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Intermedia
Kinds of Intermedia Terms modified by Intermedia Selected AbstractsEvaluation of the genetic basis of phenotypic heterogeneity in north Indian patients with Thalassemia majorEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2010Nidhi Sharma Abstract Objectives: To assess the molecular basis of phenotypic heterogeneity in north Indian patients with thalassemia major (TM). Methods: To determine the clinical severity, 130 patients of TM were studied for the age of first presentation and frequency of blood transfusion. The type of beta mutations, Xmn,1G, polymorphism and G6PD Mediterranean mutation was characterized. Analysis of the phenotypic presentation and the genotype was performed. Results: Majority (83.8%) presented before 1 year of age (mean 8.8 months). The caste distribution showed 41.6% were Aroras and 32.3% were migrants from Pakistan. IVS1-5(G,C) was commonest (32.7%) and the common five Indian mutations comprised of 88.4% of alleles. The mean age of presentation with IVS1-5(G,C), Fr 8/9, (+G) 619-bp del and IVS1-1(G,T) homozygosity was 4.3, 6, 3.4 and 9.1 months respectively. Xmn,1G, status showed ,/, in 66.9%, +/, in 26.1% and +/+ in 6.9% patients. Xmn,1G,,/, presented before 1 year of age. The mean age of presentation with +/+ was 18.3 months. Six hemizygous boys and one heterozygous girl with G6PD Mediterranean were found (prevalence 5.3%). Eight patients could be reclassified as thalassemia intermedia on follow up. Conclusions: This study showed that majority of TM in north India present before 1 year of age and homozygous 619-bp deletion presents the earliest. The presence of Xmn-1G, polymorphism delays the presentation, is associated with the IVS 1-1 (G,T) and shows variable improvement with hydroxyurea therapy. Based on the results of genotyping, reevaluation of patients can improve the outcome in a few patients. [source] Distribution and frequency of , -thalassemia mutations in northwestern and central GreeceEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 2 2003I. Georgiou Abstract: Objectives : , -Thalassemia is a common autosomal recessive disorder resulting from over 200 different mutations of the , -globin genes. The spectrum of , -thalassemia mutations in Greece has been previously described in the population of the capital city of Athens, or in , -thalassemia patients having transfusion therapy. The aim of the present study was to identify the distribution of the most common , -thalassemia mutations in the population of northwestern and central Greece. Methods : The data for this study were derived from a total of 1130 unrelated subjects including 46 , -thalassemia major, three , -thalassemia intermedia and 1081 carriers identified in our antenatal screening program. , -Thalassemia mutations were identified by ARMS, DGGE and Reverse Dot Blot. Results : The most common mutation, IVS-I-110, is followed, in order of frequency, by the mutations Cd-39, IVS-I-1, IVS-II-1, Cd-6, IVS-I-6, IVS-I-5, IVS-II-745, Cd-5 and 44 bp del. IVS-I-110 and Cd-39 frequencies are similar with those found in other Balkan countries. Significant differences in regional distribution were observed. The results showed a clear drift of the distribution of the most frequent IVS-I-110 mutation in the south,north (29.4, 40.0, 44.6 and 61.7%) and the east,west axis (31.8 and 44.6%). Conclusions : Population screening and prenatal diagnosis are significantly facilitated by these data. Furthermore, the detailed distribution tables of , -thalassemia mutations are essential for counseling and extraction of genetic diversity estimates for population genetic studies in other inherited disorders. [source] Prevotella intermedia lipopolysaccharide stimulates release of tumor necrosis factor-, through mitogen-activated protein kinase signaling pathways in monocyte-derived macrophagesFEMS IMMUNOLOGY & MEDICAL MICROBIOLOGY, Issue 2 2007Sung-Jo Kim Abstract The purpose of this study was to investigate the effects of lipopolysaccharide from Prevotella intermedia, a major cause of inflammatory periodontal disease, on the production of tumor necrosis factor (TNF)-, and the expression of TNF-, mRNA in differentiated THP-1 cells, a human monocytic cell line. The potential involvement of the three main mitogen-activated protein kinase (MAPK) signaling pathways in the induction of TNF-, production was also investigated. Lipopolysaccharide from P. intermedia ATCC 25611 was prepared by the standard hot phenol,water method. THP-1 cells were incubated in the medium supplemented with phorbol myristate acetate to induce differentiation into macrophage-like cells. It was found that P. intermedia lipopolysaccharide can induce TNF-, mRNA expression and stimulate the release of TNF-, in differentiated THP-1 cells without additional stimuli. Treatment of the cells with P. intermedia lipopolysaccharide resulted in a simultaneous activation of three MAPKs [extracellular signal-related kinase 1/2 (ERK1/2), c-Jun N-terminal kinase 1/2 (JNK1/2) and p38]. Pretreatment of the cells with MAPK inhibitors effectively suppressed P. intermedia lipopolysaccharide-induced TNF-, production without affecting the expression of TNF-, mRNA. These data thus provided good evidence that the MAPK signaling pathways are required for the regulation of P. intermedia lipopolysaccharide-induced TNF-, synthesis at the level of translation more than at the transcriptional level. [source] Energetics approach to predicting mortality risk from environmental stress: a case study of coral bleachingFUNCTIONAL ECOLOGY, Issue 3 2009Kenneth R. N. Anthony Summary 1Coral bleaching events, predicted to increase in frequency and severity as a result of climate change, are a threat to tropical coral-reef ecosystems worldwide. Although the onset of spatially extensive, or ,mass', bleaching events can be predicted using simple temperature stress metrics, no models are available for predicting coral mortality risk or sub-lethal stress associated with bleaching. Here, we develop a model that links the functional response of colony energy balance and energy-store dynamics to coral mortality risk and recovery during and following bleaching events. 2In a series of simulations using response functions and parameter values derived from experimental studies for two Indo-Pacific coral species (Acropora intermedia and Montipora monasteriata), we demonstrate that prior energy-costly disturbances and alternative energy sources are both important determinants of coral mortality risk during and following bleaching. 3The timing of the onset of coral mass mortality is determined by a combination of bleaching severity (loss rate of photopigments), duration of the bleaching event, heterotrophy and the size of energy reserves (as lipid stores) before bleaching occurs. 4Depending on initial energy reserves, model results showed that high rates of heterotrophy could delay the onset of coral mortality by up to three weeks. Survival following bleaching was also strongly influenced by remaining lipid reserves, rates of heterotrophy, and rates of photopigment (or symbiont) recovery. 5Our results indicate that energy-costly disturbances and low availability of food, before and during bleaching events, respectively, work to increase bleaching-induced coral mortality risk for acroporid corals on Indo-Pacific reefs. [source] Hemin nutritional stress inhibits bacterial invasion of radicular dentine by two endodontic anaerobesINTERNATIONAL ENDODONTIC JOURNAL, Issue 2 2007R. M. Love Abstract Aim, To determine if anaerobic bacteria routinely found in infected dentine and root canals require the presence of heme in the environment in order for them to invade dentinal tubules. Methodology, Noncarious, unrestored human teeth with single root canals were prepared for invasion experiments and soaked in either TSB-M supplemented with hemin (5 ,g mL,1) (n = 12 roots), TSB-M media (n = 12 roots) or TSB-M media followed by hemin soak (n = 12 roots) for 2 days, then inoculated with either Prevotella intermedia ATCC 25611 or Peptostreptococcus micros ATCC 33270 and incubated anaerobically for 14 days. Roots were prepared for light microscopy, stained with Brown and Brenn or antisera raised to the bacteria, and invasion within tubules assessed using a tubule invasion index (TI). Data were analysed using Student's t -test and Mann,Whitney U -test. Results,Prevotella intermedia (TI = 0.7 ± 0.04) and P. micros (TI = 0.96 ± 0.08) showed low invasion when grown in the presence of hemin with cells generally restricted to the superficial 20 ,m of the tubules, whilst neither bacteria invaded tubules (TI = 0) when hemin was absent from the growth media (P < 0.01). Conclusions, Hemin was required in the growth medium for P. intermedia and P. micros to invade dentinal tubules. [source] Induction of vascular endothelial growth factor expression in human pulp fibroblasts stimulated with black-pigmented BacteroidesINTERNATIONAL ENDODONTIC JOURNAL, Issue 9 2004L.-C. Yang Abstract Aim, To investigate the effect of black-pigmented Bacteroides on the expression of vascular endothelial growth factor (VEGF) gene in human pulp fibroblasts. Methodology, The supernatants of Porphyromonas endodontalis, Porphyromonas gingivalis and Prevotella intermedia were used to evaluate VEGF gene expression in human pulp fibroblasts. The levels of mRNAs were measured by the quantitative reverse-transcriptase polymerase chain reaction analysis. Results, Black-pigmented Bacteroides induced significantly high levels of VEGF mRNA gene expression in human pulp fibroblasts (P < 0.05). In addition, the expression of VEGF depended on the bacteria tested. Conclusions, Black-pigmented Bacteroides may be involved in developing pulpal disease through the stimulation of VEGF production that would lead to the expansion of the vascular network coincident to progression of the inflammation. [source] Effects of instrumentation, irrigation and dressing with calcium hydroxide on infection in pulpless teeth with periapical bone lesionsINTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2002L. B. Peters Abstract Aim The aim of this study was to evaluate the fate of microorganisms in root canals of teeth with infected pulps and periapical bone lesions with and without the use of calcium hydroxide medication. Methodology Endodontic samples were cultured and microorganisms were counted and identified in 43 teeth before (sample 1) and after (sample 2) treatment during the first visit and before (sample 3) and after (sample 4) treatment during the second visit. In the first visit teeth were instrumented and half of the teeth were filled with a thick slurry of calcium hydroxide in sterile saline. The other teeth were obturated with gutta-percha and AH-26 sealer. After 4 weeks the teeth with calcium-hydroxide were accessed again and after microbiological sampling they were obturated with gutta-percha and AH-26 sealer. Results The mean total colony forming unit (CFU) counts of positive samples dropped significantly as a result of canal preparation during the first visit from 1.0 × 106 to 1.8 × 103 (between samples 1 and 2) but increased to 9.3 × 103 in the period between the two visits (sample 2 and 3). There was no difference in mean total CFU counts of positive samples between the end of the first (sample 2) and the end of the second visit (sample 4). The most frequently isolated species were Prevotella intermedia, Capnocytophaga spp., Actinomyces odontolyticus, Propionibacterium acnes and Peptostreptococcus micros. Conclusions Although a calcium hydroxide paste was placed in the prepared canals, the number of positive canals had increased in the period between visits. However, the number of microorganisms had only increased to 0.93% of the original number of CFU (sample 1). It is concluded that a calcium hydroxide and sterile saline slurry limits but does not totally prevent regrowth of endodontic bacteria. [source] An interplay of alleviating mutations in the