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PubMed2004

Detection frequency of periodontitis-associated bacteria by polymerase chain reaction in subgingival and supragingival plaque of periodontitis and healthy subjects.

The aim of this study was to compare the detection frequencies of 25 bacterial species in subgingival and supragingival plaque of 18 untreated periodontitis subjects and 12 periodontally healthy subjects. Genomic DNA was extracted from subgingival and supragingival plaque samples, and bacterial detection was performed by polymerase chain reaction of the 16S rRNA genes. Fourteen bacteria showed no relationship with periodontitis, and 11 of these 14 species were frequently detected (> or =50%) in subgingival plaque in both periodontitis and healthy subjects. Nine bacteria such as Eubacterium saphenum, Prevotella intermedia, and Treponema denticola seemed to be related to periodontitis; their detection frequencies in subgingival plaque samples were higher in periodontitis than in healthy subjects, but these differences were not statistically significant by multiple comparisons (0.002< or =P<0.05). Two species (Mogibacterium timidum and Porphyromonas gingivalis) were detected significantly more frequently in subgingival plaque of periodontitis subjects than of healthy subjects (P<0.002), with P. gingivalis being detected only in periodontitis subjects, suggesting that these two species are closely related to periodontitis. There were no significant differences in the detection frequencies of the 25 bacteria between subgingival and supragingival plaque, suggesting that the bacterial flora of supragingival plaque reflects that of subgingival plaque.

Adult↗
PubMed1978

Effect of experimentally induced marginal periodontitis and periodontal scaling on the dental pulp.

Experimental breakdown of the periodontal attachment apparatus was produced in six young adult monkeys to study the effect on the tissue of the dental pulp by (1) periodontitis, (2) scaling and plaque accumulation on exposed root dentin. Periodontal tissue breakdown was induced by the placement of ligatures around the neck of 92 permanent teeth. Subsequent plaque formation caused marked loss of periodontal tissue support, which after a period of 5--7 months amounted to 30--40% of the root length. One group of teeth received no further treatment. Other teeth were subjected to scaling and root planing. Following treatment, plaque was allowed to accumulate for 2, 10, and 30 days on the freshly planed root dentin surfaces. Histologic examination revealed that in comparison to teeth with normal periodontal conditions, 57% of the teeth exposed to periodontitis exhibited pathologic pulp tissue alterations. Secondary dentin formation and/or inflammatory cell infiltrates were observed within localized areas of the pulp subjacent to root surfaces exposed to periodontal tissue destruction. The changes within the pulp were of "mild" nature and only one tooth displayed signs of total pulp necrosis. Lateral canals communicating with both the pulp cavity and the exposed root surface were never detected. Teeth subjected to scaling and subsequent plaque accumulation in comparison with teeth with periodontitis alone exhibited no obvious aggravation or increased incidence of pathologic pulp reactions. The findings show that in the monkey (1) periodontal destruction limited to the cervical half of the root and (2) plaque accumulation on exposed root dentin does not cause severe alteration in the pulp of the roots involved.

Animals↗
PubMed2005

Antimicrobial profiles of periodontal pathogens isolated from periodontitis patients in The Netherlands and Spain.

BACKGROUND AND AIM: Antimicrobial resistance of periodontal pathogens towards currently used antibiotics in periodontics has been investigated in a previous study. Microbial resistance in the periodontal microflora was more frequently observed in Spanish patients in comparison with Dutch patients. The aim of the present study was to compare antimicrobial susceptibility profiles of five periodontal bacteria isolated from periodontitis patients in Spain and in The Netherlands. MATERIAL AND METHODS: Subgingival plaque samples from adult patients with periodontitis were collected and cultured on selective and non-selective plates. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum and Micromonas micros were isolated and used for minimal inhibitory concentration tests using the Epsilometer (E-test) technique. Eight different antibiotics were tested on all bacterial isolates. MIC50 and MIC90 values for each antibiotic and each species were determined and the percentage of resistant strains was calculated. RESULTS: Significantly higher MIC values were noted in Spanish strains of F. nucleatum for penicillin, ciprofloxacin, of P. intermedia for penicillin, amoxicillin and tetracycline, of M. micros for tetracycline, amoxicillin and azithromycin, and of P. gingivalis for tetracycline and ciprofloxacin. Based on breakpoint concentrations, a higher number of resistant strains in Spain were found in F. nucleatum for penicillin, amoxicillin and metronidazole, in Prevotella intermedia for tetracycline and amoxicillin, and in A. actinomycetemcomitans for amoxicillin and azithromycin. Resistance of P. gingivalis strains was not observed for any of the antibiotics tested both in Spain and The Netherlands. CONCLUSIONS: Differences exist in the susceptibility profiles of periodontal pathogens isolated from periodontitis patients in Spain and in The Netherlands. This implicates that antibiotic susceptibility testing is necessary to determine efficacy of antimicrobial agents. Also, clinical studies with antibiotics should take these differences into account. The information from the present study indicates that it may not be possible to develop uniform protocols for usage of antibiotics in the treatment of severe periodontitis in the European Union.

