Cellular source and tetracycline‐inhibition of gingival crevicular fluid collagenase of patients with labile diabetes mellitusJournal of Clinical Periodontology - Tập 19 Số 2 - Trang 146-149 - 1992
T Sorsa, Tuula Ingman, Kimmo Suomalainen, Sirkka Halinen, Herkko Saari, Yrjö T. Konttinen, Veli‐Jukka Uitto, L M Golub
Abstract Accelerated periodontal tissue destruction in patients with labile insulin‐dependent diabetes mellitus (DM) and localized juvenile periodontitis (LJP) has been suggested to be related to functional abnormalities of neutrophils. We have recently found that collagenase in gingival crevicular fluid (GCF) of adult periodontitis patients is primarily derived from neutrophils and that neutrophil collagenase activity is more sensitive to inhibition by tetracyclines than collagenase produced by fibroblasts. This study is to characterize the cellular sources, activation and inhibition of collagenase in GCF of DM patients and to compare it with collagenase in LJP GCF. We found differences which may have therapeutic implications. Specific doxycycline inhibition tests revealed that GCF collagenase in DM is derived from neutrophils, whereas the enzyme in LJP originates primarily from fibroblasts. Oxidant, sodium hypochlorite activated efficiently GCF collagenase of DM but not LJP patients. In contrast, plasmin activated LJP GCF collagenase but not that of DM patients. In GCF of DM patients 50–60% of collagenase existed in an active form, whereas in LJP GCF, the enzyme was almost completely in a latent form. The results suggest that collagenase in GCF of periodontitis patients with labile DM is primarily derived from neutrophils and that tetracycline therapy may be an effective adjunct in treatment aimed at controlling the periodontal breakdown in these patients. On the other hand, in LJP the anti‐collagenase property of tetracyclines may be less important for control of periodontal tissue destruction because of the tetracycline‐resistance of fibroblast collagenase.
Relation of counts of microbial species to clinical status at the sampled siteJournal of Clinical Periodontology - Tập 18 Số 10 - Trang 766-775 - 1991
S. S. Socransky, A. D. Haffajee, Claire M. Smith, Serge Dibart
Abstract The purpose of the present investigation was to relate clinical characteristics at a site to the frequency of detection, absolute counts and proportions of 14 subgingival species. Subgingival plaque samples were removed by curette from the mesial surface of 2299 teeth in 3 healthy and 87 subjects with periodontal attachment loss. Samples were dispersed, diluted and plated on Trypticase soy agar supplemented with 5% sheep blood. After 7 days of anaerobic incubation, colonies were lifted onto nylon filters, lysed and the DNA fixed to the filters. Digoxygenin‐labeled DNA probes were used to identify colonies of each test species. Measurements of pocket depth, attachment level, recession, redness, bleeding on probing and suppuration were made at each sampled site. Total viable counts at sites ranged from 103 to > 108 and were strongly related to pocket depth. Mean total counts at sites < 3 mm averaged 4.6 × 106, while mean counts at sites > 7 mm averaged 2.0 × 107. Species enumerated and % of sites colonized were as follows; V. parvula 44; S. sanguis 11 36; B. intermedius I 33; C. ochracea 31; B. intermedius II 30; S. sanguis I 29; B. gingivalis 27; S. intermedius 25; P. micros 24; W. recta 23; F. nucleatum ss vincentii 18; B. forsythus 15; A. actinomycetemcomitans serotype a 10; A. actinomycetemcomitans serotype b 8. Counts of B. intermedius II were higher at sites which exhibited gingival redness while B. intermedius I was higher at sites which bled on probing. A. actinomycetemcomitans serotype b was more frequent and at higher mean % at sites without recession. The opposite was true for S. sanguis II. B. gingivalis was somewhat more prevalent and at higher levels at suppurating sites. B. gingivalis, B. intermedius I and II and B. forsythus were found more frequently and at higher levels at sites with deeper pockets, while V. parvula was less prevalent at sites with pocket depths < 4 mm. B. gingivalis, B. intermedius I and A. actinomycetemcomitans serotype b increased with increasing pocket depth in both localized and widespread disease subjects, but mean counts were higher in the localized disease subjects at any pocket depth. Only W. recta was found at higher levels at deep sites in widespread disease subjects when compared with similar sites in localized disease subjects. No suspected pathogens were detected in 38% of shallow sites, 31% of intermediate sites and 22% of deep sites. 2/3 of deep pockets, but less than 1/2 of shallow pockets harbored at least 2 of the suspected pathogens.
