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PubMed2005

Association of interleukin-1 polymorphisms with periodontal disease.

BACKGROUND: Several studies have investigated genetic polymorphisms for cytokines as potential genetic markers for periodontitis. Some studies have found that interleukin (IL)-1A and IL-1B polymorphisms are associated with a higher severity of periodontitis, while others found no association. The aims of this study were to determine the prevalence of the IL-1A-889 and IL-1B+3954 (previously described as +3953) polymorphisms in Chileans and their association with periodontitis. METHODS: Subjects aged 20 to 48 were selected from people requesting dental treatment at a public health center in Santiago, Chile. A case-control study of 330 cases of periodontitis patients and 101 healthy controls was performed. A full-mouth periodontal examination was performed on each subject and a structured questionnaire was conducted to determine smoking habits. Cases were categorized as having initial, moderate, or severe periodontitis according to the percentage of sites with clinical attachment loss > or =3 mm. Genomic DNA was analyzed for polymorphism in the IL-1A gene at site -889 and IL-1B gene at site +3954 by polymerase chain reaction (PCR) amplification followed by restriction enzyme digestion and gel electrophoresis. Data were analyzed by chi square test, analysis of variance (ANOVA), and by calculating odds ratio (OR) and 95% confidence intervals (CI). RESULTS: Demographic and socio-economic characteristics of subjects were similar in cases and in controls. A higher frequency of heterozygous of the IL-1A-889 was found in cases than in controls, but the difference was not significant. The heterozygous of the IL-1B+3954 was significantly higher in cases than in controls and was associated with periodontitis (OR 3.12, 95% CI 1.59 to 6.09, P = 0.001). The homozygous for allele 1 of the IL-1B+3954 was a protective factor for periodontitis (OR 0.35, 95% CI 0.19 to 0.66, P = 0.001). The prevalence of positive genotype (at least one allele 2 present at each locus) was significantly higher in cases (26.06%) than in controls (9.9%) and was significantly associated with periodontitis (OR 3.21, 95% CI 1.60 to 6.44, P = 0.001), irrespective of the smoking status and periodontitis severity. Sensitivity of positive genotype was 26%, the specificity 90%, and the positive predictive value 89%. CONCLUSION: Within the limits of this study, the results show that individuals carrying the positive genotype have significantly greater risk for developing periodontitis.

Adult↗
PubMed2006

Salivary histamine level as a predictor of periodontal disease in type 2 diabetic and non-diabetic subjects.

BACKGROUND: Some previous investigations underscored the role of histamine in periodontal disease, especially in diabetic patients, but the behavior of this inflammatory mediator in the early phases of periodontal involvement remains unclear. The aim of the present study was to correlate the presence of histamine in saliva with clinical parameters in healthy, periodontitis-affected, and diabetic subjects to ascertain whether this amine may serve as a predictive index of periodontal risk. METHODS: For this purpose, subjects were selected as follows: 1) with newly diagnosed type 2 diabetes mellitus; 2) with neither diabetes nor periodontitis; 3) with no diabetes but with chronic, untreated periodontal disease. Histamine salivary levels were measured at the initial time (T0) and after 6, 12, and 24 months using high-performance liquid chromatography. The main periodontal indexes were recorded at the same time intervals. RESULTS: At T0, a very typical shape of the histamine chromatogram was found for all patients of the three groups; at this time, the salivary histamine levels of diabetic patients were increased and comparable to those of healthy patients with periodontal disease, whereas healthy subjects with no periodontitis showed reduced histamine levels. Further controls at 6, 12, and 24 months showed a statistically significant correlation between the increase of salivary histamine and the worsening of the periodontal indexes in diabetic and non-diabetic subjects. CONCLUSION: These results suggest that salivary histamine may serve as a predictive index in the prevention of periodontal disease.

Aged↗
PubMed2006

Unilateral severe chronic periodontitis associated with ipsilateral surgical resection of cranial nerves V, VI, and VII.

