Full-mouth scaling and root planing were performed, with the exception of 2 pre-selected sites, which served as controls. Tetracycline fibres were applied in 5 pockets located in the same half mouth. Analysis of clinical findings showed that mechanical instrumentation in combination with TCF application led to a greater improvement in clinical parameters than scaling and root planing only. Microbial analysis showed a statistically significant greater reduction in the percentages of detection for B. forsythus, P. nigrescens and A. naeslundii genospecies II in pockets where tetracycline fibres were applied. In conclusion, the clinical and microbiological data of the present study suggest that the adjunctive use of TCF improves the clinical response of scaling and root planing in aggressive periodontitis patients.

Actinomyces↗
PubMed2006

Gingival crevicular fluid levels of calprotectin and myeloperoxidase during therapy for generalized aggressive periodontitis.

BACKGROUND: Levels of the inflammation marker calprotectin in gingival crevicular fluid correspond to clinical and biochemical parameters of periodontal inflammation. Neutrophil granulocytes (polymorphonuclear neutrophils: PMNs) are supposed to be the main source of calprotectin in gingival crevicular fluid, but evidence is still lacking. The influence of periodontal therapy on gingival crevicular fluid levels of calprotectin has not yet been determined. OBJECTIVES: Gingival crevicular fluid levels of calprotectin were monitored during therapy for generalized aggressive periodontitis. Interrelations between calprotectin and the PMN marker myeloperoxidase (MPO) were evaluated. MATERIAL AND METHODS: Gingival crevicular fluid samples were collected from 23 patients with generalized aggressive periodontitis before and 3 months after non-surgical therapy with an adjunctive antimicrobial medication. Clinical parameters were recorded with a pressure-calibrated electronic probe. Levels of calprotectin and MPO in gingival crevicular fluid were analysed by enzyme-linked immunosorbent assay (ELISA) procedures. RESULTS: At baseline, levels of calprotectin and MPO were highly correlated. Bleeding and suppurating sites showed significantly higher levels of calprotectin and MPO than non-bleeding, non-suppurating sites. Therapy significantly decreased levels of both biomarkers. These changes of calprotectin and MPO were highly correlated and also related to probing-depth reduction. Three months after therapy, the levels of both markers still showed significant correlations in initially deep sites, whereas in initially shallow sites no significant correlation was found. After therapy, levels of markers in bleeding and non-bleeding sites were comparable. CONCLUSION: The correlations between calprotectin and MPO indicate that PMNs are a major contributor to the calprotectin content in gingival crevicular fluid of severely affected sites. Calprotectin levels in gingival crevicular fluid and their changes reflect periodontal inflammation as well as the clinical treatment outcome. A prognostic potential of this marker substance remains to be determined.

Adult↗
PubMed2005

[Interleukin-1 polymorphisms in patients with aggressive periodontitis].

PURPOSE: To study whether interleukin-1 (IL-1) genotypes and/or alleles were associated with aggressive periodontitis (AgP). METHODS: Anti-coagulated peripheral blood samples were obtained from 122 AgP patients and 95 healthy controls. Genomic DNA was extracted from each sample. Single nucleotide polymorphisms (SNPs) at IL-1A +4845 and IL-1B +3954 were analyzed by standard polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. The polymorphism of a variable number tandem repeat (VNTR) in intron 2 of IL-1RN was detected by PCR amplification and fragment size analysis. The genotypes and/or alleles distribution differences between two groups were analyzed by logistic regression analysis. RESULTS: The frequencies of A2+ genotype and allele 2 at IL-1A +4845 were significantly increased in male AgP patients compared with male controls (genotype: 18.0% vs 4.3%, adjusted OR=5.58, 95% CI=1.09-28.68, P=0.039; allele: 9.0% vs 2.2%, adjusted OR=4.97, 95% CI=1.01-24.50, P=0.049). CONCLUSIONS: The IL-1A +4845 polymorphism may be associated with AgP susceptibility in Chinese males.

Aggressive Periodontitis↗
PubMed2001

Local versus systemic adjunctive antibiotic therapy in 28 patients with generalized aggressive periodontitis.