clinical phenotype of ,-thalassaemia intermediaINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 6 2004A. NADKARNI Summary Prediction of a , -thalassaemia major phenotype from the , -genotype is generally relatively straightforward. However, despite the ability to accurately define the , -thalassaemia mutations, prediction of a , -thalassaemia intermedia phenotype from the genotype sometimes remains problematic and this has important implications in genetic counselling and prenatal diagnosis. We report a 11-year-old Indian male child with a thalassaemia intermedia phenotype. , -Globin gene analysis of the family showed that he was a compound heterozygote with the ,88 (C,T) ,+ -mutation and the IVS1 nt 130 (G,C) ,0 -mutation. Both these mutations are rare among Indians. The propositus was also found to be heterozygous for the XmnI polymorphism and had a normal , -genotype. In this family interplay of two alleviating mutations (a milder promoter mutation along with a gene for raised HbF) might have synergistically compensated for lack of globin chains in the patient. Hence, the nature of the , -genotype as well as the knowledge of the presence or absence of alleviating factors will help the clinician to decide whether early commencement of a regular transfusion regime is necessary. [source] Thalassemia: macroscopic and radiological study of a caseINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 3 2007A. Lagia Abstract Differentiation of the genetic and the acquired anaemias, particularly in areas of the world where they may co-exist, has been a challenge for palaeopathologists for over 100 years. In this paper we present macroscopic and radiographic skeletal lesions that are associated with the thalassemias in a 14-year-old girl from a modern reference collection of the University of Athens. This individual is of known sex, age, cause of death, place and dates of birth and death. The case is examined in terms of epidemiology, growth, distribution and severity of lesions and differential diagnosis. The entire skeleton is affected by marrow hyperplasia: lesions of the axial skeleton are extreme, and the appendicular skeleton is severely affected as well. The odontofacial manifestations that are diagnostic of thalassemia and differentiate it from other anaemias are present and include: maxillary and mandibular hyperplasia, reduced sinuses, displacement of maxillary dental structures, overbite, and generalised osteopenia. The development of extreme bone lesions and the ,advanced' age-at-death of this individual is explained as either the result of thalassemia major under a low transfusion regimen that was the norm during her lifetime, or to a form of thalassemia intermedia that allows survival to later life at the expense of gross skeletal alterations. The present status of skeletal studies in Greece does not support the identification of a genetic anaemia in past populations. The potential contribution of the current analysis in differentiating the anaemias in antiquity is evaluated. Copyright © 2006 John Wiley & Sons, Ltd. [source] Immunohistochemical assessment of parafibromin in mouse and human tissuesJOURNAL OF ANATOMY, Issue 6 2006Andrea Porzionato Abstract Parafibromin is a protein encoded by the HRPT2 oncosuppressor gene, whose mutation causes the hyperparathyroidism,jaw tumour syndrome, characterized by the occurrence of parathyroid adenoma or carcinoma, fibro-osseous jaw tumours, and renal neoplastic and non-neoplastic abnormalities. Non-morphological techniques, such as Northern and Western blotting and reverse transcriptase-PCR, indicate that parafibromin is ubiquitously expressed, but extensive immunohistochemical studies have not been performed. To increase our knowledge of the distribution and patterns of expression of parafibromin, we examined its expression and location in many different mouse and human organs by immunohistochemistry. There were no substantial differences in parafibromin expression between mouse and human. We found widespread expression of parafibromin, except in connective tissue, smooth muscle, endothelium and some other types of epithelia (colonic, urinary, tubaric, uterine, thyroid). Heterogeneity of positivity intensity and subcellular location (nuclear, nucleocytoplasmic, cytoplasmic) was found between tissues and cell types, suggesting differential functional involvement of parafibromin. Moreover, higher parafibromin expression was found in cell types, such as hepatocytes, cells of the base of gastric glands, renal cortex tubules and the pars intermedia of the hypophysis, which are characterized by different proliferative capacity, thus indicating that the cellular function of parafibromin may not be reduced only to its anti-proliferative effect. [source] Stress response of yeast candida intermedia to Cr(VI)JOURNAL OF BIOCHEMICAL AND MOLECULAR TOXICOLOGY, Issue 6 2003Polona Jamnik Abstract Stress response of yeast Candida intermedia ZIM 156 exposed to chromium(VI) was investigated. Yeast cells were treated with Cr(VI) in concentrations of 50, 100, 300 and 500 ,M in the mid-exponential growth phase. Monitoring of some bioprocess parameters during growth, specifically pO2, showed that Cr(VI) addition, specifically in concentration of 100 and partially 50 ,mol/L, increased metabolism intensity, which is connected to induced stress responses. Furthermore, oxidation of 2,,7,-dichlorofluorescin indicated increased intracellular oxidant level, specifically at 100 ,M Cr(VI) concentration. Antioxidant defense systems were further investigated. Catalase and superoxide dismutase activity was not increased in the cells exposed to the both Cr(VI) concentrations, which indicate that catalase and superoxide dismutase do not participate in cell defense systems. In contrast intracellular glutathione content in reduced form increased significantly in the cells exposed to 100 ,mol Cr(VI)/L. Therefore, we demonstrated that glutathione plays an important role in the stress response of C. intermedia to Cr(VI). © 2003 Wiley Periodicals, Inc. J Biochem Mol Toxicol 17:316,323, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/jbt.10093 [source] Gingival changes during pregnancy: II.JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2010Influence of hormonal variations on the subgingival biofilm Carrillo-de-Albornoz A, Figuero E, Herrera D, Bascones-Martínez A. Gingival changes during pregnancy: II. Influence of hormonal variations on the subgingival biofilm. J Clin Periodontol 2010; 37: 230,240. doi: 10.1111/j.1600-051X.2009.01514.x. Abstract Aim: To determine whether the exacerbated gingival inflammation that develops in pregnant women is related to a change in the subgingival biofilm induced by the increase in hormone levels during pregnancy. Material and Methods: This open cohort study included 48 pregnant and 28 non-pregnant women without periodontitis. Pregnant women were evaluated in the first, second and third trimester and at 3 months after delivery. Non-pregnant women were evaluated twice, with a 6-month interval, assessing microbiological, clinical and hormonal variables at each visit. Total anaerobic counts and frequency of detection and proportions were calculated. The Friedman test with the Bonferroni correction was used for intra-group comparisons and Mann,Whitney U -tests for inter-group assessment. Correlations were analysed by means of Spearman's rank correlation coefficient. Results: Proportions of the subgingival periodontal pathogens did not differ throughout pregnancy, although significant differences were found for all the pathogens after delivery. Porphyromonas gingivalis -positive patients presented an increase in gingival inflammation (p<0.001) that was not related to plaque. Correlations were found between maternal hormone levels and P. gingivalis and Prevotella intermedia. Conclusion: Qualitative differences in periodontal pathogens were found from pregnancy to post-partum. Patients harbouring P. gingivalis presented and increased gingival inflammatory status. [source] Detection of periodontal bacterial DNA in serum and synovial fluid in refractory rheumatoid arthritis patientsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2009Rita E. Martinez-Martinez Abstract Aim: To identify periodontal bacterial DNA (PBDNA) by PCR in subgingival dental plaque (SDP), serum and synovial fluid (SF) of rheumatoid arthritis (RA) with periodontal disease (PD) patients and to explore the possible PBDNA transport pathways from mouth to joints. Methods: This cross-sectional prolective study involved 19 subjects with RA and PD. Informed consent, health and dental questionnaires were obtained. SDP, SF and serum samples were obtained, and leucocytes were isolated from blood. DNA was extracted and PCR assays to detect main PD species were carried out. Cultures on agar plates and broth, from each sample, were performed. Results: Hundred percentage of patients showed PBDNA in SDP and SF and 83.5% in serum. Prevotella intermedia (89.4% and 73.6%) and Porphyromonas gingivalis (57.8% and 42.1%) were the species most frequently detected in SDP and SF, respectively. In SDP, 4.05 different bacterial species were found followed by 1.19 in serum and 2.26 in SF. Culture onto agar plates and broth did not show any bacterial growth, leucocytes were not positive to PBDNA by PCR. Conclusion: This study suggests that PBDNA could have a role on the RA aetiology. The possible pathway of transport of PBDNA from mouth to joints could be via the free form of DNA. [source] Salivary interleukin-1, concentration and the presence of multiple pathogens in periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2009Ulvi Kahraman Gursoy Abstract Aim: This study aimed to find salivary enzymes and/or cytokines that would reflect periodontitis, alone or in combination with salivary microbial markers. Material and Methods: The salivary concentrations of elastase, lactate dehydrogenase, interleukin-1, (IL-1,), interleukin-6, and tumour necrosis factor- ,, and the presence of five periodontal pathogens, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola, were analysed from salivary specimens of 165 subjects, a subpopulation of Health 2000 Health Examination Survey in Finland; 84 of the subjects had probing pocket depth (PPD) of 4 mm at 14 or more teeth (the advanced periodontitis group), while 81 subjects had no teeth with PPD of 4 mm (the control group). All subjects had at least 20 teeth and no systemic diseases. Results: Among the salivary cytokines and enzymes tested, IL-1, was the only biomarker associated with periodontitis. An association was also found with the presence of multiple periodontal pathogens. Salivary IL-1, and the presence of multiple periodontal pathogens were associated with periodontitis at the same magnitude, when they were in the logistic regression model individually or together. Conclusion: We suggest that salivary IL-1, and the presence of multiple periodontal pathogens in saliva should be studied more thoroughly as markers of periodontitis. [source] Bleeding on probing differentially relates to bacterial profiles: the Oral Infections and Vascular Disease Epidemiology StudyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2008Ryan T. Demmer Abstract Aim: Various bacterial species are differentially prevalent in periodontal health, gingivitis or periodontitis. We tested the independent associations between three bacterial groupings and gingival inflammation in an epidemiological study. Material and Methods: In 706 Oral Infections and Vascular Disease Epidemiology Study (INVEST) participants 55 years, bleeding on probing (BoP), pocket depth (PD) and subgingival plaque samples (n=4866) were assessed in eight sites per mouth. Eleven bacterial species were quantitatively assayed and grouped as follows: (i) aetiologic burden (EB, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia); (ii) putative burden (PB, Campylobacter rectus, Eikenella corrodens, Fusobacterium nucleatum, Micromonas micros, Prevotella intermedia); (iii) health-associated burden (HAB, Actinomyces naeslundii, Veillonella parvula). Results: After mutual adjustment for EB, PB and HAB, the BoP prevalence increased by 45% ( p<0.0001) across increasing quartiles of EB while BoP decreased by 13% ( p<0.0001) across increasing quartiles of HAB. Mean PD increased 0.8 mm and decreased 0.3 mm from the first to fourth quartiles of EB (p<0.0001) and HAB ( p<0.0001), respectively. Among 1214 plaque samples with fourth quartile EB, 60% were collected from sites with PD 3 mm. Conclusion: Bacterial species believed to be aetiologically related to periodontitis were associated with BoP in sites with minimal PD and/or attachment level (AL). Species presumed to be associated with periodontal health demonstrated inverse associations with BoP. [source] Antimicrobial profiles of periodontal pathogens isolated from periodontitis patients in the Netherlands and SpainJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2005A. J. Van Winkelhoff Abstract Background and Aim: Antimicrobial resistance of periodontal pathogens towards currently used antibiotics in periodontics has been investigated in a previous study. Microbial resistance in the periodontal microflora was more frequently observed in Spanish patients in comparison with Dutch patients. The aim of the present study was to compare antimicrobial susceptibility profiles of five periodontal bacteria isolated from periodontitis patients in Spain and in the Netherlands. Material and Methods: Subgingival plaque samples from adult patients with periodontitis were collected and cultured on selective and non-selective plates. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum and Micromonas micros were isolated and used for minimal inhibitory concentration tests using the Epsilometer (E-test) technique. Eight different antibiotics were tested on all bacterial isolates. MIC50 and MIC90 values for each antibiotic and each species were determined and the percentage of resistant strains was calculated. Results: Significantly higher MIC values were noted in Spanish strains of F. nucleatum for penicillin, ciprofloxacin, of P. intermedia for penicillin, amoxicillin and tetracycline, of M. micros for tetracycline, amoxicillin and azithromycin, and of P. gingivalis for tetracycline and ciprofloxacin. Based on breakpoint concentrations, a higher number of resistant strains in Spain were found in F. nucleatum for penicillin, amoxicillin and metronidazole, in Prevotella intermedia for tetracycline and amoxicillin, and in A. actinomycetemcomitans for amoxicillin and azithromycin. Resistance of P. gingivalis strains was not observed for any of the antibiotics tested both in Spain and the Netherlands. Conclusions: Differences exist in the susceptibility profiles of periodontal pathogens isolated from periodontitis patients in Spain and in the Netherlands. This implicates that antibiotic susceptibility testing is necessary to determine efficacy of antimicrobial agents. Also, clinical studies with antibiotics should take these differences into account. The information from the present study indicates that it may not be possible to develop uniform protocols for usage of antibiotics in the treatment of severe periodontitis in the European Union. [source] Subgingival microbiota of chronic periodontitis subjects from different geographic locationsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2004A. D. Haffajee Abstract Background: Most clinical studies assume that the subgingival microbiota is similar from one geographic location to another. The purpose of the present investigation was to examine the composition of the subgingival microbiota in chronic periodontitis subjects from four countries. Method: Subjects with chronic periodontitis (N, Sweden=101; USA=115; Brazil=58; Chile=26) were recruited. Subjects were measured at baseline for plaque, gingivitis, bleeding on probing (BOP), suppuration, pocket depth (PD) and attachment level (AL) at six sites per tooth. Subgingival plaque samples taken from the mesial aspect of each tooth at baseline were individually analyzed for their content of 40 bacterial species using checkerboard DNA,DNA hybridization (total samples=6036). % DNA probe counts comprised by each species was determined for each site and averaged across sites in each subject. Significance of differences in proportions of each species among countries was determined using ancova adjusting for age, mean pocket depth, gender and smoking status. p- Values were adjusted for multiple comparisons. Results: On average, all species were detected in samples from subjects in the four countries. Thirteen species differed significantly in adjusted mean proportions among countries even after adjusting for multiple comparisons. Porphyromonas gingivalis, one species that differed in proportions among countries, comprised adjusted means of 7.5, 11.9, 1.6 and 6.6% of the microbiota in subjects from Brazil, Chile, Sweden and USA (p<0.001), while mean proportions of Treponema denticola were 6.7, 4.2, 0.8 and 2.3, respectively (p<0.001). In contrast, a key periodontal pathogen, Tannerella forsythensis, exhibited mean proportions ranging from 6.2,8.5% and did not differ significantly among countries. Besides these species, prominent species in Brazil were Actinomyces naeslundii genospecies 1 and 2 (8.4%, 7.2%) and Prevotella intermedia (6.5%); in Chile, Prevotella melaninogenica (6.4%) and Neisseria mucosa (5.3%); in Sweden A. naeslundii genospecies 2 (8.4%), Capnocytophaga gingivalis (7.1%) and Peptostreptococcus micros (5.0%); in USA A. naeslundii genospecies 2 (7.5%), P. intermedia (6.8%) and C. gingivalis (6.1%). Conclusions: The microbial profiles of subgingival plaque samples from chronic periodontitis subjects in four countries showed surprisingly marked differences. These differences persisted after adjusting for age, mean pocket depth, gender and smoking status. [source] Microbiological shifts in intra- and extraoral habitats following mechanical periodontal therapyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2004Thomas Beikler Abstract Objectives: The aim of the present study was to analyze the intra- and extraoral colonization dynamics of periodontal pathogens following supra- and subgingival debridement. Material and Methods: Thirty five patients with chronic periodontitis were enrolled in the study. Supra- and subgingival plaque samples, saliva, and swab samples from mucosa and extraoral sites were taken at baseline and 6 weeks, 3 months and 6 months after mechanical periodontal therapy. Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Eikenella corrodens (Ec), Tannerella forsythensis (Tf), Prevotella intermedia (Pi), Prevotella nigrescens (Pn), and Treponema denticola (Td) were identified by PCR. Results: Supra- and subgingival debridement decreased the number of subgingival sites infected with the analyzed pathogens only transiently, if at all. However, the detection frequencies of Tf, Td, Ec, Pi, and Pn in the supragingival region, of Pg, Td, and Pn at the oral mucosa sites (mostly the tongue), and of all pathogens except Aa in saliva increased over the 6-month observation period. Td was the only pathogen recorded in notable quantities in the extraoral habitat (external ear canal). Conclusion: The results indicate that supra- and subgingival debridement results in a dissemination of periodontal pathogens within the oral cavity. [source] Antibiotic resistance profile of the subgingival microbiota following systemic or local tetracycline therapyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2004Rosa Maria J. Rodrigues Abstract Background: Tetracyclines have been extensively used as adjunctives to conventional periodontal therapy. Emergence of resistant strains, however, has been reported. This study evaluated longitudinally the tetracycline resistance patterns of the subgingival microbiota of periodontitis subjects treated with systemic or local tetracycline therapy+scaling and root planing (SRP). Methods: Thirty chronic periodontitis patients were randomly assigned to three groups: SRP+500 mg of systemic tetracycline twice/day for 14 days; SRP alone and SRP+tetracycline fibers (Actsite®) at four selected sites for 10 days. Subgingival plaque samples were obtained from four sites with probing pocket depths (PPD)6 mm in each patient at baseline, 1 week, 3, 6 and 12 months post-therapy. Samples were dispersed and diluted in pre-reduced anaerobically sterilized Ringer's solution, plated on Trypticase Soy Agar (TSA)+5% blood with or without 4 ,g/ml of tetracycline and incubated anaerobically for 10 days. The percentage of resistant microorganisms were determined and the isolates identified by DNA probes and the checkerboard method. Significance of differences among and within groups over time was sought using the Kruskal,Wallis and Friedman tests, respectively. Results: The percentage of resistant microorganisms increased significantly at 1 week in the tetracycline groups, but dropped to baseline levels over time. The SRP+Actsite® group presented the lowest proportions of resistant species at 6 and 12 months. No significant changes were observed in the SRP group. The predominant tetracycline-resistant species included Streptococcus spp., Veillonela parvula, Peptostreptococcus micros, Prevotella intermedia, Gemella morbillorum and Actinobacillus actinomycetemcomitans (Aa). A high percentage of sites with resistant Aa, Porphyromonas gingivalis and Tanerella forsythensis was observed in all groups at baseline. However, T. forsythensis was not detected in any group and P. gingivalis was not present in the SRP+Actsite® group at 1 year post-therapy. Aa was still frequently detected in all groups after therapy. However, the greatest reduction was observed in the SRP+Actsite® group. Conclusion: Local or systemically administered tetracycline results in transitory selection of subgingival species intrinsically resistant to this drug. Although the percentage of sites harboring periodontal pathogens resistant to tetracycline were quite elevated in this population, both therapies were effective in reducing their prevalence over time. [source] Quadrant root planing versus same-day full-mouth root planingJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2004III. Dynamics of the immune response Abstract Objectives: The aim of this study was to determine whether same-day full-mouth scaling and root planing (FM-SRP) and quadrant scaling and root planing (Q-SRP) resulted in variations in the systemic humoral immune response dynamics (antibody titres and avidity) during active treatment and 3 and 6 months post-therapy. Material and Methods: Forty patients with chronic periodontitis were recruited into this study. Subjects were randomised into two groups and received either scaling and root planing quadrant by quadrant at 2-weekly intervals (Q-SRP group) or same-day full-mouth scaling and root planing (FM-SRP group). Clinical measurements and serum samples were obtained at baseline and approximately 6 weeks after the last clinical intervention (R1) and 6 months after the initiation of therapy (R2). Furthermore, serum samples were obtained from each patient undergoing therapy (Q-SRP and FM-SRP) at 3 bi-weekly instances so as to determine the short-term effects of each session of scaling and root planing on the dynamics of the humoral immune response. Serum antibody titre was assayed by enzyme-linked immunosorbent assay (ELISA) and antibody avidity was measured by thiocyanate dissociation against five putative periodontal pathogens: Porphyromonas gingivalis; Actinobacillus actinomycetemcomitans; Prevotella intermedia; Treponema denticola and Bacteroides forsythus. Results: Both therapies resulted in similar antibody titre reductions against the majority of the organisms tested and although there was a distinct trend for antibody avidity to increase following therapy, this was not found to be statistically significant, reflecting marked inter-individual variation. In addition, no