Adult↗
PubMed2006

Periodontal pathogens in atheromatous plaques isolated from patients with chronic periodontitis.

BACKGROUND AND OBJECTIVE: It has been suggested that chronic infections may predispose to cardiovascular disease. The relationship between periodontal disease and cardiovascular disease has been a subject of increasing research in recent years. The isolation and identification of periodontal bacteria from atheromatous plaque can contribute to our knowledge of this vascular disease. The aim of this study was to isolate and identify periodontal bacteria from the periodontal pockets of different patients and to compare them with the microorganisms detected in the atheromatous plaques obtained from the same patients. MATERIAL AND METHODS: Clinical isolates were obtained from 12 patients with periodontal wounds and atheromathous plaques. These samples were cultured in the appropriate bacteriological culture media and incubated in an anaerobic system. Periodontal bacteria were identified using polymerase chain reaction (PCR) assays. RESULTS: From the 12 patients studied, nine presented different periodontopathic bacterial species. In two, Actinobacillus actinomycetemcomitans was present in the periodontal pockets and the respective atheromatous plaques. CONCLUSION: The presence of A. actinomycetemcomitans in atheromatous plaques and the periodontal pockets of the same patients could indicate a role for periodontal pathogenic bacteria in the atherosclerosis disease process.

Aged↗
PubMed1989

Periodontitis in sheep: a model for human periodontal disease.

The use of sheep as a suitable animal model of destructive forms of human periodontal disease has been assessed from comparative radiological, histological, and serological investigations of sheep with and without periodontal disease. The results showed that, in sheep with periodontitis, bone resorption, collagen breakdown, degradation of blood capillary vessel walls, cellular infiltration of plasma cells, lymphocytes, and epithelial infiltration were significantly greater than in sheep without periodontitis, and the features are similar to those in rapidly destructive forms of periodontal disease in man. The levels of serum IgG antibody reactive against B. gingivalis antigens (measured by ELISA) were significantly higher in sheep with periodontitis than those without, similar to the association reported in some types of human periodontal diseases. These findings suggest that periodontitis in sheep could represent a suitable animal experimental model for certain types of rapidly destructive human periodontal diseases.

Alveolar Process↗
PubMed1999

Periodontitis in the house musk shrew (Suncus murinus): a potential animal model for human periodontal disease.

BACKGROUND: Our understanding of periodontal diseases has been facilitated greatly by the use of animal models. However, no animal model has been identified that truly reflects the disease seen in humans. Suncus murinus, a rat-sized laboratory house musk shrew, has received attention as a valuable animal model due to ease of handling. In the studies described here, periodontal conditions in Suncus murinus were evaluated to determine the usefulness of the shrew as an experimental model for understanding various aspects of periodontal diseases. METHODS: Periodontal tissues of 34 Suncus murinus (18 to 430 days old) were examined macroscopically, morphometrically, histologically, and ultrastructurally. RESULTS: Dentition pattern is I3/1, C1/1, P2/1, M3/3. Spontaneous gingival swelling with accumulation of plaque was observed in more than two-thirds of animals older than 200 days. Morphometric analysis of alveolar bone demonstrated a pattern of bone loss that correlated closely with animal age. Histologically, periodontal lesions varying from gingivitis to periodontitis, similar to those observed in humans, were noted. Marked infiltration of lymphocytes and plasma cells in the connective tissue was noted, usually not seen in periodontal lesions of rodents. Although osteoclastic alveolar bone resorption was noted, active bone resorption was not a frequent feature in specimens obtained from chronic inflammatory lesions. Ultrastructurally, degradation of collagen fibers in the inflamed area and ingestion of collagen fibrils by fibroblasts in the deeper connective tissue were often seen. CONCLUSIONS: These results indicate the potential utility of Suncus murinus as a model to study periodontal disease; e.g., chronic nature of the inflammatory periodontal lesions, similar to those in humans, as well as other advantages including size and ease of handling and housing of these animals.

