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Severe Periodontal Destruction (severe + periodontal_destruction)
Selected AbstractsEffect of interleukin-1 gene polymorphism in a periodontally healthy Hispanic population treated with mucogingival surgeryJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2002Raul G. Caffesse Abstract Objectives: A genetic test for susceptibility of periodontal disease has been introduced. A positive test indicates a risk factor for more severe periodontal destruction. The prevalence of genotype positive subjects has been reported around 30%. In a Mexican population, we have found a 26% prevalence of genotype positive individuals. Few studies have reported the response to therapy in these individuals. The purpose of this study was to assess the response to mucogingival surgery in an otherwise periodontally healthy Hispanic population. Materials and methods: 22 subjects (7 male and 15 female) with a mean age of 45 years participated. They were treated 3 years prior for the treatment of Types I and II recession defects using connective tissue grafts. No other active periodontal treatment was required, except for preventive maintenance. A full-mouth clinical evaluation was performed which included assessment of gingival inflammation and measurements of probing pocket depth and clinical attachment levels. Mean values per patient were determined. A finger stick blood sample was collected using specially provided DNA filter paper, let dried, and mailed for processing. Results: Results indicated that 5 out of the 22 subjects were genotype positive. The genotype positive subjects presented the following values: GI 1.13±0.17, PPD 2.48±0.46, and CAL 3.38±0.66. The values for the genotype negative subjects were GI 1.06±0.14, PPD 2.38±0.31 and CAL 3.11±0.53. No statistical significant differences were found when both groups were compared (p>0.05). Furthermore, the treatment of the localized recessions was effective and provided similar amount of coverage in genotype positive and negative subjects. However, more genotype negative subjects showed complete coverage of the recession than genotype positive individuals. Conclusions: Within the limits of this study it is concluded that (1) periodontal health can be maintained with proper preventive maintenance irrespective of the genotype present, (2) the mean response to mucogingival surgery to cover localized gingival recessions is similar irrespective of the IL-1 periodontal genotype, however, full coverage is achieved more frequently in genotype negative subjects. Zusammenfassung Ziele: Es wurde ein Gentest für die Anfälligkeit bezüglich einer Parodontalerkrankung eingeführt. Ein positiver Test ist ein Zeichen für einen Risikofaktor für eine stärkere parodontale Destruktion. Die Prävalenz von genotyp-positiven Personen wurde mit etwa 30% angegeben. In einer mexikanischen Population haben wir eine Prävalenz von 26% von genotyp-positiven Individuen vorgefunden. Nur wenige Studien haben bei diesen Patienten über die Reaktion auf die Therapie berichtet. Der Zweck dieser Studie war es die Heilung nach mukogingivaler Chirurgie in einer im Übrigen parodontal gesunden Population mit spanischen Abstammung. Material und Methode: 22 Patienten (7 Männer und 15 Frauen) mit einem Durchschnittsalter von 45 Jahren nahmen an der Studie teil. Sie wurden vor 3 Jahren zur Deckung einer Rezession von Typ I oder II mit einem Bindegewebetransplantat behandelt. Es war keine weitere parodontale Behandlung außer präventiven Erhaltungstherapie notwendig. Es wurde eine vollständige klinische Untersuchung des Gebisses durchgeführt, die die Bestimmung der gingivalen Etnzündung, sowie die Messung der Sondierungstiefe und des klinischen Attachmentniveaus beinhaltete. Es wurden für jeden Patienten die Mittelwerte bestimmt. Eine Blutprobe von der Fingerbeere wurde entnommen, auf ein specielles DNA-Filterpapier aufgetragen, getrocknet und zur Weiterverarbeitung versendet. Ergebnisse: Die Ergebnisse zeigten, dass 5 von 22 Patienten genotyp-positiven waren. Die genotyp-positiven Patienten wiesen folgende Werte auf: GI 1.13±0.17, PPD 2.48±0.46 und CAL 3.38±0.66. Die Werte für die genotyp-negativen Patienten betrugen: GI 1.06±0.14, PPD 2.38±0.31 und CAL 3.11±0.53. Beim Vergleich beider Gruppen ergaben sich keine statistisch signifikanten Unterschiede (p>0.05). Des weiteren war die Behandlung der