evidence emerged from this study to support increased antibody titres following the active phases of both treatment approaches due to an inoculation effect. Nevertheless, significant short-term increases in antibody avidity to most test bacteria were noted for both treatment strategies. Conclusion: Both therapies were associated with a reduction in antibody titres and an increase in the binding ability or avidity of antibodies, but there was a marked inter-subject variability and statistical significance was reached for only some of the test bacteria. No significant differences in the humoral antibody dynamics were found between the two treatment approaches. [source] Quadrant root planing versus same-day full-mouth root planingJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2004II. Microbiological findings Abstract Objectives: The aim of this study was to test the hypothesis that over a period of 6 months, same-day full-mouth scaling and root planing (FM-SRP) resulted in greater reductions in the detection frequency of five putative periodontal pathogens compared with quadrant scaling and root planing (Q-SRP) in chronic periodontitis patients. Materials and Methods: Forty patients were recruited into this study. Subjects were randomised into two groups. The FM-SRP group received full-mouth scaling and root planing completed within the same day, while the Q-SRP group received quadrant root planing at 2-weekly intervals over four consecutive sessions. Selected-site analyses were performed on the deepest site in each quadrant before and after therapy, at approximately 3 and 6 months from baseline (R1 and R2) and clinical indices were recorded with an electronic pressure-sensitive probe. In addition, subgingival plaque samples were collected from these sites at baseline (BAS), at reassessment 1 (R1), approximately 6 weeks after the completion of therapy and at reassessment 2 (R2), 6 months from baseline. Polymerase chain reaction (PCR) was used to determine the presence of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Treponema denticola and Bacteroides forsythus in plaque. Results: Both therapies resulted in significant improvements in all clinical indices both at R1 and R2. A marked reduction in the presence of all candidate periodontal pathogens was noted after both treatment modalities, reaching statistical significance for the majority of the test organisms. These improvements were maintained over a period of 6 months. When the two treatment groups were compared, a significantly higher percentage of Q-SRP patients was positive for P. intermedia at R1 compared with FM-SRP patients (p<0.05). In addition, a greater reduction in the patient prevalence for T. denticola was found for the FM-SRP group than the Q-SRP group at R1 and R2 from baseline (p<0.005), but the significance of this is questionable given the skewed detection frequency of this organism at baseline between the two treatments (p<0.01). Conclusion: This study failed to confirm that same-day FM-SRP resulted in greater microbiological improvements compared with Q-SRP at 2-weekly intervals over a 6-month period, as determined by PCR. [source] Relationship between periodontal pocket sulfide levels and subgingival speciesJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2003G. Torresyap Abstract Background: Many species implicated in the pathogenesis of periodontal disease produce volatile sulfur compounds (VSC). This investigation examined the relationship between levels of sulfide and subgingival bacterial species in the same periodontal pockets. Material and Methods: Twenty chronic periodontitis subjects were measured clinically at six sites per tooth for plaque, gingivitis, bleeding on probing, suppuration, pocket depth and attachment level. Subgingival plaque samples, taken from the mesial aspect of each tooth, were individually analyzed for their content of 40 bacterial species using checkerboard DNA,DNA hybridization. Sulfide levels were measured at the same sites using a Diamond Probe/Perio 2000 system. Clinical and microbiological data were averaged for sulfide-positive and -negative sites separately in each subject and then averaged across subjects. Significance differences in clinical and microbial parameters between sulfide-positive and -negative sites were sought using the Wilcoxon signed ranks test. Results: Mean total DNA probe counts (×105, ±SEM) at sulfide-negative and -positive sites were 44.0±9.9 and 65.0±13.3, respectively (p<0.01). Seventeen species were found at significantly higher levels in sulfide-positive than -negative sites. These included abundant producers of VSC such as members of the genera Fusobacterium, Campylobacter, Prevotella, Treponema and Eubacterium, and Bacteriodes forsythus, Selenomonas noxia and Propionibacterium acnes. Prevotella intermedia, Bacteriodes forsythus, Prevotella nigrescens, Fusobacterium nucleatum ss vincentii and Treponema denticola exhibited the greatest difference in mean counts between sulfide-negative and -positive sites. Orange and red complex species were at higher counts at shallow (<4 mm) sulfide-positive than shallow sulfide-negative sites. Although not statistically significant, mean clinical parameters were somewhat higher at sulfide-positive than sulfide-negative sites. Conclusions: Intra-pocket sulfide levels reflect the levels of sulfide-producing species and may provide useful diagnostic information. Zusammenfassung Grundlagen: Viele Spezies, die mit der Pathogenese der Parodontalerkrankung verbunden sind produzieren flüchtige Schwefelkomponenten (VSC). Diese Studie untersuchte die Verbindung zwischen dem Sulfid-Niveau und subgingivalen Spezies in den gleichen parodontalen Taschen. Methode: 20 Patienten mit chronischer Parodontitis wurden an 6 Stellen pro Zahn klinisch befundet hinsichtlich Plaque, Gingivitis, BOP, Eiterentleerung, Taschentiefe und Attachmentniveau. Unter Verwendung der Schachbrett-DNA,DNA-Hybridisierung wurden subgingivale Plaqueproben von der mesialen Stelle eines jeden Zahns individuell hinsichtlich des Vorkommens von 40 bakteriellen Spezies untersucht. An der gleichen Stelle wurde mittels des Diamond Probe/Perio 2000 Systems das Niveau des Sulfids gemessen. Von den klinischen und mikrobiologischen Daten wurden bei jedem Patienten getrennt für Sulfid-positiv und Sulfid-negativ ein Durchschnitt gebildet und anschließend der Durchschnitt für alle Patienten berechnet. Nach signifikanten Unterschieden in den klinischen und mikrobiologischen Parametern zwischen Sulfid-positiven und Sulfid-negativen Stellen wurde unter Verwendung des Wilcoxon signed ranks Test gesucht. Ergebnisse: Die mittlere Bakterienanzahl mit Gesamt-DNA-Sonden (× 105, ±SEM) betrug an den Sulfid-negativen Stellen und Sulfid-positiven Stellen 44.0±9.9 bzw. 65.0±13.3 (p<0.01). Bei 17 Spezies wurde ein signifikant höheres Niveau in den Sulfid-positiven Stellen vorgefunden. Die umfasste Bakterien die reichlich VSC produzieren, wie Mitglieder der Genera Fusobacterium, Campylobacter, Prevotella, Treponema und Eubacterium und B. forsythus, S. noxia und P. acnes. P. intermedia, B. forsythus, P. nigrescens, F. nucleatum ssvincentii und T. denticola zeigten den größten Unterschied zwischen Sulfid-positiven und Sulfid-negativen Stellen in der durchschnittlichen Bakterienanzahl. Spezies des orangen und roten Komplexes lagen in höherer Anzahl in flachen (<4 mm) Sulfid-positiven, als in flachen Sulfid-negativen Taschen vor. Obwohl statistisch nicht signifikant, lagen die durchschnittlichen klinischen Parameter bei den Sulfid-positiven etwas höher als bei den Sulfid-negativen Taschen Schlussfolgerungen: Die innerhalb der Taschen gemessenen Sufiid-Niveaus spiegeln das Niveau der Sulfid-produzierenden Spezies wieder und könnten eine nützliche diagnostische Information liefern. Résumé Plusieurs espèces impliquées dans la pathogenèse de la maladie parodontale produisent des composés de sulfate volatiles (VSC). Cette étude examine la relation entre les niveaux de sulfate et les espèces bactériennes sous-gingivales dans les mêmes poches parodontales. Vingt sujets avec parodontite chronique ont subi un examen clinique au niveau de six sites par dent pour la plaque dentaire, la gingivite, la profondeur de poche au sondage (BOP), la suppuration, la profondeur de poche et le niveau d'attache. Des échantillons de plaque sous-gingivale prélevés en mésial de chaque dent ont été analysés individuellement pour leur contenu de 40 espèces bactériennes à l'aide de l'hybridisation ADN-ADN croisée. Les niveaux de sulfate ont été mesurés au niveau des mêmes sites par le système de sonde Diamond/Perio 2000. Les moyennes des données cliniques et microbiologiques ont étéétablies pour les sites sulfate positif et négatif chez chaque sujet et par sujet. Des différences significatives dans les paramètres cliniques et microbiologiques entre les sites sulfate positif et négatif ont été observées via le test de Wilcoxon. Les moyennes totales des comptes de la sonde ADN (x105,+/,ES) au niveau des sites sulfate négatif et positif étaient respectivement de 44,0 +/,9,9 et 65,0+/,13,3 (p<0,01). Dix sept espèces ont été trouvées à des niveaux hautement plus significatifs dans des sites sulfate positif que négatif. Ceux-ci comprennaient d'abondants producteurs de VSC tels que les Fusobacterium, Catnpylobacter, Prevotella, Treponema, Eubacterium, B. forsythus, S. noxia etP. acnes, P. intermedia, B. forsythus, P. nigrescens, F. nucleatum ss vincentii et T. denticola qui montraient la plus grande différence dans la moyenne des comptes entre les sites sulfate négatif et positif. Les espèces complexe orange et rouge étaient plus nombreuses dans les sites de faible profondeur (<4 mm) sulfate positif que dans les sites peu profonds sulfate négatif. Bien que statistiquement non significative la moyenne des paramètres cliniques a été quelque peu plus élevée au niveau des sites sulfate positif qu'au niveau des négatifs. Les niveaux de sulfate intrapoche reflètent les niveaux des espèces produisant du sulfate et pourraient apporter une information de diagnostic pratique. [source] Clinical and microbiological studies of periodontal disease in Sjögren's syndrome patientsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2002B. Kuru Abstract Background: Little is known about the periodontal status of patients with Sjögren's Syndrome (SS), a chronic inflammatory autoimmune disease characterized by xerophthalmia and xerostomia. The aim of the present study was to evaluate whether the periodontal status of SS patients, in terms of clinical and microbiological parameters, differs from systemically healthy age- and gender-matched controls. Methods: 8 primary SS and 10 secondary SS patients were examined in comparison with 11 control subjects. All patients were diagnosed by the European Community Criteria. Control subjects were systemically healthy and not undergoing periodontal treatment. The comparison of clinical status was made in terms of mean periodontal parameters (plaque index, gingival index, gingival recession, probing pocket depth, probing attachment level and bleeding on probing) as well as the frequency distribution of probing pocket depth and probing attachment level measurements. Microbiological assays of the subgingival dental plaque samples were carried out by both a chairside enzyme test (Periocheck®) for the detection of peptidase activity (PA) and a polymerase chain reaction (PCR) analysis for 9 selected periodontal micro-organisms (Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Treponema denticola, Porphyromonas gingivalis, Eikenella corrodens, Campylobacter rectus, Bacteroides forsythus, Streptococcus oralis). Results: The occurrence, severity and extent of periodontal lesions were not significantly different between the 3 patient groups for all periodontal parameters examined. No significant differences in the sub-gingival plaque samples from control, primary or secondary SS patients for the PA test, frequency or type of periodontal micro-organisms