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Fawzy El-Sayed K, Graetz C, Köhnlein T, Mekhemar M, Dörfer C. Effect of total sonicated Aggregatibacter actinomycetemcomitans fragments on gingival stem/progenitor cells. Med Oral Patol Oral Cir Bucal 2018; 23:e569-e578. [PMID: 30148477 PMCID: PMC6167108 DOI: 10.4317/medoral.22661] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 08/16/2018] [Indexed: 01/24/2023] Open
Abstract
Background Aggregatibacter-actinomycetemcomitans (A.actinomycetemcomitans) are strongly associated with localized-aggressive-periodontitis (LAgP). The study’s aim was to test for the first time the effect of total sonicated A.actinomycetemcomitans-bacterial-fragments on gingival mesenchymal stem/progenitor cells’ (G-MSCs) proliferation and regenerative gene expression in-vitro. Material and Methods G-MSCs were isolated, characterized, expanded and stimulated by total sonicated A.actinomycetemcomitans-bacterial-fragments (0 (negative-control), 15, 60, 120 and 240µg/ml; serovar-b; n=6/group). Cellular proliferation and NF-κβ (NFKB1), Alkaline Phosphatase (ALPL), Collagen-I (COL1A1), Collagen-III (COL3A1), Osteonectin (SPARC) and Osteopontin (SPP1) m-RNA expression were assessed via reverse-transcription-polymerase-chain-reaction (RT-PCR) at 24, 48 and 72 hours and CFUs-ability evaluated at twelve days. Results G-MSCs demonstrated stem/progenitor cells’ characteristics. A.actinomycetemcomitans-bacterial-fragments (up to 72 hours) resulted in marked G-MSCs’ proliferation over-time (p<0.001) and elevated NFKB1 (p=0.017), COL1A1 (p=0.025), SPARC (p=0.025), decreased ALPL (p=0.017), with no significant differences for COL3A1 and SPP1 expression or stimulation times (p>0.05; Friedman-test). Longer-term stimulation for twelve days reduced G-MSCs’ CFUs. Conclusions Sonicated A.actinomycetemcomitans-bacterial-fragments’ exert beneficial short-term effects on G-MSCs’ proliferative and non-mineralized tissue forming aptitude. Results shed new light on the importance of periodontal treatment for LAgP patients, using power driven sonic/ultrasonic devices, which, in addition to reducing the subgingival microbial load, produces cell-stimulatory A.actinomycetemcomitans-bacterial-fragments, with positive attributes on tissue reparative/regenerative responses of tissue resident stem/progenitor cells in their niche. Key words:Ultrasonic, Aggregatibacter actinomycetemcomitans, stem cells, gingiva, Aggressive periodontitis.
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Affiliation(s)
- K Fawzy El-Sayed
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts-Universität zu Kiel, Arnold-Heller-Str. 3, Haus 26, 24105 Kiel, Germany,
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de Coo A, Quintela I, Blanco J, Diz P, Carracedo Á. Assessment of genotyping tools applied in genetic susceptibility studies of periodontal disease: A systematic review. Arch Oral Biol 2018; 92:38-50. [DOI: 10.1016/j.archoralbio.2018.04.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/23/2018] [Accepted: 04/25/2018] [Indexed: 12/14/2022]
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Dar-Odeh N, Fadel HT, Abu-Hammad S, Abdeljawad R, Abu-Hammad OA. Antibiotic Prescribing for Oro-Facial Infections in the Paediatric Outpatient: A Review. Antibiotics (Basel) 2018; 7:antibiotics7020038. [PMID: 29693642 PMCID: PMC6022866 DOI: 10.3390/antibiotics7020038] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/18/2018] [Accepted: 04/24/2018] [Indexed: 12/14/2022] Open
Abstract
There are many reports on the complications associated with antibiotics abuse during the treatment of paediatric patients, particularly those related to antimicrobial resistance. The dental profession is no exception; there is growing evidence that dental practitioners are misusing antibiotics in the treatment of their paediatric patients. This review is directed to dental practitioners who provide oral healthcare to children. It is also directed to medical practitioners, particularly those working in emergency departments and encountering children with acute orofacial infections. A systematic search of literature was conducted to explore the clinical indications and recommended antibiotic regimens for orofacial infections in paediatric outpatients. The main indications included cellulitis, aggressive periodontitis, necrotizing ulcerative gingivitis, and pericoronitis. Amoxicillin was found to be the most commonly recommended antibiotic for short durations of 3–5 days, with metronidazole or azithromycin being the alternative antibiotics in penicillin-sensitive patients.
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Affiliation(s)
- Najla Dar-Odeh
- Dental College & Hospital, Taibah University, Al Madinah Al Munawwarah 42353, Saudi Arabia.
- Faculty of Dentistry, University of Jordan, Amman 11942, Jordan.
| | - Hani T Fadel
- Dental College & Hospital, Taibah University, Al Madinah Al Munawwarah 42353, Saudi Arabia.
| | | | - Rua'a Abdeljawad
- Department of Pediatrics, Ibn Alhaitham Hospital, Amman 11942, Jordan.
| | - Osama A Abu-Hammad
- Dental College & Hospital, Taibah University, Al Madinah Al Munawwarah 42353, Saudi Arabia.
- Faculty of Dentistry, University of Jordan, Amman 11942, Jordan.
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Feres M, Louzoun Y, Haber S, Faveri M, Figueiredo LC, Levin L. Support vector machine-based differentiation between aggressive and chronic periodontitis using microbial profiles. Int Dent J 2018; 68:39-46. [DOI: 10.1111/idj.12326] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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55
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Suligowska K, Czarniak P, Krawczyk M, Szcześniak P, Król E, Kusiak A, Sabiniewicz R, Wierzba T, Utracka A, Urban M, Wytrykowska A, Pakalska A, Drewek K, Giczewska A, Popowski P, Wrotkowska M, Marczulin J, Bochniak M, Zdrojewski T. An assessment of health status and health behaviours in adolescents: main points and methods of the SOPKARD-Junior programme. Arch Med Sci 2018; 14:38-51. [PMID: 29379531 PMCID: PMC5778424 DOI: 10.5114/aoms.2016.63742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/16/2016] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The study involved preparing and implementation a model of complex screening programme for adolescents and comparison of anthropometric examinations between the population of the SOPKARD-Junior programme and representative sample of Polish children in the same age. MATERIAL AND METHODS The screening programme in 14-15 year old pupils (n = 282) included: anthropometric, blood pressure, echocardiographic, electrocardiographic, carotid arteries, kidney and thyroid ultrasound examinations, as well as respiratory, dental and masticatory system, orthopaedic, psychological and psychiatric assessment. Blood and urine tests were also performed. The results of anthropometric examinations from the SOPKARD-Junior and OLAF programmes were used for comparative analysis. RESULTS Statistically significant (p < 0.001) differences between young people from Sopot and their peers in the general Polish population were found in height (+3.61 cm for boys), body mass (+5.19 kg for boys and +3.99 kg for girls), body mass index (+0.99 kg/m2 for boys and +1.33 kg/m2 for girls), waist circumference (+4.52 cm for boys and +4.52 cm for girls) and hip circumference (+2.51 cm for boys). The highest attendance rate was achieved for examinations performed in school (e.g. anthropometric and blood pressure measurements - n = 268; 95%) and the lowest for the echocardiograpy performed in local hospital (n = 133; 47%). The mean score of the programme quality (scale 1-6) assessed by children was 4.63. CONCLUSIONS The SOPKARD-Junior programme represents an attempt to develop a model of screening assessments for teenagers in Poland. Preliminary results of the SOPKARD-Junior programme indicate small differences in the biological development of Sopot youth in comparison with their peers from Polish population of the OLAF programme. The high attendance rate on research conducted at the school indicate that proposed health examinations in adolescents are acceptable and feasible.
