[Bacteria and periodontal diseases].
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Mouth↗
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Results for “PERIODONTAL DISEASE”
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[Treatment of periodontal diseases].
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Dentistry↗
[Why so much untreated periodontal disease?].
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Humans↗
Classification and epidemiology of periodontal diseases.
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Humans↗
Periodontal disease as a risk factor for ischemic stroke.
BACKGROUND AND PURPOSE: Chronic infectious diseases may increase the risk of stroke. We investigated whether periodontal disease, including periodontitis and gingivitis, is a risk factor for cerebral ischemia. METHODS: We performed a case-control study with 303 patients examined within 7 days after acute ischemic stroke or transient ischemic attack, 300 population controls, and 168 hospital controls with nonvascular and noninflammatory neurological diseases. All subjects received a complete clinical and radiographic dental examination. The individual mean clinical attachment loss measured at 4 sites per tooth served as the main indicator for periodontitis. RESULTS: Patients had higher clinical attachment loss than population (P<0.001) and hospital (P=0.010) controls. After adjustment for age, sex, number of teeth, vascular risk factors and diseases, childhood and adult socioeconomic conditions, and lifestyle factors, the risk of cerebral ischemia increased with more severe periodontitis. Subjects with severe periodontitis (mean clinical attachment loss >6 mm) had a 4.3-times-higher (95% confidence interval, 1.85 to 10.2) risk of cerebral ischemia than subjects with mild or without periodontitis (<or=3 mm). Severe periodontitis was a risk factor in men but not women and in younger (<60 years) but not older subjects. Periodontitis increased the risk of cerebral ischemia caused by large-artery atherosclerosis, cardioembolism, and cryptogenic etiology. Gingivitis and severe radiologic bone loss were also independently associated with the risk of cerebral ischemia, whereas caries was not. CONCLUSIONS: Our study indicates that periodontal disease, a treatable condition, is an independent risk factor for cerebral ischemia in men and younger subjects.
Acute Disease↗
[Risk factors in periodontal disease].
Some life styles and systemic pathologies represent risk factors for the periodontal disease. Cigarette smoking in particular increases the speed of progression of periodontitis. Other conditions such as diabetes mellitus, presence of genetic markers and some bacteria are significantly correlated with the periodontal disease.
Age Factors↗
Detection of highly and minimally leukotoxic Actinobacillus actinomycetemcomitans strains in patients with periodontal disease.
This study examined the prevalence of highly and minimally leukotoxic Actinobacillus actinomycetemcomitans in patients with periodontal disease. Pooled subgingival plaque samples from 136 patients with some form of periodontal disease were examined. Subjects were between 14 and 76 years of age. Clinical examinations included periodontal pocket depth (PD), plaque index (PI) and bleeding index (BI). The obtained plaque samples were examined for the presence of highly or minimally leukotoxic A. actinomycetemcomitans strains by the polymerase chain reaction (PCR). Chi-square and logistic regression were performed to evaluate the results. Forty-seven subjects were diagnosed with gingivitis, 70 with chronic periodontitis and 19 with aggressive periodontitis. According to chi-square there was no significant correlation detected between PD (chi2 = 0.73), PI (chi2 = 0.35), BI (chi2 = 0.09) and the presence of the highly leukotoxic A. actinomycetemcomitans. The highly leukotoxic A. actinomycetemcomitans strains were correlated with subjects that were 28 years of age and younger (chi2 = 7.41). There was a significant correlation between highly leukotoxic A. actinomycetemcomitans and aggressive periodontitis (chi2 = 22.06). This study of a Brazilian cohort confirms the strong association between highly leukotoxic A. actinomycetemcomitans strains and the presence of aggressive periodontitis.
Adolescent↗
Clinical, microbiological and immunological features of subjects with destructive periodontal diseases.