observed. Conclusion: No significant differences could be detected in either clinical or microbiological parameters of primary or secondary SS patients compared with that of control subjects. The results of the present study thus support the notion that the periodontal status of patients with SS do not differ from systemically healthy age- and gender-matched controls. Zusammenfassung Hintergrund: Es ist wenig über den parodontalen Status von Patienten mit Sjögren Syndrom (SS) bekannt, einer chronischen entzündlichen Autoimmunerkrankung, die durch Xerophtalmie und Xerostomie charakterisiert ist. Das Ziel der vorliegenden Studie war zu überprüfen, ob der parodontale Status der SS-Patienten bi Berücksichtigung der klinischen und mikrobiologischen Parameter von demjenigen bei systemisch gesunden alters- und geschlechtspassenden Kontrollen abweicht. Methoden: 8 primäre SS und 10 sekundäre SS Patienten wurden mit 11 Kontrollpersonen vergleichend untersucht. Alle Patienten waren durch Kriterien der EU diagnostiziert. Die Kontrollpersonen waren systemisch gesund und erhielten keine parodontale Behandlung. Der Vergleich des klinischen Status wurde auf der Basis von mittleren parodontalen Parametern (Plaque-Index, Gingivaindex, gingivale Rezession, Sondierungstiefe, Stützgewebeniveau, Provokationsblutung) sowie der Verteilungsmuster der Sondierungstiefe und des Stützgewebeniveaus vorgenommen. Mikrobiologische Assay's von subgingivalen Plaqueproben wurden sowohl mit einem chairside Enzymtest (Periocheck®) für die Feststellung der Peptidaseaktivität (PA) und einer Polymerasekettenreaktion (PCR) für 9 selektierte parodontale Mikroorganismen (Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Treponema denticola, Porphyromonas gingivalis, Eikenella corrodens, Campylobacter rectus, Bacteroides forsythus, Streptococcus oralis) durchgeführt. Ergebnisse: Das Vorkommen, die Schwere und die Ausdehnung von parodontalen Läsionen unterschied sich nicht signifikant zwischen den 3 Patientengruppen für alle geprüften parodontalen Parameter. Es gab auch keine signifikanten Differenzen in den subgingivalen Plaqueproben von den Kontrollen, den primären oder sekundären SS Patienten für die PA Teste und Frequenz oder Art von beobachteten parodontalen Mikroorganismen. Schlussfolgerung: Es konnten keine signifikanten Differenzen sowohl bei den klinischen oder mikrobiologischen Parametern von primären oder sekundären SS Patienten im Vergleich mit Kontrollpersonen entdeck werden. Die Ergebnisse der vorliegenden Studie unterstützen die Ansicht, dass sich der parodontale Status von Patienten mit SS nicht von demjenigen gesunder alters- und geschlechtspassender Kontrollen unterscheidet. Résumé Origine: On en sait peu sur l'état parodontal des patients atteints du syndrome de Sjögren (SS), une maladie chronique autoimmune inflammatoire caractérisée par une xérophtalmie et une xérostomie. Le but de cette étude était d'évaluer si l'état parodontal des patients SS, en terme de paramètres cliniques et microbiologiques était différent de sujets contrôles en bonne santé générale du même âge et du méme sexe. Méthodes: 8 patients atteints de SS primaires et 10 de SS secondaires furent examinés et comparés avec des sujets contrôles. Tous les patients étaient diagnostiqués selon les critères de la communauté européenne. Les sujets contrôles étaient en bonne santé générale et ne suivaient pas de traitement parodontal. La comparaison des états parodontaux fut réalisée pour les paramètres cliniques moyens (indice de plaque, gingival, récession gingivale, profondeur de poche au sondage, niveau d'attache et saignement au sondage) et aussi pour la frèquence de distribution des mesures des profondeurs de poche au sondage et des niveaux d'attache. Les tests microbiologiques des échantillons de plaque sous-gingivale ont été réalisés à la fois par un test enzymatique au fauteuil (Periocheck®) pour la détection de l'activité peptidase (PA) et par réaction de polymérase en chaine (PCR) pour 9 micro-organismes parodontaux sélectionnés (Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Treponema denticola, Porphyromonas gingivalis, Eikenella corrodens, Campylobacter rectus, Bacteroides forsythus, Streptococcus oralis). Résultats: La survenue, la sévérité et l'étendue de la maladie parodontale n'étaient pas significativement différente entre les 3 groupes de patients pour tous les paramètres parodontaux examinés. Aucune différence significative ne fut observée entre les échantillons de plaque sous-gingivale des contrôles et ceux des patients atteints de SS primaire et secondaire, pour PA, la frèquence ou le type de micro-organismes. Conclusions: Aucune différence significative ne put être détectée, ni pour les paramètres cliniques, ni pour les paramètres microbiologiques des patients atteints de SS primaire ou secondaire lorsque l'on comparait avec les sujets contrôles. Les résultats de cette étude corroborent ainsi l'idée suivant laquelle l'état parodontal des patients atteints de SS ne différe pas de celui des sujets en bonne santé du même âge et du même sexe. [source] Distribution of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia in an Australian populationJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2001S. M. Hamlet Abstract Background, aim: The present study describes (i) the natural distribution of the three putative periodontopathogens Porphyromonas gingivalis, Prevotella intermedia and Actinobacillus actinomycetemcomitans in an Australian population and (ii) the relationship between these organisms, pocket depths and supragingival plaque scores. Methods: Subgingival plaque was collected from the shallowest and deepest probing site in each sextant of the dentition. In total, 6030 subgingival plaque samples were collected from 504 subjects. An ELISA utilising pathogen-specific monoclonal antibodies was used to quantitate bacterial numbers. Results::A. actinomycetemcomitans was the most frequently detected organism (22.8% of subjects) followed by P. gingivalis and P. intermedia (14.7% and 9.5% of subjects respectively). The majority of infected subjects (83%) were colonised by a single species of organism. A. actinomycetemcomitans presence was over-represented in the youngest age group but under-represented in the older age groups. Conversely, P. gingivalis and P. intermedia presence was under-represented in the youngest age group but over-represented in the older age groups. Differing trends in the distribution of these bacteria were observed between subjects depending upon the site of the infection or whether a single or mixed infection was present; however, these differences did not reach significance. Bacterial presence was strongly associated with pocket depth for both A. actinomycetemcomitans and P. gingivalis. For A. actinomycetemcomitans, the odds of a site containing this bacterium decrease with deeper pockets. In contrast, for P. gingivalis the odds of a site being positive are almost six times greater for pockets >3 mm than for pockets 3 mm. These odds increase further to 15.3 for pockets deeper than 5 mm. The odds of a site being P. intermedia positive were marginally greater (1.16) for pockets deeper than 3 mm. Conclusions: This cross-sectional study in a volunteer Australian population, demonstrated recognised periodontal pathogens occur as part of the flora of the subgingival plaque. Prospective longitudinal studies are needed to examine the positive relationship between pocket depth and pathogen presence with periodontal disease initiation and/or progression. Zusammenfassung Hintergrund: Die vorliegende Studie beschreibt: 1.) die natürliche Verteilung der 3 vermutlichen Parodontalpathogene Porphyromonas gingivalis und Prevotella intermedia und Actinobacillus actinomycetemcomitans in einer Australischen Population und 2.) das Verhältnis zwischen diesen Organismen, der Taschentiefe und den supragingivalen Plaquewerten. Methoden: In jedem Sextanten des Gebisses wurde subgingivale Plaque von der flachsten und tiefsten Stelle entnommen. Insgesamt wurden 6030 subgingivalen Plaqueproben bei 504 Personen entnommen. Um die Anzahl der Bakterien zu quantifizieren wurde ein ELISA, welcher mit pathogen-spezifische monoklonale Antikörper arbeitet, verwendet. Ergebnisse:A. actinomycetemcomitans war der Keim, der am häufigsten nachgewiesen wurde (22.8% der Personen), gefolgt von P. gingivalis und P. intermedia (14.7% bzw. 9.5% der Personen). Die Mehrheit der Personen (83%) wurde von einer einzigen Spezies eines Organismus kolonisiert. Das Vorkommen von A. actinomycetemcomitans war in der jüngsten Altersgruppe überrepräsentiert, aber in der älteren Altersgruppen unterrepräsentiert. Im Gegensatz dazu war das Vorkommen von P. gingivalis und P. intermedia in der jüngsten Altersgruppe unterepräsentiert, aber in der älteren Altersgruppen überrepräsentiert. Zwischen der Personen wurden unterschiedliche Trends in der Verteilung dieser Bakterien beobachtet. Diese waren abhängig von der Stelle der Infektion oder ob eine Monoinfektion oder Mischinfektion vorhanden war. Jedoch erreichten diese Unterschiede nicht den Bereich der Signifikanz. Sowohl für A. actinomycetemcomitans als auch P. gingivalis war das Vorkommen von Bakterien stark mit der Taschentiefe assoziiert. Für A. actinomycetemcomitans nimmt die Odds einer Stelle welche das Bakterium enthält mit der Tiefe der Tasche ab. Im Gegensatz dazu ist die Odds einer Stelle die positiv für P. gingivalis ist fast sechsmal größer für Taschen >3 mm als für Taschen 3 mm. Diese Odds erhöht sich weiter auf 15.3 für Taschen die tiefer als 5 mm sind. Die Odds einer Stelle die positive für P. intermedia ist war nur etwas größer (1.16) für Taschen, die tiefer als 3 mm sind. Schlussfolgerung: Diese Querschnittsstudie einer Australischen Population von Freiwillingen zeigte, dass die erkannten Parodontalpathogene ein Bestandteil der Flora der subgingivalen Plaque sind. Prospektive Langzeitstudien sind notwendig, um die positive Beziehung zwischen der Taschentiefe und dem Vorkommen von Pathogenen mit dem Beginn und der Progression einer Parodontalerkrankung zu untersuchen. Résumé Origine: Cette étude décrit (i) la distribution naturelle des 3 parodontopathogènes présume,Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis et Prevotella intermedia dans une population australienne et (ii) la relation entre ces organismes, les profondeurs de poche et les scores de plaque supragingivale. Méthodes: La plaque sous-gingivale a été prélevée sur le site le moins profond et sur le site le plus profond de chaque sextant de la denture. Au total, 6030 échantillons de plaque sous-gingivale ont été prélevés chez 504 sujets. Un test ELISA par anticorps monoclonaux spécifiques des pathogènes a permis de quantifier les nombres de bactéries. Résultats:Actinobacillus actinomycetemcomitans était l'organisme le plus fréquement détecté (22.8%) des sujets) suivi de Porphyromonas gingivalis et Prevotella intermedia (14.7% et 9.5% des sujets, respectivement). La majorité des sujets infectés (83%) étaient colonisés par une unique espèce d'organisme. La présence d'Actinobacillus actinomycetemcomitansétait surreprésentée dans le groupe des plus jeunes mais sous-représentée dans les groupes plus agés. Des tendances différentes de la distribution de ces bactéries étaient observées entre les sujets selon le site d'infection ou la présence d'une infection unique ou mixte. Cependant, ces différences n'étaient pas significatives. La présence bactérienne était fortement associée avec la profondeur de poche pour Actinobacillus actinomycetemcomitans et Porphyromonas gingivalis, pour Actinobacillus actinomycetemcomitans, les chances d'un site de contenir cette bactérie diminuant avec la profondeur de poche, alors que pour Porphyromonas gingivalis, les chances d'un site d'être positif étaient 6× plus grande pour des poches >3 mm que pour les poches 3 mm. Ces chances augmentaient en plus à 15.3 pour les poches >5 mm. Les chances d'un site d'être positif pour P. intermediaétaient légèrement plus importantes