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PubMed1985

Relationship between some subgingival bacteria and periodontal pocket depth and gain or loss of periodontal attachment after treatment of adult periodontitis.

We studied the association between post-treatment periodontal disease activity and subgingival Bacteroides gingivalis, Bacteroides intermedius, spirochetes and motile rods. 20 adults, 22-62 years, with moderate-to-severe periodontitis participated in a split-mouth treatment study. All individual quadrants received supragingival cleaning and in addition, subgingival scaling and a NaHCO3-NaCl-H2O2 slurry, subgingival scaling alone, slurry alone, or no subgingival treatment. Post-treatment periodontal disease status was determined over a period of 12 months by changes in probing periodontal pocket depth and probing periodontal attachment level. Subgingival specimens obtained by paper point-sampling were evaluated for B. gingivalis and B. intermedius using indirect immunofluorescence and for spirochetes and motile rods using bright light phase contrast microscopy. A total of 142 periodontitis lesions representing all 4 quadrants of the 20 subjects were studied. The relationship between clinical data and bacteria was analyzed using logistic regression. The probability of the study organisms being present in subgingival sites at 3 to 6 months after treatment increased with increased residual pocket depth. The presence of B. gingivalis showed a strong positive association (p less than 0.004) with loss of periodontal attachment. A significant association was also found for spirochetes (p less than 0.008) but not for motile rods (p greater than 0.35) or B. intermedius (p greater than 0.13). Similar results were obtained at 12 months after therapy, except that the presence of motile rods was significantly associated with loss of periodontal attachment (p less than 0.03). Caution must be exercised when using B. gingivalis or spirochetes to evaluate treatment efficacy. If the presence of these organisms was utilized to indicate progressing periodontitis, many active lesions could be identified, and only 1 to 17% and 13 to 43% of sites in remission at 3-6 months after therapy would be expected to harbor B. gingivalis and spirochetes, respectively. The consequences of treating periodontal sites in remission would mainly be limited to cost and inconvenience. However, since several active periodontitis lesions did not reveal the organisms, treatment decisions based solely on the absence of the organisms may result in the omission of needed therapy. As a practical consideration, periodontal treatment should be continued as long as B. gingivalis and maybe spirochetes are detectable in the subgingival microflora. In the absence of these organisms, and until additional periodontal pathogens have become known, the decision to continue or conclude periodontal therapy must b

Adult↗
PubMed2006

Periodontal infections and coronary heart disease: role of periodontal bacteria and importance of total pathogen burden in the Coronary Event and Periodontal Disease (CORODONT) study.

BACKGROUND: Chronic inflammation from any source is associated with increased cardiovascular risk. Periodontitis is a possible trigger of chronic inflammation. We investigated the possible association between periodontitis and coronary heart disease (CHD), focusing on microbiological aspects. METHODS: A total of 789 subjects (263 patients with angiographically confirmed, stable CHD and 526 population-based, age- and sex-matched controls without a history of CHD) were included in the Coronary Event and Periodontal Disease (CORODONT) study. Subgingival biofilm samples were analyzed for periodontal pathogens Actinobacillus actinomycetemcomitans, Tannerella forsythensis, Porphyromonas gingivalis, Prevotella intermedia, and Treponema denticola using DNA-DNA hybridization. The need for periodontal treatment in each subject was assessed using the Community Periodontal Index of Treatment Needs (CPITN). The main outcome measures included total periodontal pathogen burden, number of the various periodontal pathogens in the subgingival biofilm, and periodontal treatment needs (according to the CPITN). RESULTS: In multivariable analyses, we found a statistically significant association between the periodontal pathogen burden (log10 of the sum of all pathogens) (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.34-2.74; P<.001) or the number of A actinomycetemcomitans in periodontal pockets (log10) (OR, 2.70; 95% CI, 1.79-4.07; P<.001) and the presence of CHD. In addition, a statistically significant association between an increase in mean CPITN score by 1 and the presence of CHD (OR, 1.67; 95% CI, 1.08-2.58; P = .02) was observed. CONCLUSIONS: Our findings suggest an association between periodontitis and presence of CHD. Periodontal pathogen burden, and particularly infection with A actinomycetemcomitans, may be of special importance.

