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Periodontal Pathogens (periodontal + pathogen)

Distribution by Scientific Domains
Medical Sciences100%
Distribution within Medical Sciences
Periodontology65%
Implant Dentistry6%
5 Other Subdomains29%

Kinds of Periodontal Pathogens

  • putative periodontal pathogen
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    Terms modified by Periodontal Pathogens

  • periodontal pathogen Porphyromona gingivali
    		•

    Selected Abstracts

    Biofilms in the Edentulous Oral Cavity

    JOURNAL OF PROSTHODONTICS, Issue 5 2008
    Amit Sachdeo BDS, DMSc
    Abstract Purpose: The oral cavity presents numerous surfaces for microbial colonization. These surfaces produce biofilms of differing complexities unique to each individual. Several studies have looked at biofilms in dentate patients. There has been limited research regarding biofilms on dentures or soft tissues of edentulous patients. The purpose of the present investigation was to provide meaningful data describing microbial ecological relationships in the oral cavity of edentulous patients and to evaluate the microbiota on hard and soft tissue surfaces and saliva in edentulous patients wearing complete dentures. Materials and Methods: Sixty-one edentulous subjects with complete maxillary and mandibular dentures were recruited. "Supragingival" biofilm samples were taken from 28 denture teeth for each subject. Biofilm samples were also taken from the dorsal, lateral, and ventral surfaces of the tongue, floor of mouth, buccal mucosa, hard palate, vestibule/lip, "attached gingiva," and saliva. Samples were individually analyzed for their content of 41 bacterial species using checkerboard DNA,DNA hybridization. Levels and proportions of each species were determined for every sample location. Results: Periodontal pathogens such as Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis were clearly present in the samples from the edentulous subjects. Microbial profiles in samples from the soft tissue surfaces differed among site locations. Samples from the dorsum of the tongue exhibited the highest bacterial counts followed by the "attached gingiva" and the lateral surfaces of the tongue, while the lowest mean counts were found in samples from the buccal mucosa and labial vestibules. Using cluster analysis of the proportions of the test species, three clusters were formed. The first cluster comprised saliva, supragingival plaque, and the lateral and dorsal surfaces of the tongue. The second cluster comprised the other six soft tissue surfaces. Species on the denture palate formed a third cluster. Conclusions: One of the major findings in this study was the detection of periodontal pathogens, A. actinomycetemcomitans and P. gingivalis, in the edentulous subjects, as these species were thought to disappear after removal of all natural teeth. This finding has implications regarding future dental treatment and the general health of individuals. Distinct patterns of microbial colonization were seen on the different soft tissue surfaces. Thus, this investigation provided the first step in defining the organisms that are associated with edentulous patients on both soft (mucosa) and hard surfaces (denture). The study also provided meaningful data that described microbial ecological relationships in the oral cavity of edentulous subjects. The authors believe that this study is the first comprehensive assessment of the microbiota in the complete denture-wearing subject. [source]

    The microbiota on different oral surfaces in healthy children

    MOLECULAR ORAL MICROBIOLOGY, Issue 3 2009
    W. Papaioannou
    Introduction:, Knowledge of the early oral colonization patterns could provide a better understanding of oral biofilm development and disease initiation that in turn could be the basis for early preventive programmes. Methods:, Microbial samples were collected from five different oral habitats from a total of 93 children (age 3,12 years), attending the Dental School of the University of Athens, who were split into three age groups. A total of 38 microbial species were sought out by the checkerboard DNA,DNA hybridization technique. Results:, All of the test species, except Parvimonas micra and Porphyromonas gingivalis, differed significantly among sample locations providing quite distinct microbial profiles for the different oral surfaces. Supragingival and subgingival plaque had similar profiles and exhibited higher proportions of Actinomyces species and Green complex while soft tissue samples were dominated by streptococci of the Yellow complex. The profiles of the tongue dorsum and saliva were also similar. Many of the species were in similar proportions in all three age groups for a given location. Periodontal pathogens showed increases in proportions with increasing age. Specifically, the Red complex species (Tannerella forsythia, P. gingivalis, Treponema denticola) showed a significant increase in proportion with age (P < 0.05) in all sample locations. Conclusions:, The results showed a pattern of colonization in children similar to that previously found in adults. Differences in the profile between age groups suggest a gradual maturation of the oral microbiota, with it being made up of an increasing number of Orange and Red complex species. [source]

    Periodontal pathogens in subgingival plaque of HIV-positive subjects with chronic periodontitis

    MOLECULAR ORAL MICROBIOLOGY, Issue 3 2003
    M Patel
    Many putative periodontal pathogens associated with periodontal disease in human immunodeficiency virus (HIV)-infected patients also occur in non-HIV-infected individuals. This study examined the prevalence of eight periodontal pathogens in HIV-positive and HIV-negative patients with chronic periodontitis using the 16s RNA polymerase chain reaction technique. The results showed a significant prevalence of Porphyromonas gingivalis and Treponema denticola among HIV-negative patients compared to HIV-positive patients. Sixty percent of the patients in both groups were colonized by five to six species. Odds ratio analysis revealed a statistically significant positive association between three of the 28 possible combinations in the HIV-positive group. They included Prevotella nigrescens/Campylobacter rectus, P. nigrescens/P. gingivalis and P. nigrescens/T. denticola. Although the prevalence of periodontal pathogens is similar in both the groups, the combination of certain periodontal pathogens may be responsible for chronic periodontitis seen in HIV-infected adults. [source]

    Regulation of type I plasminogen activator inhibitor in human gingival fibroblasts with cyclosporine A

    ORAL DISEASES, Issue 4 2010
    Y-C Ho
    Oral Diseases (2010) 16, 396,401 Objectives:, Cyclosporine A (CsA) is used as an immunosuppressive agent and its prominent side effect is the induction of gingival overgrowth. Type I plasminogen activator inhibitor (PAI-1) has shown to play an important role in CsA-induced gingival overgrowth. However, little is known about whether factors can modulate CsA-induced PAI-1 expression. Methods:, Cytotoxicity, reverse transcriptase-polymerase chain reaction, and enzyme-linked immunosorbent assay were used to investigate the effects of Human gingival fibroblasts (HGFs) exposed to CsA. In addition, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, interlukin-1,, tumor necrosis factor-,, mitogen-activated protein kinase kinase (MEK) inhibitor U0126, signal-regulated protein kinase (ERK) inhibitor PD98059 and cell-permeable glutathione precursor N -acetyl- L -cysteine (NAC) were added to test how they modulated the effects of CsA-induced PAI-1 expression. Results:, The concentration of CsA higher than 500 ng ml,1 demonstrated cytotoxicity to HGFs (P < 0.05). Periodontal pathogens as well as proinflammatory cytokines were found to increase the CsA-induced PAI-1 mRNA and protein expression (P < 0.05). Pharmacological agents NAC, U0126, and PD98059 were found to decrease the CsA-induced PAI-1 mRNA and protein expression (P < 0.05). Conclusions:, Cyclosporine A (CsA) may predispose to gingival overgrowth under inflammatory environments. The regulation of PAI-1 expression induced by CsA might be critically related with the intracellular glutathione and the ERK-MAPK pathway. [source]