Psychosocial factors in inflammatory periodontal diseasesJournal of Clinical Periodontology - Tập 22 Số 7 - Trang 516-526 - 1995
A.M. Monteiro da Silva, H. N. Newman, D. A. Oakley
Abstract.Reviewing the literature concerning the possible role of psychosocial factors in the aetiology of inflammatory periodontal diseases, it may be concluded that there is evidence which strongly suggests that emotional stress is one of the predisposing factors to ANUG. On the other hand, it is not clear that the scientific evidence is sufficient to substantiate the hypothesis that psychosocial factors are of aetiological importance in periodontitis. The proposed mechanisms which may mediate the putative relationship between psychosocial conditions and inflammatory periodontal diseases remain to be tested. However, psychoneuroimmunologic studies make lowered host resistance especially interesting as a possible mechanism. Although available studies do not definitively support causal relationships, they suggest that psychosocial factors may be involved in the aetiology of inflammatory periodontal diseases, which, in turn, would relate to clinical management of these conditions.
Treatment of periodontal infections due to anaerobic bacteria with short‐term treatment with metronidazoleJournal of Clinical Periodontology - Tập 8 Số 1 - Trang 29-44 - 1981
Walter J. Loesche, S. A. Syed, Edith C. Morrison, Barbara E. Laughon, Natalie S. Grossman
Abstract In the present report, five selected periodontal patients were treated for 1 week with metronidazole. Two of the patients had their teeth scaled and root‐planed the week they received metronidazole. Prior to treatment, B. asaccharolyticus accounted for 41 % of the cultivable isolates and the spirochetes averaged 29 % of the microscopic count in plaque removed from each of four pockets per patient. The presence of these elevated proportions of periodontopathic bacteria combined with the presence of periodontal pockets and attachment loss suggested that the patients were in a state of an active infectious process involving primarily anaerobic bacteria. If this be the case, then antimicrobial therapy directed against these anaerobes with metronidazole was indicated. The 1‐week treatment with metronidazole significantly reduced the proportions of these organisms for up to 6 months after treatment. Coincident with these findings was an improvement in the clinical parameters, especially in those sites that initially had greater than 5 mm pocket or attachment loss. These sites showed a 2 mm or more reduction in pocket depth and an almost 2 mm gain in apparent attachment that was evident 6 months after treatment. The results obtained were in only five patients. However, the magnitude of improvement suggests that antimicrobial therapy directed against anaerobic organisms may be a valuable adjunct to periodontal therapy.
Stage of hepatocellular carcinoma is associated with periodontitisJournal of Clinical Periodontology - Tập 38 Số 11 - Trang 1015-1020 - 2011
Naofumi Tamaki, Akinobu Takaki, Takaaki Tomofuji, Yasumasa Endo, Kenta Kasuyama, Daisuke Ekuni, Tetsuya Yasunaka, Kazuhide Yamamoto, Manabu Morita
AbstractAimPeriodontitis induces overproduction of reactive oxygen species (ROS). This state increases circulating ROS levels and may affect hepatocellular carcinoma (HCC). The Japan Integrated Stage (JIS) score is a novel staging system for HCC. The objective of the present study was to compare JIS scores in HCC patients with and without periodontitis.
Material and MethodsWe recruited 64 HCC patients comprising 31 chronic periodontitis subjects (HCC + P) and 33 periodontally healthy controls (HCC + H). Their JIS scores were recorded. Serum levels of reactive oxygen metabolites (ROM) from HCC + P, HCC + H and healthy age‐ and gender‐matched subjects with healthy gingiva (control, n = 15) were also assessed for circulating ROS levels.
ResultsThe HCC + P and HCC + H groups had similar body mass index, habitual drinking and tobacco exposure data. The HCC + P group showed higher JIS scores than the HCC + H group (p = 0.027). Both the HCC + P and HCC + H groups had higher serum levels of ROM than controls (p < 0.001), while serum levels of ROM in the HCC + P group were a further 25.8% higher than those in the HCC + H group (p < 0.001).
ConclusionHCC patients with periodontitis had higher JIS score and circulating ROS level than HCC patients without periodontitis.
Periodontitis in individuals with liver cirrhosis: A case–control studyJournal of Clinical Periodontology - Tập 46 Số 10 - Trang 991-998 - 2019
Fernando Oliveira Costa, Eugênio José Pereira Lages, Elizabeth Maria Bastos Lages, Luís Otávio Miranda Cota
AbstractAimThe aim of this study was to evaluate the association between liver cirrhosis and periodontitis.
