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PubMed1989

Morphotypes of the subgingival microflora in diabetic adolescents in Finland.

The morphotypes of the subgingival microflora from 85 12 to 18-year-old Finnish adolescents with insulin-dependent diabetes mellitus (IDDM) were studied in Gram- and Rhodes-stained smears. A comparison was made with subgingival plaque samples from paired age- and sex-matched healthy controls. Significant differences were found in the distribution of the morphotypes. The microflora in the IDDM patient group contained significantly lower proportions of Gram-positive and Gram-negative cocci and total Gram-positive bacteria and higher proportions of Gram-negative rods, fusiforms, and total Gram-negative bacteria. In the Rhodes-stained samples, the patients had more straight and curved rods and less fusiforms than the controls. The proportions of spirochetes and flagellated bacteria were almost identical in both groups. The clinical periodontal status of the subjects had been reported in a separate study. In spite of similar Plaque Index scores, the patients had more gingivitis than the controls. This finding may be explained by the distribution of morphotypes: more Gram-negative rods and total Gram-negative bacteria (periodontally more pathogenic forms) in the diabetic patients.

Adolescent↗
PubMed1990

The effect of clindamycin on the microbiota associated with refractory periodontitis.

The purpose of this investigation was to determine the effect of clindamycin hydrochloride, as an adjunct to scaling, on the microbiota associated with refractory periodontitis and to elucidate the probable causative bacteria associated with the disease. Microbial samples were collected from a subset of 9 patients with severe adult periodontitis who had not responded to conventional treatment modalities including the use of tetracycline and other antibiotics. Microbial samples were collected from a relatively deep site determined to be actively losing attachment and a comparably deep, but quiescent, control site in each patient prior to clindamycin therapy. Samples continued to be collected from the same sites for up to 1 year post-therapy. The microbial flora of each sample were enumerated by darkfield microscopy and predominant cultivable methods. Prior to clindamycin therapy, both active and control sites consisted on average of approximately 50% spirochetes and motile rods and 40% Gram-negative anaerobic rods. Bacteroides intermedius and Porphyromonas gingivalis (formerly B. gingivalis) were elevated in the active, as compared to control, sites and accounted for approximately 20% of the cultured microbiota in the former. Following treatment with clindamycin, the Gram-negative components of the microbiota were either eliminated or severely suppressed. At 1 year post-therapy, spirochetes and motile rods together accounted for about 15% of the microscopic flora. Total Gram-negative anaerobic rods accounted for approximately 20%, and B. intermedius and P. gingivalis combined accounted for less than 2% of the cultured microbiota from historical active sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Alveolar Bone Loss↗
PubMed1990

Microscopic characterization of root surface-associated microbial plaque in localized juvenile periodontitis.

The purpose of this investigation was to characterize by scanning electron microscopy, the microbial morphotypes associated with the roots of teeth from patients exhibiting localized juvenile periodontitis (LJP). Eighteen teeth were examined from 10 adolescent patients who satisfied the standard clinical diagnostic criteria for LJP. The microscopic evaluation was facilitated by dividing that portion of the root exposed to the periodontal pocket into coronal, middle, and apical one-thirds. Controls consisted of an equal number of teeth matched as to pocket depth and anatomical type obtained from patients exhibiting adult periodontitis (AP). All specimens were coded and examiners were unaware of their origins. Results of the SEM evaluation revealed little difference in microbial morphotypes comprising the root associated plaque in the coronal one-third of LJP specimens when compared to the AP controls. The dominant microbial morphotypes were cocci, short and long rods, filamentous microorganisms, and spirochetes. However, microbial plaque located in the middle and apical one-third root zones of LJP specimens was distinctly different than that of AP specimens. In the deeper pocket zones the dominant microbial morphotypes in LJP specimens were limited to cocci, short rods, coccobacilli, and various sized spirochetes. In contrast, AP specimens exhibited a collection of microbial morphotypes consisting of cocci, short rods, long rods, filamentous organisms and spirochetes. Calculus was found on the root surfaces of all specimens regardless of disease category although, as a group, the LJP specimens featured lesser amounts. Although areas of root resorption were common in both LJP and AP groups, they were more frequently observed in LJP specimens, likely associated with the generally less confluent deposits of calculus and plaque.

Adolescent↗
PubMed1991

Effects of metronidazole on periodontal treatment needs.