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Affiliation(s)
- Klaudia Suligowska
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland
| | - Piotr Czarniak
- Department of Paediatrics, Nephrology and Hypertension, Medical University of Gdansk, Gdansk, Poland
| | - Michał Krawczyk
- Department of Respiratory Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Przemysław Szcześniak
- Department of Paediatrics, Nephrology and Hypertension, Medical University of Gdansk, Gdansk, Poland
| | - Ewa Król
- Department of Nephrology, Transplantation Medicine and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Aida Kusiak
- Department of Periodontology and Oral Mucosal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Robert Sabiniewicz
- Department of Paediatric Cardiology and Congenital Heart Disease, Medical University of Gdansk, Gdansk, Poland
| | - Tomasz Wierzba
- Department of Physiology, Medical University of Gdansk, Gdansk, Poland
| | | | - Magdalena Urban
- Department of Dental Techniques and Masticatory System Dysfunctions, Medical University of Gdansk, Gdansk, Poland
| | - Anna Wytrykowska
- Department of Dental Techniques and Masticatory System Dysfunctions, Medical University of Gdansk, Gdansk, Poland
| | - Anna Pakalska
- Mental Health Clinic for Children and Adolescents, Gdansk Medical Centre, Gdansk, Poland
| | - Konrad Drewek
- Department of Trauma and Orthopaedic Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Anna Giczewska
- Department of Biomedical Engineering, Gdansk University of Technology, Gdansk, Poland
| | - Piotr Popowski
- Department of Public Health and Social Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Magdalena Wrotkowska
- Department of Hygiene and Epidemiology, Medical University of Gdansk, Gdansk, Poland
| | - Joanna Marczulin
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland
| | - Mariusz Bochniak
- Department of Periodontology and Oral Mucosal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Tomasz Zdrojewski
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland
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Single Sitting Surgical Treatment of Generalized Aggressive Periodontitis Using GTR Technique and Immediate Implant Placement with 10-Year Follow-Up. Case Rep Dent 2018; 2018:6194042. [PMID: 29607223 PMCID: PMC5828322 DOI: 10.1155/2018/6194042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 12/10/2017] [Accepted: 01/02/2018] [Indexed: 11/25/2022] Open
Abstract
This case report exhibits a patient with generalized aggressive periodontitis who has been under maintenance for the past 12 years after being surgically treated in a single sitting and restored with dental implants. A 41-year-old systemically healthy male patient presented complaining of lower anterior teeth mobility and pain in the upper right quadrant. After clinical and radiographic examination, the upper right molars and lower anterior incisors were deemed unrestorable. Covered by doxycycline, the patient received a nonsurgical periodontal treatment. Three weeks later, teeth extraction, immediate implant placement, immediate nonloading provisional prosthesis, and a guided tissue regeneration were performed at indicated areas in a single sitting. The clinical decisions were based on patient compliance, the status of the existing periodontal tissues, and the prognosis of the remaining teeth. During the 12-year follow-up period, no residual pockets were observed and there was no exacerbation of the inflammatory condition. Marginal bone stability is present on all implants. For aggressive periodontal disease, a high risk of relapse as well as limited success and survival of dental implants should be considered. This case shows proper containment of the disease based on appropriate treatment planning and a strict maintenance program.
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57
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Nibali L. Development of the gingival sulcus at the time of tooth eruption and the influence of genetic factors. Periodontol 2000 2017; 76:35-42. [DOI: 10.1111/prd.12158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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58
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Schwendicke F, Biffar AS, Graetz C. Long-term treatment costs for aggressive periodontitis in a German population. J Clin Periodontol 2017; 44:1245-1252. [DOI: 10.1111/jcpe.12814] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - Anne Sophie Biffar
- Clinic for Conservative Dentistry and Periodontology; Christian-Albrechts-University; Kiel Germany
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology; Christian-Albrechts-University; Kiel Germany
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Gonçalves PF, Harris TH, Elmariah T, Aukhil I, Wallace MR, Shaddox LM. Genetic polymorphisms and periodontal disease in populations of African descent: A review. J Periodontal Res 2017; 53:164-173. [PMID: 29105764 DOI: 10.1111/jre.12505] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2017] [Indexed: 01/22/2023]
Abstract
Aggressive periodontitis is a rare but rapidly progressing form of periodontal disease that usually affects otherwise systemically healthy individuals, at a young age. It usually affects first molars and incisors, which are usually lost if treatment is not properly and early rendered. Although of low prevalence, it affects individuals of African descent at a higher prevalence, and usually multiple members within the same family. Several studies have been performed in the attempt to evaluate specific single nucleotide polymorphisms (SNPs) that could be associated with this disease. To the best of our knowledge, the present article provides the first review of the literature focusing on studies that evaluated SNPs in patients of African descent with aggressive periodontitis. Several SNPs have been evaluated in different genes according to their role in the pathogenesis of the disease, with positive and negative associations (such as IL1, FCGR3B, FPR1, LTF, CYBA, GLT6D1, TLR4) with both the localized and generalized forms of aggressive periodontitis. Given the complexity of periodontitis, the difficulty in gathering large cohorts diagnosed with this rare form of disease, and the fact that candidate gene studies may only determine part of the genetic risk of a disease, the search for specific SNPs associated with aggressive periodontitis seems to be a long one, most likely to result in the combination of multiple SNPs, in multiple genes.
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Affiliation(s)
- P F Gonçalves
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA.,Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, MG, Brazil
| | - T H Harris
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - T Elmariah
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - I Aukhil
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - M R Wallace
- Department of Molecular Genetics and Microbiology, College of Medicine, University of Florida, Gainesville, FL, USA.,University of Florida Genetics Institute, University of Florida, Gainesville, FL, USA
| | - L M Shaddox
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
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60
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Goh V, Nihalani D, Yeung KWS, Corbet EF, Leung WK. Moderate- to long-term therapeutic outcomes of treated aggressive periodontitis patients without regular supportive care. J Periodontal Res 2017; 53:324-333. [DOI: 10.1111/jre.12517] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2017] [Indexed: 12/14/2022]
Affiliation(s)
- V. Goh
- Faculty of Dentistry; The University of Hong Kong; Hong Kong China
- Faculty of Dentistry; The National University of Malaysia; Kuala Lumpur Malaysia
| | - D. Nihalani
- Faculty of Dentistry; The University of Hong Kong; Hong Kong China
| | - K. W. S. Yeung
- Faculty of Dentistry; The University of Hong Kong; Hong Kong China
| | - E. F. Corbet
- Faculty of Dentistry; The University of Hong Kong; Hong Kong China
| | - W. K. Leung
- Faculty of Dentistry; The University of Hong Kong; Hong Kong China
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61
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Burgess DK, Huang H, Harrison P, Kompotiati T, Aukhil I, Shaddox LM. Non-Surgical Therapy Reduces Presence of JP2 Clone in Localized Aggressive Periodontitis. J Periodontol 2017; 88:1263-1270. [PMID: 28820321 DOI: 10.1902/jop.2017.170285] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Previous studies have provided substantial evidence of the association of Aggregatibacter actinomycetemcomitans, and its highly leukotoxic JP2 genotype, with localized aggressive periodontitis (LAgP). The present study aims to evaluate presence of JP2 in individuals with LAgP after periodontal treatment. METHODS Sixty African-American patients with LAgP, aged 5 to 25 years, were examined. At baseline, probing depth (PD), clinical attachment level (CAL), bleeding on probing, and plaque index were measured, and subgingival plaque was collected from LAgP diseased and healthy sites for each participant. Patients received whole-mouth ultrasonic debridement, scaling and root planing, and a 7-day prescription of amoxicillin and metronidazole. Participants were reevaluated and resampled and received regular maintenance therapy at 3, 6, and 12 months after treatment. Polymerase chain reaction was used to detect presence of the JP2 genotype before and after treatment. RESULTS At baseline, the JP2 sequence was identified in 75% of LAgP diseased sites and in 56.67% of healthy sites. At 3, 6, and 12 months after treatment, the number of patients was 40, 31, and 31, respectively, and JP2 detection decreased to 17.5%, 6.45%, and 3.23%, respectively, in diseased sites (P <0.001) and to 2.5%, 3.23%, and 0%, respectively, in healthy sites (P <0.001). Clinical parameters of disease were also significantly reduced after therapy (P <0.001). Additionally, significant correlations were observed between JP2 presence and mean PD (P <0.002) and CAL (P <0.001), after therapy. CONCLUSION Periodontal therapy was successful in reducing clinical parameters of LAgP and subgingival presence of JP2 in diseased and healthy sites.
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Affiliation(s)
| | - Hong Huang
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL
| | - Peter Harrison
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL.,Department of Periodontology, School of Dental Science, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Theodora Kompotiati
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL
| | - Ikramuddin Aukhil
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL
| | - Luciana M Shaddox
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL
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Bajaj P, Agarwal E, Rao NS, Naik SB, Pradeep AR, Kalra N, Priyanka N, Kumari M. Autologous Platelet-Rich Fibrin in the Treatment of 3-Wall Intrabony Defects in Aggressive Periodontitis: A Randomized Controlled Clinical Trial. J Periodontol 2017; 88:1186-1191. [PMID: 28820320 DOI: 10.1902/jop.2017.120661] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Platelet-rich fibrin (PRF) has recently been applied in osseous regeneration. The aim of the present study is to explore the efficacy of PRF in treatment of intrabony defects (IBDs) in aggressive periodontitis. METHODS Fifty-four IBDs in 17 patients were treated either with autologous PRF with open flap debridement (OFD) or OFD alone. Clinical and radiologic parameters such as probing depth (PD), clinical attachment level (CAL), IBD depth, and percentage defect change were recorded at baseline and 9 months postoperatively. RESULTS Mean PD reduction and mean CAL gain were significantly greater in PRF compared with the control group. Furthermore, a significantly greater percentage of mean bone defect change was found in the PRF group. CONCLUSION Within the limits of the present study, there is greater bone fill at sites treated with PRF with conventional OFD than conventional OFD alone.