lokalisierten Rezession effektiv und lieferte bei genotyp-positiven und genotyp-negativen Patienten einen ähnlichen Anteil an Wurzeldeckung. Jedoch zeigten mehr genotyp-negative Patienten eine vollständige Rezessionsdeckung als genotyp-positive Patienten. Schlussfolgerungen: Mit den Einschränkungen dieser Studie kann die Schlussfolgerung gezogen werden, dass (1) unabhängig vom vorliegenden Genotyp mit geeigneten präventiven Maßnahmen die parodontale Gesundheit erhalten werden kann und (2) dass unabhängig vom IL-1-Genotyp, die durchschnittliche Reaktion auf die mukogingivale Chirurgie zur Deckung von lokalisierten Gingivarezessionen ähnlich ist. Jedoch wird eine vollständige Deckung häufiger bei genotyp-negativen Patienten erreicht. Résumé But: Un test génétique pour la suscpetibilitéà la maladie parodontale est présenté. Un test positif indique un facteur de risque pour une destruction parodontale plus sévère. La fréquence globale de sujets positifs au génotype semblerait être de 30%. Dans une population mexicaine, une fréquence globale de 26% d'individus positifs pour le génotype a été trouvée. Peu d'études ont apporté la réponse au traitement chez ces individus. Le but de cette investigation a été de mesurer la réponse de la chirurgie muco-gingivale dans une population hispanique parodontalement saine. Matériaux et méthodes: 7 hommes et 15 femmes d'un âge moyen de 45 ans y ont participé. Ils avaient été traités 3 ans auparavant pour des lésions de récession de type I et II en utilisant des greffes de tissu conjonctif. Aucun autre traitement parodontal actif n'avait été requis, sauf pour la maintenance. Une évaluation clinique de toute la bouche a été effectuée comprenant l'estimation de l'inflammation gingivale et les measures de la profondeur de poche au sondage et des niveaux d'attache clinique. Les valeurs moyennes par patient ont été déterminées. Un échantillon sanguin par piqûre du doigt a été récolté en utilisant un papier filtre ADN, qui fût séché et envoyé pour analyse. Résultats: Les résultats ont indiqué que 5 des 22 sujets étaient génotype positif. Ces sujets présentaient les valeurs suivantes: GI 1.13±0.17, PPD 2.48±0.46 mm et CAL 3.38±0.66 mm. Les valeurs chez les sujets génotype négatif étaient: GI 1.06±0.14, PPD 2.38±0.31 mm et CAL 3.11±0.53 mm. Aucune différence statistiquement significative n'a été trouvée lorsque les deux groupes ont été comparés. De plus le traitement des récessions locales était effectif et apportait une quantité semblable de recouvrement chez les deux types de sujets. Cependant davantage de sujets génotype négatif bénéficiaient d'un recouvrement complet de la récession. Conclusions: Dans les limites d l'étude présente: (1) la santé parodontale peut être maintenue avec des mesures préventives quelque soit le génotype présent, (2) la réponse moyenne de la chirurgie muco-gingivale pour recouvrir des récessions gingivales locales est semblable quelque soit le génotype parodontal IL-1, bien qu'un recouvrement complet est plus souvent réalisé chez les sujets génotype négatif. [source] Periodontal disease among indigenous people in the Amazon rain forestJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2001Mauricio Ronderos Abstract Background: People are not all equally susceptible to periodontitis. To understand the epidemiology and natural history of this disease, it is important to study populations with varying genetic backgrounds and environmental exposures. Aim: Characterize the periodontal condition of a sample of indigenous adults in a remote region of the Amazon rain forest and determine the association of periodontal disease with various demographic, behavioral and environmental factors. Methods: A cross-sectional evaluation of 244 subjects aged 20,70 years was conducted. Pocket depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), plaque and calculus were assessed for the Ramfjord index teeth. Results: These people had high levels of plaque, calculus and BOP. The mean PD was rather shallow (2.45 mm in 20,29 year-olds to 2.73 mm in 50+ year-olds) and did not increase significantly with age. Mean CAL (0.57 mm in 20,29 year-olds and 2.26 mm in 50+ year-olds) and mean location of the free gingival margin in relation to the cemento-enamel junction changed significantly with age (p<0.0001). Multivariate analysis revealed that increasing age, bleeding on probing and calculus scores were positively