Periodontitis, a common cause of tooth loss in adult populations, is an inflammatory response to the overgrowth of anaerobic organisms such as spirochetes and bacteroides and, in some cases, micro-aerophilic organisms in the subgingival plaque. In the present investigation, using a double-blind clinical design, we sought to determine whether 1 week of metronidazole treatment plus debridement of the tooth surfaces was superior to 1 week of placebo treatment plus debridement (positive control) in reducing the subsequent amount of periodontal surgery given to the patients. Thirty-nine patients were randomly assigned to either the metronidazole or placebo (positive control) groups. All patients were given the necessary scaling and root planing and were unsupervised in their usage of the medication. After the completion of this treatment, they were reexamined and it was found that the metronidazole regimen caused a significant reduction in surgical needs of about 5 teeth per patient compared to the positive control (difference before and after treatment 8.3 +/- 6.8 teeth metronidazole versus 2.9 +/- 4.8 positive control, P = 0.007). The difference between groups was maintained during the 2 to 3 years' recall period. Metronidazole had a significant effect on the site specific reduction of spirochetes: 90% of the sites in the metronidazole group versus 64% in the positive-control group had a decrease in the percentage of spirochetes (P less than 0.05). We conclude that systemic metronidazole given 250 mg tid for 7 days in conjunction with debridement of the tooth surfaces can significantly reduce the need for periodontal surgery compared to the standard regimen which included only debridement.

Alveolar Bone Loss↗
PubMed1991

Subgingival microflora of advanced periodontitis in the Dominican Republic.

A study of the predominant subgingival microflora was carried out in 24 periodontitis patients, 18 to 60 years of age, in Santo Domingo, Dominican Republic. Paper point sampling, transport in VMGA III, and conventional microbiological techniques were utilized. Direct microscopic examination revealed that cocci and nonmotile organisms made up 85% of the total organisms and spirochetes as little as 3%. Nonselective culturing showed Gram-negative organisms to constitute 53% of total isolates. Fusobacterium nucleatum averaged 15%, black-pigmented anaerobes 7%, and Peptostreptococcus micros 10% of the cultivable microflora. Enteric rods and acinetobacter species were recovered from 16 patients and comprised 23% of the cultivable flora. Enterobacter cloacae occurred in 8 patients, Klebsiella oxytoca in 3 patients, and 7 other species in 10 patients. Parallel studies have found a significantly lower prevalence of enteric rods in advanced periodontitis patients in the USA. In conclusion, fewer spirochetes and markedly more enteric rods seem to inhabit adult periodontitis lesions in Santo Domingo patients compared to those in USA. High levels of subgingival enteric rods in periodontitis patients in Santo Domingo may have important prophylactic and therapeutic implications.

Adolescent↗
PubMed1991

Clinical documentation and occurrence of putative periodontopathic bacteria in human immunodeficiency virus-associated periodontal disease.

Human immunodeficiency virus (HIV)-associated gingivitis (HIV-G) and HIV-associated periodontitis (HIV-P) are two intraoral lesions manifested by patients with HIV infection. Periodontal indices were measured for 87 subjects in 5 study groups: HIV-seropositive patients with healthy periodontium (HIV-H), with HIV-G, or with HIV-P; and non-HIV-infected subjects with healthy periodontium (H) or with adult chronic periodontitis (P). The quantitative clinical parameters were compared and statistically significant intergroup differences were noted. The mean scores on PI and PD do not discriminate between HIV-seropositive and non-HIV-infected seronegative cohorts, but a significant difference in the GI between HIV-H and H was noted. When categories of PD and AL are examined, some differences become apparent. Generally, the PD and AL of HIV-P are not as great as those of P. PI correlates well with GI (r = 0.86) in P, but does not (r = 0.33) in HIV-P. In addition, the occurrence of selected putative periodontopathic bacteria (Porphyromonas gingivalis, spirochetes, and motile eubacteria) in these lesions was determined by brightfield (after staining), darkfield and immunofluorescent microscopy. No difference in microbiological profile in the bacterial groups monitored was found between P and HIV-P. Spirochetes were found to be more abundant than P. gingivalis in the lesions of P and HIV-P. In marked contrast, P. gingivalis was found to be in highest numbers in samples from the gingival crevice of H as determined by indirect immunofluorescence.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Comparative study of subgingival microbiological sampling techniques.