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Affiliation(s)
- Pavan Bajaj
- Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore, Karnataka, India
| | - Esha Agarwal
- Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore, Karnataka, India
| | - Nishanth S Rao
- Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore, Karnataka, India
| | - Savitha B Naik
- Department of Endodontics and Conservative Dentistry, Government Dental College and Research Institute
| | - A R Pradeep
- Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore, Karnataka, India
| | - Nitish Kalra
- Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore, Karnataka, India
| | - N Priyanka
- Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore, Karnataka, India
| | - Minal Kumari
- Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore, Karnataka, India
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Kumar S, Tadakamadla J, Zimmer-Gembeck M, Kroon J, Lalloo R, Johnson NW. The Effect of Parenting Practices on the Severity of Gingival Bleeding in Children. J Periodontol 2017; 88:744-751. [DOI: 10.1902/jop.2017.160817] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Santhosh Kumar
- School of Dentistry and Oral Health, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Jyothi Tadakamadla
- School of Dentistry and Oral Health, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | | | - Jeroen Kroon
- School of Dentistry and Oral Health, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Ratilal Lalloo
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Newell W. Johnson
- School of Dentistry and Oral Health, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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Ediani Machado M, Tomazoni F, Ruffo Ortiz F, Ardenghi TM, Zanatta FB. Impact of Partial-Mouth Periodontal Examination Protocols on the Association Between Gingival Bleeding and Oral Health–Related Quality of Life in Adolescents. J Periodontol 2017; 88:693-701. [DOI: 10.1902/jop.2017.160622] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Michely Ediani Machado
- Department of Stomatology, Faculty of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Fernanda Tomazoni
- Department of Stomatology, Faculty of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Fernanda Ruffo Ortiz
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Thiago Machado Ardenghi
- Department of Stomatology, Faculty of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Fabricio Batistin Zanatta
- Department of Stomatology, Faculty of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
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Bendoraitienė E, Zūbienė J, Vasiliauskienė I, Saldūnaitė K, Andruškevičienė V, Basevičienė N, Slabšinskienė E. Periodontal status in 18-year-old Lithuanian adolescents: An epidemiological study. MEDICINA-LITHUANIA 2017; 53:253-258. [PMID: 28668306 DOI: 10.1016/j.medici.2017.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 01/25/2017] [Accepted: 06/12/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the periodontal and oral hygiene status of 18-year-old Lithuanian adolescents. MATERIALS AND METHODS Cross-sectional data were collected by a multistage sampling approach that was used to draw a representative sample of 1063 adolescents attending schools. In total, 20 schools from the alphabetical list of educational institutions in Lithuania agreed to participate. Periodontal status was evaluated using the Periodontal Screening and Recording (PSR) index. The oral hygiene status was assessed using the Silness-Löe plaque index. RESULTS The analysis of the PSR index showed that 77.1% of the study population exhibited gum bleeding on probing, had supragingival and/or subgingival calculus, and shallow pockets. Analysis of the composition of the PSR index revealed that in children whose parents had low education levels (18.6%), gum bleeding was more common than in those whose parents had medium education levels (9.5%) (P<0.05). Our data showed that in 40.0% of the study participants, oral hygiene status was satisfactory, with a statistically significant difference between boys (46.9%) and girls (35.3%) (P<0.001). CONCLUSIONS The results of our study showed that the periodontal and oral hygiene status of 18-year-old Lithuanian population could be characterized as poor. In total, 77.1% of the study participants were found to have periodontal conditions such as gum bleeding, dental calculus, and shallow pockets. The anterior teeth of the mandible were most frequently affected.
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Affiliation(s)
- Eglė Bendoraitienė
- Department of Preventive and Paediatric Dentistry, Medical Academy, Lithuanian University of Health Sciences, Lithuania.
| | - Jūratė Zūbienė
- Department of Preventive and Paediatric Dentistry, Medical Academy, Lithuanian University of Health Sciences, Lithuania
| | - Ingrida Vasiliauskienė
- Department of Preventive and Paediatric Dentistry, Medical Academy, Lithuanian University of Health Sciences, Lithuania
| | - Kristina Saldūnaitė
- Department of Preventive and Paediatric Dentistry, Medical Academy, Lithuanian University of Health Sciences, Lithuania
| | - Vilija Andruškevičienė
- Department of Preventive and Paediatric Dentistry, Medical Academy, Lithuanian University of Health Sciences, Lithuania
| | - Nomeda Basevičienė
- Department of Dental and Oral Diseases, Medical Academy, Lithuanian University of Health Sciences, Lithuania
| | - Eglė Slabšinskienė
- Department of Preventive and Paediatric Dentistry, Medical Academy, Lithuanian University of Health Sciences, Lithuania
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66
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Machado ME, Tomazoni F, Casarin M, Ardenghi TM, Zanatta FB. Partial-mouth periodontal examination protocols for the determination of the prevalence and extent of gingival bleeding in adolescents. Community Dent Oral Epidemiol 2017; 45:427-433. [DOI: 10.1111/cdoe.12306] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 04/10/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Michely Ediani Machado
- Department of Stomatology; School of Dentistry; Federal University of Santa Maria; Santa Maria Rio Grande do Sul Brazil
| | - Fernanda Tomazoni
- Department of Stomatology; School of Dentistry; Federal University of Santa Maria; Santa Maria Rio Grande do Sul Brazil
| | - Maísa Casarin
- Department of Stomatology; School of Dentistry; Federal University of Santa Maria; Santa Maria Rio Grande do Sul Brazil
| | - Thiago M. Ardenghi
- Department of Stomatology; School of Dentistry; Federal University of Santa Maria; Santa Maria Rio Grande do Sul Brazil
| | - Fabricio Batistin Zanatta
- Department of Stomatology; School of Dentistry; Federal University of Santa Maria; Santa Maria Rio Grande do Sul Brazil
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67
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Graetz C, Sälzer S, Plaumann A, Schlattmann P, Kahl M, Springer C, Dörfer C, Schwendicke F. Tooth loss in generalized aggressive periodontitis: Prognostic factors after 17 years of supportive periodontal treatment. J Clin Periodontol 2017; 44:612-619. [DOI: 10.1111/jcpe.12725] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Anna Plaumann
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Peter Schlattmann
- Institute of Medical Statistics; Computer Sciences and Documentation; Jena University Hospital; Jena Germany
| | - Maren Kahl
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Claudia Springer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christof Dörfer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité University of Berlin; Berlin Germany
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68
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Li S, Di P, Zhang Y, Lin Y. Immediate implant and rehabilitation based on All-on-4 concept in patients with generalized aggressive periodontitis: A medium-term prospective study. Clin Implant Dent Relat Res 2017; 19:559-571. [PMID: 28371086 DOI: 10.1111/cid.12483] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 02/22/2017] [Accepted: 02/23/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND Aggressive periodontitis renders a great challenge to the conventional implant due to the risks of infection and ongoing marginal bone loss (MBL). A study about full-arch immediate implant and restoration in patients with advanced generalized aggressive periodontitis (GAP) was not read, even though the All-on-4 concept has been proven to be predictable for edentulous patients. PURPOSE This prospective study aimed to evaluate the feasibility and medium-term outcomes of immediate implant and rehabilitation based on the All-on-4 concept in patients with advanced GAP via clinical and radiographic analyses. MATERIALS AND METHODS Seventeen patients (mean age 39.4 years) with advanced GAP received immediate postextraction implant and rehabilitation based on the All-on-4 concept between January 2009 and January 2014. Eighty implants were inserted into 20 arches (7 maxillae and 13 mandibles). The average follow-up duration was 5 years (range 2-7). Complications, probing depth, and plaque, bleeding, and gingiva indices were evaluated. MBL was measured based on the panoramic radiographs taken immediately after surgery and annually thereafter. RESULTS The cumulative survival rate (CSR) of the implants was 98.75% (79/80) after an average of 5 years. One tilted implant failed due to peri-implantitis. The average peri-implant MBL was 0.8 ± 0.4 and 1.2 ± 0.3 mm after 1 and 7 years, respectively. The CSR was 100% (20/20) for definite prostheses, while 85% (17/20) for provisional prostheses. The average probing depth, and plaque, bleeding, and gingiva indices at the last recall visit were 3.0 ± 0.5, 1.2 ± 0.4, 0.5 ± 0.5, and 0.4 ± 0.4 mm, respectively. Patient showed high satisfaction to the overall effects. CONCLUSIONS Based on this study, the All-on-4 concept provided predictable outcomes in patients with GAP in 2- to 7-year follow-ups, and averted the severe bone defect area of aggressive periodontitis.