Adult↗
PubMed2001

Microbiological characteristics of subgingival microbiota in adult periodontitis, localized juvenile periodontitis and rapidly progressive periodontitis subjects.

OBJECTIVE: To describe the prevalence of the cultivable subgingival microbiota in periodontal diseases and to draw attention to the polymicrobial nature of periodontic infections. METHODS: The study population consisted of 95 patients, 51 females and 44 males, aged 14-62 years. Twenty-nine patients exhibited adult periodontitis (AP), six localized juvenile periodontitis (LJP), and 60 rapidly progressive periodontitis (RPP). Two to four pooled bacterial samples were obtained from each patient. Samples were collected with sterile paper points from the deepest periodontal pockets. The samples were cultured under anaerobic and microaerophilic conditions using selective and non-selective media. Isolates were characterized to species level by conventional biochemical tests and by a commercial rapid test system. RESULTS: Prevotella intermedia and Capnocytophaga spp. were the most frequently detected microorganisms in all diagnostic groups. Porphyromonas gingivalis and Peptostreptococcus micros were found more frequently in AP and RPP patients, while Actinobacillus actinomycetemcomitans and Eikenella corrodens were associated with AP, LJP and RPP patients. The other bacterial species, including Actinomyces spp., Streptococcus spp. and Eubacterium spp., were detected at different levels in the three disease groups. CONCLUSIONS: The data show the complexity of the subgingival microbiota associated with different periodontal disease groups, indicating that the detection frequency and levels of recovery of some periodontal pathogens are different in teeth affected by different forms of periodontal disease.

Adolescent↗
PubMed1994

Prevalence of periodontitis and suspected periodontal pathogens in families of adult periodontitis patients.

The aim of the present study was to investigate the prevalence of periodontopathic microorganisms and periodontal destruction in the spouses and children of adult periodontitis patients. For this study, 24 families were selected on the basis of one parent with severe periodontal breakdown and the presence of Actinobacillus actinomycetemcomitans and/or Porphyromonas gingivalis and/or more than 30% Prevotella intermedia subgingivally. The clinical examination of both parents and children included pocket depth and clinical attachment loss (CAL) measurements. Samples for bacterial examination were obtained from the mucous membranes, the saliva and pockets. Pocket selection was based on the most advanced periodontitis situation found in a subject. The samples were cultured for the detection of A. actinomycetemcomitans, P. gingivalis and P. intermedia. By phase-contrast microscopy, the % of spirochetes and motile microorganisms was assessed. The number of children within each family varied between 1 and 3. In total 49 children were investigated with a range in age of 3 months to 15 years. Results showed that under the age of 5 years, none of the children had CAL, whereas in the age group of 5-15 years, 26.5% had 1-5 sites in the primary and/or permanent dentition with 1-3 mm CAL. 3 of the spouses had no interproximal CAL. 16 of the 24 spouses had a light to moderate form of periodontitis, with at least one site with 1 to 4 mm CAL and 5 spouses had severe periodontal breakdown with sites showing at least 8 mm CAL. Spirochetes, motile microorganisms and P. intermedia were frequently present in all family members. 18 out of the 24 probands were positive for P. gingivalis. This organism was found once only in a 5-year-old boy and in 11 of the spouses. A. actinomycetemcomitans was detected in 13 probands; 5 children and 5 of the spouses were also positive for this bacterium. If a child harboured one of the periodontopathogens, at least 1 of the parents was also positive for that bacterium. This phenomenon may be due to transmission of microorganisms between family members. Comparison of the clinical data reported in the present study with similar clinical parameters from epidemiological studies of the Dutch population suggest that the spouses and children of adult periodontitis patients might be at relatively high risk of developing periodontal breakdown.

Adolescent↗
PubMed1989

[Morphological study of periodontal tissues in the initial stage of periodontal disease. Part 2. Analysis of morphological measurement and status of periodontal disease].