The presence of specific bacteria in subgingival plaque has been used as an indicator of active periodontal disease. The technique of subgingival sampling may conjecturally influence the identification and enumeration of microorganisms reported. In this study, paper point sampling and scaler sampling are compared. Subgingival samples using both methods were taken from three surfaces in each of 12 patients at the following time points: at each of two appointments one week apart before treatment and at each of two appointments 12 and 13 weeks following treatment. Microbiological analyses were undertaken to determine the total number of colony forming units, the proportions of suspected periodontal pathogens, and the number of spirochetes using phase contrast microscopy. Significantly higher numbers of colony forming units and spirochetes were found for paper point sampling both before and after treatment.

Adult↗
PubMed1992

Relative proportions of pathogen-related oral spirochetes (PROS) and Treponema denticola in supragingival and subgingival plaque from patients with periodontitis.

The purpose of this study was to use monoclonal antibodies to enumerate spirochetes in dental plaque, including the newly recognized pathogen-related oral spirochete (PROS) and specific serovars of Treponema denticola. Plaque was collected from control subjects with no apparent periodontal disease and from sites of moderate to severe chronic periodontitis in patients with inflammatory periodontal disease. Individual monoclonal antibodies were used to determine whether spirochetes were present and then a double-staining protocol was employed to count total spirochetes and specific treponemes in individual microscopic fields. Results indicate that spirochetes are more common at diseased sites and in subgingival plaque than at healthy sites or in supragingival plaque. Together PROS and T. denticola comprised the majority of all spirochetes in all samples and PROS and T. denticola serovars "B" and D were most numerous in plaque from patients with periodontitis. PROS were the majority of all spirochetes in supragingival plaque (76.2% +/- 23.8%) and subgingival plaque (60.9% +/- 19.1%) from periodontitis patients, significantly larger than the percentage of T. denticola serovar "B" (P less than .001 for both supragingival and subgingival plaque) and serovar D (P less than .01 for supragingival and P less than .001 for subgingival plaque). These observations indicate that PROS are the predominant spirochete in plaque from sites of patients with periodontitis, but other analytical approaches are necessary to determine if PROS or T. denticola are pathogenic.

Adult↗
PubMed1992

Minocycline slow-release formulation effect on subgingival bacteria.

The purpose of this study was to determine the microbiological efficacy of an adjunctive minocycline periodontal formulation delivered subgingivally. Subjects were systemically healthy but exhibited severe periodontitis; i.e., probing depths greater than 6 mm. The two study groups included individuals who received minocycline or a placebo periodontal formulation after root planing. Subgingival plaque samples were obtained at baseline; prior to treatment; and at 1, 3, and 6 months. Plaque was evaluated by darkfield microscopy and further analyzed for total dark-pigmented Bacteroides species, P. intermedia, P. gingivalis and Streptococcus, Actinomyces, Eikenella, Actinobacillus, Capnocytophaga, and Fusobacterium species using cultivable flora techniques. In addition, plaque was evaluated for yeast on a selective agar medium. When compared to the placebo, the minocycline group had significantly lower proportions of spirochetes at 1 and 3 months and lower proportions of motile rods at 3 months. Furthermore, when compared to the placebo group, the minocycline patients had lower mean proportions of dark-pigmented Bacteroides spp. and P. intermedia at 1 and 3 months as well as lower proportions of E. corrodens at 1 month. The minocycline group had significant decreases in proportions of spirochetes at 1 and 3 months, motile rods at 1 and 3 months, and increases in cocci at 1, 3, and 6 months when compared to baseline. In the placebo group, root planing was also effective at decreasing spirochetes at 1, 3, and 6 months, but with significant differences seen only at 3 and 6 months. However, the degree of reduction in spirochete proportions was greater in the minocycline group when compared with the placebo group.(ABSTRACT TRUNCATED AT 250 WORDS)

Actinomyces↗
PubMed1992

The apical border plaque in chronic adult periodontitis. An ultrastructural study. I. Morphology, structure, and cell content.

THIS STUDY CONCERNS THE APICAL BORDER (AB) plaque in relation to chronic adult periodontitis (AP). Fifty-six teeth from 24 patients with AP were examined by transmission electron microscopy (TEM). The AB was not discrete with islands of bacteria in the so-called plaque-free zone (PFZ). Coronal to the AB, the established plaque commonly consisted of three to four layers of Gram-positive and Gram-negative cocci, rods, filaments, and spirochetes and a superficial layer, mainly of spirochetes, but including filaments, "test tube brush," and "corn-cob" formations. The most apical apparently intact organisms in the PFZ were in bacterial islands or in isolation and were predominantly Gram-negative cocci and rods, with occasional other morphotypes. The most apical microorganisms were invariably ghost cells. A cuticle of varying thickness and structure was present at the plaque/tooth interface. It was concluded that there was a limited range of intact bacterial morphotypes in the apical border plaque in chronic periodontitis.