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Affiliation(s)
- Sha Li
- Department of Oral Implantology, School and Hospital of Stomatology, Peking University, Beijing, People's Republic of China
| | - Ping Di
- Department of Oral Implantology, School and Hospital of Stomatology, Peking University, Beijing, People's Republic of China
| | - Yu Zhang
- Department of Oral Implantology, School and Hospital of Stomatology, Peking University, Beijing, People's Republic of China
| | - Ye Lin
- Department of Oral Implantology, School and Hospital of Stomatology, Peking University, Beijing, People's Republic of China
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69
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Damgaard C, Kantarci A, Holmstrup P, Hasturk H, Nielsen CH, Van Dyke TE. Porphyromonas gingivalis-induced production of reactive oxygen species, tumor necrosis factor-α, interleukin-6, CXCL8 and CCL2 by neutrophils from localized aggressive periodontitis and healthy donors: modulating actions of red blood cells and resolvin E1. J Periodontal Res 2017; 52:246-254. [PMID: 27146665 PMCID: PMC5097708 DOI: 10.1111/jre.12388] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Porphyromonas gingivalis is regarded as a significant contributor in the pathogenesis of periodontitis and certain systemic diseases, including atherosclerosis. P. gingivalis occasionally translocates from periodontal pockets into the circulation, where it adheres to red blood cells (RBCs). This may protect the bacterium from contact with circulating phagocytes without affecting its viability. MATERIAL AND METHODS In this in vitro study, we investigated whether human peripheral blood neutrophils from 10 subjects with localized aggressive periodontitis (LAgP) and 10 healthy controls release the proinflammatory cytokines interleukin (IL)-6, tumor necrosis factor α (TNF-α), the chemokine (C-X-C motif) ligand 8 (CXCL8; also known as IL-8) and chemokine (C-C motif) ligand 2 (CCL2; also known as monocyte chemotactic protein-1) and intracellular reactive oxygen species (ROS) in response to challenge with P. gingivalis. In addition, the impact of RBC interaction with P. gingivalis was investigated. The actions of resolvin E1 (RvE1), a known regulator of P. gingivalis induced neutrophil responses, on the cytokine and ROS responses elicited by P. gingivalis in cultures of neutrophils were investigated. RESULTS Upon stimulation with P. gingivalis, neutrophils from subjects with LAgP and healthy controls released similar quantities of IL-6, TNF-α, CXCL8, CCL2 and intracellular ROS. The presence of RBCs amplified the release of IL-6, TNF-α and CCL2 statistically significant in both groups, but reduced the generation of ROS in the group of healthy controls, and showed a similar tendency in the group of subjects with LAgP. RvE1 had no impact on the production of intracellular ROS, TNF-α, IL-6, CXCL8 and CCL2 by neutrophils from either group, but tended to reduce the generation of ROS in subjects with LAgP in the absence of RBCs. CONCLUSIONS Our data support that binding to RBCs protects P. gingivalis from ROS and concomitantly enhances neutrophil release of proinflammatory cytokines providing a selective advantage for P. gingivalis growth.
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Affiliation(s)
- Christian Damgaard
- Section for Periodontology, Microbiology and Community
Dentistry, Department of Odontology, Faculty of Health and Medical Sciences,
University of Copenhagen, Copenhagen, Denmark
- Institute for Inflammation Research, Center for
Rheumatology and Spine Disease, Rigshospitalet, Copenhagen University Hospital,
Copenhagen, Denmark
- Department of Applied Oral Sciences, Center for
Periodontology, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Alpdogan Kantarci
- Department of Applied Oral Sciences, Center for
Periodontology, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Palle Holmstrup
- Section for Periodontology, Microbiology and Community
Dentistry, Department of Odontology, Faculty of Health and Medical Sciences,
University of Copenhagen, Copenhagen, Denmark
| | - Hatice Hasturk
- Department of Applied Oral Sciences, Center for
Periodontology, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Claus H. Nielsen
- Section for Periodontology, Microbiology and Community
Dentistry, Department of Odontology, Faculty of Health and Medical Sciences,
University of Copenhagen, Copenhagen, Denmark
- Institute for Inflammation Research, Center for
Rheumatology and Spine Disease, Rigshospitalet, Copenhagen University Hospital,
Copenhagen, Denmark
| | - Thomas E. Van Dyke
- Department of Applied Oral Sciences, Center for
Periodontology, The Forsyth Institute, Cambridge, Massachusetts, USA
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70
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Burgess D, Huang H, Harrison P, Aukhil I, Shaddox L. Aggregatibacter actinomycetemcomitans in African Americans with Localized Aggressive Periodontitis. JDR Clin Trans Res 2017; 2:249-257. [PMID: 28879247 DOI: 10.1177/2380084417695543] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aims to investigate the prevalence of the highly leukotoxic JP2 sequence versus the minimally leukotoxic non-JP2 sequence of Aggregatibacter actinomycetemcomitans within a cohort of 180 young African Americans, with and without localized aggressive periodontitis (LAP), in north Florida. The study included patients aged 5 to 25 y: 60 LAP patients, 60 healthy siblings (HS), and 60 unrelated healthy controls (HC). Subgingival plaque was collected from LAP sites-diseased (PD ≥5 mm with bleeding on probing) and healthy (PD ≤3 mm with no bleeding on probing)-and from healthy sites of HS and HC. Plaque DNA was extracted and analyzed by polymerase chain reaction for the detection of the JP2 and non-JP2 sequences of A. actinomycetemcomitans. Overall, 90 (50%) subjects tested positive for the JP2 sequence. Fifty (83.33%) LAP subjects were carriers of the highly leukotoxic JP2 sequence, detected in 45 (75%) diseased sites and 34 (56.67%) healthy sites. Additionally, JP2 carriage was found in 16 HS (26.67%) and 24 HC (40%; P < 0.0001, among groups). The non-JP2 sequence was detected in 26 (14.44%) total subjects: 17 (28.33%) LAP patients detected in equal amounts of diseased and healthy sites (n = 11, 18.33%), 6 (10%) HS sites, and 3 (5%) HC sites (P < 0.05, among groups). The JP2 sequence was strongly associated with LAP-diseased sites in young African Americans, significantly more so than the non-JP2 (ClinicalTrials.gov NCT01330719). Knowledge Transfer Statement: Clinicians may use the results of this study to identify susceptible individuals to aggressive periodontitis, potentially leading to more appropriate selection of therapeutic choices.
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Affiliation(s)
- D Burgess
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - H Huang
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - P Harrison
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA.,Division of Periodontology, School of Dental Science, Trinity College Dublin, Dublin, Ireland
| | - I Aukhil
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - L Shaddox
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA.,Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
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71
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Modin C, Abadji D, Adler L, Jansson L. Treatment compliance in patients with aggressive periodontitis - a retrospective case-control study. Acta Odontol Scand 2017; 75:94-99. [PMID: 27899029 DOI: 10.1080/00016357.2016.1259497] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To investigate if differences according to discontinuation of treatment could be identified between patients with aggressive periodontitis and chronic periodontitis at two specialist clinics of periodontology irrespective of the effects of background factors. MATERIALS AND METHODS This is a retrospective case-control study. The variables were registered from dental records. The population consisted of patients referred to two specialist clinics of periodontology during three years. A study group was included consisting of 234 patients with a diagnosis of aggressive periodontitis. A control group with a diagnosis of chronic periodontitis was randomly selected. RESULTS In total, 234 patients (4% of the referrals) with a diagnosis of aggressive periodontitis were referred to the two periodontal clinics during a period of three years. Forty-two per cent of the non-compliant patients were smokers compared to 31% for the compliers and this difference was statistically significant. Patients with aggressive periodontitis interrupted their periodontal treatment significantly more frequently (46%) compared to those patients with chronic periodontitis (34%). The non-compliant patients had significantly deeper periodontal pockets at baseline as well as significantly more sites with bleeding at probing. In a stepwise logistic regression analysis, aggressive periodontitis, smoking and the relative frequency of sites with periodontal pockets >4 mm at baseline were the remaining variables with a significant influence on the incidence of interrupting ongoing periodontal treatment. CONCLUSIONS The patient group with aggressive periodontitis interrupted the periodontal treatment significantly more often irrespective of background factors and risk factors, which may be regarded as a major health problem.