BACKGROUND: The central and peripheral nervous systems participate in several local physiological and pathological processes. There is experimental evidence that the inflammatory, local immune, and wound healing responses of a tissue can be modulated by its innervation. The aim of this clinical report is to present a case of unilateral severe periodontitis associated with ipsilateral surgical resection of the fifth, sixth, and seventh cranial nerves and to discuss the possible contribution of the nervous system to periodontal pathogenesis. METHODS: A 39-year-old female patient with a history of a cerebrovascular accident caused by a right pontine arteriovenous malformation and destruction of the right fifth, sixth, and seventh cranial nerves was diagnosed with severe chronic periodontitis affecting only the right maxillary and mandibular quadrants. The patient's oral hygiene was similar for right and left sides of the mouth. Percentages of tooth surfaces carrying dental plaque were 41% and 36% for right and left sides, respectively. Non-surgical and surgical periodontal therapy was performed, and the patient was placed on a regular periodontal maintenance schedule. RESULTS: Healing following initial periodontal therapy and osseous periodontal surgery occurred without complications. Follow-up clinical findings at 1 year revealed stable periodontal health. CONCLUSIONS: This case report suggests that periodontal innervation may contribute to the regulation of local processes involved in periodontitis pathogenesis. It also suggests that periodontal therapy can be performed successfully at sites and in patients affected by paralysis.

Abducens Nerve↗
PubMed2000

Periodontal health of Singapore school children over two decades from 1970 to 1994.

Dental health surveys of school children in Singapore from the past two decades were reviewed to document changes in prevalence and severity of periodontal disease. In 1970, 1979, 1984, 1989 and 1994 a sample of 12,801, 10,232, 4,203, 4,733 and 5,005 school children aged 6-18 years respectively, were examined in schools by the Dental Division, Ministry of Health. Parameters examined were oral hygiene, calculus, gingival inflammation/bleeding and periodontal pockets. Oral hygiene was assessed by the Oral Hygiene Index of Greene and Vermillion. Periodontal condition was assessed by observation of presence or absence of gingival inflammation and periodontal pockets in the early surveys, and the Community Periodontal Index of Treatment Needs in 1989 and 1994. Findings demonstrated oral hygiene among children in Singapore was good. The mean Debris Scores for 6-11 year old were 0.74, 0.78 and 0.72 respectively in 1979, 1984 and 1989 while those of 12-18 year old were 0.43, 0.80 and 0.56 respectively for the corresponding years. Proportions of younger children with no periodontal disease were 32.2%, 60.0%, 59.0%, 31.0% and 34.4% in 1970, 1979, 1984, 1989 and 1994 respectively. For children aged twelve and above, proportions with no periodontal disease were 24.5%, 55.8%, 29%, 12% and 30% respectively in 1970, 1979, 1984, 1989 and 1994. Prevalence of gingivitis remained relatively high. However, a decrease in gingivitis from 1970 to 1979 in both age groups was noted. The period from 1984 to 1994, trends were dealt with cautiously due to changes in indices used. Severity of periodontal disease declined in terms of reduced mean number of diseased units/sextants and decrease in prevalence of periodontal pockets. Comparison of survey data for 1970, 1979, 1984, 1989 and 1994 shows improvement in periodontal health among children in Singapore over the past 2 decades. There is a continuing need for greater effort to promote better oral hygiene practices in view that only one third of children in 1994 had no periodontal disease.

Adolescent↗
PubMed2003

Interleukin-1beta, clinical parameters and matched cellular-histopathologic changes of biopsied gingival tissue from periodontitis patients.