Adult↗
PubMed1992

The apical border plaque in chronic adult periodontitis. An ultrastructural study. II. Adhesion, matrix, and carbohydrate metabolism.

THE AIM OF THIS STUDY was to characterize the plaque matrix and relevant aspects of metabolism of the apical border plaque in relation to teeth affected by chronic adult periodontitis. The material comprised 56 teeth from 24 patients. Ruthenium red, alcian blue, lanthanum nitrate, and safranin 0 were used to label matrix polyanionic macromolecules and periodic acid-thiosemicarbazide-silver proteinate for intracellular polysaccharide (IPS). The matrix components were amorphous, fibrillar, or globular. Many intact bacteria exhibited extracellular polysaccharides or glycocalyces associated with their cell wall and cytoplasmic IPS granules. The latter varied in size and distribution and were evident even in the most apically-advanced intact microorganisms. The results indicate that the matrix and IPS features of the apical border plaque in chronic periodontitis in certain respects resemble those of subcontact area plaque on children's teeth, associated with chronic gingivitis and approximal caries. They also suggest the establishment of acidic regions in the microniches of the periodontal pocket.

Adult↗
PubMed1993

Microbiological and clinical monitoring of non-localized juvenile periodontitis in young adults: a report of 11 cases.

It has been shown that patients with localized juvenile periodontitis (LJP) often harbor Actinobacillus actinomycetemcomitans in the subgingival area. However, little is known of the oral microflora in non-LJP juvenile periodontitis patients with less extensive disease. The purpose of this study was to describe the microflora and clinical parameters of young adults with minor to moderate periodontitis during treatment for a period of 1 year. Eleven patients 15 to 16 years of age were studied. All of them had 4 to 8 mm loss of attachment at minimally one site, but the typical clinical description of localized juvenile periodontitis was an exclusion criterion in this study. Microbiological examination of the deepest periodontal pocket and of the tongue revealed that 6 patients harbored Actinobacillus actinomycetemcomitans and 5 harbored Porphyromonas gingivalis. Almost all subjects showed relatively high proportions of Prevotella intermedia, Campylobacter rectus, motile organisms, and spirochetes. On the basis of clinical and microbiological parameters the 11 patients could be assigned to 1 of 2 groups. Six cases had moderate periodontal breakdown with loss of attachment at 7 to 44 sites. All harbored A. actinomycetemcomitans and 5 of them P. gingivalis. These 6 cases responded relatively well to initial treatment despite the continued presence of A. actinomycetemcomitans. The other group consisted of 5 cases with relatively minor periodontal breakdown; i.e, 1 or 2 sites with 4 to 6 mm loss of attachment. Neither A. actinomycetemcomitans nor P. gingivalis was detected in the deepest pocket of these patients. All 5 responded well to initial treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Impaired bactericidal activity of PMN from two brothers with necrotizing ulcerative gingivo-periodontitis.

The purpose of this study was to investigate the pathogenesis of necrotizing ulcerative gingivo-periodontitis (ANUP) diagnosed in two brothers, age 9 (ANUP1) and 14 (ANUP2) from rural Egypt. Complete blood count, differential and blood chemistry were within normal limits for both brothers and they were not malnourished. The phagocytosis and killing function of their polymorphonuclear leukocytes (PMN) towards four bacterial species were assessed using a fluorochrome microassay. The selection of bacterial species was based on preliminary microbiological results in early onset periodontitis in Egypt. Fluorochrome-labeled Prevotella intermedia, Peptostreptococcus micros, Campylobacter rectus, and Porphyromonas gingivalis were pre-opsonized with ANUP serum and added to PMN from both ANUP patients, as well as PMN from three sex-matched and two sex- and age-matched healthy Egyptian control (CTL) subjects. We found significant depressions (P < 0.05) in PMN phagocytosis and killing of C. rectus and P. intermedia by ANUP1 and ANUP2, when compared to all CTL PMN. An assessment of the Gram-negative subgingival microflora present in both ANUP patients (in colony forming unit percent of total CFU recovered) (CFU %) revealed the presence of P. intermedia (ANUP1, 41.7 CFU %; ANUP2, 14.8 CFU %), Fusobacterium nucleatum (ANUP1, 3.6 CFU %; ANUP2, 48.1 CFU %), and Veillonella spp. (ANUP1, 18.2 CFU %; ANUP2, 18.5 CFU %). Spirochetes were also observed in cytocentrifuged, Gram-stained plaque from both ANUP patients. The predominant Gram-positive bacterial species recovered from both NUG1 and NUG2 was Streptococcus morbillorum.