MethodsThis case–control study included 294 individuals, 98 cases with liver cirrhosis and 196 controls. A full‐mouth periodontal examination was performed and plaque index, probing depth, clinical attachment level and bleeding on probing were recorded. The association of risk variables with periodontitis was tested through univariate analysis and multivariate logistic regression, stratified by alcohol status.
ResultsA high prevalence of periodontitis was observed among cases (62.2%) when compared to controls (41.8%). Individuals with cirrhosis presented a chance ~2 higher of having periodontitis than controls (OR = 2.28; 95% CI 1.39–3.78; p < .001). Significant variables associated with periodontitis in the final logistic models were as follows: (a) no/occasional alcohol use model—number of teeth up 14, age ≥45–55 years, male sex and smoking; (b) moderate and intensive alcohol use models—cirrhosis, number of teeth up 14, age ≥45–55 years, male sex and smoking.
ConclusionsAn important risk association between liver cirrhosis and periodontitis was observed. Additionally, the intensive alcohol use significantly increased the risk for periodontitis.
Nitric oxide production, systemic inflammation and lipid metabolism in periodontitis patients: possible gender aspectJournal of Clinical Periodontology - Tập 40 Số 10 - Trang 916-923 - 2013
Oleh Andrukhov, Hady Haririan, Kristina Bertl, Wolf‐Dieter Rausch, Hans‐Peter Bantleon, Andreas Moritz, Xiaohui Rausch‐Fan
AbstractAimNitric oxide (NO) plays a crucial role in vascular tone regulation and is involved in pathogenesis of periodontitis. In this cross‐sectional study, we investigated the serum and saliva levels of NO metabolites in periodontal disease and their relationship with serum C‐reactive protein (CRP) levels, lipids metabolism and periodontal disease severity.
Material and MethodsSerum and saliva were collected from non‐smoking patients with generalized severe periodontitis (n = 89) and healthy controls (n = 56). Serum and salivary levels of NO metabolites, serum levels of high density lipoproteins (HDL), low density lipoproteins (LDL), triglycerides, cholesterol and CRP were measured. Data were analysed in whole population and in different gender groups.
ResultsPeriodontitis patients exhibited significantly lower serum and saliva levels of NO metabolites and significantly higher LDL, cholesterol and CRP levels than control group. Similar findings were observed within male but not within female population. Serum NO metabolites levels exhibited significant negative correlation with CRP in whole population and in male population. Significant positive correlation of serum NO metabolite levels with HDL levels was observed in whole population.
ConclusionNO production is reduced in periodontitis, especially in male population. Gender might be an important factor in assessing risk of cardiovascular disease in periodontitis.
The impact of motivational interviewing on communication of patients undergoing periodontal therapyJournal of Clinical Periodontology - Tập 46 Số 7 - Trang 740-750 - 2019
Julia Kitzmann, Petra Ratka‐Krueger, Kirstin Vach, Johan Peter Woelber
AbstractAimThere has been growing interest in motivational interviewing (MI) as a structured method for supporting health behaviour change in periodontal therapy. The aim of this study was to investigate the influence of communication techniques used in MI on statements of patients undergoing periodontal therapy.
Materials and MethodsThirty audio‐recorded sessions between dental MI providers and their patients undergoing periodontal therapy were coded using the German version of the Motivational Interviewing Sequential Code for Observing Process Exchanges (MISCOPE; D). Sequential analyses were performed to access transition probabilities among certain counsellor and patient statements.
ResultsMI‐consistent counsellor statements were statistically significantly positive correlated with patients’ language in favour of change (change talk) (OR = 1.31; p = 0.027). MI‐inconsistent statements were statistically significantly more likely to be followed by patients’ language against change (sustain talk) (OR = 2.27, p = 0.002). An additional sequential analysis revealed significant correlations between certain evocative counsellor behaviours and the language of their patients.
ConclusionSpecific verbal expressions described in the theory of MI significantly influence the subsequent statements of the patient in periodontal therapy. Accordingly, the periodontist can guide patient communication in a desired direction, evoke motivational statements and reduce expressions of resistance.
Đặc điểm kiểu gen của Porphyromonas gingivalis được phân lập từ mảng bám dưới nướu và mẫu máu ở những đối tượng có tình trạng nhiễm trùng huyết dương tính với bệnh viêm nướu Dịch bởi AI Journal of Clinical Periodontology - Tập 35 Số 9 - Trang 748-753 - 2008
Paula Juliana Pérez‐Chaparro, Patrice Gracieux, Gloria Inés Lafaurie, Pierre‐Yves Donnio, Martine Bonnaure‐Mallet
AbstractMục tiêu: Mục tiêu của nghiên cứu này là điều tra mối quan hệ dòng vi khuẩn giữa Porphyromonas gingivalis được phân lập từ mảng bám dưới nướu và mẫu máu ở những bệnh nhân bị viêm nướu có xét nghiệm huyết thanh dương tính với nhiễm trùng huyết tạm thời.