The morphological characteristics of periodontal tissue in periodontal disease have been interpreted differently by a number of clinical observers. Many have reported that the malposition and functional malocclusion of teeth is injurious to the periodontium. We reported in Part I that a system for evaluating periodontal status was developed for the diagnosis and management of the interproximal area at the initial stage of bone resorption. The patient group consisted of 36 adults, from 21 to 55 years of age. The severity score represented the calculated loss of periodontal support tissues: loss of alveolar bone, evaluated roentgenologically, bone level and pattern in vertical and horizontal form, periodontal pocket and gingival inflammation. Because poor oral hygiene and other factors caused swelling by gingival inflammation, we obtained study specimens from patients with chronic periodontal disease after a few tooth brushing instructions, and scalings during initial therapy in order to detect initial and established pathological changes in periodontal tissue. The purpose of this study was to clarify the relationship between periodontal disease status and morphological diagnostic indicators and different degrees of harmony and disharmony in the lower jaw. In all age groups the average percentage of bone loss and intraosseous defects tended to be higher in the groups categorized as Type III and Type F, and in the area that showed a very deep concave Spee curve to the occlusal plane in Pattern D. We considered that these morphological characteristics might be of secondary importance for diagnosis. Oral local factors were the primary extrinsic factor in the pathogenesis of horizontal and vertical interproximal bone absorption in the area of the premolars and molars.

Alveolar Process↗
PubMed2006

Description of the subgingival microbiota of periodontally untreated Mexican subjects: chronic periodontitis and periodontal health.

BACKGROUND: Recent studies have suggested that changes in the prevalence and/or proportion of distinct microorganisms characterize the subgingival microbial profiles of populations around the world. At present, no information is available on the subgingival microbiota of Mexican subjects. The purpose of the present study was to determine the microbial composition of subgingival plaque in Mexican subjects with untreated chronic periodontitis. METHODS: A total of 44 chronic periodontitis and 20 periodontally healthy subjects (who were currently non-smokers) were selected. Clinical measurements including plaque accumulation, gingival erythema, bleeding on probing, suppuration, probing depth, and attachment level were recorded at six sites of every tooth. Up to 28 subgingival plaque samples were obtained from each subject and individually analyzed to determine the levels, proportion, and prevalence of 40 microbial species using the checkerboard DNA-DNA hybridization technique. RESULTS: Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythensis were the only species that presented higher mean levels in periodontitis subjects. The proportions of P. gingivalis (P<0.001), T. forsythensis (P<0.01), and red complex species (P. gingivalis, T. forsythensis, and T. denticola; P<0.001) as a group were also significantly higher in periodontitis subjects. Periodontally healthy subjects harbored a significantly larger proportion of Actinomyces species (P<0.05). No significant differences were detected in the percentage of carriers of any of the species tested. CONCLUSIONS: Our results revealed that the subgingival microbiota of untreated chronic periodontitis Mexican subjects was characterized by increases in the level, prevalence, and proportion of classic periodontal pathogens. However, the prevalence and proportion of specific microbial species varied significantly from the results of other reports on subjects from different geographical locations.

Adult↗
PubMed1980

Immunopathology of periodontal disease. I. Immunologic profiles in periodontitis and juvenile periodontitis.

Eleven patients with periodontitis, ten patients with juvenile periodontitis and ten control subjects were studied to compare systemic and local immunologic responses and various other blood parameters. A more intensified immunologic response was seen in juvenile periodontitis as compared to periodontitis or controls as evidenced by: (1) greater number of plasma cells and lymphocytes in biopsy specimens of involved gingiva stained by Harris hematoxylin and eosin; (2) significant decrease in serum C4 levels and slightly elevated serum IgG levels as determined by radial immunodiffusion; (3) marked increase of positive fluorescing cells in biopsy specimens stained with antihuman immunoglobulin conjugate and an increase in complement deposition in the same tissues as determined by immunofluorescence. No significant differences among the two groups of patients and control subjects were observed with respect to complete blood counts, coagulation studies, or blood glucose levels. These findings suggest that the immunologic responses in periodontitis and juvenile periodontitis are qualitatively similar, but that the intensity of the response is greater in juvenile periodontitis.