Age Factors↗
PubMed2004

Endothelial dysfunction in patients with chronic periodontitis and its improvement after initial periodontal therapy.

BACKGROUND: Recent epidemiological data suggested that there is a relationship between periodontal health and atherosclerotic coronary heart disease. Although hypothetical models were proposed, the exact mechanism of this association has not been clarified. The aim of this study is to investigate whether there is an endothelial dysfunction in patients with chronic periodontitis and, if present, whether recovery is possible with therapy. METHODS: The study groups consisted of 28 patients (mean age: 45.5 +/- 8.6 years) with chronic periodontitis and without any atherosclerotic vascular disease, and 26 healthy controls (mean age: 43.7 +/- 6.8 years). Cardiovascular risk factors were investigated in both groups. Brachial artery responses to reactive hyperemia (endothelium-dependent dilatation [EDD]) and sublingual nitroglycerin (endothelium-independent dilatation [EID]) were measured using high-resolution vascular ultrasound in both groups. Measurements were taken before and after initial periodontal therapy in the periodontal patients. RESULTS: There was no significant difference between the groups with regard to cardiovascular risk factors. In the baseline measurements, EDD and EID were significantly impaired in patients with chronic periodontitis when compared with the controls (8.4% +/- 4.0% versus 19.4% +/- 8.1%, P<0.0001; 13.3% +/- 6.3% versus 29.5% +/- 10.0%, P<0.0001 for EDD and EID, respectively). After non-surgical periodontal therapy, EDD and EID improved significantly (from 8.4% +/- 4.0% to 17.7% +/- 5.7%, P<0.0001; and from 13.3% +/- 6.3% to 24.9% +/- 7.3%, P<0.0001 for FMD and EID, respectively). The EDD and EID changes in the controls were insignificant. CONCLUSION: This study showed that endothelial functions were impaired in patients with chronic periodontitis and that they improve following initial periodontal therapy.

Arteriosclerosis↗
PubMed2003

[Change of circulating TNF-alpha in patients with advanced periodontitis before and after periodontal initial therapy].

OBJECTIVE: To investigate the effect of periodontal initial therapy on circulating tumor necrosis factor-alpha (TNF-alpha) in patients with periodontitis. METHODS: Patients with advanced periodontitis were selected. Sulcus bleeding index (SBI), probing depth (PD), and circulating TNF-alpha concentration were assessed respectively before and 4-6 weeks after periodontal initial therapy. RESULTS: The level of circulating TNF-alpha in patients with periodontitis was significantly higher than that in healthy control subjects (P < 0.01). After periodontal initial therapy, SBI, PD and circulating TNF-alpha concentration were reduced significantly (P < 0.01) in patients with periodontitis. CONCLUSION: Periodontitis may have profound effects on systemic health through the elevation of circulating TNF-alpha. Prevention and treatment of periodontitis should be important in maintaining systemic health.

Adult↗
PubMed2005

[Changes of circulating IFN-gamma, IL-4 in patients with chronic periodontitis before and after periodontal initial therapy].

PURPOSE: To investigate the effect of periodontal initial therapy on circulating blood serum interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) in patients with chronic periodontitis. METHODS: 15 patients with chronic periodontitis and 15 healthy people were selected. Circulating blood serum IFN-gamma and IL-4 were measured using double antibody sandwich ELISA; Student's t test was used for comparing sulcus bleeding index (SBI), probing depth (PD), and circulating IFN-gamma, IL-4 in patients with chronic periodontitis that were assessed respectively before and 4 to 6 weeks after periodontal initial therapy. RESULTS: The level of blood serum IFN-gamma, IL-4 in patients with chronic periodontitis was significantly higher than the control group (P<0.01); After periodontal initial therapy, SBI, PD, and circulating IFN-gamma concentration were reduced significantly (P<0.01); IL-4 concentration had no significant difference (P>0.05). CONCLUSIONS: Blood serum IFN-gamma, IL-4 were associated with chronic periodontitis; The control of gingival infection may reduce blood serum IFN-gamma concentration; IL-4 concentration was not reduced with the control of gingival infection. Periodontal initial therapy.