OBJECTIVE: The aim of the present study was to investigate whether interleukin (IL)-1beta in diseased tissues adjacent to periodontal pockets can reflect the degree of inflammation and destruction of these tissues pathologically. BACKGROUND: IL-1beta-dependent mechanisms have been strongly implicated in contributing to inflammation and destruction of bone and attachment loss, which are characteristic features of periodontal disease. This biochemical mediator released during pro-inflammatory processes has not been objectively integrated with clinical and histopathologic features of periodontal disease. METHODS: Periodontitis-affected inflamed tissue and clinically nonaffected healthy gingivae were harvested from 14 periodontal patients, respectively. The severity of tissue inflammation was illustrated by clinical parameters and cellular histologic changes and quantified by histometric assessments. IL-1beta in these extracted specimens was measured with an enzyme-linked immunosorbent assay (ELISA) technique. Pathogenic roles that IL-1beta plays in gingival inflammation and pathologic tissue changes in tissue sections were analyzed statistically. RESULTS: The overall total tissue IL-1beta, tissue concentration of IL-1beta, and percentage of inflammatory cell infiltration (PICI) determined from diseased gingivae were obviously higher than those of controls from both healthy sites of periodontitis and non-periodontitis subjects. With increasing gingival index (GI), plaque index (PlI), and probing depth (PD), there was a marked elevation in total tissue IL-1beta. Total tissue IL-1beta was significantly correlated with GI, PlI, the PICI, and tissue alterations. Polymorphonuclear leukocytes (PMNs) and monocyte-macrophage cells seemed to predominate in heavily infiltrated areas of diseased gingiva. These cell types were confirmed by immunocytochemical localization with either monoclonal mouse antihuman neutrophil elastase antibody or monoclonal mouse antihuman macrophage (CD68) antibody, respectively. Total tissue IL-1beta and the PICI were also elevated in diseased gingivae near deeper PD, while neither total IL-1beta nor tissue concentration was statistically correlated with PD. Thus, correlation analysis indicates that IL-1beta level in inflamed periodontal tissues correlates highly with clinical parameters (GI and PlI) and PICI (the degree of inflammation). CONCLUSIONS: These observations suggest that IL-1beta plays a significant role in the pathogenic mechanisms of periodontal tissue destruction, and that measurement of tissue IL-1beta would be a valuable aid and useful for diagnostic markers of periodontal diseases.

Adult↗
PubMed2000

Comparison of profiles of key periodontal pathogens in periodontium and endodontium.

Despite the established anatomical relationship between the periodontal and pulpal tissues, bacterial migration between endodontium and periodontium is still under discussion. The objective of this study was an investigation of profiles of periodontal pathogens in pulpal and periodontal diseases affecting the same tooth by means of 16S rRNA gene directed polymerase chain reaction (PCR). 31 intact teeth with both pulp and marginal infections were investigated. The diagnosis was based on clinical and radiological examination. Samples were taken from the gingival sulcus or periodontal pocket, respectively, with sterile paper points before trepanation of the teeth. After trepanation sterile paper points and Hedstroem files were used for taking samples from the root canal. Specific PCR methods were used to detect the presence of the following pathogens: Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Eikenella corrodens, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia and Treponema denticola. In addition, quantitative competitive PCR was used to determine the total bacterial count of the samples. The investigated pathogens were proven to be present in the endondontium in all disease categories. Particularly in endodontic samples of "chronic apical periodontitis" and "chronic adult periodontitis" profiles of the periodontal pathogens were found. The results confirmed that periodontal pathogens often accompany endodontic infections and supported the idea that the periodontic-endodontic interrelationships should be considered as critical pathways which might contribute to refractory courses of endodontic or periodontal diseases.

Adult↗
PubMed2001

Prospective 3-year study of cross-arch fixed partial dentures in patients with advanced periodontal disease.