pour les poches de plus de 3 mm. Conclusions: Cette étude croisée dans une population volontaire australienne a démontré que des pathogènes parodontaux reconnus font partie de leur plaque sous-gingivale. Des études prospectives longitudinales sont nécessaires pour examiner les relations positives entre la profondeur de poche et la présence de pathogènes et l'initiation et/ou la progression de la maladie. [source] Absence of a specific subgingival microflora in adults with Down's syndromeJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2001W. Reuland-Bosma Abstract Background: Periodontal disease in Down's syndrome (DS) is generally characterized by a high degree of bone loss. Bone loss of 5 mm or more is observed in 70% of these subjects. Among DS subjects, considerable differences in disease progression occur. So far, no studies have been conducted in which specific properties of the subgingival microflora have been related to the condition observed. Aims: To investigate (1) the subgingival microflora in DS subjects and other mentally retarded (control) individuals which were matched to the utmost and (2) to investigate the subgingival microflora of a "low-risk" and a " high-risk" group formed in DS subjects. Material and Methods: 17 DS subjects and 17 control subjects were matched with respect to age, plaque level and bleeding on probing. In addition, the DS group was divided in a "low-risk" group (0,2 teeth lost due to periodontal disease n=6) and a "high-risk"group (6,13 teeth lost due to periodontal disease n=11). Prevalence and proportions of the putative periodontal pathogens Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Bacteroides forsythus, Peptostreptococcus micros, Fusobacterium nucleatum and Campylobacter rectus in the subgingival plaque were determined using anaerobic culture techniques. No differences in the prevalence of distinct suspected periodontopathic bacteria and bacterial subgingival composition between the DS group and the control group could be established. Also no differences in the prevalence of the seven investigated microbial species between the "low-risk" and the "high-risk" group were observed. Conclusions: Because of the lack of differences in microflora between the DS group and the control group, a specific effect of the microbiological composition in the periodontal status of subjects with DS can be excluded in this population. Host factors constitute the more likely explanation of the differences observed in DS. Zusammenfassung Basis: Die parodontale Erkrankung beim Down Syndrom (DS) ist allgemein durch einen hohen Grad von Knochenverlust charakterisiert. Knochenverlust von 5 mm und mehr wird bei 70% der Personen beobachtet. Unter den DS Personen bestehen beträchtliche Differenzen in der Erkrankungsprogression. Bis heute sind keine Studien durchgeführt worden, in welchen die spezifischen Eingenschaften der subgingivalen Mikroflora in Beziehung zu den Bedingungen beobachtet wurden. Ziele: Untersuchung (1) der subgingivalen Mikroflora bei DS Personen und anderen mental retardierten (Kontrollen) Personen, die zu einer größten gemischt wurden und (2) der subgingivalen Mikroflora von Gruppen mit "geringem Risiko" und Gruppen mit "hohem Risiko" bei DS Personen. Material und Methoden: 17 DS Personen mit 17 Kontrollpersonen wurden im Hinblick auf Alter, Plaquemenge und Blutung auf Provokation eingeteilt. Zusätzlich wurde die DS Gruppe in "geringes Risiko" (0,2 Zähne infolge von parodontaler Erkrankung verloren, n=6) und in "hohes Risiko" (6,13 Zähne infolge parodontaler Erkrankung verloren, n=11) eingeteilt. Das Vorkommen und die Relationen von putativen parodontalen Pathogenen Actinobacillus actinomycetemcomitants, Porphyromonas gingivalis, Prevotella intermedia, Bacteroides forsythus, Peptostreptococcus micros, Fusobacterium nucleatum und Campylobacter rectus in der subgingivalen Plaque wurden mit anaerober Kulturtechnik bestimmt. Ergebnisse: Es konnten keine Differenzen in der Prävalenz der bezeichneten parodontopathogenen Bakterien und der bakteriellen subgingivalen Zusammensetzung zwischen DS Gruppe und der Kontrollgruppe beobachtet werden. Auch zwischen der Gruppe "geringes Risiko" und "hohes Risiko" wurden keine Differenzen in der Prävalenz der 7 untersuchten Spezies beobachtet. Schlußfolgerungen: Weil keine Differenzen in der Mikroflora zwischen DS Gruppe und der Kontrollgruppe vorhanden sind, kann ein spezifischer Effekt der mikrobiologischen Zusammensetzung beim parodontalen Status der Personen mit DS in dieser Population ausgeschlossen werden. Für die Erklärung der Differenzen, die bei den DS Personen beobachtet werden, sind die Wirtsfaktoren mehr wahrscheinlich. Résumé Origine: La maladie parodontale lors du syndrôme de Down (DS) est généralement caractérisée par une importante perte osseuse. Cette perte osseuse atteint 5 mm ou plus chez 70% de ces malades. Parmi les sujets DS, des différences considérables dans la progression de cette maladie se manifestent. Aucune étude n'a encore été entreprise dans laquelle la microflore sous-gingivale a été mise en relation avec les conditions observées. But: Le but de cette étude a été (1) d'analyser la microflore sous-gingivale chez les sujets DS et d'autres retardés mentaux servant de contrôles et (2) mieux connaître la microflore sous-gingivale chez les groupes de patients DS avec faible et haut risques. Matériaux et méthodes: 17 sujets DS et 17 sujets contrôles ont été analysés de manière parallèle en fonction de l'âge, du niveau de plaque dentaire et du saignement au sondage. De plus, le groupe DS était scindé en deux sous-groupes: "petit risque" (0 à 2 dents perdues pour cause de maladie parodontale; n=6), et "haut risque" (6 à 13 dents perdues; n=11). La fréquence globale et les proportions de pathogènes parodontaux putatifs l'Actinobacillus actinomycetemcomitans, le Porphyromonas gingivalis, le Prevotella intermedia, le Bacteroides forsythus, le Peptostreptococcus micros, le Fusobacterium nucleatum et le Campylobacter rectus dans la plaque sous-gingivale ont été déterminés en utilisant des techniques de culture anaérobie. Résultats: Aucune différence dans la fréquence globlale de ces bactéries ni dans la composition de la flore sous-gingivale n'a été trouvée entre le groupe DS et le groupe contrôle. Il n'y avait également aucune différence entre les sous-groupes à faible et à haut risques. Conclusions: Parce qu'aucune différence n'a été décelée dans la microflore entre les groupes DS et contrôle, aucun effet spécifique de leur flore sous-gingivale ne pourrait être responsable; les facteurs de l'hôte constituent très vraisemblablement l'explication des différences observées chez les sujets DS. [source] Changes in subgingival microflora and humoral immune response following periodontal therapyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2001I. B. Darby Abstract Objectives: To investigate the effect of scaling and root planing (SRP) on the microflora and humoral immune response in adult periodontitis. Materials & Methods: Clinical measurements, subgingival plaque samples, gingival crevicular fluid and sera were taken from 4 sites in 28 adult periodontitis patients before and after SRP. Polymerase chain reaction was used to determine the presence of A. actinomycetemcomitans, P. gingivalis,B. forsythus, P. intermedia, and T. denticola. ELISA was used to investigate the systemic and local antibody titres to these organisms, and thiocyanate dissociation for the determination of serum antibody avidity. Results: SRP produced a good clinical improvement. On a subject basis there was little significant change in the microflora. However, on a site basis, there were significant reductions in P. intermedia, B. forsythus and T. denticola. There was little change in systemic and local antibody titres following SRP, although there was a significant reduction in antibody avidity to P. gingivalis and P. intermedia Conclusion: Post-therapy clinical improvement was associated with a reduction in bacterial prevalence, but statistical significance was only reached at a site level and this microbial reduction was not significant for all organisms. No significant post-therapy effects on the humoral immune response were noted other than a reduced antibody avidity to P. gingivalis and P. intermedia. The lack of a clear pattern in the humoral immune response may reflect a failure of the host response to produce adequate levels of biologically functional antibodies, and complex interactions between the subgingival flora and the host response. Zusammenfassung Ziele: Untersuchung des Effektes von Scaling und Wurzelglättung (SRP) auf die Mikroflora und menschliche Immunantwort bei der Erwachsenen-Parodontitis. Material und Methoden: Klinische Messungen, subgingivale Plaqueproben, gingivale Sulkusflüssigkeit und Serum wurden von 4 Flächen bei 28 Patienten mit Erwachsenen-Parodontitis vor und nach SRP aufgenommen. Die Polymerase-Ketten-Reaktion wurde genutzt, um die Präsenz von A. actinomycetemcomitans, P. gingivalis, B. forsythus, P. intermedia und T. denticola zu bestimmen. ELISA wurde für die Bestimmung der systemischen und lokalen Antikörpertiter gegen diese Organismen genutzt. Die Thiocyanat-Dissoziation wurde für die Bestimmung der Serumantikörperaktivitart genutzt. Ergebnisse: SRP erbrachte eine gute klinische Verbesserung. Auf der Basis der Person gab es eine geringe signifikante Veränderung der Mikroflora. Jedoch gab es auf der Basis der Fläche eine signifikante Reduktion von P. intermedia, B. forsythus und T. denticola. Geringe Veränderungen in den systemischen und lokalen Antikörpertitern in der Folge von SRP waren zu beobachten, obwohl eine signifkante Reduktion der Antikörperaktivität zu P. gingivalis und P. intermedia vorhanden war. Schlußfolgerung: Die posttherapeutischen klinischen Verbesserungen waren mit einer Reduktion der bakteriellen Prävalenz verbunden, die statistische Signifikanz wurde aber nur auf der Basis der Fläche erreicht, und diese mikrobielle Reduktion war nicht signifikant für alle Organismen. Keine signifikanten posttherapeutischen Effekte auf die menschliche Immunantwort wurden außer einer reduzierten Antikörperaktivität zu P. gingivalis und P. intermedia beobachtet. Der Mangel in einem klaren Muster in der menschlichen Immunantwort könnte einen Fehler in der Wirtsantwort zur Produktion adäquater Level von biologisch funktionellen Antikörpern und komplexen Interaktionen zwischen der subgingivalen Flora und der Wirtsantwort reflektieren. Résumé But: L'objectif de cette étude est de rechercher les effets du détartrage et du surfaçage radiculaire (SRP) sur la microflore et la réponse immunitaire humorale chez des patients atteints de parodontite de l'adulte. Méthodes: Les mesures cliniques, les échantillons de plaque sous-gingivale, le fluide gingivale et le serum ont été prélevés sur 4 sites chez 28 patients atteints de parodontite de l'adulte avant et après SRP. La réaction de polymérase en chaine a été utilisé pour déterminer la présence de Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus, Prevotella intermedia et Treponema denticola. Le test ELISA a été utilisé pour rechercher les titres d'anticorps locaux et systèmiques vis à vis de ces organismes, et la dissociation au thiocyanate a été utilisée pour la détermination de l'avidité des anticorps sériques. Résultats: SRP entrainait une bonne amélioration clinique. Individuellement par patient, il y avait peu de modifications de la microflore. Cependant, en ce qui concerne les sites, il y avait des réductions significatives de Prevotella intermedia, Bacteroides forsythus et Treponema denticola. Il y avait peu de changements pour les titres d'anticorps systèmiques et locaux suite au SRP, bien que l'on observait une réduction significative de l'avidité des anticorps envers Porphyromonas gingivalis et Prevotella intermedia. Conclusions: L'amélioration clinique consécutive au traitement était associée avec une réduction de la prévalence bactérienne, mais une signification statistique n'était