76 subjects with prior evidence of destructive periodontal diseases were monitored clinically and immunologically every 2 months for up to 5 years. Clinical parameters measured included bleeding on probing, gingival redness, plaque accumulation, suppuration, pocket depth and attachment level. Blood samples were taken by venipuncture and serum antibody levels to a series of 18 subgingival species determined. 33 of these subjects showed evidence of active disease during the monitoring period, based on changes in attachment level measurements assessed using the tolerance method of analysis. Mean attachment loss in these 33 subjects varied from 1.4 mm to 9.0 (median value 3.4 mm) and subjects whose mean attachment level was above the median showed a higher % of pockets greater than 3 mm and more suppuration. Severity of gingival inflammation related poorly to mean attachment loss. Subgingival plaque samples were taken from the active site(s) and from control sites of equal pocket depth and attachment loss in the same active disease subjects, prior to therapy, for predominant cultivable microbiota studies. 50 randomly selected isolates were identified from each sample. Predominant cultivable species in 170 pretreatment active and inactive sites combined (8500 isolates) were enumerated. The most frequently detected species were F. nucleatum (112 sites) and S. intermedius (106 sites), although the predominant species in the samples from each subject differed. The distribution of putative pathogens differed among subjects. For example, A. actinomycetemcomitans was found in 21 samples in 11 subjects and B. forsythus was found in 18 samples from 10 individuals. Antibody response patterns to the 18 subgingival species also varied among subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Viruses in periodontal disease - a review.
The purpose of this review was to evaluate the evidence supporting the hypothesis that viral infection plays a role in the development of periodontitis. An involvement in periodontal diseases has been suspected specifically for human immunodeficiency virus (HIV) and herpes viruses. An association has been demonstrated between HIV infection and some distinct forms of periodontal infection, i.e. necrotizing lesions. Furthermore, reports of increased prevalence and severity of chronic periodontitis in HIV-positive subjects suggests that HIV infection predispose to chronic periodontitis. Several studies, most of them from the same research group, have demonstrated an association of herpesviruses with periodontal disease. Viral DNA have been detected in gingival tissue, gingival cervicular fluid (GCF) and subgingival plaque from periodontaly diseased sites. In addition markers of herpesviral activation have been demonstrated in the GCF from periodontal lesions. Active human cytomegalovirus (HCMV) replication in periodontal sites may suggest that HCMV re-activation triggers periodontal disease activity. Concerns regarding sampling, methods and interpretation cast doubts on the role of viruses as causes of periodontal disease.
Dental Plaque↗
Association between HLA system and periodontal diseases.
HLA system plays an important role in the regulation of the immune response. Association between HLA genes and disease has been shown for several disorders, in particular auto-immune diseases. HLA system may also be associated with periodontal diseases. It has been suggested that HLA-A2 is related to resistance in juvenile periodontitis and A9 to susceptibility in juvenile periodontitis (JP) and rapidly progressive periodontitis (RPP). DR2, DR4 and DQw1 may also be susceptibility factors in JP and RPP. If implicated in periodontal diseases, HLA system may be associated with low or non-responsiveness to plaque bacterial antigens which could result in disease progression.
Aggressive Periodontitis↗
Current role of pharmaceuticals in prevention of caries and periodontal disease.
Epidemiological studies, based on the tooth surface as a unit of reference, confirm a strong correlation between dental plaque and the initiation of dental caries and periodontal disease. Therefore, prevention of caries and periodontal disease must be based on plaque control. Dental plaque can be controlled both mechanically and chemically. Both methods can be achieved by self-care, or professionally by dentists and dental hygienists. Chemical antimicrobial products are used for non-specific plaque control, as well as against specific microbes associated with the aetiology of caries and periodontal disease. Most products are applied topically (mouthrinses, gels, dentifrices and varnishes). The use of fluoride is generally accepted specifically for caries prevention. It is evident that the caries preventive effects of fluorides are mainly post-eruptive due to fluoride in drinking water, milk, salt and tablets. Dentifrices are the major, most widespread commercial product for topical use, followed by mouthrinses, gels, prophy pastes and slow-release fluoride products such as varnishes and glass ionomers. Dentifrices, mouthrinses and gels containing both fluorides and antimicrobial agents are also available. Products, methods and programmes for all individuals and selected risk individuals are discussed.
Chlorhexidine↗
Relationship between periodontal disease status and combination of biochemical assays of gingival crevicular fluid.