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Affiliation(s)
- Carolina Modin
- Department of Periodontology, Public Dental Service at Eastman Institutet, Stockholm, County Council, Sweden
| | - Denise Abadji
- Department of Periodontology, Public Dental Service at Eastman Institutet, Stockholm, County Council, Sweden
| | - Lottie Adler
- Department of Periodontology, Public Dental Service at Eastman Institutet, Stockholm, County Council, Sweden
| | - Leif Jansson
- Department of Periodontology, Public Dental Service at Eastman Institutet, Stockholm, County Council, Sweden
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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72
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Miller KAFS, Branco-de-Almeida LS, Wolf S, Hovencamp N, Treloar T, Harrison P, Aukhil I, Gong Y, Shaddox LM. Long-term clinical response to treatment and maintenance of localized aggressive periodontitis: a cohort study. J Clin Periodontol 2016; 44:158-168. [PMID: 27767222 DOI: 10.1111/jcpe.12640] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2016] [Indexed: 11/27/2022]
Abstract
AIM To evaluate long-term clinical response to periodontal therapy and maintenance in localized aggressive periodontitis (LAP). MATERIALS AND METHODS One hundred forty-one African Americans diagnosed with LAP, aged 5-25 years, were enrolled. Patients underwent periodontal mechanical debridement plus 1 week of amoxicillin/metronidazole. Mechanical therapy was repeated as needed and clinical parameters were recorded at baseline, 3, 6, 12, 18 and 24 months, and two additional annual follow-up visits after treatment. Radiographs from primary dentition of patients with LAP in permanent dentition, and additional healthy siblings (HS) were analysed retrospectively. RESULTS Periodontal therapy significantly improved probing depth and clinical attachment level up to 4 years (mean reductions: 2.18 ± 1.03 and 2.80 ± 1.43 mm, respectively). Percentage of affected sites was reduced at all time points and maintained up to 4 years. Non-compliance with antibiotics/appointments negatively affected the treatment response. Ninety per cent of LAP patients in permanent dentition and 32% of HS presented radiographic bone loss in primary dentition. CONCLUSIONS Mechanical debridement with 1 week of systemic antibiotics along with proper periodontal maintenance was effective in the treatment and successful maintenance of LAP for up to 4 years. LAP in permanent dentition may be preceded in the primary dentition. Clinicaltrials.gov #NCT01330719.
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Affiliation(s)
- Karina A F S Miller
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Luciana S Branco-de-Almeida
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA.,Department of Dentistry II, School of Dentistry, Federal University of Maranhão, São Luís, MA, Brazil
| | - Sandra Wolf
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Nicole Hovencamp
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Tina Treloar
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Peter Harrison
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA.,Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Ikramuddin Aukhil
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Yan Gong
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Luciana M Shaddox
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
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73
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Ryder MI, Yao TJ, Russell JS, Moscicki AB, Shiboski CH. Prevalence of periodontal diseases in a multicenter cohort of perinatally HIV-infected and HIV-exposed and uninfected youth. J Clin Periodontol 2016; 44:2-12. [PMID: 27801947 DOI: 10.1111/jcpe.12646] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2016] [Indexed: 11/30/2022]
Abstract
AIMS To compare the prevalence and severity of periodontal diseases between 180 perinatally HIV-infected (PHIV) and 118 perinatally HIV-exposed and uninfected (PHEU) youth in a cross-sectional study conducted at 11 clinical sites in the United States and Puerto Rico from the Adolescent Master Protocol study of the Pediatric HIV/AIDS cohort study (PHACS) network. METHODS Several analyses were conducted, employing the current CDC/AAP classification for periodontitis and incorporating a definition of gingivitis based on a bleeding on probing (BOP) threshold, and analyses based on more detailed whole-mouth, intra-oral regionally, site-based and tooth-based criteria of BOP, plaque levels, pockets depths and clinical attachment levels. RESULTS After adjusting for plaque control habits and behavioural and sociodemographic factors, there were no significant differences in periodontal diseases between the PHIV and PHEU youth using any of these criteria. For PHIV youth, there was no significant association between parameters of periodontal disease and current HIV status. CONCLUSIONS Although no significant differences in periodontal parameters were noted between the PHIV and PHEU youth, the influence of antiretroviral therapy merits further exploration in this cohort in a longitudinal study.
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Affiliation(s)
- Mark I Ryder
- Division of Periodontology, Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
| | - Tzy-Jyun Yao
- Center for Biostatistics in AIDS Research (CBAR), Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jonathan S Russell
- Center for Biostatistics in AIDS Research (CBAR), Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Anna-Barbara Moscicki
- Division of Adolescent Medicine, Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Caroline H Shiboski
- Division of Oral Medicine, Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
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Dufty J, Gkranias N, Petrie A, McCormick R, Elmer T, Donos N. Prevalence and treatment of necrotizing ulcerative gingivitis (NUG) in the British Armed Forces: a case-control study. Clin Oral Investig 2016; 21:1935-1944. [PMID: 27830369 DOI: 10.1007/s00784-016-1979-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 10/11/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Necrotizing ulcerative gingivitis (NUG) has been seen in military populations throughout history. This study aims to determine the prevalence, treatment modality and risk factors associated with NUG in the British Armed Forces. MATERIALS AND METHODS A whole population dataset of the British Armed Forces was searched to determine cases of NUG during the period 1 January to 31 December 2012. Individual case records were identified, and a case-control study undertaken with data gathered and analysed against a randomised control group, matched for age, sex and service. RESULTS A prevalence rate for NUG of 0.11 % was determined against the whole military population. The majority of cases received (alone or in combination) the following: oral hygiene instruction (66.5 %), antibiotics (64.4 %) and a mouthwash (58.1 %). Of the cases, 48.7 % received debridement. Analgesics were only prescribed in 8.4 % of the cases, and smoking cessation advice was only given in 10.7 % of the cases. Analysis of risk factors against the control group showed an increase in odds ratios for diagnosis of NUG of 3.4 (95 % CI 2.0-5.7) for current smokers and 7.3 (95 % CI 1.9-28.0) for individuals with an overall Basic Periodontal Examination (BPE) score of 3. CONCLUSIONS Whilst NUG is a rare disease, it is evident from this study that it still occurs within the British Armed Forces. A strong association was shown between NUG and current smokers and those cases with an overall BPE score of 3. CLINICAL RELEVANCE This study provides prevalence data for NUG in the British Armed Forces and description of its treatment and associated risk factors. Oral hygiene and smoking must be addressed in patients with NUG and prescribing protocols should be carefully followed.
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Affiliation(s)
- J Dufty
- Defence Medical Services, Ministry of Defence, London, UK
| | - N Gkranias
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - A Petrie
- Biostatistics Unit, UCL Eastman Dental Institute, London, UK
| | - R McCormick
- Defence Medical Services, Ministry of Defence, London, UK
| | - T Elmer
- Defence Medical Services, Ministry of Defence, London, UK
| | - N Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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75
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Lee JH, Lee JS, Choi JK, Kweon HI, Kim YT, Choi SH. National dental policies and socio-demographic factors affecting changes in the incidence of periodontal treatments in Korean: A nationwide population-based retrospective cohort study from 2002-2013. BMC Oral Health 2016; 16:118. [PMID: 27814698 PMCID: PMC5097391 DOI: 10.1186/s12903-016-0310-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 10/25/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Dental insurance coverage has recently expanded in Korea. The number of patients diagnosed with periodontal disease (PD), and the actual number of periodontally compromised patients has increased. However, few studies have investigated the relationships between the prevalence of periodontal disease and the incidence of PD treatment, dental insurance policies, and socio-demographic factors. To determine the incidence of periodontal treatments required, the comprehensive longitudinal data of the National Health Insurance Service were used. This study evaluated changes in the incidence of periodontal treatments, using data from the Korean National Health Insurance Cohort Database. METHODS A random stratified sample of 1,025,340 Korean patients was selected from National Health Insurance database, using 1,476 multistage samplings (of sex, age, and income level) for 12 years from 2002 to 2013. Chi-square analysis, and univariate, and multivariate logistic regression were used to evaluate the association of socio-demographic factors with the prevalence of PD and the incidence of periodontal treatment. RESULTS The incidence of periodontal treatment steadily and significantly increased, in both male and female participants, from 2002 to 2013. The increase was associated with socio-demographic factors and changes in national dental insurance policies. The incidence of periodontal treatment evaluated by age is influenced by the changes in national dental policies. These results suggest that the increase in patients diagnosed with PD reflects changes in dental policies and insurance benefits. CONCLUSIONS This study confirms that national dental policies and socio-demographic factors are related to the incidence of periodontal treatments. The incidence of periodontal treatment is significantly related to the expansion of insurance coverage in South Korea.
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Affiliation(s)
- Jae-Hong Lee
- Department of Periodontology, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, 35233, South Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Jung-Kyu Choi
- Department of Health Insurance Research, Ilsan Hospital, National Health Insurance Service, Goyang, 10444, South Korea
| | - Hye-In Kweon
- Department of Periodontology, Ilsan Hospital, National Health Insurance Service, 100 Ilsan-ro Ilsan-donggu, Goyang, 10444, South Korea
| | - Young-Taek Kim
- Department of Periodontology, Ilsan Hospital, National Health Insurance Service, 100 Ilsan-ro Ilsan-donggu, Goyang, 10444, South Korea.