Adolescent↗
PubMed2006

[Correlation between sulfide levels in periodontal pocket of periodontitis patients and periodontal clinical parameters].

OBJECTIVE: To assess the correlation between sulfide levels in periodontal and volatile sulfide compounds (VSC) in oral cavity and to assess the correlation between sulfide levels in periodontal pocket (pS) and periodontal clinical parameters. METHODS: VSC in oral cavity was measured by halimeter one week after grossly supragingival cleaning. Then pS in periodontal pockets was measured by Diamond probe/Perio 2000 system, followed by probing using Williams periodontal probe to get the records of probing depth (PD). Based on the above examination results, 4 - 8 sites with PD > or = 5 mm and/or pS > 0 were selected for the following longitude observation in each patient. The plaque index (PLI), bleeding index (BI), clinical attachment level (CAL) of the target site were recorded. The same examination was repeated during the recalling time of 6 weeks, 3 and 6 months after the initial periodontal therapy. RESULTS: VSC levels are significantly correlated with the numbers of sites with pS > 0 (r = 0.592, P < 0.001) and pS value. pS values were positively correlated with BI at low level during the maintenance time of 6 weeks, 3 and 6 months (r = 0.183, 0.411, 0.350, P < 0.05) respectively. After the initial therapy pS, PD, CAL, BI, PLI and VSC in oral cavity significantly improved at 6 weeks (P < 0.001) and further improved and kept stable at 3 and 6 months. CONCLUSIONS: pS reflects the sulfide levels in pockets with site specificity and may be considered as objective parameter to evaluate the treatment effect, and to indicate the early inflammation in periodontal tissue during the maintenance period.

Adolescent↗
PubMed1989

[Morphological study of periodontal tissues in the initial stage of periodontal disease. Part 1. Application of a morphological measurement and a system for evaluating the periodontal status].

The functional aberration of occlusion, based on the morphology of the alveolar process, causes chronic irritation of the periodontium in addition to the concomitant effect of other local environment factors. This investigation was designed to study the role of morphological characteristics in the periodontal disease process. The periodontal health of 22 subjects was recorded by clinical and roentgenological measurements of the loss of periodontal tissue. The criteria for this selection were no loss of or a crowding of adjoining teeth and no disharmony in occlusal contact. Morphological data were measured around the premolars and molars of lower jaws on the study models individuals, in bucco-lingual width of the alveolar bone in relationship to the width of the crown and the sagittal figure of the Spee curve etc. by using a three-dimensional analyzer. The subjects were categorized as Type II when the records indicated a ratio of the crown width/bone width of 1/1.2. Types I and III, depended on a greater and smaller ratio, respectively. Type W symbolized the alveolar process, of which the interproximal bone showed a considerable curvature mediodistally. Type F showed a flat pattern. The sagittal figure of the Spee curve was divided into four patterns: Pattern A or B, when the cusp of the canine and first premolar leveled over or on the occlusal plane; Pattern C, when the cusp of the canine leveled over and the first premolar under the occlusal plane, and Pattern D, when all cusps, canine, premolar and molar, were under the occlusal plane. The distance from the occlusal plane to the deepest point of the Spee curve was divided into four groups: Pattern a, when the distance was 0-1.0 mm, Pattern b, 1.1-2.0 mm, Pattern c, 2.1-3.0 mm and Pattern d, 3.1-4.0 mm. These results suggest that the morphological evaluation is a useful diagnostic indicators on a rational basis. The morphological characteristics might be related to the presence of periodontal disease and allowed to speculate the pathological changes in established stage, and also to the response to periodontal treatment in the initial stage of periodontal disease.

Alveolar Process↗
PubMed1982

Immunopathology of periodontal disease. II. Immunofluorescent studies on the localized immune response in periodontitis and juvenile periodontitis.