STATEMENT OF PROBLEM: Several choices exist for the treatment of advanced periodontal disease. One is a combined periodontal and prosthetic treatment that includes cross-arch fixed partial dentures (FPDs). However, the outcomes of such therapy have been reported mainly from studies in Scandinavian countries. PURPOSE: The aims of this study were: (1) to longitudinally evaluate, after periodontal and prosthodontic treatment that included cross-arch FPDs, treatment outcomes in Korean patients who suffered from severe periodontitis; and (2) to evaluate the patients' treatment assessments and the FPDs after 3 years. MATERIAL AND METHODS: This survey included 39 Korean patients provided with 50 FPDs. Clinical and radiographic examinations were performed at the time of delivery of the FPDs and at the 3-year follow-up examinations. The prostheses were divided into 3 groups according to design (end abutments, unilateral cantilever, and bilateral cantilevers) and the amount of supporting tissues at the time of insertion. On average, only 26% of the total original periodontal tissue remained at the time of insertion. The FPDs consisted of 11 to 14 units, with a mean of 5 to 7 abutments in the 3 groups. The mean periodontal ligament area of the abutments was 79% of the total ligament area of the replaced teeth. RESULTS: At the 3-year follow-up examination, the FPDs were stable in all patients, who in general displayed good oral hygiene and had healthy periodontal conditions. The change in periodontal ligament area over the 3-year observation period was negligible (1 mm(2) per dental unit) and showed no statistically significant difference in relation to FPD design. Most patients were satisfied with the function of their FPDs with respect to mastication, phonetics, hygiene, esthetics, and chewing comfort. A few patients stated that they were careful with the FPDs and avoided certain foods (for example, raw peanuts and grilled squid) because they felt insecure with the cantilever segments. Most patients reported that they would choose the same treatment again. CONCLUSION: Patients with advanced periodontal disease demonstrated successful outcomes over a 3-year period and reported satisfaction with combined periodontal and restorative treatment that included cross-arch FPDs.

Adult↗
PubMed1985

The composition of the subgingival microflora of young adults suffering from juvenile periodontitis.

The composition of subgingival plaque, from healthy and periodontally diseased regions, as well as the clinical periodontal condition of 6 patients, 17 to 24-years-old suffering from juvenile periodontitis were examined. 6 older patients with rapidly progressive periodontitis served as a control. Samples of subgingival plaque were taken from first molars and central incisors and were analysed morphologically by dark-field microscopy. In the control group in healthy regions the ratio between non-motile and motile bacteria was 27:1 and about 1:1 in deep pockets. In the juvenile periodontitis group in diseased regions, motile bacteria made up only 1/4 of the bacteria present. The results clearly show that our relatively old patients with juvenile periodontitis had a completely different microflora in their periodontally diseased regions than patients with common periodontitis. As regards our observations by dark-field microscopy, one can assume, however, that with increasing age, there might be a shift of the flora associated with juvenile periodontitis lesions from a rather simple composition to a more complex composition very similar to the flora seen in rapidly progressive adult periodontitis lesions.

Adolescent↗
PubMed1990

Actinobacillus actinomycetemcomitans in families afflicted with periodontitis.

The purpose of this study was to determine the prevalence of Actinobacillus actinomycetemcomitans (Aa) in individuals from families where at least one individual has an early onset form of periodontitis. Twenty-three families with 73 subjects were evaluated in this study. Forty-seven early onset periodontitis subjects outside the 23 families were also studied. Prevalence of detection of Aa in family members ranged from 49% to 66% among groups constituted by clinical findings indicative of no loss of attachment, adult periodontitis, generalized severe juvenile periodontitis, or localized juvenile periodontitis. Whether the data were analyzed by subject or by site, no statistical differences could be found in prevalence (proportion of positive samples) among those clinical groups. The only significant difference was that localized juvenile periodontitis subjects had higher concentrations of Aa in their Aa-positive sites than did the other clinical groups. The prevalence of Aa-positive sites in subjects without attachment loss, but who are members of families in which early onset periodontitis is represented, was much higher than in other reports where periodontally healthy subjects were not related to early onset periodontitis cases. This suggests that Aa may be transmitted among members of families in which one or more members has an early onset form of periodontitis.

Actinobacillus↗
PubMed2000

Periodontal disease and risk of cerebrovascular disease: the first national health and nutrition examination survey and its follow-up study.