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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76
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Periodontal disease detection in primary and mixed dentitions. Eur Arch Paediatr Dent 2016; 17:407-411. [DOI: 10.1007/s40368-016-0248-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 07/14/2016] [Indexed: 01/09/2023]
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77
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Kissa J, Chemlali S, El Houari B, Amine K, Khlil N, Mikou S, Nadifi S, Albandar JM. Aggressive and chronic periodontitis in a population of Moroccan school students. J Clin Periodontol 2016; 43:934-939. [DOI: 10.1111/jcpe.12584] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Jamila Kissa
- Department of Periodontology; Faculté de Médecine Dentaire; Université Hassan II; Casablanca Morocco
| | - Sihame Chemlali
- Department of Periodontology; Faculté de Médecine Dentaire; Université Hassan II; Casablanca Morocco
| | - Bouchra El Houari
- Department of Periodontology; Faculté de Médecine Dentaire; Université Hassan II; Casablanca Morocco
| | - Khadija Amine
- Department of Periodontology; Faculté de Médecine Dentaire; Université Hassan II; Casablanca Morocco
| | - Nadia Khlil
- Department of Periodontology; Faculté de Médecine Dentaire; Université Hassan II; Casablanca Morocco
| | - Salwa Mikou
- Department of Periodontology; Faculté de Médecine Dentaire; Université Hassan II; Casablanca Morocco
| | - Sellama Nadifi
- Faculté de Médecine et de Pharmacie; Université Hassan II; Casablanca Morocco
| | - Jasim M. Albandar
- Department of Periodontology and Oral Implantology; School of Dentistry; Temple University; Philadelphia PA USA
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78
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Gurgel BCDV, Montenegro SCL, Dantas PMC, Pascoal ALDB, Lima KC, Calderon PDS. Frequency of peri-implant diseases and associated factors. Clin Oral Implants Res 2016; 28:1211-1217. [DOI: 10.1111/clr.12944] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2016] [Indexed: 12/17/2022]
Affiliation(s)
| | | | | | | | - Kenio Costa Lima
- Department of Dentistry; Federal University of Rio Grande do Norte; Natal Brazil
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79
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Shaddox LM, Spencer WP, Velsko IM, Al-Kassab H, Huang H, Calderon N, Aukhil I, Wallet SM. Localized aggressive periodontitis immune response to healthy and diseased subgingival plaque. J Clin Periodontol 2016; 43:746-53. [PMID: 27037664 DOI: 10.1111/jcpe.12560] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2016] [Indexed: 11/29/2022]
Abstract
AIM The objective of this case-control study was to compare the inflammatory response of peripheral blood from localized aggressive periodontitis (LAP) patients when stimulated with healthy or diseased plaque samples. MATERIALS AND METHODS Whole blood and subgingival plaque samples were collected from 13 LAP subjects, 14 siblings of LAP subjects and six periodontally healthy individuals. Whole blood was stimulated for 24 h with plaque samples generated from healthy or diseased sites. The levels of 14 cyto/chemokines were detected using multiplex technology. RESULTS Localized aggressive periodontitis-derived cultures displayed higher levels of G-CSF, INFγ, IL10, IL12p40, IL1β, IL-6, IL-8, MCP-1, MIP-1α, and TNFα, than control cultures regardless of stimulus used. Whole blood from healthy siblings displayed higher levels of IL-6 compared to control subjects, but lower levels than those observed in cultures from LAP participants. CONCLUSIONS This study suggests that although bacteria is an important factor in eliciting the hyper-inflammatory response observed in LAP patients, the predisposition of host's response to bacterial presence may play a more significant role than the components of the stimulatory plaque.
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Affiliation(s)
- Luciana M Shaddox
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA.,Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - William P Spencer
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Irina M Velsko
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Hiba Al-Kassab
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Hong Huang
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Nadia Calderon
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Ikramuddin Aukhil
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Shannon M Wallet
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
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80
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Stein JM, Machulla HKG, Deschner J, Fickl S, Jockel-Schneider Y, Tamm M, Schulz S, Reichert S. Prevalence of periodontitis in individuals with human leukocyte antigens (HLA) A9, B15, A2, and B5. Clin Oral Investig 2016; 20:703-10. [DOI: 10.1007/s00784-015-1570-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 08/16/2015] [Indexed: 10/23/2022]
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81
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Funieru C, Klinger A, Băicuș C, Funieru E, Dumitriu HT, Dumitriu A. Epidemiology of gingivitis in schoolchildren in Bucharest, Romania: a cross-sectional study. J Periodontal Res 2016; 52:225-232. [PMID: 27093564 DOI: 10.1111/jre.12385] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Gingivitis is the most prevalent oral disease in children, being strongly associated to social gradients. Many studies have reported different results concerning the extent and intra-oral distribution of gingivitis in children. The aim of this study was to investigate the epidemiologic parameters and socio-related risk factors of gingivitis in the 10-17-year-old Bucharest schoolchildren population and to analyze its intra-oral distribution. MATERIAL AND METHODS Cross-sectional data were obtained from 1595 schoolchildren, social condition being assigned using a simple questionnaire. Classes of students were used as clusters in a single-stage cluster sampling method. An intra-oral exam was performed for all the children included in this study. Silness and Löe scores, prevalence and the extent of gingivitis were calculated. RESULTS The gingival scores showed a mild inflammation and the prevalence of gingivitis was 91%. Boys had a higher gingival (0.19 vs. 0.18; p < 0.05) and plaque scores (0.71 vs. 0.59; p < 0.01) than girls. Children who did not live in overcrowded households, whose parents had a better education and those who had direct access to school dental services displayed better gingival conditions (p < 0.05). Gingivitis was more severe on the upper teeth, with the maximum score being reached at the right upper lateral incisor (0.63 on distal surface). CONCLUSIONS Gingival condition in Bucharest schoolchildren population was associated to social gradients. School dental services are also another factor that seems to be related with gingivitis.
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Affiliation(s)
- C Funieru
- Department of Preventive Dentistry, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,RECIF (Réseau d' Epidémiologie Clinique International Francophone), Bucharest, Romania
| | - A Klinger
- Department of Periodontology, Faculty of Dental Medicine, Hadassah and Hebrew University Medical Center, Jerusalem, Israel
| | - C Băicuș
- RECIF (Réseau d' Epidémiologie Clinique International Francophone), Bucharest, Romania.,Department of Internal Medicine, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | | | - H T Dumitriu
- Department of Periodontology, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - A Dumitriu
- Department of Periodontology, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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82
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Peruzzo DC, Gimenes JH, Taiete T, Casarin RCV, Feres M, Sallum EA, Casati MZ, Kantovitz KR, Nociti FH. Impact of smoking on experimental gingivitis. A clinical, microbiological and immunological prospective study. J Periodontal Res 2016; 51:800-811. [DOI: 10.1111/jre.12363] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2015] [Indexed: 01/12/2023]
Affiliation(s)
- D. C. Peruzzo
- Division of Periodontics; Department of Oral Pathology; São Leopoldo Mandic Institute and Research Center; Campinas São Paulo Brazil
| | | | - T. Taiete
- Division of Periodontics; Department of Prosthodontics and Periodontics; Piracicaba Dental School; University of Campinas; São Paulo Brazil
| | - R. C. V. Casarin
- Department of Periodontics; Paulista University; São Paulo Brazil
| | - M. Feres
- Department of Periodontics; Guarulhos University; São Paulo Brazil
| | - E. A. Sallum
- Division of Periodontics; Department of Prosthodontics and Periodontics; Piracicaba Dental School; University of Campinas; São Paulo Brazil
| | - M. Z. Casati
- Division of Periodontics; Department of Prosthodontics and Periodontics; Piracicaba Dental School; University of Campinas; São Paulo Brazil
| | - K. R. Kantovitz
- Department of Pediatric Dentistry; Piracicaba Dental School; University of Campinas; São Paulo Brazil
| | - F. H. Nociti
- Division of Periodontics; Department of Prosthodontics and Periodontics; Piracicaba Dental School; University of Campinas; São Paulo Brazil
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83
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Kesim S, Çiçek B, Aral CA, Öztürk A, Mazıcıoğlu MM, Kurtoğlu S. Oral Health, Obesity Status and Nutritional Habits in Turkish Children and Adolescents: An Epidemiological Study. Balkan Med J 2016; 33:164-72. [PMID: 27403385 DOI: 10.5152/balkanmedj.2016.16699] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 09/10/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Studies evaluating the relationship between oral health status and obesity have provided conflicting data. Therefore, there is a great need to investigate and clarify the possible connection in a comprehensive sample. AIMS To assess the relationship of obesity and oral health status among children and adolescents aged 6 to 17 years-old. STUDY DESIGN Cross-sectional study. METHODS Data were obtained from 4,534 children and adolescents (2,018 boys and 2,516 girls). Questionnaires were sent home prior to examination; afterwards, anthropometric and dental data were collected from participants. Community Periodontal Index (CPI) and number of decayed, missing, and filled teeth in the permanent dentition (DMFT), and deciduous dentition (dmft) index were used to measure oral health status. Height, body weight, body mass index (BMI), waist circumference (WC), and body fat percentage were analyzed. RESULTS For DMFT scores, healthy (score=0) girls and boys had significantly higher BMI and WC values than unhealthy (score>1) girls and boys (p<0.05). Healthy girls had higher fat percentage values than unhealthy girls (p<0.05). In terms of CPI scores, healthy boys had lower BMI and WC values than unhealthy boys (p<0.05). According to multiple binary logistic regression results for model 1, BMI predicted DMFT scores in both genders but CPI scores only in boys. No beverage consumption predicted DMFT scores in boys, while milk consumption predicted DMFT scores in girls. No meal skipping predicted CPI scores in boys. For model 2, WC predicted DMFT scores in both genders and CPI scores only in boys. Milk consumption predicted DMFT scores only in girls. No meal skipping predicted CPI scores for both gender (p<0.05). According to DMFT, there were significant differences between the frequencies of the BMI groups (normal weight, overweight and obese) at the age of 7 (girls only), 9, 10, and 16 (boys only) years and overall (only girls) (p<0.05). According to CPI, significant differences between the frequencies of the BMI groups at the age of 16 (boys only) and 17 (girls only) were seen (p<0.05). CONCLUSION Periodontal and dental status appears to correlate with nutritional habits and obesity. Obesity and dental/periodontal diseases are multifactorial diseases that follow similar risk patterns and develop from an interaction between chronic conditions originating early in life. It is important for all health professionals to educate patients at risk about the progression of periodontal and dental diseases and the importance of proper oral hygiene.