Nguyên liệu và phương pháp: Những bệnh nhân không liên quan có bệnh viêm nướu mãn tính hoặc viêm nướu hung hãn nghiêm trọng cần điều trị tẩy sạch và lên kế hoạch điều trị gốc (SRP) đã được đưa vào nghiên cứu. Việc xác định kiểu gen của từng mẫu được thực hiện bằng kỹ thuật điện di gel trường xung. Mối quan hệ di truyền giữa các chủng được phân lập trong một cá thể hoặc giữa các bệnh nhân khác nhau được xác định bằng phân tích cây phát sinh chủng loài (dendogram analysis).
Kết quả: Sau khi SRP, từ 16 bệnh nhân, bảy bệnh nhân cho kết quả dương tính với nhiễm trùng huyết P. gingivalis và chín bệnh nhân âm tính. Ba mươi hai chủng được phân lập từ mảng bám dưới nướu và mẫu máu trước và trong suốt quá trình gây ra nhiễm trùng huyết tạm thời. Phần lớn bệnh nhân mang một kiểu dòng vi khuẩn. Hai bệnh nhân cho thấy các chủng khác nhau trong mẫu bám và mẫu máu, cho thấy rằng có thể tìm thấy nhiều hơn một chủng trong mảng bám dưới nướu. Các mẫu P. gingivalis từ bệnh nhân bị viêm nướu sau khi nhiễm trùng huyết tạm thời kế tiếp SRP cho thấy sự đa dạng cao giữa các mẫu phân lập.
Kết luận: Trong 6/16 trường hợp, mẫu P. gingivalis giống nhau đã được tìm thấy trong máu và trong khoang miệng. Đặc điểm di truyền của P. gingivalis cho thấy không có mối liên hệ của một kiểu dòng duy nhất với nhiễm trùng huyết tạm thời.
Efficacy of periodontal plastic surgery procedures in the treatment of localized facial gingival recessions. A systematic reviewJournal of Clinical Periodontology - Tập 41 Số s15 - 2014
Francesco Cairo, Michele Nieri, Umberto Pagliaro
AbstractBackgroundThe aim of this Systematic Review (SR) was to assess the clinical efficacy of periodontal plastic surgery procedures in the treatment of localized gingival recessions (Rec) with or without inter‐dental clinical attachment loss (iCAL).
Material and MethodsElectronic and hand searches were performed to identify randomized clinical trials (RCTs) on treatment of single gingival recessions with at least 6 months of follow‐up. Primary outcome variable was complete root coverage (CRC). Secondary outcome variables were recession reduction (RecRed) and keratinized tissue (KT) gain. To evaluate treatment effect, Odds Ratios were combined for dichotomous data and mean differences in continuous data using a random‐effect model.
ResultsFifty‐one RCTs (53 articles) with a total of 1574 treated patients (1744 recessions) were included in this SR. Finally, 30 groups of comparisons were identified and a total of 80 meta‐analyses were performed. Coronally Advanced Flap (CAF) was associated with higher probability of CRC and higher amount of RecRed than Semilunar Coronal Positioned Flap (SCPF). The combination CAF plus Connective Tissue Graft (CAF+CTG) or CAF plus Enamel Matrix Derivative (CAF+EMD) was more effective than CAF alone in terms of CRC and RecRed. The combination CAF plus Collagen Matrix (CAF+CM) achieved higher RecRed than CAF alone. In addition, CAF+CTG achieved CRC more frequently than CAF+EMD, SCPF, Free Gingival Graft (FGG) and Laterally Positioned Flap (LPS). CAF+CTG was also associated with higher RecRed than Barrier Membranes (CAF+GTR), CAF+EMD and CAF+CM. GTR was not able to improve the clinical efficacy of CAF. Studies adding Acellular Dermal Matrix (ADM) under CAF showed a large heterogeneity and not significant benefits compared with CAF alone. Multiple combinations, using more than a single graft/biomaterial under the flap, usually provide similar or less benefits than simpler, control procedures in term of root coverage outcomes.
ConclusionsCAF procedures alone or with CTG, EMD are supported by large evidence in modern periodontal plastic surgery. CAF+CTG achieved the best clinical outcomes in single gingival recessions with or without iCAL.