BACKGROUND: Periodontal disease has been found to be a potential risk factor for coronary heart disease. However, its association with cerebrovascular accidents (CVAs) is much less studied. METHODS: This study examines the association between periodontal disease and CVA. The study cohort comprises 9962 adults aged 25 to 74 years who participated in the First National Health and Nutrition Examination Survey and its follow-up study. Baseline periodontal status was categorized into (1) no periodontal disease, (2) gingivitis, (3) periodontitis, and (4) edentulousness. All CVAs (International Classification of Diseases, Ninth Revision [ICD-9], codes 430-438) were ascertained by hospital records for nonfatal events and death certificates for fatal events. The first CVA, nonfatal or fatal, was used to define incidence. Relative risks were estimated by hazard ratios from the Cox proportional hazard model with adjustment for several demographic variables and well-established cardiovascular risk factors. Weights were used to generate risk estimates. RESULTS: Periodontitis is a significant risk factor for total CVA and, in particular, nonhemorrhagic stroke (ICD-9, 433-434 and 436-438). Compared with no periodontal disease, the relative risks (95% confidence intervals) for incident nonhemorrhagic stroke were 1.24 (0.74-2.08) for gingivitis, 2.11 (1.30-3.42) for periodontitis, and 1.41 (0.96-2.06) for edentulousness. For total CVA, the results were 1.02 (0.70-1.48) for gingivitis, 1.66 (1.15-2.39) for periodontitis, and 1.23 (0.91-1.66) for edentulousness. Increased relative risks for total CVA and nonhemorrhagic stroke associated with periodontitis were also seen in white men, white women, and African Americans. Similar results were found for fatal CVA. CONCLUSION: Periodontal disease is an important risk factor for total CVA and, in particular, nonhemorrhagic stroke.

Adult↗
PubMed2005

Retrospective evaluation of complete-arch fixed partial dentures connecting teeth and implant abutments in patients with normal and reduced periodontal support.

STATEMENT OF PROBLEM: The clinical outcome of complete-arch fixed prostheses supported by implants and natural tooth abutments in patients with normal or reduced periodontal support has been reported by few studies, with controversial results. PURPOSE: The purpose of this study was to report on the implant success rate, prosthetic complications, and the occurrence of tooth intrusion, when complete-arch fixed prostheses, supported by a combination of implants and teeth, were fabricated for patients with normal and reduced periodontal support. MATERIAL AND METHODS: Nineteen patients with residual teeth that served as abutments were consecutively treated with combined tooth- and implant-supported complete-arch fixed prostheses and were retrospectively evaluated after a period varying from 24 to 94 months. Nine patients showed reduced periodontal support as a result of periodontal disease and treatment (RPS group), and 10 patients had normal periodontal support of the abutment teeth (more than 2/3 of periodontal support [NPS group]). Ninety implants and 72 tooth abutments were used to support 19 fixed partial dentures. Screw- and cement-retained metal-ceramic and metal-resin prostheses were fabricated with rigid and nonrigid connectors. Implant survival and success rates, occurrence of caries and tooth intrusion, and prosthetic complications were recorded. The number of teeth, implants, prosthetic units, fixed partial dentures, and nonrigid connectors were compared with a t test to assess differences between the 2 groups, while data for the occurrence of intrusions and prosthetic complications were compared with the Fisher exact test (alpha=.05). RESULTS: One of the 90 implants was lost (99% survival rate) over 24 to 94 months, while 3 implants showed more than 2 mm of crestal bone loss (96% success rate) over the same period. No caries were detected, but 5.6% (4/72) of the abutment teeth exhibited intrusion. Intrusion of abutment teeth was noted in 3 patients who had normal periodontal support (13% of teeth in NPS group) of the abutment teeth and was associated with nonrigid connectors. No intrusion of teeth was noted in the patients exhibiting reduced periodontal support regardless of the type of connector or when a rigid connector was used for either group. The number of intruded teeth was significantly greater in patients with intact periodontal support (P=.03). CONCLUSIONS: Complete-arch fixed prosthesis supported by implant and tooth abutments may be associated with intrusion of teeth with intact periodontal support when nonrigid connectors are used to join the implant- and tooth-supported sections of the prostheses. However, fixed partial dentures supported by implants and teeth with reduced periodontal support were not associated with tooth intrusion, regardless of the type of connectors used.