    Subgingival microbiota of chronic periodontitis subjects from different geographic locations

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2004
    A. 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]

    Enhanced monocyte migration and pro-inflammatory cytokine production by Porphyromonas gingivalis infection

    JOURNAL OF PERIODONTAL RESEARCH, Issue 2 2010
    A. Pollreisz
    Pollreisz A, Huang Y, Roth GA, Cheng B, Kebschull M, Papapanou PN, Schmidt AM, Lalla E. Enhanced monocyte migration and pro-inflammatory cytokine production by Porphyromonas gingivalis infection. J Periodont Res 2009; doi: 10.1111/j.1600-0765.2009.01225.x. © 2009 The Authors. Journal compilation © 2009 Blackwell Munksgaard Background and Objective:,Porphyromonas gingivalis, a major periodontal pathogen, has been reported to be involved in atherogenesis. In order to further understand this pathogen's link with systemic inflammation and vascular disease, we investigated its influence on murine monocytes and macrophages from three different sources. Material and Methods:, Concanavalin A-elicited peritoneal macrophages, peripheral blood monocyte-derived macrophages and WEHI 274.1 monocytes were infected with either P. gingivalis 381 or its non-invasive fimbriae-deficient mutant, DPG3. Results:, Infection with P. gingivalis 381 markedly induced monocyte migration and significantly enhanced production of the pro-inflammatory cytokines, tumor necrosis factor-, and interleukin-6. Consistent with a role for this pathogen's major fimbriae and/or its invasive capacity, infection with DPG3 had a minimal effect on both monocyte attraction and pro-inflammatory cytokine production. Conclusion:, Since monocyte recruitment and activation are important steps in the development of vascular inflammation and atherosclerosis, these results suggest that P. gingivalis infection may be involved in these processes. [source]

    Pro-inflammatory cytokine production from normal human fibroblasts is induced by Tannerella forsythia detaching factor

    JOURNAL OF PERIODONTAL RESEARCH, Issue 2 2008
    N. Tomi
    Background and Objective:,Tannerella forsythia is a periodontal pathogen. Recently, we have reported that the cytopathic component of T. forsythia contains two distinct factors. One arrests the cell cycle at the G2 phase and the other, named forsythia detaching factor, detaches adhesion-dependent immortalized human cells. In this study, we investigated the biological function of forsythia detaching factor using human normal fibroblasts. Material and Methods:, A recombinant forsythia detaching factor, reported previously, was used. TIG-3 cells, cultured in the absence or presence of forsythia detaching factor, were lysed and the supernatant was analyzed by western blotting with polyclonal forsythia detaching factor antibodies. The cells were subsequently fractionated to isolate the cytoplasmic, mitochondrial and remaining fractions. In order to measure the activity of mitochondria using nicotinamide adenine dinucleotide-linked reductase, the water-soluble tetrazolium method was used. The mitochondrial oxidative membrane potential was estimated by measuring the oxidization-dependent fluorogenic conversion of dihydrotetramethylrosamine using flow cytometry. The concentration of interleukin-8 in the culture supernatant was assayed using a Human IL-8 ELISA kit. Results:, Forsythia detaching factor-treated cells detached from the substratum and aggregated from 3 to 24 h. Then, the detached cells resumed adhesion and proliferated after 48 h. The western blot analysis revealed that most forsythia detaching factor trans -located into the mitochondrial fraction. Forsythia detaching factor suppressed the nicotinamide adenine dinucleotide-linked reductase activity in a dose-dependent manner and consequently increased the mitochondrial oxidative membrane potential. The production of interleukin-8 was reinforced in forsythia detaching factor-treated cells at 72 h through an increase of the mitochondrial oxidative membrane potential. Conclusion:, The forsythia detaching factor might be involved in the virulence of T. forsythia through induction of the pro-inflammatory cytokine interleukin-8. [source]

    The host cytokine response to Porphyromonas gingivalis is modified by gingipains

    MOLECULAR ORAL MICROBIOLOGY, Issue 1 2009
    P. G. Stathopoulou
    Background/aims:, Clinical studies indicate that primary proinflammatory cytokines, such as interleukin-1, (IL-1,) are elevated in the gingival crevice around teeth with periodontitis but the secondary cytokines and chemokines, IL-6 and IL-8, are not. The human gingival epithelial cells (HGECs) lining the gingival sulcus respond to perturbation by microbes of dental plaque by releasing a wide range of cytokines. Porphyromonas gingivalis, a putative periodontal pathogen, possesses numerous virulence factors some of which directly impact on the host response. In the present study, we sought to determine how P. gingivalis influences the inflammatory cytokine responses. Methods:, HGECs were challenged with P. gingivalis and other putative periodontal pathogens, and the resultant production of IL-1,, IL-6, and IL-8 was assayed by enzyme-linked immunosorbent assay (ELISA). Culture supernatants and recombinant human cytokines were challenged with live P. gingivalis wild-type and gingipain-deficient strains and the resultant cytokine profile was assessed by ELISA and Western blot. Results:, We show here that primary HGECs challenged with live P. gingivalis result in high levels of IL-1, but not the related secondary cytokines IL-6 and IL-8. We further demonstrate that cytokine response differences are the result of the action of P. gingivalis proteases, with lysine gingipain being the most effective. Conclusion:, We conclude that P. gingivalis, through lysine gingipain, can subvert the protective host proinflammatory response by direct cytokine degradation. Changes in the crevicular cytokine profile have consequences in periodontal disease pathogenesis that should be considered in the development of diagnostic and therapeutic modalities. [source]

    Distribution of Porphyromonas gingivalis fimA genotypes in cardiovascular specimens from Japanese patients