obtenue que pour les sites, et cette réduction microbienne n'était pas significative pour tous les organismes. Suite au traitement, aucun effet significatif sur la réponse immunitaire humorale n'était mis en évidence, en dehors de la diminution de l'avidité des anticorps vis à vis de Porphyromonas gingivalis et Prevotella intermedia. L'absence de caractéristiques nettes de la réponse immunitaire humorale pourrait reflèter l'échec de la réponse de l'hôte à produire des niveaux suffisants d'anticorps biologiquement fonctionnels, et également les interactions complexes entre la flore sous-gingivale et cette réponse de l'hôte. [source] Relationship of cigarette smoking to the subgingival microbiotaJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 5 2001A. D. Haffajee Abstract Background: The relationship of cigarette smoking to the composition of the subgingival microbiota is not clear. Some studies indicated higher levels of certain species in smokers, while other studies failed to detect differences in the microbiota between subjects with different smoking histories. Thus, the purpose of the present investigation was to examine the prevalence, proportions and levels of the subgingival species in adult subjects who were current, past or never smokers. Method: 272 adult subjects ranging in age from 20,86 years with at least 20 teeth were recruited for study. Smoking history was obtained using a questionnaire. Clinical measures were taken at 6 sites per tooth at all teeth excluding third molars at a baseline visit. Subgingival plaque samples were taken from the mesial surface of all teeth excluding third molars in each subject at baseline and assayed individually for counts of 29 subgingival species using checkerboard DNA-DNA hybridization. Subjects were subset according to smoking history into never (n=124), past (n=98) and current smokers (n=50). Uni-variate and multi-variate analyses were used to seek associations between smoking category and the counts, proportions and prevalence of subgingival species. Results: Greater differences were observed for the prevalence (% of sites colonized) of the test species in the 3 smoking groups than were observed for counts or proportions of total counts. Members of the orange and red complexes including E. nodatum, F. nucleatum ss vincentii, P. intermedia, P. micros, P. nigrescens, B. forsythus, P. gingivalis and T. denticola were significantly more prevalent in current smokers than in the other 2 groups. The difference in prevalence between smokers and non-smokers was due to greater colonization at sites with pocket depth <4 mm. Stepwise multiple linear regression analysis indicated that combinations of the prevalence of 5 microbial species and pack years accounted for 44% of the variance for mean pocket depth (p<0.000001), while the prevalence of 3 microbial taxa along with age, pack years, current smoking and gender accounted for 31% of the variance in mean attachment level (p<0.000001). The difference in prevalence between current and never smokers of all members of the red complex and 8 of 12 members of the orange complex was significantly greater in the maxilla than in the mandible. Conclusions: The major difference between the subgingival microbiota in subjects with different smoking history was in the prevalence of species rather than counts or proportions. The greater extent of colonization in smokers appeared to be due to greater colonization at pocket depths <4 mm. Differences in colonization patterns between current and never smokers were greater in the maxilla than in the mandible. Zusammenfassung Grundlagen: Die Beziehung zwischen dem Zigarettenrauchen und der Zusammensetzung der subgingivalen Mikroflora ist nicht klar. Einige Studien verweisen auf höhere Titer von bestimmten Spezies bei Rauchern, während andere Studien keine Unterschiede in der Mikroflora zwischen Personen mit unterschiedlichem Raucher- oder Nichtraucherverhalten nachweisen konnten. Daher war der Zweck der vorliegenden Studie die Untersuchung von Prävalenz, Anteil und Titer der subgingivalen Spezies bei erwachsenen Patienten, die zur Zeit, früher oder niemals Raucher waren. Methode: Für die Studie wurden 272 erwachsene Patienten im Alter zwischen 20 und 86 Jahren und wenigstens 20 Zähnen rekrutiert. Die Anamnese des Rauchverhaltens wurde under Verwendung eines Fragebogens durchgeführt. Bei einer Eingangsuntersuchung erfolgten die klinischen Messungen an 6 Stellen pro Zahn bei allen Zähnen außer den dritten Molaren. Bei der Eingangsuntersuchung wurden, bei allen Zähnen außer den dritten Molaren, von den Mesialflächen subgingivale Plaqueproben entnommen. Für die einzelnen Flächen wurde die Anzahl von 29 subgingivalen Spezies mittels Schachbrett-DNA-DNA-Hybridisierung bestimmt. Die Patienten wurden entsprechend der Rauchervorgeschichte in folgende Gruppen eingeteilt: niemals (n=124), früher (n=98) und zur Zeit (n=50). Um Assoziationen zwischen den Rauchkategorien und der Anzahl, dem Anteil und der Prävalenz der subgingivalen Spezies herauszufinden wurden eine uni-variate und multi-variate Analyse verwendet. Ergebnisse: Es wurden größere Unterschiede zwischen den 3 Gruppen hinsichtlich der Prävalenz der Testspezies (% der Taschen die kolonisiert waren) beobachtet als bei der Anzahl oder dem Anteil an der Gesamtzahl der Keime beobachtet wurde. Die Prävalenz der Keime des orangen und roten Komplexes einschließlich. E. nodatum, F. nucleatum ss vincentii, P. intermedia, P. micros, P. nigrescens, B. forsythus, P. gingivalis und T. denticola war bei den aktuellen Rauchern stärker prävalent als in den anderen beiden Gruppen. Die Differenz in der Prävalenz zwischen Rauchern und Nichrauchern wurde verursacht durch eine stärkere Kolonisation in Taschen mit einer Taschentiefe <4 mm. Die schrittweise multiple lineare Regressionsanalyse zeigte, dass Kombinationen der Prävalenz von 5 mikrobiellen Spezies und der Packungsjahre für 44% der Varianz der mittleren Taschentiefe verantwortlich waren (p<0.000001), während die Prävalenz von 3 mikrobiellen Taxa zusammen mit Alter, Packungsjahre, Raucherstatus und Geschlecht für 31% der Varizna im mittleren Attachmentniveau verantwortlich waren (p<0.000001). Die Differenz in der Prävalenz zwischen den aktuellen Rauchern und den die niemals rauchten war für alle Keime der roten Komplexes und 8 von 12 Keimen des orangen Komplexes im Oberkiefer signifikant größer als im Unterkiefer. Schlussfolgerung: Der Hauptunterschied zwischen der subgingivalen Mikroflora bei Patienten mit unterschiedlicher Rauchervorgeschichte lag mehr bei der Prävalenz der Spezies als bei der Anzahl der Keime oder den Anteilen an der Gesamtflora. Das größere Maß an Kolonisation bei den Rauchern schien durch eine stärkere Kolonisation in Taschen <4 mm verursacht zu sein. Differenzen im Kolonisationsmuster zwischen aktuellen Rauchern und Nichtrauchern die niemals rauchten waren im Oberkiefer größer als im Unterkiefer. Résumé Origine, but: La relation entre l'usage de la cigarette et la composition de la microflore sous gingivale n'est pas claire. Certaines études indiquent d'importants niveaux de certaines espèces chez les fumeurs, alors que d'autres études n'arrivent pas à détecter de différences dans la micrflore entre des sujets ayant des histoires tabagiques différentes. Aussi, le propos de cette recherche est d'examiner la prévalence, les proportions et le niveau des espèces sous gingivales chez des sujets adultes fumeurs, anciens fumeurs ou non-fumeurs. Méthodes: 272 sujets adultes, âgès de 20 à 86 ans, ayant au moins 20 dents furent recrutés pour l'étude. L'histoire tabagique fut obtenue à l'aide d'un questionnaire. Des mesures cliniques furent prises sur 6 sites par dents, sur toutes les dents à l'exception des troisièmes molaires lors de la première visite. Des échantillons de plaque sous gingivale étaient prélevés sur la face mésiale de chaque dent à l'exception des troisièmes molaires chez chaque sujet lors de la première visite et individuellement testés pour le comptage de 29 espèces sousgingivales par hybridisation en damier ADN-ADN. Les sujets étaient groupés en sous ensembles en fonction de leur histoire tabagique en non-fumeurs (n=124), ancien fumeurs (n=98), et fumeurs (n=50). Des analyses monovariées et multivariées furent utilisées pour rechercher des associations entre les catégories de fumerus et les comptages, proportions et prévalences des espèces bactériennes. Résultats: De plus grandes différences étaient observées pour la prévalence (% de sites colonisés) des expèces testées dans les 3 groupes, que pour le comptage ou la proportion des comptages totaux. Les membres des complexes orange et rouge dont E. nodatum, F. nucléatum ss vicentii, P. intermedia, P. micros, P. nigrescens, B. forsythus, P. gingivalis, et T. denticolaétait significativement plus prévalent chez les fumeurs que dans les 2 autres groupes. La différence de prévalence entre les fumeurs et les non-fumeurs était due à une plus grande colonisation des sites dont la profondeur de poche était <4 mm. L'analyse par régression linéaire multiple stepwise indiquait que les combinaisons de la prévalence de 5 espèces microbiennes et les paquets-années comptaient pour 44% de la variance pour la moyenne de profondeur de poche (p<0.000001), alors que la prévalence de 3 taxons microbiens avec l'âge, les paquets-années, le tabagisme présent et le sexe comptaient pour 31% de la variance pour le niveau d'attache moyen (p<0.000001). La différence de prévalence entre les fumerus en activité et les non-fumeurs (jamais fumé) de tous les membres du complexe rouge et de 8 des 12 membres du complexe orange était significativement plus élevée au maxillaire qu'à la mandibule. Conclusions: La différence majeure entre les microflores sous gingivales chez les sujets ayant des histoires tabagiques différentes se trouvaient dans la prévalence des expèces plutôt que dans leurs quantité ou leurs proportions. La plus grande importance de colonisation chez les fumerus apparaît être dûe à une colonisation plus grande dans les poches <4 mm. Des différences des caractéristiques de colonisation entre les fumerus actifs et les personnes n'ayant jamais fuméétaient plus importantes au maxillaire qu'à la mandibule. [source] Amoxicillin plus metronidazole in the treatment of adult periodontitis patientsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2001A double-blind placebo-controlled study Abstract Background, aims: The aim of this double-blind, parallel study was to evaluate the adjunctive effects of systemically administered amoxicillin and metronidazole in a group of adult periodontitis patients who also received supra- and subgingival debridement. Methods: 49 patients with a diagnosis of generalised severe periodontitis participated in the study. Random assignment resulted in 26 patients in the placebo (P) group with a mean age of 40 years and 23 patients in the test (T) group which had a mean age of 45 years. Clinical measurements and microbiological assessments were taken at baseline and 3 months after completion of initial periodontal therapy with additional placebo or antibiotic treatment. Patients received coded study medication of either 375 mg amoxicillin in combination with 250 mg metronidazole or identical placebo tablets, every 8 hours for the following 7 days. Results: At baseline, no statistically significant differences between groups were found for any of the clinical parameters. Except for the plaque, there was a significantly larger change in the bleeding, probing pocket depth (PPD) and clinical attachment level (CAL) in the T-group as compared to the P-group after therapy. The greatest reduction in PPD was found at sites with initial PPD of 7 mm, 2.5 mm in the P-group and 3.2 mm in the T-group. The improvement in CAL was most pronounced in the PPD category 7 mm and amounted to 1.5 mm and 2.0 mm in the P- and T-groups, respectively. No significant decrease was found in the number of patients positive for any of the test species in the P-group. The number of patients positive for Porphyromonas gingivalis, Bacteroides forsythus and Prevotella intermedia in the T-group showed a significant decrease. After therapy there was a significant difference between the P- and the T- group in the remaining number of patients positive for P. gingivalis, B. forsythus and Peptostreptococcus micros. 