Adolescent↗
PubMed1994

Effects of tetracycline-containing gel and a mixture of tetracycline and citric acid-containing gel on non-surgical periodontal therapy.

The purpose of this study was to assess the clinical and microbiological effects of a newly developed root conditioning gel system containing tetracycline or a mixture of tetracycline and citric acid on non-surgical periodontal therapy. Sixty-four (64) single-rooted teeth with a probing depth of 4 to 6 mm were randomly subjected to one of the following four treatments; 1) root planing alone (RP group); 2) tetracycline-containing gel alone (TCG group); 3) root planing plus tetracycline-containing gel (RP + TCG group); or 4) root planing plus a mixture of tetracycline and citric acid-containing gel (RP + TC-CAG group). Probing depth, attachment level, and tooth mobility were measured and the presence of dental plaque and gingival inflammation was recorded at baseline and after 2, 4, 8, and 12 weeks. Subgingival plaque samples from each site were collected at the same visits and examined with phase contrast microscopy for proportions of motile rods and spirochetes. Plaque index, gingival sulcus bleeding index (SBI), probing depth, and attachment level decreased significantly in all groups compared to the baseline values (P < 0.05). A significant decrease in probing pocket depth was noted after 12 weeks in RP + TC-CAG group compared to the other groups (P < 0.05). Significantly more gain in attachment was detected in the RP + TC-CAG group compared to the TCG group (P < 0.05). Tooth mobility scores also decreased later in the study. A significant decrease in the proportion of motile rods was found primarily in the RP + TC-CAG group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Subgingival distribution of Treponema denticola, Treponema socranskii, and pathogen-related oral spirochetes: prevalence and relationship to periodontal status of sampled sites.

Aims of this study were to comprehensively describe the intraoral distribution of the spirochete morphogroup and of 7 antigenically distinct oral treponema, and to relate their presence to periodontal status. Periodontal tissues were evaluated at 4 sites on every tooth except third molars and 76 subjects were classified according to the worst periodontal condition at any one site: Group 1, gingivitis (n = 13); Group 2, early periodontitis (n = 38); and Group 3, advanced periodontitis (n = 25). Subgingival plaque was collected from each half of every tooth evaluated clinically. Spirochetes were identified with phase contrast microscopy and specific treponema were detected immunochemically using monoclonal antibodies to Treponema denticola serovars A-D, T. socranskii subspecies bucalle, T. socranskii subspecies socranskii, and T. pallidum (pathogen-related oral spirochetes, PROS). The counting protocol was conservative and probably underestimated the actual presence of organisms. Spirochetes were found at one or more sites in approximately 60% of subjects in all groups. PROS were found in approximately 40% of subjects in all groups while T. denticola (predominantly serotype B) and T. socranskii (exclusively T. socranskii subsp. buccale) were more frequently observed in Group 2 (roughly 25% for both treponema) than in Groups 1 or 3. Overall, spirochetes were detected in less than 15% of the 4,040 sites examined. Spirochetes were found at more sites of periodontitis (group mean range 20 to 40%) than of gingivitis (6 to 20%), and were only infrequently found at sites of periodontal health (4 to 10%). Spirochetes were identified most often in plaque from around molars and they were usually found in only one of two samples from individual teeth. Results of this study suggest that although spirochetes are most often found associated with periodontitis, their distribution is restricted and most periodontitis sites do not harbor spirochetes.

Adult↗
PubMed1995

The apical border plaque in severe periodontitis. An ultrastructural study.