    MOLECULAR ORAL MICROBIOLOGY, Issue 2 2008
    K. Nakano
    Introduction:,Porphyromonas gingivalis, a major periodontal pathogen, is gaining increasing attention for its possible association with cardiovascular diseases. Its fimbriae are classified into six genotypes (types I,V and Ib) based on the diversity of the fimA genes encoding the fimbrial subunits. In this study, fimA genotypic distribution was analyzed in P. gingivalis -infected cardiovascular specimens. Methods:, A total of 112 heart valves and 80 atheromatous plaque specimens were collected from patients undergoing cardiovascular surgery, as well as 56 dental plaque specimens. Bacterial DNA was extracted from each, and polymerase chain reaction analysis was carried out with a P. gingivalis -specific set of primers. P. gingivalis- positive specimens were further analyzed to discriminate the fimA genotype using polymerase chain reaction with fimA type-specific primer sets. Results:,P. gingivalis was detected in 10.4% of the cardiovascular specimens and 50.0% of the dental plaque samples. In the latter, type II was most frequently detected (35.7%), followed by types I (28.6%) and IV (21.4%), while types IV and II were detected with considerable frequencies of 45.0% and 30.0%, respectively, in the cardiovascular specimens. In contrast, the occurrence of type I was limited (5.0%) in the cardiovascular specimens. Conclusion:, These results suggest that specific fimA genotypic clones, which are reportedly associated with periodontitis, are also frequently harbored in cardiovascular specimens, indicating the possible involvement of type II and IV clones in the initiation and progression of cardiovascular diseases. [source]

    Characterization of two outer membrane protein antigens of Porphyromonas gingivalis that are protective in a murine lesion model

    MOLECULAR ORAL MICROBIOLOGY, Issue 1 2004
    B. C. Ross
    Porphyromonas gingivalis is a key periodontal pathogen that has been implicated in the aetiology of chronic adult periodontitis. The aim of this study was to characterize two potential vaccine candidates (PG32 and PG33) identified from a previous genomic sequence analysis. Gene knockout studies suggested that these proteins play an important role in bacterial growth and are transcriptionally linked. Analysis of 14 laboratory and clinical isolates of P. gingivalis found that in all strains, both genes were present with a high level of conservation and that the two proteins were also expressed in vitro. Truncated recombinant PG32 and PG33 proteins were produced in Escherichia coli in an attempt to increase the solubility of the proteins while retaining their native conformation. While most of the truncated proteins remained insoluble, two truncated proteins showed good solubility and high levels of protection in the P. gingivalis murine lesion model and may be considered as potential vaccine candidates for further testing in models of human periodontal disease. [source]

    Gingival changes during pregnancy: II.

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2010
    Influence 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]

    Monozygotic twins are discordant for chronic periodontitis: clinical and bacteriological findings

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2010
    Gaudy L. Torres de Heens
    Torres de Heens GL, Loos BG, van der Velden U. Monozygotic twins are discordant for chronic periodontitis: clinical and bacteriological findings. J Clin Periodontol 2010; 37: 120,128. doi: 10.1111/j.1600-051X.2009.01511.x. Abstract Objectives: The aim of this study was to assess, in monozygotic (MZ) and dizygotic (DZ) twin pairs in whom the proband of the twin pair was suffering from moderate to severe chronic periodontitis, the contribution of genetics, periodontal pathogens and lifestyle factors towards the clinical phenotype. Material and Methods: For this study, 18 adult twin pairs were selected on the basis of interproximal attachment loss (AL) 5 mm in 2 non-adjacent teeth in one twin member. The study included 10 MZ and eight DZ twin pairs, in whom the periodontal condition, presence of periodontal pathogens, educational level, smoking behaviour and body mass index (BMI) were evaluated. Results: Both MZ and DZ twins were discordant regarding AL and alveolar bone loss. Discordance was greater in DZ compared with MZ twins. In MZ twins, the discordance could not be explained by education, smoking, BMI and periodontal pathogens. In DZ twins, 45.6% of the discordance could be explained by more pack-years of the probands. Conclusion: The results confirm a possible role of genetic factors in periodontitis. However, the magnitude of the genetic effects on disease severity may have been overestimated previously. [source]

    Salivary interleukin-1, concentration and the presence of multiple pathogens in periodontitis

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2009
    Ulvi 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]

    Periodontal diseases and health: Consensus Report of the Sixth European Workshop on Periodontology

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2008
    Denis Kinane
    Abstract Introduction: The remit of this group was to update the knowledge base on periodontal diseases and health. Material and Methods: The literature was systematically searched and critically reviewed in five specific topics. Results: Prevalence of periodontitis: The data suggest a trend towards a lower prevalence of periodontitis in recent years. Adverse pregnancy outcome: The findings indicate a likely association between periodontal disease and an increased risk of adverse pregnancy outcomes. There is no evidence that treating periodontal disease decreases the rate of adverse pregnancy outcomes. Prevalence and distribution of periodontal pathogens: Genetic analysis of bacteria has demonstrated an unanticipated diversity within species. Carriage rates and particular subsets of these species vary between ethnic groups. Few of these differences can be related to differences in disease prevalence. Diabetes mellitus: Evidence on the association supports the concept of increased severity but not extent of periodontitis in subjects with poorly controlled diabetes. It is inconclusive that periodontal treatment results in improved metabolic control. Cardiovascular diseases: Evidence suggests that having periodontitis contributes to the total infectious and inflammation burden and may contribute to cardiovascular events and stroke in susceptible subjects. The impact of periodontal therapy must be further investigated. [source]

    Subgingival microbial profiles in chronic periodontitis patients from Chile, Colombia and Spain

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2008
    David Herrera
    Abstract Aim: To investigate the subgingival microbiota of distinct periodontitis patient populations, in Chile, Colombia and Spain, using identical clinical and bacteriological methods. Material and Methods: In this multicentre study, 114 chronic periodontitis patients were selected. Patients were examined using an identical clinical protocol and pooled subgingival samples were obtained from each patient. Samples were processed in the three laboratories by means of culturing under identical clinical and microbiological protocols. Total anaerobic counts and frequency of detection and proportions of nine periodontal pathogens were calculated. Variables were analysed by means of anova, ,2, Kruskal,Wallis and Dunn's multiple comparison tests. Results: The Colombian population demonstrated greater severity of periodontitis, with significantly deeper mean probing pocket depth, and had a significantly lower percentage of current smokers. When comparing samples from the three patient populations, the total counts were significantly higher in the Colombian patients. The numbers of putative pathogens differed among groups. Tannerella forsythia was found less frequently in Chilean samples, while Parvimonas micra and enteric rods differed significantly among the three population groups. Conclusion: Significant differences among Chile, Colombia and Spain existed regarding the frequency and proportions of specific periodontal pathogens in the subgingival microbiota of periodontitis patients. [source]