BACKGROUND: Currently, no biochemical assay involving gingival crevicular fluid is utilized routinely as a screening test for periodontal disease. OBJECTIVE: The objective of the present study was to evaluate the potential of gingival crevicular fluid assay as a screening methodology. METHODS: The subject population was comprised of 27 volunteers. Nine participants were classified as 'subject with periodontal destruction' (SPD) exhibiting at least one site with pocket depth and attachment loss>3.5 mm, whereas the remaining individuals were categorized as 'subject with minimal periodontal destruction' (SMD). Gingival crevicular fluid was collected from fixed sites via a standardized method. Biochemical assays of 12 substances (hemoglobin, albumin, transferrin, alpha(1)-antitrypsin, fibronectin, IgA, IgG, IgM, lactoferrin, myeloperoxidase and neutrophil elastase) were conducted at a commercial laboratory. Power transformation of total quantities in gingival crevicular fluid was performed for statistical analysis. RESULTS: Relationships between total quantity of each substance and periodontal disease status were unclear. Logistic regression analysis yielded six predictive models, which consisted of substance pairs: neutrophil elastase/IgA, neutrophil elastase/hemoglobin, neutrophil elastase/alpha(1)-antitrypsin and neutrophil elastase/IgG, and IgA/albumin and IgA/transferrin (p<0.05). Regression lines for SPD and SMD on a scattergram of IgA and neutrophil elastase were nearly parallel within the range of amounts in gingival crevicular fluid. The predictive model derived from both substances afforded sensitivity and specificity of 88% and 94%, respectively. CONCLUSIONS: These results indicated that the combination of IgA and neutrophil elastase in gingival crevicular fluid may be crucial for prediction of periodontal disease status. Furthermore, these data suggested that biochemical assays employing both substances in gingival crevicular fluid may provide a satisfactory screening test for periodontal disease.
Adult↗
The relationship between periodontal disease and blood glucose level among type II diabetic patients.
The aim of this study was to determine the relationship between periodontal disease and the blood glucose level among type II non-insulin dependent diabetic mellitus (NIDDM) subjects. Forty subjects, 20 in each group, of healthy and diabetic subjects, ages ranged 20-70 years, were examined at King Saud University, College of Dentistry. Clinical examination included frequency of oral hygiene practices, periodontal status by using the Community Periodontal Index of Treatment Needs (CPITN), fasting blood glucose level (FBGL), and random blood glucose level (RBGL). Unstandardized orthopantomograms (OPGs) were taken for radiographic findings. The number of missing teeth (tooth loss) was assessed from the radiographs. The results showed that periodontal disease severity was high among diabetic subjects. Diabetic subjects brushed less frequently, and they had a higher blood glucose level than healthy subjects. The mean CPITN score was compared with mean blood glucose level and the severity of periodontal disease. There was a steady increase in blood glucose level with increase in CPITN scores, i.e., CPITN score 13.5 to 19.12 corresponded with 142 mg/dl and 173.2 mg/dl FBGL, and 184.2 and 199.12 mg/dl RBGL among diabetic subjects. The study indicated that diabetic subjects should improve their oral hygiene practices and control of blood glucose levels should be emphasized. Further studies are needed among diabetics and healthy subjects from the general population with better sampling techniques and a larger sample size.
Adult↗
Associations of medical status and physical fitness with periodontal disease.
To determine the possible associations of medical status and physical fitness with periodontal disease, a cross-sectional study was conducted. The subjects were 517 males and 113 females aged 23 to 83 years who participated in a multiphasic health test at the Aichi Prefectural Center of Health Care, Japan, from 1992 to 1997. Their periodontal status was assessed by means of the CPITN scoring system. To assess the strength of associations between the examined factors and the score, odds ratios were computed using ordinal logistic models. Conventional risk factors such as old age, smoking habits, and higher fasting plasma glucose and simplified debris index increased the risk of periodontal disease. Hypertension, hematuria, leucocytosis or thrombocytosis, positive C-reactive protein and higher serum alkaline phosphatase were positively associated with the score, whereas higher serum high-density lipoprotein cholesterol was related to a lower risk. Poor physical fitness affecting aerobic capacity, foot balance and reaction was associated with a higher CPITN score. These associations were independent of the conventional risk factors. Although these new potential risk factors should be further investigated for their causal relationship, our findings suggested a close relationship of oral health to medical status and physical fitness.