Adult↗
PubMed2002

Sister chromatid exchange (SCE) analysis in periodontitis.

BACKGROUND: Emerging data indicate that genetic factors may be associated with the etiopathogenesis of aggressive periodontitis. Sister chromatid exchange (SCE) is a sensitive method that might reflect an instability of DNA or a deficiency of DNA repair. The aim of the present study was to investigate SCE frequency of patients with different forms of periodontal disease and to determine whether this cytogenetic marker in patients with aggressive periodontitis can be differential compared to patients with chronic periodontitis and control subjects. METHODS: SCE was analysed in peripheral blood lymphocyte chromosomes of 13 patients with generalised aggressive periodontitis (G-AP), 10 patients with chronic periodontitis (CP) and 10 control subjects. The periodontal parameters of probing depth, clinical attachment level, the presence of bleeding on probing and plaque were recorded. Peripheral blood lymphocytes obtained from both patient groups and control subjects were cultured in the presence of 5-Bromo-2-deoxyuridine in complete darkness for 72 h. For scoring SCE frequency, 20 metaphases were studied from each donor. RESULTS: The frequency of SCE was found to be 6.7 +/- 0.9 per cell in patients with G-AP, 6.5 +/- 1.5 per cell in CP patients and 6.9 +/- 1.1 in control subjects. No statistically significant differences were found between groups (p > 0.05). CONCLUSIONS: The data indicate that there the cyotogenetic damage in the aggressive type of periodontal disease is not greater than in chronic periodontitis and control subjects. Although no aberrant cytogenetic damage was observed in different forms of periodontitis compared to control, this does not discount the importance of other genetic factors in the pathogenesis of periodontal disease.

Acute Disease↗
PubMed2003

A hidden periodontitis epidemic during the 20th century?

OBJECTIVES: Increasing evidence suggests a strong causal link between smoking and periodontitis. The goal of this study was to impute how the secular changes in smoking prevalence during the 20th century impacted the advanced periodontitis incidence in the US. METHODS: Epidemiological analyses based on US prevalence data of advanced periodontitis and smoking, and predictions of future smoking prevalence. RESULTS: Assuming other risk factors for periodontitis remained constant, we estimated that the incidence of advanced periodontitis decreased by 31% between 1955 and 2000. The changes in smoking habits, and consequently the changes in periodontitis incidence, depended strongly on education and gender. Between 1966 and 1998, we estimated a 43% decreased periodontitis incidence among college-educated individuals versus only an 8% decrease among individuals with less than a high school education. Between 1955 and 1999, we estimated a 41% decrease among males versus a 14% decrease among females. By the year 2020, the incidence of advanced periodontitis may decrease 43% from its level in 1955. CONCLUSIONS: A periodontitis epidemic fueled by smoking remained hidden for most of the 20th century. Because this epidemic was hidden, it distorted our understanding of the treatment and etiology of periodontitis. The socioeconomic polarization of this epidemic will dictate alterations in patterns of periodontal care.

Adult↗
PubMed2000

Primer for antimicrobial periodontal therapy.

Successful prevention and treatment of periodontitis is contingent upon effective control of the periodontopathic microbiota. Periodontal pathogens reside in subgingival sites but also colonize supragingival plaque, tongue dorsum and other oral sites. Controlling destructive periodontal disease warrants a comprehensive antimicrobial approach that targets periodontal pathogens in various ecological niches of the oral cavity. Also, to effectively combat periodontal pathogens, the various elements of antimicrobial periodontal therapy should be engaged within a short period of time. Scaling and root planing, with or without periodontal surgery, along with proper oral hygiene, constitute the primary approach to controlling periodontopathogens. Antimicrobial agents administered systemically or locally can help suppress periodontal pathogens in periodontal sites and in the entire mouth. Microbiological testing aids the clinician in selecting the most effective antimicrobial agent or combination of agents, and in monitoring the effectiveness of periodontal treatment. The present paper considers theoretical and practical aspects of effective antimicrobial treatment of destructive periodontal disease.