Local immunologic responses were studied in eleven patients with periodontitis, ten patients with juvenile periodontitis, and ten control subjects by performing immunofluorescence on gingival biopsies. F(ab')2 monospecific conjugates to human IgG, IgM, IgA, IgD, and kappa and lambda light chains were used as well as monospecific conjugates to human IgE and properdin. Biopsies from patients with juvenile periodontitis displayed a more intensified immunologic response as evidenced by increases of (I) positive cells stained with a F(ab')2 antihuman immunoglobulin conjugate; (2) IgG, IgM, and kappa and lambda containing cells; (3) extracellular fluorescence of IgG, IgM, IgA, and kappa and lambda light chains; and (4) properdin deposition. Neither IgD nor IgE conjugates reacted significantly with biopsies from the three patient groups. These findings support our previous conclusion that immunologic responses in periodontitis and juvenile periodontitis appear qualitatively similar, but that patients with juvenile periodontitis exhibit a more intense immune response.

Fluorescent Antibody Technique↗
PubMed1998

Analysis of gingival crevicular fluid intracytoplasmic enzyme activity in patients with adult periodontitis and rapidly progressive periodontitis. A longitudinal study model with periodontal treatment.

In the present study, the activity of 3 functionally related enzymes, creatine kinase (CK), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) levels in the rest and flow gingival crevicular fluid (rGCF, fGCF) from patients with rapidly progressive periodontitis (RPP) and adult periodontitis (AP) were determined before and after periodontal treatment, including maintenance. When rGCF and fGCF mean enzyme levels were compared, rGCF was found to contain approximately twice as much enzyme levels than fGCF throughout the study. The findings of the present study revealed that both the rGCF and fGCF samples also contained higher CK, LDH, and AST levels than serum samples. Baseline clinical parameters and GCF enzyme levels presented a significant decline throughout the non-surgical and surgical treatment phases in both patient groups, with surgical treatment being more effective. Despite clinical stability, in the AP group levels of LDH and AST showed a tendency to increase in the third month, while enzyme levels still continued to decrease in the RPP group, who received additional antibiotics during the surgical phase. These findings suggest that GCF intracytoplasmic enzyme profile is related with periodontal status and successful periodontal treatment, in addition to clinical improvement, has a significant effect on this profile. Analysis of biochemical events, more specifically intracytoplasmic enzyme levels in GCF, are likely to offer a sensitive measure of periodontal pathology which may help in overcoming the existing limitations of clinical parameters. For this purpose, analysis of rGCF intracytoplasmic enzymes seems to be more beneficial.

Adult↗
PubMed1985

Reaction of human sera from juvenile periodontitis, rapidly progressive periodontitis, and adult periodontitis patients with selected periodontopathogens.

The levels of serum antibody reactive to selected periodontopathogens were determined in 182 clinically characterized patients: 35 healthy control, 50 juvenile periodontitis, 42 adult periodontitis and 55 rapidly progressive periodontitis. Reactive antibody levels were determined using an enzyme-linked immunosorbent assay with whole cell preparations of Bacteroides gingivalis, Capnocytophaga (Bacteroides) ochraceus, Fusobacterium nucleatum and Actinobacillus actinomycetemcomitans (Y-4) serving as antigens. Increased reactivity to B. gingivalis and F. nucleatum was observed in all three disease groups studied while antibody reactive to A. actinomycetemcomitans was increased in juvenile and rapidly progressive periodontitis. Antibody levels reactive to C. ochraceus in healthy subjects did not differ from those observed in any disease patient groups. Possible implications in the etiology and progression of the diseases coupled with environmental changes which occur in the econiche of the periodontal pocket are described.

Actinobacillus↗
PubMed1986

Serum IgA and IgG antibodies to Treponema vincentii and Treponema denticola in adult periodontitis, juvenile periodontitis and periodontally healthy subjects.