Adult↗
Use of the basic periodontal examination and radiographs in the assessment of periodontal diseases in general dental practice.
OBJECTIVES: The aims of this study were to investigate (1) the use of the basic periodontal examination (BPE) by general dental practitioners (GDPs) and their selection of radiographs for the assessment of periodontal disease and (2) whether this selection concurred with existing selection (referral) criteria. METHODS: Three mailings of a self-completion questionnaire were sent to 800 GDPs working in the National Health General Dental Service in England and Wales. Dentists were presented with six clinical scenarios for which they were asked to describe their use of radiographs. RESULTS: Ninety-one percent of dentists reported that they used the BPE in new patients, with 56% using it for all patients; 84% of dentists used BPE in recall patients. BPE use was related to the dentists' age and postgraduate qualifications. There was a wide variation in the radiographic views used for periodontal disease assessment. The choice of radiographs was not generally in line with the Faculty of General Dental Practitioners (UK) 1998 selection criteria, particularly for the clinical scenarios of pocketing >5 mm, irregular pocketing or pockets associated with teeth with heavy restorations. Sixty seven percent of dentists concurred with recommendations for radiographs for a suspected periodontal-endodontic lesion. CONCLUSIONS: A majority of dentists reported clinical screening for periodontal diseases using the BPE. There was considerable variation in the selection and use of radiographs and practice was not in line with existing guidelines for many clinical situations. Evidence-based referral criteria should be actively promoted to ensure high standards of radiographic practice in general dental practice.
Adult↗
The role of Actinobacillus actinomycetemcomitans in periodontal disease.
The different forms of periodontitis are all associated with a distinct bacterial flora. However, a clear relationship is described between localized juvenile periodontitis (LJP) and Actinobacillus actinomycetemcomitans. Eleven LJP patients all harboured A. actinomycetemcomitans. The arrest of LJP is often impossible, due to the inability to eliminate A. actinomycetemcomitans. Therefore, antibiotic treatment was introduced in combination with the initial treatment. We studied the effect of periodontal treatment on the microflora and clinical status of periodontal disease patients using different therapies. Group 3 attained the best results (initial treatment and a combination metronidazole and amoxicillin), the group to eliminate A. actinomycetemcomitans effectively.
Actinobacillus↗
Clinical outcome observed in subjects with recurrent periodontal disease following local treatment with 25% metronidazole gel.
BACKGROUND: The aim of this study was to evaluate the clinical outcome in patients with recurrent periodontal disease following treatment with 25% metronidazole gel. METHODS: Twenty subjects in a maintenance care program but with recurrent periodontal disease participated. Three months after scaling and root planing, a total of 40 sites, 2 in each patient, with probing depth > or = 5 mm were selected. One site randomly selected was treated with metronidazole gel (test) and the other site with a placebo gel (control). Baseline and follow-up measurements included plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL). RESULTS: There were no statistically significant differences in PI, GI, BOP, PD, or CAL between test and control sites. CONCLUSION: This study showed that local treatment with 25% metronidazole gel did not seem to influence the clinical healing in this group of subjects with recurrent periodontal disease.
Adult↗
Association of periodontal disease and histologic lesions in multiple organs from 45 dogs.
Forty-five mixed breed dogs were evaluated for the presence and extent of periodontal disease. Histopathology was performed on samples of lung, myocardium, liver, kidney, tonsil, spleen, submandibular lymph node and tracheobronchial lymph node. Mitral valves were evaluated grossly. Statistical analysis was used to determine if there was a relationship between the extent of periodontal disease and histopathologic changes in the tissues examined. In the forty-five dogs studied, an association was found between periodontal disease and histopathologic changes in kidney, myocardium (papillary muscle), and liver.
Animals↗