    Periodontal therapy alters gene expression of peripheral blood monocytes

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2007
    Panos N. Papapanou
    Abstract Aims: We investigated the effects of periodontal therapy on gene expression of peripheral blood monocytes. Methods: Fifteen patients with periodontitis gave blood samples at four time points: 1 week before periodontal treatment (#1), at treatment initiation (baseline, #2), 6-week (#3) and 10-week post-baseline (#4). At baseline and 10 weeks, periodontal status was recorded and subgingival plaque samples were obtained. Periodontal therapy (periodontal surgery and extractions without adjunctive antibiotics) was completed within 6 weeks. At each time point, serum concentrations of 19 biomarkers were determined. Peripheral blood monocytes were purified, RNA was extracted, reverse-transcribed, labelled and hybridized with AffymetrixU133Plus2.0 chips. Expression profiles were analysed using linear random-effects models. Further analysis of gene ontology terms summarized the expression patterns into biologically relevant categories. Differential expression of selected genes was confirmed by real-time reverse transcriptase-polymerase chain reaction in a subset of patients. Results: Treatment resulted in a substantial improvement in clinical periodontal status and reduction in the levels of several periodontal pathogens. Expression profiling over time revealed more than 11,000 probe sets differentially expressed at a false discovery rate of <0.05. Approximately 1/3 of the patients showed substantial changes in expression in genes relevant to innate immunity, apoptosis and cell signalling. Conclusions: The data suggest that periodontal therapy may alter monocytic gene expression in a manner consistent with a systemic anti-inflammatory effect. [source]

    Women with a recent history of early-onset pre-eclampsia have a worse periodontal condition

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2007
    Alina Kunnen
    Abstract Objective: Pre-eclampsia is a complication of pregnancy characterized by systemic vascular dysfunction and pathological changes in placental arteries. Growing evidence of chronic infection as an aetiological factor in vascular diseases prompted us to study maternal periodontal disease in subjects with early-onset pre-eclampsia (<34 weeks). Methods: A case,control study was carried out on 17 early-onset pre-eclamptic women and 35 controls with uncomplicated pregnancies in a period of 3,28 months postpartum. All were Caucasians. Full-mouth periodontal examinations were performed to determine the periodontal condition. Subgingival-plaque samples were analysed by anaerobic culture techniques for the presence of seven bacterial periodontal pathogens. Potential confounders as age, smoking, educational level and body mass index were determined. Results: Severe periodontal disease was found in 82% of the pre-eclamptic and in 37% of the control group (p=0.009). After adjusting for age, smoking and educational level, the odds ratio was 7.9 (95% CI: 1.9,32.8). The periodontopathic microorganism Micromonas micros was more prevalent in the case group (p=0.040) while Campylobacter rectus was more prevalent in the control group (p=0.047). Conclusion: These results indicate that Caucasian women with a recent history of early-onset pre-eclampsia have a worse periodontal condition, as compared with women with uncomplicated deliveries. [source]

    Clinical and microbiological effects of different antimicrobials on generalized aggressive periodontitis

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2006
    Christiana Xajigeorgiou
    Abstract Aim: To evaluate and compare the effects of adjunctive metronidazole plus amoxicillin, doxycycline and metronidazole on clinical and microbiological parameters in patients with generalized aggressive periodontitis. Material and Methods: Forty-three patients participated in this randomized clinical trial divided into four groups. Six weeks after scaling and root planning (SRP), groups 1,3 received adjunctive metronidazole, plus amoxicillin, doxycycline and metronidazole respectively, and group 4 acted as controls. Clinical recordings concerning probing depth, probing attachment level and bleeding on probing were performed at baseline, 6 weeks after SRP and 6 months from baseline. Subgingival samples were analysed using the ,checkerboard' DNA,DNA hybridization for Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Tannerella forsythia and Treponema denticola. Results: All treatments resulted in improvement of clinical parameters (ANOVA p>0.05). Systemic administration of metronidazole plus amoxicillin or metronidazole resulted in statistically significant greater reduction of the proportion of sites > 6mm than SRP (z -test, p<0.05). These antimicrobials yielded a significant effect on levels of important periodontal pathogens for 6 months. Conclusion: Adjunctive metronidazole plus amoxicillin or metronidazole alone (when A.actinomycetemcomitans is not involved) is effective in deep pockets of aggressive periodontitis patients. [source]

    Antimicrobial profiles of periodontal pathogens isolated from periodontitis patients in the Netherlands and Spain

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2005
    A. 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]

    Scaling and root planing, systemic metronidazole and professional plaque removal in the treatment of chronic periodontitis in a Brazilian population II , microbiological results

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2005
    L. H. Carvalho
    Abstract Objective: The current investigation evaluated changes in levels and proportions of 39 bacterial species in subgingival plaque samples after scaling and root planing (SRP) alone or in combination with systemic metronidazole and/or professional cleaning in subjects with chronic periodontitis. Methods: Forty-four adult subjects (mean age 45±6 years) with periodontitis were randomly assigned in four treatment groups, a control (C, n=10) that received SRP and placebo and three test groups treated as follows: T1 (n=12): SRP and metronidazole (M, 400 mg tid) for 10 days; T2 (n=12): SRP, weekly professional supragingival plaque removal for 3 months (PC) and placebo; and T3 (n=10): SRP, M and PC. Subgingival plaque samples were taken from seven sites per subject at baseline and 90 days post-therapy. Counts of 39 subgingival species were determined using checkerboard DNA,DNA hybridization. Significance of differences over time was determined using the Wilcoxon signed ranks test and among groups using ancova. Results: The mean counts of the majority of the species were reduced post-therapy in the 4 treatment groups. Counts (× 105±SEM) of Porphyromonas gingivalis, Tannerella forsythensis and Treponema denticola were significantly reduced in groups T2 and T3. Levels of beneficial species, such as some Actinomyces species, Veillonella parvula, Streptococcus sanguis, Streptococcus oralis and Streptococcus gordonii were minimally affected in levels when the combined therapy was applied (T3). Mean proportions of red complex species decreased from 18.4% at baseline to 3% at 90 days post-therapy in group T3 (p<0.01), from 25.8% to 2.3% in group T2 (p<0.01), from 17.7% to 5.6% in group T1 (p<0.05) and from 19.4% to 8.8% in group C (NS). Proportions of the suspected periodontal pathogens from the orange complex were also markedly reduced in groups T2 and T3. Conclusions: All treatments reduced counts and proportions of red complex species. Adjunctive therapy appeared to have a greater effect and also affected members of the orange complex. [source]