Adult↗
PubMed2000

Response of periodontal ligament fibroblasts and gingival fibroblasts to pulsating fluid flow: nitric oxide and prostaglandin E2 release and expression of tissue non-specific alkaline phosphatase activity.

The capacity of the periodontal ligament to alter its structure and mass in response to mechanical loading has long been recognized. However, the mechanism by which periodontal cells can detect physical forces and respond to them is largely unknown. Besides transmission of forces via cell-matrix or cell-cell interactions, the strain-derived flow of interstitial fluid through the periodontal ligament may mechanically activate the periodontal cells, as well as ensure transport of cell signaling molecules, nutrients and waste products. Mechanosensory cells, such as endothelial and bone cells, are reported to respond to a flow of fluid with stimulated prostaglandin E2 (PGE2) and nitric oxide production. Therefore, we examined the PGE2 and nitric oxide response of human periodontal ligament and gingival fibroblasts to pulsating fluid flow and assessed the expression of tissue non-specific alkaline phosphatase activity. Periodontal ligament and gingival fibroblasts were subjected to a pulsating fluid flow (0.7 +/- 0.02 Pa, 5 Hz) for 60 min. PGE2 and nitric oxide concentrations were determined in the conditioned medium after 5, 10, 30 and 60 min of flowing. After fluid flow the cells were cultured for another 60 min without mechanical stress. Periodontal ligament fibroblasts, but not gingival fibroblasts, responded to fluid flow with significantly elevated release of nitric oxide and decreased expression of tissue non-specific alkaline phosphatase activity. In both periodontal ligament and gingival fibroblasts, PGE2 production was significantly increased after 60 min of flowing. Periodontal ligament fibroblasts, but not gingival fibroblasts, produced significantly higher levels of PGE2 during the postflow culture period. We conclude that human periodontal ligament fibroblasts are more responsive to pulsating fluid flow than gingival fibroblasts. The similarity of the early nitric oxide and PGE2 responses to fluid flow in periodontal fibroblasts with bone cells and endothelial cells suggests that these three cell types possess a similar sensor system for fluid shear stress.

Adolescent↗
PubMed2005

Association of periodontitis with increased white blood cell count and blood pressure.

This study was aimed to examine the association of periodontitis with white blood cell (WBC) count and blood pressure (BP). In 2002, 424 subjects (manufacturing workers) were investigated for periodontitis by a general dentist. All were Japanese. Among them, 364 subjects (269 men and 95 women) who also attended the next year's (2003) screening were enrolled for this study. Of the 364 subjects, 55 (15.1%) had periodontitis. We also measured the BP and WBC count in periodontitis and non-periodontitis subjects at baseline and 1-year later follow-up. The WBC count higher in subjects with periodontitis than in subjects without periodontitis, both at baseline [mean +/- standard error (SE) 6.6 x 10(3) +/- 0.2 x 10(3)/ml vs 5.8 +/- 0.3 x 10(3)/ml; p < 0.001] and follow-up (7.0 +/- 0.3(3)/ml vs 6.5 +/- 0.1(3)/ml; p = 0.003). The systolic BP was higher in subjects with periodontitis than in subjects without periodontitis, both at the baseline (128 +/- 2.1 mmHg vs 120.8 +/- 0.8 mmHg; p < 0.001) and follow-up (129.2 +/- 2.3 mmHg vs 123.0 +/- 0.8 mmHg; p = 0.011), and so was the diastolic BP both at baseline (76 +/- 1.5 mmHg vs 71.2 +/- 0.6 mmHg; p = 0.003) and follow-up (80.5 +/- 1.7 mmHg vs 75.4 +/- 0.7 mmHg; p = 0.004). Periodontitis is associated with increased BP and WBC count. This finding may provide one underlying pathway linking periodontitis and cardiovascular disease.

Adult↗
PubMed2006

Progressive periodontal disease and risk of very preterm delivery.