13 patients with untreated adult periodontitis (AP) were compared to 8 subjects free of periodontal disease (H) with respect to plaque index (PlI), gingival index (GI), probing depth (PD) and differential counts of subgingival bacterial morphotypes from a pooled sample of 6 surfaces with the greatest probing depth. Serum antibody levels to T. vincentii and T. denticola strains were also determined in these subjects as well as in the sera from 5 subjects with localized juvenile periodontitis (LJP). Subjects with AP had significantly elevated proportions of spirochetes and motile rods and lower proportions of coccoid cells than H subjects. They also exhibited significantly higher PlI and GI scores and greater probing depths. Antibody levels were normalized against a standard serum and expressed as ELISA units (EU). IgA and IgG antibody levels to all tested spirochete strains were significantly elevated in AP subjects as compared to subjects in group H or subjects with LJP. No significant differences in antibody titers were detectable between the H and LJP groups with respect to any of the tested strains. No significant correlation could be demonstrated between serum antibody titers to any of the oral spirochete strains tested and the proportions of oral spirochetes determined microscopically.

Adult↗
PubMed1981

Comparative antibody titers to Actinobacillus actinomycetemcomitans in juvenile periodontitis, chronic periodontitis and periodontally healthy subjects.

Circulating antibody levels to four strains of Actinobacillus actinomycetemcomitans (Aa) were determined by means of an indirect immunofluorescent technique in three groups of 21 subjects each, including one with juvenile periodontitis (JP), one with chronic periodontitis (CP) and one free of periodontal disease (N). Mean levels of antibody to Aa were significantly elevated in the JP group as compared to the CP and N groups with respect to strains Y4, 29522 and 29524, but not strain 29523. Since strains Y4, 29522 and 29524 contain a leukotoxin that is missing from strain 29523, the results suggest that the leukotoxin could account for the difference in the immune response among the three groups of subjects. Varying the end-point considered to represent positive fluorescence did not significantly affect the results, although discrimination among the three groups appeared to be somewhat better at lower intensities of fluorescence. Because of wide variations in antibody titers recorded in individual subjects, elevated levels of antibody to certain strains of Aa may not be useful as a primary diagnostic test for JP, but may be of value in confirming an otherwise uncertain clinical diagnosis.

Actinobacillus↗
PubMed1998

Crevicular fluid level of beta-glucuronidase in relation to clinical periodontal parameters and putative periodontal pathogens in early-onset periodontitis.

Analysis of beta-glucuronidase (betaG) in the gingival crevicular fluid (GCF) provides an indication of neutrophil influx into the crevicular environment. The aim of this study was to test the hypotheses that: (1) betaG is significantly elevated in individuals with early-onset periodontitis (EOP) and that betaG activity correlates with disease severity; and (2) betaG level may reflect the local bacterial challenge in the gingival crevice. The study subjects consisted of a sub-sample of individuals examined in the National Survey of Oral Health of United States Children, which was undertaken during the 1986/87 school year. A total of 249 individuals were selected based on presence or absence of clinical attachment loss at baseline. The individuals were examined a second time 6 years later and the clinical attachment loss was assessed, and subgingival plaque and GCF were collected. The subjects were classified into 3 types of EOP and a control group. BetaG activity in the GCF and the levels of 7 putative micro-organisms in the pocket were assessed. The generalized EOP group had the highest betaG activity, followed by the localized and incidental EOP groups, and the controls, respectively. There was a significant increase in betaG activity with the increase in probing depth. Also, sites with bleeding on probing had a significantly higher betaG activity than sites without bleeding. However, the effect of gingival inflammation on betaG activity was more evident in the generalized and localized EOP groups. Sites harboring high levels of one or more of the micro-organisms tended to have high betaG activity. There were moderate differences between the organisms with respect to their effect on betaG activity, but sites with high numbers of Porphyromonas gingivalis, Prevotella intermedia, or Treponema denticola also had the highest betaG activity. The present findings suggest that betaG activity in GCF from patients with EOP can be of value in the early identification of individuals at higher risk of developing EOP The findings also suggest that host mechanisms leading to higher betaG activity in EOP represent systemic responses and are only partly related to the presence of local factors at the site-level.

Adolescent↗
PubMed2005

Real-time polymerase chain reaction quantification of human cytomegalovirus and Epstein-Barr virus in periodontal pockets and the adjacent gingiva of periodontitis lesions.