    Microbiological shifts in intra- and extraoral habitats following mechanical periodontal therapy

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2004
    Thomas 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]

    Quadrant root planing versus same-day full-mouth root planing

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2004
    III. 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 planing

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2004
    II. 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]

    Distribution of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia in an Australian population

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2001
    S. 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]

    Generalized cervical root resorption associated with periodontal disease

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2001
    Wouter Beertsen
    Abstract Background and description of case: The etiology and pathogenesis of generalized cervical root resorptions is not well understood. In the present report, a case of severe cervical root resorption involving 24 anterior and posterior teeth is presented. The lesions developed within a period of 2 years after the patient had changed to an acid-enriched diet. They extended far into the coronal dentin and were associated with gingival inflammation and crestal bone resorption. However, no generalized clinical attachment loss had occurred. Culturing of subgingival plaque revealed the presence of several putative periodontal pathogens among which Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Treatment consisted of mechanical debridement supported by systemic antibiotics (amoxycillin plus metronidazole) and dietary advice. Results: Within 1 year after the onset of treatment, all resorptive lesions had repaired by ingrowth of a radio-opaque mineralized tissue. The crestal areas showed radiological evidence of bone repair. 3 years after the onset of therapy, one premolar was extracted and examined histologically. It appeared that irregularly-shaped masses of woven bone-like tissue had invaded into the domain of the resorbed coronal dentin and were bordered by thin layers of acellular cementum. Conclusion: It is concluded that, in this patient, the cervical resorptions were likely the result of an osteoclastic response extending into the roots because the root-protective role of the junctional epithelium did not develop. We hypothesize that this was due to the combined effects of a periodontopathogenic microflora and a dietary confounding factor. Zusammenfassung Hintergrund und Beschreibung des Falls: Die Ätiologie und die Pathogenese der generalisierten Wurzelresorptionen ist nicht besonders bekannt. In der vorliegenden Fallpräsentation wird ein schwerer Fall von Wurzelresorption gezeigt, die 24 anteriore und posteriore Zähne einbezog. Die Läsionen entwickelten sich innerhalb einer Periode von 2 Jahren, nachdem der Patient zu einer Säure-angereicherten Diät gewechselt hatte. Die Läsionen dehnten sich in das koronale Dentin aus und waren mit gingivaler Entzündung und krestaler Knochenresorption verbunden. Jedoch wurde kein generalisierter Attachmentverlust beobachtet. Die Kultur der subgingivalen Plaque erbrachte das Vorhandensein von verschiedenen putativen parodontalen Pathogenen, unter ihnen Actinobacillus actinomycetemcomitans und Porphyromonas gingivalis. Die Behandlung bestand in der mechanischen Reinigung unterstützt mit systemischen Antibiotika (Amoxicillin und Metronidazol) und Diätanweisungen. Ergebnisse: Innerhalb eines Jahres nach dem Beginn der Therapie waren alle Resorptionsläsionen repariert durch das Einwachsen von röntgenopakem mineralisierten Gewebe. Die krestalen Regionen zeigten radiologisch nachgewiesene Knochenreparatur. 3 Jahre nach Therapiebeginn wurde ein Prämolar extrahiert und histologisch untersucht. Es schien, daß irreguläre geformte Massen von verflochtenem knochen-ähnlichen Gewebe in den Hauptteil des resorbierten koronalen Dentins hineingelangt sind und von dünnen Schichten azellulären Zementes begrenzt wurden. Zusammenfassung: Es wird geschlußfolgert, daß bei diesem Patient die zervikalen Resorptionen wahrscheinlich das Ergebnis einer osteoklastischen Reaktion waren, bis in die Wurzeln ausgedehnt, weil sich die wurzelschützende Rolle des Verbindungsepithels nich entwickelt hatte. Wir nehmen an, daß dies in der Folge eines kombinierten Effektes von parodontopathogenen Keimen und eines verwirrenden diätetischen Faktors geschah. Résumé Origine: L'étiologie et la pathogenèse des résorptions radiculaires cervicales généralisées ne sont pas suffisamment connues. Dans le rapport présent, un cas de résorption radiculaire cervicale sévère se rapportant à 24 dents antérieures et postérieures est présenté. Les lésions s'étaint développées durant les 2 années qui ont suivi le changement de régime alimentaire du patient vers un régime plus acide. Elles s'étendaient profondément dans la dentine coronaire et étaient associées à une inflammation gingivale et une résorption osseuse crestale. Cependant, aucune perte d'attache clinique généralisée n'est apparue. La culture de la plaque dentaire sous-gingivale a révélé la présence de plusieurs pathogènes parodontaux putatifs parmi lesquels l'Actinobaccilus actinomycetemcomitans et le Porphyromonas gingivalis. Le traitement a consisté en un nettoyage mécanique associéà l'utilisation d'antibiotiques par voie systémique (amoxycilline + métronidazole) et un conseil diététique. Résultats. Dans l'année qui a suivi ce traitement, toutes les lésions de résorption ont été guéries par la croissance d'un tissu minéralisé radio-opaque. Les zones crestales montraient une évidence radiologique de réparation osseuse. 3 ans après le démarrage de ce traitement, une prémolaire a été avulsée et examinée histologiquement. Il est apparu que des masses de formes irrégulières de tissus ressemblant à de l'os ouaté avaient envahi le domaine de dentine coronaire résorbé et étaient entourées par de fines couches de cément acellulaire. Conclusions: Chez ce patient, les résorptions cervicales étaient vraisemblablement dûes à une réponse ostéoclastique s'étendant dans les racines parce que le rôle de protection radiculaire de l'épithélium de jonction ne s'étaient pas développé. Cette situation était vraisemblablement dûe à des effets combinés de la microflore parodonto-pathogène et d'un facteur diététique. [source]

    Change in subgingival microbial profiles in adult periodontitis subjects receiving either systemically-administered amoxicillin or metronidazole