This study concerns the apical border (AB) plaque in relation to severe forms of periodontitis (SP), including juvenile, post-juvenile, and rapidly progressing periodontitis. Twenty-four (24) teeth from 16 patients with SP were examined by transmission electron microscopy (TEM). The AB was not discrete, with islands of bacteria in the so-called plaque-free zone (PFZ). Coronal to the AB the established plaque consisted of a layer of Gram-positive cocci and ghost cells and a superficial layer mainly of Gram-negative morphotypes, including cocci, rods, filaments, fusiforms, and spirochetes. The most apical apparently intact organisms in the PFZ were in bacterial islands or in isolation and were predominantly Gram-negative cocci and rods, with ghost cells in abundance. Ruthenium red, alcian blue-lanthanum nitrate, and safranin O were used to label matrix polyanionic macromolecules, and periodic acid (thiosemicarbazide) silver proteinate for intracellular polysaccharide (IPS). The matrix components were mainly fibrillar. Many intact bacteria exhibited extracellular polysaccharides or glycocalyces associated with their cell wall, and cytoplasmic IPS granules. The latter varied in distribution and were evident even in the most apically advanced intact microorganisms. The results indicate that IPS and some matrix features of the apical border plaque in severe periodontitis in certain aspects resemble those of sub-contact area plaque on children's teeth, in health or associated with early chronic gingivitis, and with those in chronic adult periodontitis. They also suggest the establishment of acidic regions in the microniche at the bottom of the periodontal pocket in the various forms of periodontitis differing in rate of progression. It was concluded that there was a limited range of intact bacterial morphotypes in the apical border plaque in severe periodontitis, similar to those in chronic adult periodontitis.

Adolescent↗
PubMed1995

Bacterial-stimulated cytokine production of peripheral mononuclear cells from patients of various periodontitis categories.

Periodontitis is a general term for disease categories, including juvenile periodontitis (JP), rapidly progressive periodontitis (RPP), and adult periodontitis (AP), which may or may not share a common etiology and pathogenesis. These disease categories are characterized by differences in progression of tissue destruction and differences in age group susceptibility, but not, to our knowledge, by differences in cytokine responses of inflammatory cells. The present study examined blood cell counts and interindividual variation in the ability of PBMC of patients in three different categories of periodontitis to produce cytokines after stimulation with different oral bacterial species in vitro. The AP group had a significantly lower production of IL-1ra when stimulated with Porphyromonas gingivalis (P.g.) and Actinobacillus actinomycetemcomitans (A.a.) (P < 0.05). Streptococcus sanguis (S.s.), which is associated with normal periodontal conditions, induced extremely high levels of IL-1 alpha and TNF alpha production in all groups. The RPP group had a significantly higher number of monocytes (MC) than the AP group (P < 0.05). Additionally, JP patients had a significantly higher concentration of polymorphonuclear granulocytes compared to juvenile controls (P < 0.05). In conclusion, IL-1 alpha, TNF alpha, or IL-6 production by peripheral blood MC after in vitro stimulation with oral bacterial type stains may not distinguish different categories of periodontitis. The results support the hypothesis that the cytokine IL-1ra is produced in different concentrations in the two groups: RPP and AP. Furthermore, elevated MC concentration in the RPP group compared to the AP group may be an important pathogenic feature in RPP.

Adolescent↗
PubMed1995

Occurrence of certain bacterial species and morphotypes in juvenile periodontitis in Chile.

The occurrence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Eikenella corrodens, Fusobacterium nucleatum, Campylobacter rectus, Capnocytophaga species, and certain bacterial morphotypes was determined in 18 affected and 18 unaffected sites in 10 localized juvenile periodontitis (LJP) patients, and in 10 affected and 10 unaffected sites in 5 generalized juvenile periodontitis (GJP) patients. The subgingival proportion of the 7 bacterial species was determined by selective and nonselective culturing. The results showed that when considering the pure prevalence of bacteria ( > 0%) there were significant differences (P < 0.05) in the subgingival plaque microflora of the affected sites versus those of the unaffected sites for P. gingivalis, A. actinomycetemcomitans, P. intermedia, E. corrodens, C. rectus, and F. nucleatum in LJP, and for P. gingivalis, P. intermedia, and F. nucleatum in GJP. The mean proportions of cocci, motile rods and spirochetes were also significantly different (P < 0.05) in affected sites compared to unaffected sites. Capnocytophaga sp, F. nucleatum, P. intermedia, and E. corrodens were found in more than 75% of affected sites in LJP. When taking the approach that an organism, to be associated with periodontal disease, has to be detected above a certain minimum threshold, the results indicated that bacteria most frequently associated with LJP and GJP in Chile are P. gingivalis (66% of LJP and 80% of GJP affected sites), and A. actinomycetemcomitans (44% of LJP and 50% in GJP affected sites). Different bacterial species may be judged to be important in the disease process depending upon whether a pure bacterial prevalence, or a prevalence above a certain detection level, is considered.

Adolescent↗