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Affiliation(s)
- Servet Kesim
- Department of Periodontology, Erciyes University School of Dentistry, Kayseri, Turkey
| | - Betül Çiçek
- Department of Nutrition and Dietetics, Erciyes University School of Health Sciences, Kayseri, Turkey
| | - Cüneyt Asım Aral
- Department of Periodontology, Şifa University School of Dentistry, İzmir, Turkey
| | - Ahmet Öztürk
- Department of Biostatistics and Medical Informatics, Erciyes University School of Medicine, Kayseri, Turkey
| | | | - Selim Kurtoğlu
- Department of Pediatrics, Division of Neonatology, Erciyes University School of Medicine, Kayseri, Turkey
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84
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Allin N, Cruz-Almeida Y, Velsko I, Vovk A, Hovemcamp N, Harrison P, Huang H, Aukhil I, Wallet SM, Shaddox LM. Inflammatory Response Influences Treatment of Localized Aggressive Periodontitis. J Dent Res 2016; 95:635-41. [PMID: 26917438 DOI: 10.1177/0022034516631973] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
We previously reported a systemic hyperinflammatory response to bacterial lipopolysaccharide (LPS) in children with localized aggressive periodontitis (LAP). Additionally, different levels of this response were observed within the LAP group. It is unknown whether this hyperinflammatory response influences the clinical response to periodontal treatment in these children. Therefore, the goal of this study was to evaluate the influence of LPS responsiveness present prior to treatment on the clinical response to treatment within the LAP cohort. Prior to treatment, peripheral blood was collected from 60 African American participants aged 5 to 21 y, free of systemic diseases, and diagnosed with LAP. Blood was stimulated with ultrapure LPS from Escherichia coli, and Luminex assays were performed to quantify 14 cytokine/chemokine levels. Principal component and cluster analyses were used to find patterns of cytokine/chemokine expression among participants and subdivide them into clusters. Three distinct clusters emerged among LAP participants: a high responder group (high level of response for INFg, IL6, and IL12p40), a mixed responder group (low for some and high for other cytokines/chemokines), and a low responder group (low overall cytokine/chemokine response). Periodontal clinical parameters were compared among these groups prior to and 3, 6, and 12 mo following treatment with mechanical debridement and systemic antibiotics. High responders presented the lowest reductions in clinical parameters after treatment, whereas the low responders presented the highest reductions. In our LAP participants, distinct patterns of LPS response were significantly predictive of changes in clinical parameters after treatment. Future studies are needed to evaluate the underlying mechanisms predicting the heterogeneity of LAP activity, severity, and response to treatment (ClinicalTrials.gov NCT01330719).
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Affiliation(s)
- N Allin
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Y Cruz-Almeida
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - I Velsko
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - A Vovk
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - N Hovemcamp
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - P Harrison
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - H Huang
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - I Aukhil
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - S M Wallet
- Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - L M Shaddox
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, USA Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL, USA
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85
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Abstract
A paradigm shift several decades ago elucidated that aggressive periodontitis (AgP) was not a degenerative disorder but a rapid progressive form of plaque-induced inflammatory periodontal disease. Ensuing years of research have led to linkage analysis identification of specific genetic defects responsible for AgP in some families and to the finding that subgingival detection of A. actinomycet-emcomitans JP2 clone is a predictive factor for disease onset and progression. However, rather disappointingly, these ‘proven’ risk factors are only detected in a small subset of AgP cases. Recent advances are leading to a new paradigm shift, with the realization that genetically-driven dysbiotic changes in the subgingival microbiota may predispose to a cascade of events leading to the rapid periodontal tissue destruction seen in AgP. This review tries to dissect the existing literature on the host response-microbial axis of AgP and to propose possible pathogenic pathways in line with current theories.
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Affiliation(s)
- Luigi Nibali
- a Periodontology Unit and Department of Clinical Research; UCL Eastman Dental Institute ; London , UK
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86
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Merchant SN, Vovk A, Kalash D, Hovencamp N, Aukhil I, Harrison P, Zapert E, Bidwell J, Varnado P, Shaddox LM. Localized aggressive periodontitis treatment response in primary and permanent dentitions. J Periodontol 2015; 85:1722-9. [PMID: 25186780 DOI: 10.1902/jop.2014.140171] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The comparative treatment response of children and young adults with localized aggressive periodontitis treatment (LAgP) affecting primary and permanent dentition is unknown. The objective of this study is to evaluate the influence of non-surgical periodontal therapy with adjunctive systemic antibiotics on the clinical outcome of children and young adults with primary versus permanent dentition affected by LAgP. METHODS A cohort of 97 African American participants aged 5 to 21 years (30 males and 67 females; 22 primary and 75 permanent dentitions affected) diagnosed with LAgP were included. Patients presented with no significant medical history. All patients underwent periodontal therapy, which consisted of full-mouth mechanical debridement at baseline and the 3-, 6-, and 12-month appointments. Additionally, all patients were prescribed a 1-week regimen of systemic antibiotics at the initial appointment. Clinical parameters were analyzed, including probing depth, clinical attachment level (CAL), bleeding on probing, and percentage of visible plaque. RESULTS Overall, periodontal therapy was found to be effective in improving the clinical outcomes of both primary and permanent dentitions. Although baseline CALs were similar between the groups, the reduction in mean CAL at 3, 6, and 12 months and reduction in percentage plaque at 3 months were significantly greater in primary dentition compared with permanent dentition. CONCLUSIONS Non-surgical therapy with systemic antibiotics is effective for LAgP in both primary and permanent dentitions. A greater reduction in CAL in LAgP of primary dentition may suggest that younger children may carry a greater propensity for positive treatment outcomes and healing potential compared with children/young adults with permanent dentition.
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Affiliation(s)
- Sherin N Merchant
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL
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87
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Herrera D, Alonso B, de Arriba L, Santa Cruz I, Serrano C, Sanz M. Acute periodontal lesions. Periodontol 2000 2015; 65:149-77. [PMID: 24738591 DOI: 10.1111/prd.12022] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2012] [Indexed: 11/30/2022]
Abstract
This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute disease is under control, definitive treatment should be provided, including appropriate therapy for the pre-existing gingivitis or periodontitis. Among other acute conditions affecting the periodontal tissues, but not caused by the microorganisms present in oral biofilms, infectious diseases, mucocutaneous diseases and traumatic or allergic lesions can be listed. In most cases, the gingival involvement is not severe; however, these conditions are common and may prompt an emergency dental visit. These conditions may have the appearance of an erythematous lesion, which is sometimes erosive. Erosive lesions may be the direct result of trauma or a consequence of the breaking of vesicles and bullae. A proper differential diagnosis is important for adequate management of the case.
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88
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Diabetes mellitus related bone metabolism and periodontal disease. Int J Oral Sci 2015; 7:63-72. [PMID: 25857702 PMCID: PMC4817554 DOI: 10.1038/ijos.2015.2] [Citation(s) in RCA: 149] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2014] [Indexed: 02/06/2023] Open
Abstract
Diabetes mellitus and periodontal disease are chronic diseases affecting a large number of populations worldwide. Changed bone metabolism is one of the important long-term complications associated with diabetes mellitus. Alveolar bone loss is one of the main outcomes of periodontitis, and diabetes is among the primary risk factors for periodontal disease. In this review, we summarise the adverse effects of diabetes on the periodontium in periodontitis subjects, focusing on alveolar bone loss. Bone remodelling begins with osteoclasts resorbing bone, followed by new bone formation by osteoblasts in the resorption lacunae. Therefore, we discuss the potential mechanism of diabetes-enhanced bone loss in relation to osteoblasts and osteoclasts.