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2001
    M. Feres
    Abstract Aim: The current investigation evaluated changes in levels and proportions of 40 bacterial species in subgingival plaque samples during, immediately after and up to 1 year after metronidazole or amoxicillin therapy combined with SRP. Method: After baseline clinical and microbiological monitoring, 17 adult periodontitis subjects received full mouth SRP and 14 days systemic administration of either metronidazole (250 mg, TID, n=8) or amoxicillin (500 mg, TID, n=9). Clinical measurements including % of sites with plaque, gingival redness, bleeding on probing and suppuration, pocket depth (PD) and attachment level (AL) were made at baseline, 90, 180 and 360 days. Subgingival plaque samples were taken from the mesial surface of all teeth in each subject at baseline, 90, 180 and 360 days and from 2 randomly selected posterior teeth at 3, 7, and 14 days during and after antibiotic administration. Counts of 40 subgingival species were determined using checkerboard DNA-DNA hybridization. Significance of differences over time was determined using the Quade test and between groups using ANCOVA. Results: Mean PD was reduced from 3.22±0.12 at baseline to 2.81±0.16 (p<0.01) at 360 days and from 3.38±0.23 mm to 2.80±0.14 mm (p<0.01) in the amoxicillin and metronidazole treated subjects respectively. Corresponding values for mean AL were 3.21±0.30 to 2.76±0.32 (p<0.05) and 3.23±0.28 mm to 2.94±0.23 mm (p<0.01). Levels and proportions of Bacteroides forsythus, Porphyromonas gingivalis and Treponema denticola were markedly reduced during antibiotic administration and were lower than baseline levels at 360 days. Counts (×105, ±SEM) of B. forsythus fell from baseline levels of 0.66±0.16 to 0.04±0.02, 0.13±0.04, 0.10±0.03 and 0.42±0.19 in the amoxicillin group at 14, 90, 180 and 360 days respectively (p<0.001). Corresponding values for metronidazole treated subjects were: 1.69±0.28 to 0.02±0.01, 0.20±0.08, 0.22±0.06 and 0.22±0.08 (p<0.001). Counts of Campylobacter species, Eubacterium nodatum, Fusobacterium nucleatum subspecies, F. periodonticum and Prevotella nigrescens were also detected at lower mean levels during and immediately after therapy, but gradually increased after withdrawal of the antibiotics. Members of the genera Actinomyces, Streptococcus and Capnocytophaga were minimally affected by metronidazole. However, amoxicillin decreased the counts and proportions of Actinomyces species during and after therapy. Conclusions: The data suggest that metronidazole and amoxicillin are useful in rapidly lowering counts of putative periodontal pathogens, but must be accompanied by other procedures to bring about periodontal stability. Zusammenfassung Ziel: Die gegenwärtige Untersuchung evaluiert die Veränderungen in den Niveaus und Proportionen von 40 bakteriellen Spezies in subgingivalen Plaqueproben während, sofort nach und bis zu 1 Jahr nach Metronidazol- oder Amoxicillintherapie in Kombination mit SRP. Methoden: Nach der klinischen und mikrobiologischen Basisuntersuchung erhielten 17 erwachsene Personen mit Parodontitis eine vollständige SRP und 14 Tage eine systemische Gabe von entweder Metronidazol (250 mg, TID, n=8) oder Amoxicillin (500 mg, TID, n=9). Die klinischen Messungen schlossen die Prozentwerte der Flächen mit Plaque, der gingivalen Rötung, der Provokationsblutung und Suppuration, der Sondierungstiefe (PD) und des Stützgewebeniveaus (AL) ein. Die Messungen wurden zur Basis, am 90., am 180. und 360. Tag gemacht. Die subgingivalen Plaqueproben wurden von der mesialen Oberfläche aller Zähne zur Basis, zum 90., zum 180. und 360. Tag von jedem Probanden genommen sowie von 2 zufällig ausgesuchten posterioren Zähnen am Tag 3, 7 und 14 während und nach der Antibiotikaverordnung. Die Mengen von 40 subgingivalen Spezies wurden unter Nutzung einer checkerboard DNA-DNA Hybridisation bestimmt. Die Signifikanzen der Differenzen über die Zeit wurden mit dem Quade-Test und zwischen den Gruppen mit der ANCOVA überprüft. Ergebnisse: Die mittleren PD reduzierten sich von 3.22±0.12 mm zur Basis zu 2.81±0.16 mm (p<0.01) zum 360. Tag und von 3.38±0.23 mm zu 2.80±0.14 mm (p<0.01) bei den mit Amoxicillin bzw. mit Metronidazol behandelten Patienten. Korrespondierende Werte für die mittleren AL waren 3.21±0.30 zu 2.76±0.32 (p<0.05) und 3.23±0.28 mm zu 2.94±0.23 mm (p<0.01). Die Niveaus und die