BACKGROUND: Although the use of systemic antibiotics has been studied in patients with generalized aggressive periodontitis (formerly rapidly progressive periodontitis), the use of adjunctive tetracycline fibers in these patients has not been reported. The purpose of the present study was to compare the clinical response of local versus systemic antibiotic treatment as adjuncts to scaling and root planing in patients with GAgP. METHODS: After initial therapy and full-mouth scaling and root planing (SRP), 30 patients were randomly assigned to 1 of 2 antibiotic treatment groups. Probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded with an automated probe prior to SRP at baseline (BL) and 15, 30, 41, and 54 weeks later. Three months after SRP, the patients were treated with amoxicillin/clavulanic acid (500 mg tid; SRP + AUG group) or with local tetracycline fiber in pockets with PD > or =5 mm (SRP + TCF group). RESULTS: In both treatment groups, PD decreased significantly from BL to week 54 (6.2+/-1.5 mm to 4.7+/-1.4 mm for SRP + TCF and 6.5+/-1.4 mm to 4.2+/-0.6 mm for SRP + AUG). However, there was no statistically significant difference between the 2 groups in pocket reduction. Similarly, in both treatment groups, there were small but significant gains in CAL from BL to week 54 (12.0+/-1.8 mm to 11.3+/-1.8 mm for SRP + TCF and 12.3+/-1.5 mm to 11.2+/-1.2 mm for SRP + AUG). The difference in CAL gain between the 2 groups was not statistically significant. At the final examination, both groups showed significant PD reduction and CAL gain (P <0.001) compared to BL. The frequency and percentage of bleeding sites decreased significantly in both groups. At week 54, this decrease was significantly greater in the SRP + AUG group (31.67% for SRP + TCF versus 3.85% for SRP + AUG). CONCLUSIONS: These results indicate that the local delivery of tetracycline by a fiber or the systemic administration of amoxicillin/clavulanic acid given 3 months after scaling and root planing produced similar clinical outcomes over the 9-month observation period.

Administration, Oral↗
PubMed2001

Endodontic infection caused by localized aggressive periodontitis: a case report and bacteriologic evaluation.

A rare case of a periodontally induced endodontic lesion in a systemically healthy subject of 28 years is described. The patient, having presented with severe attachment loss on the palatal and distal aspects of his maxillary right second premolar, was diagnosed with localized aggressive periodontitis. He had never received periodontal treatment. The tooth was nonvital and showed all signs of symptomatic apical periodontitis. It was also free of any restoration. All clinical findings clearly suggested that the endodontic problem was caused by the aggressive periodontal disease. Bacteriologic screening of the pocket and the root canal, by using "checkerboard" DNA-DNA hybridization analysis, revealed diverse flora in the periodontal lesion. The sample obtained from the root canal exhibited DNA from a limited number of species, including black-pigmented anaerobic rods. No bacterial DNA was found in the root canal that was not also recovered from the periodontal pocket.

Adult↗
PubMed2003

Herpesviral-bacterial interactions in aggressive periodontitis.

BACKGROUND: Human cytomegalovirus, Epstein-Barr virus and herpesvirus co-infections occur with significantly higher frequency in actively progressing than in stable periodontitis sites of adolescents and young adults. Also, periodontal presence of cytomegalovirus and Epstein-Barr virus is associated with increased occurrence of subgingival Porphyromonas gingivalis, Bacteroides forsythus, Dialister pneumosintes, Prevotella intermedia, Prevotella nigrescens, Treponema denticola and Actinobacillus actinomycetemcomitans. AIM: This article reviews the evidence linking herpesviruses to the development of aggressive periodontitis and suggests a potential mechanism for herpesviral acceleration of the periodontal disease process. CONCLUSIONS: It seems to be a reasonable supposition that the etiopathogenesis of various types of aggressive periodontitis includes the combined action of herpesviruses and specific bacterial species. New vaccines and vaccination technologies that are being developed against herpesviruses warrant testing for their ability to induce a protective immune response against destructive periodontal disease. Clearly, the importance of combined herpesviral-bacterial infections and associated host responses in the development of periodontitis needs to be studied further.

Adolescent↗