Chronic Periodontitis↗
PubMed2005

[The clinical results of combined periodontal-orthodontic treatment on patients with periodontitis and labial displacement of incisors].

PURPOSE: To evaluate the clinical effects of combined periodontal and orthodontic method in treating labial displacement of anterior teeth caused by periodontitis. METHODS: 21 cases with periodontitis and fly-out of anterior teeth were selected. After the inflammation was controlled by essential periodontal therapy, the anterior teeth were allied by edgewise appliances; meanwhile, periodontal care and occlusal adjustment were conducted to control inflammation and occlusal trauma, until normal occlusion was established. A total of 74 teeth were treated, the periodontal probing depth and the degree of alveolar ridge resorption was recorded before and after treatment, respectively. All the data were statistically analyzed by Ridit test and Chi-square test. RESULTS: After 1-2 years of follow-up, all cases under 40 years got satisfactory effects, with significantly decreased periodontal probing depth (P<0.01) and alveolar ridge (P<0.05). CONCLUSIONS: Combined periodontal and orthodontic treatment was effective in the management of periodontitis, occlusal trauma and teeth alignment, and the effects were stable for a relatively long period. But patients over 40 years was not suitable for the treatment.

Humans↗
PubMed2002

Periodontal attachment level of extractions presumably performed for periodontal reasons.

BACKGROUND/AIMS: The aim of this study was to analyse the residual periodontal attachment in teeth extracted by East German dentists in order to determine a possible 'forceps level'. METHODS: Out of about 8000 extracted teeth collected from a dental waste disposal company, 500 teeth were randomly selected. After exclusion of wisdom teeth and premolars extracted for orthodontic reasons (intact teeth with attachment > 90%), coronal and root caries, fillings, pulp exposure and incomplete root fillings (based on X-rays) were registered. The periodontal ligament was stained with 1% Fuchsin Red and measured with a light microscope. RESULTS: For intact teeth (DF = 0, periodontal disease definition I), the mean periodontal attachment (50.5% +/- 16.0) was significantly lower than for teeth with carious defects or fillings (64.7% +/- 18.8. unpaired t-test: p < 0. 00 1). There was a marked increase in frequency of extractions in intact teeth below 70% periodontal attachment and 37% were extracted at attachment levels between 50 and 69%. Teeth with pulpal involvement showed significantly different frequency distributions and mean attachment values (77.9% +/- 17.8) than the remaining teeth (periodontal disease definition II; 55,2% +/- 15.5). CONCLUSIONS: A considerable number of teeth with no or minor coronal destruction were extracted at an attachment level of 50-70%, regardless of the tooth type. The threshold for 'periodontal' extractions seem to be too low and undifferentiated, which calls for an improvement in knowledge of periodontal diagnosis and treatment.

Dental Caries↗
PubMed2006

Periodontal status among relatives of aggressive periodontitis patients and reliability of family history report.

OBJECTIVES: To assess the periodontal status of relatives of Aggressive Periodontitis (AgP) patients, and to evaluate the reliability of the family history report as provided by the proband. MATERIAL AND METHODS: Data from 54 AgP patients were gathered along with a family history report for each of their relatives. Only 27 patients (probands) had relatives willing to be examined. This yielded a total of 61 relatives from whom the periodontal status was obtained. The family history report for each examined relative was compared with the periodontal diagnosis made at examination to assess reliability. RESULTS: Eight percentage of the examined relatives, aged between 12-76, were diagnosed with AgP, while chronic periodontitis was present in 39%, gingivitis in 38% and 15% were healthy. If the report provided by the proband was positive, the likelihood of finding any type of periodontitis in that relative was 85.7%, whereas if the report was negative the likelihood of the absence of periodontitis was 70.6%. CONCLUSION: The percentage of examined relatives who were affected with AgP (8%), although lower than percentages reported in other AgP family studies, was still higher than the prevalence of the condition in random populations. Reliability of periodontal family history was considered good and more reliable when it was positive.

Adolescent↗
PubMed2006

Periodontal and hematological characteristics associated with aggressive periodontitis, juvenile idiopathic arthritis, and rheumatoid arthritis.