Verteilung von Bacteroides forsythus, Porphyromonas gingivalis und Treponema denticola wurden während der Antibiotikabehandlung deutlich reduziert und waren am 360. Tag niedriger als zur Basis. Die Mengen (×105, ±SEM) von B. forsythus fielen von der Basis von 0.66±0.16 auf 0.04±0.02, 0.13±0.04, 0.10±0.03 und 0.42±0.19 in der Amoxicillin Gruppe an den Tagen 14, 90, 180 und 360 (p<0.001). Korrespondierende Werte für die mit Metronidazol behandelten Personen waren: 1.69±0.28 zu 0.02±0.01, 0.20±0.08, 0.22±0.06 und 0.22±0.08 (p<0.001). Die Mengen von Campylobacter sp., Eubacterium nodatum, Fusobacterium nucleatum subspecies, F. peridonticum und Prevotella nigrescens waren in den mittleren Niveaus während und sofort nach der Therapie auch niedriger, aber graduell erhöht nach Absetzen der Antibiotika. Mitglieder der Klassen Actinomyces, Streptococcus und Capnocytophaga wurden durch Metronidazol minimal beeinflußt. Jedoch verringerte Amoxicillin die Mengen und Verhältnisse von Actinomyces sp. während und nach der Therapie. Zusammenfassung: Die Daten suggerieren, daß Metronidazol und Amoxicillin in der schnellen Verringerung der Mengen von putativen parodontalen Pathogenen nützlich sind, daß dies aber durch andere Prozeduren begleitet wurden muß, um parodontale Stabilität zu erbringen. Résumé But: La présente recherche a évalué les modifications de niveaux et de proportions de 40 espèces bactériennes dans des prélèvements de plaque sous gingivale pendant, immédiatement après, et jusqu'à un an après un traitement par métronidazole ou amoxicilline associè avec le détartrage/surfaçage radiculaire. Méthode: Après avoir relevé les paramètres cliniques et microbiologiques initiaux, 17 sujets atteints de parodontite de l'adulte ont subi un détartrage/surfaçage radiculaire de toute la bouche et l'administration systémique pendant 14 jours de métronidazole (250 mg, 3× fois par jour, n=8) ou d'amoxicilline (500 mg, 3× par jour, n=9). Les mesures cliniques relevées initialement, à 90 jours, à 180 jours, et à 360 jours, étaient: le % de sites avec de la plaque, la rougeur gingivale, le saignement au sondage et la suppuration, la profondeur de poche (PD) et le niveau d'attache (AL). Des échantillons de plaque sous gingivale étaient prélevés sur la surface mésiale de toutes les dents, chez chaque sujet, initialement, à 90 jours, à 180 jours, et á 360 jours, et sur 2 dents postérieures choisies au hasard à 3, 7, et 14 jours pendant et après l'administration d'antibiotique. Le comptage de 40 expèces sous gingivales fut déterminé par la technique de l'hybridisation en damier DNA-DNA. La signification des différences au cours du temps fut déterminée par le test de Quade et entre les groupes par ANCOVA. Résultats: La profondeur moyenne des poches a étê réduite de 3.22±0.12 mm initialement à 2.81±0.16 mm (p<0.01) à 360 jours et de 3.38±0.28 mm à 2.80±0.14 mm (p<0.01) dans les groupes amoxicilline et metronidazole, respectivement. Les valeurs correspondantes pour AL étaient 3.21±0.30 à 2.76±0.32 (p<0.05) et 3.23±0.28 à 2.94±0.23 (p<0.01). Les niveau de B. forsythus, P. gingivalis et T. denticola, étaient fortement réduits pendant l'administration d'antibiotique et restaient plus bas à 360 jours qu'initialement. Les comptages (×105, ±SEM) de B. forsythus tombaient de niveaux initiaux de 0.66±0.16 à 0.04±0.02, 0.13±0.04, 0.10±0.03 et 0.42±0.19 dans le groupe amoxicilline à 14 jours, 90 jours, 180 jours, et 360 jours, respectivement (p<0.001). Les valeurs correspondantes pour les sujets traits par métronidazole étaient de: 1.69±0.28 à 0.02±0.01, 0.20±0.08, 0.22±0.06 et 0.22±0.08 (p<0.001). Les comptages des espèces Camopylobacter, Eubacterium nodatum, des espèces Fusobacterium nodatum, F. periodonticum et Prevotella nigrescensétaient également détectés à des niveaux moyens plus bas pendant, et immédiatement après traitement, mais augmentaient graduellement après cessation des antibiotiques. Les membres des genres Actinomyces, Streptococcus et Capnocytophagaétaient très peu affectés par le métronidazole. Par contre, l'amoxicilline diminuait les comptage et les proportions des Actinomyces pendant et après le traitement. Conclusions: Ces données suggèrent que le métronidazole et l'amoxicilline sont utiles pour diminuer rapidement les comptages des pathogènes parodontaux putatifs, mais qu'ils doivent être accompagnés d'autres procédés pour apporter une stabilité parodontale. [source]