associated with mean CAL (p<0.01). Sex, ethnicity, level of modern acculturation, use of coca or tobacco paste, frequency of dental visits and plaque were not associated with mean CAL. Conclusions: Periodontal disease in these people was mainly associated with gingival recession rather than deep pockets. Most people had clinical attachment loss but despite poor oral hygiene and extensive gingival inflammation, they did not have very severe periodontal destruction. [source] The periodontal abscess (I).JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2000Clinical, microbiological findings Background/aims: Little information is available regarding the diagnosis and microbiology of periodontal abscesses. The aim of this descriptive clinical and microbiological study was to provide more information in order to help in the characterisation of the periodontal abscess associated to periodontitis. Method: 29 consecutive patients with a periodontal abscess were studied by the assessment of clinical variables, including both subjective (pain, edema, redness and swelling) and objective (bleeding on probing, suppuration, probing pocket depth, tooth mobility and cervical lymphadenopathy) parameters. Microbiological samples were taken for anaerobic microbiology and processed by means of culture. Systemic involvement was also studied through the analysis of blood and urine samples using conventional laboratory standards. Results: 62% of the abscesses affected untreated periodontitis patients, and 69% were associated with a molar tooth. More than 75% of the abscesses had moderate-severe scores related to edema, redness and swelling, and 90% of the patients reported pain. Bleeding occurred in all abscesses, while suppuration on sampling was detected in 66%. Mean associated pocket depth was 7.28 mm, and 79% of teeth presented some degree of mobility. Cervical lymphadenopathy was seen in 10% of patients, while elevated leucocyte counts were observed in 31.6%. The absolute number of neutrophils was elevated in 42% of the patients. High prevalences of putative periodontal pathogens were found, including Fusobacterium nucleatum, Peptostreptococcus micros, Porphyromonas gingivalis, Prevotella intermedia and Bacteroides forsythus. Conclusions: The periodontal abscess has clear clinical characteristics and is usually associated with severe periodontal destruction. This condition may cause systemic involvement and the lesion generally has a large bacterial mass with a high prevalence of well-recognised periodontal pathogens. [source] Periodontal and oral microbiological status of an adult population undergoing haemodialysis: a cross-sectional studyORAL DISEASES, Issue 2 2007A Castillo Objectives:, The aim of this cross-sectional study was to evaluate the periodontal status and oral microbiological patterns of a population with end-stage renal disease (ESRD), undergoing haemodialysis (HD). Design:, This was a cross-sectional study, involving 52 patients from the Nephrology Department and 52 matched control subjects. Materials and methods:, The subjects had a periodontal clinical examination; subgingival plaque samples were taken and analysed using a semiquantitative polymerase chain reaction (PCR) test to detect Porphyromas gingivalis, Tannerella forsythia, Prevotella intermedia, Prevotella nigrescens and Actinobacillus actinomycetemcomitans. Subgingival plaque and saliva samples were studied for Candida and Enterobacteriaceae. Main outcome measures:, Most of the 104 subjects had some degree of loss of periodontal attachment (LPA) ,3 mm [11 (10.5%) had severe LPA; 16 (15.4%) moderate LPA; and 64 (61.5%) mild LPA]. Only 13 subjects (12.5%) presented good periodontal health. Results:, No statistically significant differences were found between the HD patients and the control group regarding bleeding index, number of teeth, or percentage of LPA ,3 mm. However, a statistically significant difference was seen in the degree of oral hygiene. Conclusions:, On the basis of the findings presented here, we cannot associate ESRD with more severe periodontal destruction. Although HD patients presented a higher number of periodontopathic microorganisms than the matched controls, a prolonged duration of HD did not bear a statistically significant relationship with the percentage of sites with LPA ,3 mm, specific microbiota or composition of biofilm. [source] | ||||||||||