BACKGROUND: Genomic sequences of human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV), two herpesviruses, can frequently be detected in periodontal pockets of progressive periodontitis lesions, but the prevalence and load of the two viruses in gingival tissue are unknown. This study determined levels of HCMV and EBV DNA in the periodontal pocket and in the adjacent gingiva of periodontitis lesions using a real-time polymerase chain reaction (PCR) assay. MATERIAL AND METHODS: A total of 20 systemically healthy periodontitis patients participated in the study. Nine patients below 35 years of age were tentatively diagnosed as having aggressive (early onset) periodontitis, and 11 patients 36-56 years of age as having chronic (adult) periodontitis. Clinical parameters were evaluated using established methods. Using periodontal curettes, specimens were harvested from 6-10 mm periodontal pockets and from the adjacent inflamed periodontal pocket wall. A 5'-nuclease (TaqMan) real-time PCR assay was used to identify and quantify genomic copies of periodontal HCMV and EBV. RESULTS: HCMV DNA was detected in 78% of subgingival and 33% of gingival tissue samples from aggressive periodontitis lesions, but only in 46% of subgingival and 9% of gingival tissue samples from chronic periodontitis lesions. In aggressive periodontitis, HCMV subgingival and gingival tissue counts were positively correlated with periodontal pocket depth and probing attachment loss at sample sites (p 6 mm, but none of 14 patients having mean pocket depth at sample teeth<or=6 mm revealed more than 100,000 copies of HCMV or EBV in subgingival or gingival samples (p=0.001; chi-squared test). In periodontitis lesions demonstrating herpesviruses in paired subgingival and gingival tissue samples, the tissue samples showed the higher HCMV copy counts in three of four patients and the higher EBV copy counts in six of eight patients. CONCLUSIONS: The elevated occurrence of HCMV and EBV DNA copies in periodontal pockets and in the gingival tissue of aggressive periodontitis lesions relative to chronic periodontitis lesions, and the increase in herpesvirus counts with increasing severity of periodontitis lend substantial support to a periodontopathic role of the two viruses. Real-time PCR determination of herpesvirus DNA in periodontal sites may become a promising marker to monitor the course of destructive periodontal disease. Herpesviruses and bacteria, now mostly studied in isolation, may cooperate synergistically in the development of periodontitis, and should probably be considered as a pathogenetic consortium in future investigations of periodontal infections.

Adult↗
PubMed2005

Application of periodontal ligament cell sheet for periodontal regeneration: a pilot study in beagle dogs.

OBJECTIVE: The ultimate goal of periodontal treatment is to regenerate the damaged periodontal support. Although periodontal ligament (PDL) cells are essential for periodontal regeneration, few studies have reported the transplantation of periodontal ligament cells to periodontal defects. We developed a new method to apply periodontal ligament cells as a sheet to the defect. The aim of this study was to investigate the periodontal healing after application of the periodontal ligament cell sheet in beagle dogs. METHODS: Autologous periodontal ligament cells were obtained from extracted premolars of each beagle dog. Periodontal ligament cell sheets were fabricated using a temperature-responsive cell culture dish. Dehiscence defects were surgically created on the buccal surface of the mesial roots of bilateral mandibular first molars of each dog. In the experimental group (five defects), periodontal ligament cell sheet with reinforced hyaluronic acid carrier was applied to the defect. Only the hyaluronic acid carrier was applied to the contralateral side as a control (five defects). Eight weeks after surgery, the animals were sacrificed and decalcified specimens were prepared. Healing of the periodontal defects was evaluated histologically and histometrically. RESULTS: No clinical signs of inflammation or recession of gingiva were observed in both experimental and control groups. In the experimental group, periodontal tissue healing with bone, periodontal ligament and cementum formation was observed in three out of five defects. In the control group, such periodontal tissue formation was not observed except in one defect. Histometric analysis revealed that the formation of new cementum in the experimental group was significantly higher than that in the control group. CONCLUSION: The periodontal ligament cell sheet has a potential to regenerate periodontal tissue and may become a novel regenerative therapy.

Adjuvants, Immunologic↗