    Mutans streptococci in subgingival plaque of treated and untreated patients with periodontitis

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2001
    W. A. Van Der Reijden
    Abstract Background: The etiology of root caries is thought to be identical to coronal caries, though root caries seem to be more complicated because of the higher susceptibility of exposed roots (dentin) by periodontal therapy to demineralization than intact enamel. This implies that mutans streptococci are the most likely pathogens in the development of root caries. Although it is known that both the numbers of mutans streptococci and the frequency of isolation in root caries lesions are negatively correlated with the distance from the gingival margin, the subgingival sulcus has not been considered a possible habitat for mutans streptococci. However, subgingival occurence of mutans streptococci in both untreated and treated periodontal patients has not been documented well in the literature. Objective: To investigate the presence and levels of mutans streptococci in the subgingival plaque of patients (n=154) in different stages of periodontal therapy. The subgingival sulcus may be a possible habitat for mutans streptococci. This localisation of mutans streptococci may be of importance in the development of root caries after periodontal surgery. Materials and methods: In this cross-sectional study, subgingival plaque samples from 154 consecutive adult periodontitis patients were tested for presence and levels of mutans streptococci and putative periodontal pathogens by anaerobic cultures. These patients were divided into 4 groups based on their stage of periodontal treatment: (1) untreated patients; (2) patients after initial periodontal therapy only; (3) patients in the maintenance phase who not underwent periodontal surgery; (4) patients after periodontal surgery. Results: The prevalence of mutans streptococci in the 4 study groups varied from 82% in untreated patients to 94% in maintenance patients. The mean proportion of mutans streptococci was 6.65% in maintenance patients versus 1.86% in untreated patients (p=0.005) and 2.51% in patients after scaling and root planing (p=0.041). Conclusions: The subgingival area is a microbial habitat for mutans streptococci that may be of importance in the development of root caries in periodontitis patients. Zusammenfassung Hintergrund: Es wird angenommen, dass die Ätiologie der Wurzelkaries und der Kronenkaries übereinstimmen, obwohl die Entstehung von Wurzelkaries komplizierter zu sein scheint wegen der erhöhten Empfindlichkeit entblößter Wurzeln (Dentin) für Demineralisation im Vergleich zu gesundem Schmelz. Das bedeutet, dass MS die wahrscheinlichsten Pathogene für die Entstehung der Wurzelkaries sind. Obwohl bekannt ist, dass die Zahl der MS und die Häufigkeit ihres Nachweises aus Wurzelkariesläsionen negativ mit dem Abstand vom Gingivarand korrelieren, wurde die subgingivale Region bisher nicht als möglicher Lebensraum für MS erwogen. Das subgingivale Vorkommen von MS bei behandelten und unbehandelten Parodontitispatienten ist in der Literatur nicht gut dokumentiert. Die subgingivale Region könnte ein möglicher Lebensraum für MS und diese Lokalisation bedeutsam für die Entstehung von Wurzelkaries nach parodontaler Therapie sein. Zielsetzung: Untersuchung des Vorkommens und der Menge von MS in der subgingivalen Plaque von Patienten zu unterschiedlichen Zeitpunkten parodontaler Therapie. Material und Methoden: In einer Querschnittsstudie wurden subgingivale Plaqueproben von 154 Patienten mit Erwachsenenparodontitis auf das Vorkommen und den Anteil von MS und putativer Parodontalpathogene in anaerober Kultur untersucht. Die Patienten wurden nach dem Stadium der parodontalen Therapie in 4 Gruppen unterteilt: (1) unbehandelte Patienten (n=51), (2) Patienten nach abgeschlossener Initialtherapie (Mundhygieneunterweisungen sowie Scaling und Wurzelglättung [SRP]) (n=41), (3) Patienten in der unterstützenden Parodontitistherapie (UPT), die nicht parodontalchirurgisch behandelt worden waren (n=48), und (4) Patienten nach Parodontalchirurgie (n=14). Ergebnisse: Die Prävalenz der MS variierte in den 4 Untersuchungsgruppen von 82% bei unbehandelten bis 94% bei UPT-Patienten. Der mittlere Anteil der MS an subgingivaler Plaque lag bei 6.65% (UPT) im Vergleich zu 1.86% (unbehandelte Parodontitis) (p=0.005) bzw. zu 2.51% (SRP) (p=0.041) und 2.18% nach Parodontalchirurgie (n.s.) Schlußfolgerungen: Die subgingivale Region ist ein Lebensraum für MS, die eine Bedeutung für die Pathogenese der Wurzelkaries bei Patienten mit Parodontitis haben könnte. Résumé L'étiologie des caries radiculaires semble étre identique à celle des caries coronaires bien que les caires radiculaires paraîssent plus compliquées vu la susceptibilité plus importante des racines exposées (dentine) par le traitement parodontal à la même déminéralisation que ne l'est l'émail intact. Ceci a comme conséquence que les Streptocoques mutans sont vraisemblabement les pathogènes les plus problables dans le dévelopment des caries radicularies. Bien qu'il soit connu que les nombres de Streptocoques mutans autant que la fréquence de l'isolation des lésions carieuses radiculaires soient en corrélation négative avec la distance depuis la gencive marginale, le sulcus gingival n'a pas été considéré comme habitat possible pour les Streptocoques mutans. Cependant, l'occurence sous-gingivale des Streptocoques mutans chez les patients avec parodontite traitée ou non n'a pas été suffisamment documentée dans la littérature. Le but de cette étude a été d'analyser la présence et les niveaux de Streptocoques mutans dans la plaque sous-gingivale de 154 patients à différentes étapes de leur traitement parodontale. Le sillon sous-gingival pourrait dont être un habitat possible pour les Streptocoques mutans. Cette localisation peut être importante dans le dévelopment des caries radiculaires après le traitement parodontal. Dans cette étude croisée des échantillons de plaque sous-gingivale ont été prélevés chez 154 patients adultes avec parodontite pour vérifier la présence et les niveaux de Streptocoques mutans et d'autres pathogènes parodontaux putatifs par culture anaérobie. Les patients étaient divisés en 4 groupes suivant le stade de leur traitement parodontal: non-traité, traitement initial seulement, phase de maintien mais sans chirurgie, et patient après chirurgie parodontale. La fréquence globale des Streptocoques mutans dans les 4 goupes variaient de 82% chez les patients non-traités à 94% chez ceux au stade de maintenance. La proportion moyenne de Streptocoques mutansétaient de 6.65% chez les patients en maintenance versus 1.86% chez les patients non-traités (p=0.005) et de 2.51% chez les patients après détartrage et surfaçage radiculaire (p=0.041). L'aire sous-gingivale est donc un habitat microbien pour les Streptocoques mutans qui pourraient être assez importants dans le développement des caries radiculaires chez les patients souffrant de parodontite. [source]

    Microbiology of destructive periodontal disease in adolescent patients with congenital neutropenia

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2000
    A report of 3 cases
    Abstract Background, aims: Congenital neutropenia is one condition that may predispose for destructive periodontal disease at a young age. In this report, we describe the microbiology of 3 adolescent patients with congenital neutropenia two of whom suffered from severe periodontitis. Method: Microbiological testing of the parents was also performed in 1 case. DNA fingerprinting was used to study transmission of putative periodontal pathogens in this case. From 1 patient with periodontitis, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis were isolated; a 2nd periodontitis patient was infected with P. gingivalis. A 3rd patient had gingivitis only and no A. actinomycetemcomitans or P. gingivalis were found. Results: Using the amplified fragment length polymorphism DNA fingerprinting technique, bacterial transmission between the father and a patient was shown for A. actinomycetemcomitans but not for P. gingivalis. [source]

    Microbial composition of supra- and subgingival plaque in subjects with adult periodontitis

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2000
    Laurie 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]

    Serum IgG reactivity to subgingival bacteria in initial periodontitis, gingivitis and healthy subjects

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2000
    A. C. R. Tanner
    Abstract Background/aims: Established periodontal diseases may be associated with antibody responses to periodontal pathogens, but it is not known at which stage of disease this antibody response is initiated. This study aimed to characterize the host systemic response in initial periodontitis, gingivitis, and periodontal health, to evaluate whether elevated serum antibodies to subgingival species could be detected in initial periodontitis. Method: Human systemic immune response were evaluated to 40 subgingival bacterial species in 16 healthy, 21 gingivitis, 11 initial periodontitis and 5 progressing recession adults. Subjects had minimal periodontal attachment level (AL) loss at baseline. Disease categories were determined after 12 months monitoring at three-month intervals. Increased AL loss 1.5 mm (disease activity) at interproximal sites defined initial periodontitis, recession was characterized by AL loss at buccal sites. Serum IgG antibodies were evaluated semi-quantitatively by immunoblot from blood taken at baseline, active and final visits. Results: No antibody was detected from 55% of reactions. When detected, levels were below those reported for advanced periodontitis subjects. There were no major differences in serum antibody levels between healthy, gingivitis and initial periodontitis subjects, despite differences in the subgingival microbiota. Serum antibodies for more species were detected in recession subjects, compared with the other study subjects. No changes in antibody levels were detected between baseline, active, and final visits. No systematic association between species colonization and presence of systemic antibody was observed. Conclusions: This study did not detect differential elevation of mean serum antibody levels in initial periodontitis subjects, suggesting that serum antibody levels are not sensitive risk markers for initial periodontitis. [source]