OBJECTIVE: The goal was to estimate whether maternal periodontal disease was predictive of preterm (less than 37 weeks) or very preterm (less than 32 weeks) births. METHODS: A prospective study of obstetric outcomes, entitled Oral Conditions and Pregnancy (OCAP), was conducted with 1,020 pregnant women who received both an antepartum and postpartum periodontal examination. Predictive models were developed to estimate whether maternal exposure to either periodontal disease at enrollment (less than 26 weeks) and/or periodontal disease progression during pregnancy, as determined by comparing postpartum with antepartum status, were predictive of preterm or very preterm births, adjusting for risk factors including previous preterm delivery, race, smoking, social domain variables, and other infections. RESULTS: Incidence of preterm birth was 11.2% among periodontally healthy women, compared with 28.6% in women with moderate-severe periodontal disease (adjusted risk ratio [RR] 1.6, 95% confidence interval [CI] 1.1-2.3). Antepartum moderate-severe periodontal disease was associated with an increased incidence of spontaneous preterm births (15.2% versus 24.9%, adjusted RR 2.0, 95% CI 1.2-3.2). Similarly, the unadjusted rate of very preterm delivery was 6.4% among women with periodontal disease progression, significantly higher than the 1.8% rate among women without disease progression (adjusted RR 2.4, 95% CI 1.1-5.2). CONCLUSION: The OCAP study demonstrates that maternal periodontal disease increases relative risk for preterm or spontaneous preterm births. Furthermore, periodontal disease progression during pregnancy was a predictor of the more severe adverse pregnancy outcome of very preterm birth, independently of traditional obstetric, periodontal, and social domain risk factors. LEVEL OF EVIDENCE: II-2.

Adolescent↗
PubMed2006

Association of Eubacterium nodatum and Treponema denticola with human periodontitis lesions.

BACKGROUND: The purpose of the present investigation was to compare the levels, proportions and percentage of sites colonized by 40 bacterial species in subgingival plaque samples from periodontally healthy subjects and patients with chronic periodontitis to seek possible pathogens other than the consensus pathogens Porphyromonas gingivalis and Tannerella forsythia. METHOD: Subgingival plaque samples were taken from the mesial aspect of each tooth in 635 subjects with chronic periodontitis and 189 periodontally healthy subjects. The samples were individually analyzed for their content of 40 bacterial species using checkerboard DNA-DNA hybridization (total samples = 21,832). Mean counts, % DNA probe counts and percentage of sites colonized at >10(5) were determined for each species in each subject and then averaged in each clinical group. Significance of difference between groups was determined using the Mann-Whitney test. Association between combinations of species and periodontal status was examined by stepwise logistic regression analysis. Analyses were repeated using a subset of subjects from both clinical groups who had proportions of P. gingivalis plus T. forsythia less than the median (4.42%) found in periodontally healthy subjects. All analyses were adjusted for multiple comparisons. RESULTS: For the 824 subjects the consensus pathogens P. gingivalis and T. forsythia as well as Eubacterium nodatum and Treponema denticola had significantly higher mean counts, proportions and percentage of sites colonized in samples from subjects with periodontitis than from periodontally healthy subjects. There were significantly more Capnocytophaga gingivalis, Streptococcus gordonii and Veillonella parvula in periodontally healthy subjects. E. nodatum, T. denticola, Streptococcus oralis, Streptococcus intermedius, Fusobacterium nucleatum ssp. vincentii all had higher counts and proportions in diseased than healthy subjects who had low proportions of P. gingivalis and T. forsythia. Logistic regression analysis indicated that the same species groups were associated with disease status after adjusting for the proportions of the other species. CONCLUSIONS: This investigation confirmed the strong association of P. gingivalis and T. forsythia with chronic periodontitis and emphasized a strong association of E. nodatum and T. denticola with periodontitis whether in the presence or absence of high levels of the consensus pathogens. Other species, including S. oralis, Eikenella corrodens, S. intermedius and F. nucleatum ssp. vincentii, were associated with disease when P. gingivalis and T. forsythia were present in low proportions.

Adult↗