BACKGROUND: Periodontitis shares several clinical and pathogenic characteristics with chronic arthritis, and there is some degree of coexistence. The aims of this study were to elucidate whether patients with localized aggressive periodontitis (LAgP), generalized aggressive periodontitis (GAgP), juvenile idiopathic arthritis (JIA), and rheumatoid arthritis (RA) share periodontal and hematological characteristics distinguishing them from individuals free of diseases. METHODS: The study population consisted of white adults ( or=4 mm, CAL>or=2 mm, and ABL>or=2 mm compared to controls. The percentage of sites with CAL>or=2 mm significantly correlated with the levels of IgM-RF and IgA-RF. Missing teeth in JIA and RA patients were not lost due to periodontitis. Patients with GAgP showed higher levels of leukocytes, including neutrophils, and CRP compared to controls. In part, JIA and RA patients showed similar results. CONCLUSIONS: Young adults with RA may develop periodontal destruction, and these patients require professional attention. Both differences and similarities in periodontal and hematological variables were seen in individuals with periodontitis, JIA, and RA.

Adult↗
PubMed1992

Clinical studies on juvenile, rapidly progressive and adult periodontitis before and after periodontal therapy (I).

The sample in the present study comprised 36 patients who were referred for treatment of periodontal disease. Twenty-four of them were early onset periodontitis (EOP) patients and 12 were adult periodontitis (AP) patients. Based upon the age, number of involved teeth and the location of diseased sites, the EOP patients were divided into two groups as juvenile periodontitis (JP) and rapidly progressive periodontitis (RPP). All the patients were individually examined both clinically and radiographically. At a baseline examination and 3 months after active therapy, the patients were evaluated for plaque, gingivitis, probing depths and probing attachment levels. Following instruction in proper oral hygiene measures, all of the patients were subjected to periodontal treatment. Treatment comprised scaling and root-planing, occlusal adjustment, tetracycline administration and periodontal surgery with osteoplasty. Results showed that age limits between JP and RPP cannot be drawn with certainty. The mean age for the JP group was 21.83 years and was 30.58 years for the RPP group. The number of involved teeth was found to increase with age. The first molars were the most frequently affected teeth followed by the incisors. Three months after active treatment, the response of periodontal tissues to therapy both in EOP and AP groups was almost identical.

Adolescent↗
PubMed2006

Periodontal status and cytoplasmic enzyme activities in gingival crevicular fluid of type 2 diabetic and/or obese patients with chronic periodontitis.

Type 2 diabetes mellitus and obesity are the most common nutritional disorders in developed and developing countries. Increased prevalence of periodontal disease is a well-known complication of type 2 diabetes mellitus (DM). As obesity is generally the first step toward type 2 diabetes mellitus, it is possible to find exacerbated periodontal disease in obese patients, also. The purpose of this cross-sectional study was to investigate the periodontal status and aspartate aminotransferase and lactate dehydrogenase enzyme activities in gingival crevicular fluid (GCF) of type 2 diabetic and/or obese chronic periodontitis patients. A total of 39 chronic periodontitis patients participated in the study. The study population was divided into four groups according to body mass index and type 2 DM status: 1) type 2 DM obese patients, n = 8; 2) type 2 DM patients, n = 12; 3) obese patients, n = 8; 4) systemically healthy control group, n = 11. Enzyme activities in gingival crevicular fluid and periodontal status were evaluated. No significant differences in age, gingival index, plaque index, aspartate aminotransferase and lactate dehydrogenase enzyme activities were observed, but probing depths were significantly higher in the DM groups than in the control group. Obesity did not seem to be a significant factor in any parameters evaluated. The present study showed increased probing depth values for the diabetic groups but failed to show any significant relation between obesity and enzyme activity or periodontal status. However, the slightly increased probing depth values in the obese groups might be a clue to an impaired immune response and predisposition to periodontitis in that patient group.

Adult↗
PubMed2006

[Expression of MMP-2 and MMP-3 in periodontal tissues of rat periodontitis model].

OBJECTIVE: To investigate the expression of MMP-2 and MMP-3 in periodontal tissues of rat periodontitis model at different stages of inflammation of varied severity. METHODS: The periodontal tissues were immunohistochemically stained by antibody of MMP-2 and MMP-3. RESULTS: MMP-2 and MMP-3 were both strongly positive in gingival epithelia and fibroblasts in periodontal ligament in rat periodontitis model. And chronic periodontitis showed lower expression of MMP-2 and MMP-3 than that of acute gingivitis and acute peridontitis. CONCLUSION: The expression of MMP-2 and MMP-3 varies in different stage of periodontitis. MMP-2 and MMP-3 may play an important role in development of periodontitis.

Animals↗