4 subgroups were created on the basis of the initial microbiological status for P. gingivalis positive (Pg-pos) and negative patients (Pg-neg) in the P- and the T-groups. The difference in reduction of PPD between Pg-pos and Pg-neg patients was particularly evident with respect to the changes in % of sites with a probing pocket depth 5 mm. This % decreased from 45% at baseline to 23% after treatment in the Pg-pos placebo subgroup and decreased from 46% to 11% in the Pg-pos test subgroup (p0.005). In contrast, the changes in the proportions of sites with a probing pocket depth 5 mm in the Pg-neg placebo and Pg-neg test subgroup were similar, from 43% at baseline to 18% after treatment versus 40% to 12%, respectively. Conclusions: This study has shown that systemic usage of metronidazole and amoxicillin, when used in conjunction with initial periodontal treatment in adult periodontitis patients, achieves significantly better clinical and microbiological results than initial periodontal treatment alone. Moreover, this research suggests that especially patients diagnosed with P. gingivalis benefit from antibiotic treatment. Zusammenfassung Zielsetzung: Das Ziel dieser placebokontrollierten Doppelblindstudie mit parallelen Gruppen war es, die zusätzlichen Effekte der systemischen Gabe von Amoxicillin und Metronidazol bei Patienten mit Erwachsenenparodontitis zu untersuchen, bei denen auch eine supra- und subgingivale Instrumentierung durchgeführt worden war. Material und Methoden: 49 Patienten mit einer generalisierten schweren Erwachsenenparodontitis nahmen an der Studie teil. Zufällige Zuweisung der Therapien führte zu 26 Patienten in der Placebo-Gruppe (P) mit einem mittleren Alter von 40 und 23 Patienten in der Test-Gruppe (T) mit einem mittleren Alter von 45 Jahren. Klinische Messungen und mikrobiologische Untersuchungen wurden zu Beginn der Therapie sowie 3 Monate nach parodontaler Initialbehandlung mit zusätzlicher Placebo- bzw. Antibiotikagabe durchgeführt. Nachdem alle Zähne mit pathologisch vertieften Taschen subgingival instrumentiert worden waren, erhielten die Patienten eine kodierte Studienmedikation, die entweder aus 375 mg Amoxicillin und 250 mg Metronidazol oder identisch aussehenden Placebotabletten bestand, die die Patienten für 7 Tage alle 8 Stunden einnehmen sollten. Ergebnisse: Zu Beginn der Studie bestand kein statistisch signifikanter Unterschied zwischen den Versuchsgruppen hinsichtlich klinischer Parameter. Nicht für den Plaque Index, aber für Sondierungsblutung, Sondierungstiefen (ST) und klinische Attachmentlevel (PAL) kam es in der T-Gruppe zu signifikant stärkeren Veränderungen im Vergleich zur P-Gruppe. Die stärkste ST-Reduktion bzw. die größten Attachmentgewinne wurden bei Stellen gefunden, die initial ST 7 mm aufgewiesen hatten: P-Gruppe: ST=2.5 mm, PAL=1.5 mm; T-Gruppe: ST=3.2 mm, PAL=2.0 mm. Für keines der untersuchten Parodontalpathogene wurde eine signifikante Reduktion in der P-Gruppe beobachtet, während sich in der T-Gruppe eine signifikante Reduktion für Porphyromonas gingivalis, Bacteroides forsythus und Prevotella intermedia ergab. Nach Therapie ergab sich ein statistisch signifikanter Unterschied zwischen T- und P-Gruppe hinsichtlich Persistenz von P. gingivalis, B. forsythus und Peptostreptococcus micros. Entsprechend dem initialen mikrobiologischen Status für P. gingivalis wurden 4 Untergruppen gebildet: P. gingivalis positive (Pg+) oder (Pg,) Patienten in der T-bzw. P-Gruppe. Der Unterschied zwischen Pg+ und Pg, Patienten war besonders groß hinsichtlich der Veränderung des %-Anteils der Stellen mit ST5 mm. Dieser verringerte sich in der Pg+ P-Untergruppe von 45% auf 23% und in der Pg+ T-Untergruppe von 46% auf 11% (p0.005). Im Unterschied dazu war die Reduktion des Anteils der ST 5 mm in der Pg, P- und T-Untergruppen gleich: P-Gruppe: 43% auf 18%; T-Gruppe von 40% auf 12%. Schlußfolgerungen: Die systemische Gabe von Amoxicillin und Metronidazol zusätzlich zu subgingivaler Instrumentierung bei Patienten mit Erwachsenenparodontitis führt zu signifikant günstigeren klinischen und mikrobiologischen Ergebnissen als die konventionelle Therapie allein. Insbesondere Patienten mit P. gingivalis scheinen von dieser unterstützenden antibiotischen Therapie zu profitieren. Résumé Le but de cette étude parallèle en double aveugle était d'évaluer les effets supplémentaires apportés par l'administration d'amoxicilline et de metronidazole dans un groupe de patients atteints de parodontite de l'adulte qui ont reçu également un débridement supra et sous gingival. 49 patients présentant un diagnostic de parodontite généralisée sévère participèrent à l'étude. La composition des groupes sélectionnés au hasard, était de 26 patients dans le groupe placebo (P) avec un âge moyen de 40 ans et 23 patients dans le groupe test (T) avec une moyenne d'âge de 45 ans. Des mesures cliniques et des prélèvements microbiologiques étaient réalisés initialement et 3 mois après la fin de la thérapeutique parodontale initiale complétée par un placebo ou un traitement antibiotique. Les patients recevaient des médicaments codés pour l'étude de 375 mg amoxicilline combiné avec 250 mg de metronidazol ou des comprimés placebo identiques, toutes les 8 heures pendant les 7 jours suivants. Initalement, aucune différence statistiquement significative entre les groupes n'était observée, pour aucun des paramètres cliniques. En dehors de la plaque, il y avait une modification plus élevée significative pour le saignement, la profondeur de poche au sondage (PPD) et le niveau clinique d'attache (CAL) dans le groupe T, par rapport au groupe P, après traitement. La plus grande réduction pour PPD était observée pour les sites ayant une profondeur de poche au sondage intiale>ou égale à 7 mm, 2.5 mm dans le groupe P et 3.2 mm dans le groupe T. L'amélioration du CAL était plus prononcée pour la catégorie >ou égale à 7 mm et allait jusqu'à 1.5 et 2.0 mm dans les groupes P et T, respectivement. Aucune diminution significative n'était trouvée pour le nombre de patients positifs pour n'importe quelle espèce test dans le groupe P. Le nomber de patients positifs pour Porphyromonas gingivalis, Bacteroides forsythus et Prevotella intermedia dans le groupe T présentait une diminution significative. Après thérapeutique, il y avait une différence significative entre les groupe P et T, en ce qui concerne le nombre de patients positifs pour P. gingivalis, B. forsythus et Peptostreptococcus micros. 4-sous groupes furent créés sur la base de l'état microbiologique pour les patients positifs àP. gingivalis (Pg-pos), et négatifs (Pg-neg), dans les groupes P et T. La différence de réduction de PPD entre les patients Pg-pos et Pg-neg était particulièrement évidente en ce qui concernait les changements en % de sites présentant une profondeur de poche au sondage >ou égale à 5 mm. Ce % diminuait de 45% initialement à 23% après traitement dans le sous-groupe Pg-pos placebo et de 46% à 11% dans le sous-groupe Pg-pos test (p<0.005). A l'inverse, les changements observés dans les proportions de sites avec une profondeur de poche au sondage >5 mm dans les sous-groupes Pg-neg placebo et Pg-neg test étaient similaires, de 43% initialement à 18% après traitement contre 40% à 12% respectivement. En conclusion, cette étude a montré que l'utilisation systèmique de metronidazole et d'amoxicilline, lorsqu'elle est utilisée en complément du traitement parodontal initial chez des patients atteints de parodontite de l'adulte, donne, de façon significative, de meilleurs résultats cliniques et microbiologiques qu'un traitement parodontal initial seul. De plus, cette recherche suggère que les patients porteurs du P. gingivalis bénéficient particulièrement d'un traitement antibiotique. [source] Occurrence of Prevotella intermedia and Prevotella nigrescens in relation to gingivitis and gingival healthJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2001M. A. Lie Abstract Aim: The occurrence of Prevotella intermedia (Pi) and Prevotella nigrescens (Pn) in relation to natural gingivitis, gingival health and 14-day experimental gingivitis was investigated in 25 non-dental students. Materials and Methods: Samples were taken from the dorsum of the tongue, the tonsils (or tonsillar area), and the supra- and subgingival plaque. Results: The microbiological results show that 73% of the samples were positive for the bacterial species presumed to be Pi and/or Pn. In natural gingivitis, gingival health and in experimental gingivitis 25, 23 and 25 subjects were found to be positive for Pi and/or Pn, respectively. The results of the 889 isolates that were succesfully purified and differentiated, show that almost all subjects were colonized with Pn whereas approximately half of the study population harboured Pi. These 2 species were isolated from both dental plaque and mucosal sites and were found to colonize the oral cavity simultaneously. Conclusion: In natural gingivitis, at the start and after 14 days of experimental gingivitis, Pn was the predominant micro-organism. [source] Microbial composition of supra- and subgingival plaque in subjects with adult periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2000Laurie Ann Ximénez-Fyvie Abstract Background, aims: The purpose of the present study was to compare and relate the microbial composition of supra and subgingival plaque in 23 adult periodontitis subjects (mean age 51±14 years). Methods: A total of 1,170 samples of supra and subgingival plaque were collected from the mesial aspect of every tooth (up to 28 supra and 28 subgingival samples) from each subject and evaluated for the presence and levels of 40 bacterial taxa using whole genomic DNA probes and checkerboard DNA-DNA hybridization. Clinical assessments including dichotomous measures of gingival redness, bleeding on probing, plaque accumulation and suppuration, as well as duplicate measures of pocket depth and attachment level, were made at 6 sites per tooth. The counts (levels), % DNA probe count (proportion) and % of sites colonized (prevalence) of each species in supra and separately in subgingival plaque were computed for each subject. Significance of differences between supra and subgingival plaque for each species was sought using the Wilcoxon signed ranks test and adjusted for multiple comparisons. Results: All 40 taxa were detected in both supra and subgingival plaque. Actinomyces species were the most prevalent taxa in both habitats. 75 to 100% of supra and 62 to 100% of subgingival sites were colonized by at least one of the 5 Actinomyces species. Supragingival samples exhibited significantly higher counts of Actinomyces naeslundii genospecies 1, Actinomyces israelii, Actinomyces odontolyticus, Neisseria mucosa, Streptococcus gordonii, Capnocytophaga ochracea and Capnocytophaga sputigena when compared with mean counts in subgingival samples taken from the same tooth surfaces. Subgingival plaque samples presented significantly higher counts of Prevotella nigrescens, Prevotella intermedia, Bacteroides forsythus and Porphyromonas gingivalis. Subgingival samples exhibited a significantly higher proportion of "red" and "orange complex" species, while supragingival plaque exhibited higher proportions of "green" and "purple" complex species as well as Actinomyces species. Suspected periodontal pathogens could be detected in supragingival plaque from sites where subgingival samples were negative for the same species. Conclusions: The data indicate that supragingival plaque can harbor putative periodontal pathogens, suggesting a possible rôle of this environment as a reservoir of such species for the spread or reinfection of subgingival sites. [source] | ||||||||||||||||||||||||||||||||||