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89
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Serum and salivary matrix metalloproteinases, neutrophil elastase, myeloperoxidase in patients with chronic or aggressive periodontitis. Inflammation 2015; 37:1771-8. [PMID: 24799321 DOI: 10.1007/s10753-014-9907-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Salivary, serum matrix metalloproteinase-8 (MMP-8), tissue inhibitor of matrix metalloproteinases-1 (TIMP-1), neutrophil elastase (NE), and myeloperoxidase (MPO) levels were investigated in generalized chronic periodontitis (GCP), generalized aggressive periodontitis (GAgP), and healthy groups. Whole-mouth clinical periodontal measurements were recorded. Salivary, serum concentrations of MMP-8, MPO, TIMP-1, and NE were determined by immunofluorometric assay or ELISA in 18 patients with GCP, 23 patients with GAgP, 18 individuals with healthy periodontium. Patients in the GAgP group were younger than the other groups (p<0.05). The study groups were similar in gender, smoking status. Plaque index was higher in GCP than GAgP group (p<0.05). Biochemical data were similar in periodontitis groups. Salivary, serum MPO, and salivary NE concentrations were higher; TIMP-1 concentrations were lower in the periodontitis groups than the controls (p<0.05). The present data support a close relationship between salivary, serum protease content and clinical periodontal parameters in patients with generalized periodontitis.
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90
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Bright R, Proudman S, Rosenstein E, Bartold P. Is there a link between carbamylation and citrullination in periodontal disease and rheumatoid arthritis? Med Hypotheses 2015; 84:570-6. [DOI: 10.1016/j.mehy.2015.03.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 10/30/2014] [Accepted: 03/01/2015] [Indexed: 01/12/2023]
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91
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Hashim NT, Linden GJ, Ibrahim ME, Gismalla BG, Lundy FT, Hughes FJ, El Karim IA. Replication of the association of GLT6D1 with aggressive periodontitis in a Sudanese population. J Clin Periodontol 2015; 42:319-24. [DOI: 10.1111/jcpe.12375] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Nada T. Hashim
- Faculty of Dentistry; University of Khartoum; Khartoum Sudan
| | - Gerard J. Linden
- Centre for Public Health; Queen's University of Belfast; Belfast UK
| | | | | | - Fionnuala T. Lundy
- Centre for Infection and Immunity; Queen's University of Belfast; Belfast UK
| | | | - Ikhlas A. El Karim
- Centre for Infection and Immunity; Queen's University of Belfast; Belfast UK
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92
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Shimizu S, Momozawa Y, Takahashi A, Nagasawa T, Ashikawa K, Terada Y, Izumi Y, Kobayashi H, Tsuji M, Kubo M, Furuichi Y. A Genome-wide Association Study of Periodontitis in a Japanese Population. J Dent Res 2015; 94:555-61. [DOI: 10.1177/0022034515570315] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Periodontitis is a multifactorial disease in which bacterial, lifestyle, and genetic factors are involved. Although previous genetic association studies identified several susceptibility genes for periodontitis in European populations, there is little information for Asian populations. Here, we conducted a genome-wide association study and a replication study consisting of 2,760 Japanese periodontitis patients and 15,158 Japanese controls. Although single-nucleotide polymorphisms that surpassed a stringent genome-wide significance threshold ( P < 5 × 10−8) were not identified, we found 2 suggestive loci for periodontitis: KCNQ5 on chromosome 6q13 (rs9446777, P = 4.83 × 10−6, odds ratio = 0.82) and GPR141-NME8 at chromosome 7p14.1 (rs2392510, P = 4.17 × 10−6, odds ratio = 0.87). A stratified analysis indicated that the GPR141-NME8 locus had a strong genetic effect on the susceptibility to generalized periodontitis in Japanese individuals with a history of smoking. In conclusion, this study identified 2 suggestive loci for periodontitis in a Japanese population. This study should contribute to a further understanding of genetic factors for enhanced susceptibility to periodontitis.
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Affiliation(s)
- S. Shimizu
- Laboratory for Genotyping Development, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
- Department of Oral Rehabilitation, Division of Periodontology and Endodontology, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu-cho, Ishikari, Hokkaido, Japan
| | - Y. Momozawa
- Laboratory for Genotyping Development, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - A. Takahashi
- Laboratory for Statistical Analysis, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - T. Nagasawa
- Research Institute of Personalized Health Sciences, Health Sciences University of Hokkaido, Tobetsu-cho, Ishikari, Hokkaido, Japan
| | - K. Ashikawa
- Laboratory for Genotyping Development, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Y. Terada
- Division of General Dentistry, University Hospital, Health Sciences University of Hokkaido, Ainosato, Sapporo, Hokkaido, Japan
| | - Y. Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - H. Kobayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - M. Tsuji
- Division of Internal Medicine, University Hospital, Health Sciences University of Hokkaido, Ainosato, Sapporo, Hokkaido, Japan
| | - M. Kubo
- Laboratory for Genotyping Development, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Y. Furuichi
- Department of Oral Rehabilitation, Division of Periodontology and Endodontology, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu-cho, Ishikari, Hokkaido, Japan
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93
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Ardila CM, Martelo-Cadavid JF, Boderth-Acosta G, Ariza-Garcés AA, Guzmán IC. Adjunctive moxifloxacin in the treatment of generalized aggressive periodontitis patients: clinical and microbiological results of a randomized, triple-blind and placebo-controlled clinical trial. J Clin Periodontol 2015; 42:160-8. [DOI: 10.1111/jcpe.12345] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Carlos Martín Ardila
- Stomatology Biomedical Group; Universidad de Antioquia (U de A); Medellín Colombia
| | | | | | | | - Isabel C. Guzmán
- Stomatology Biomedical Group; Universidad de Antioquia (U de A); Medellín Colombia
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94
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Botero JE, Rösing CK, Duque A, Jaramillo A, Contreras A. Periodontal disease in children and adolescents of Latin America. Periodontol 2000 2014; 67:34-57. [DOI: 10.1111/prd.12072] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2014] [Indexed: 01/08/2023]
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95
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Development of resistance of mutans streptococci and Porphyromonas gingivalis to chlorhexidine digluconate and amine fluoride/stannous fluoride-containing mouthrinses, in vitro. Clin Oral Investig 2014; 19:1547-53. [PMID: 25483124 DOI: 10.1007/s00784-014-1379-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 11/25/2014] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The aim if this study was to determine the minimal inhibitory concentrations of chlorhexidine digluconate and an amine fluoride/stannous fluoride-containing mouthrinse against Porphyromonas gingivalis and mutans streptococci during an experimental long-term subinhibitory exposition. MATERIAL AND METHODS Five P. gingivalis strains and four mutans streptococci were subcultivated for 20-30 passages in subinhibitory concentrations of chlorhexidine digluconate or an amine fluoride/stannous fluoride-containing mouthrinse. RESULTS Pre-passaging minimal inhibitory concentrations for chlorhexidine ranged from 0.5 to 2 mg/l for mutans streptococci and from 2 to 4 mg/l for the P. gingivalis isolates. For the amine fluoride/stannous fluoride-containing mouthrinse minimal inhibitory values from 0.125 to 0.25% for the mutans streptococci and from 0.063 to 0.125% for the P. gingivalis isolates were determined. Two- to fourfold increased minimal inhibitory concentrations against chlorhexidine were detected for two of the five P. gingivalis isolates, whereas no increase in minimal inhibitory concentrations was found for the mutans streptococci after repeated passaging through subinhibitory concentrations. Repeated exposure to subinhibitory concentrations of the amine fluoride/stannous fluoride-containing mouthrinse did not alter the minimally inhibitory concentrations of the bacterial isolates tested. CONCLUSION Chlorhexidine and the amine fluoride/stannous fluoride-containing mouthrinse are effective inhibitory agents against the oral bacterial isolates tested. No general development of resistance against chlorhexidine or the amine fluoride/stannous fluoride-containing mouthrinse was detected. However, some strains showed potential to develop resistance against chlorhexidine after prolonged exposure. CLINICAL RELEVANCE The use of chlorhexidine should be limited to short periods of time. The amine fluoride/stannous fluoride-containing mouthrinse appears to have the potential to be used on a long-term basis.
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96
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Elabdeen HRZ, Mustafa M, Hasturk H, Klepac-Ceraj V, Ali RW, Paster BJ, Van Dyke T, Bolstad AI. Subgingival microbial profiles of Sudanese patients with aggressive periodontitis. J Periodontal Res 2014; 50:674-82. [PMID: 25487558 PMCID: PMC4646740 DOI: 10.1111/jre.12250] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2014] [Indexed: 12/15/2022]
Abstract
Background and Objective Aggressive periodontitis (AgP) is prevalent and shows a rapid course in African individuals. Although a strong focus has been placed on Aggregatibacter actinomycetemcomitans, new methods support the existence of a complex subgingival microflora in AgP. The purpose of the present study was to map the subgingival microbiota as well as explore the presence of A. actinomycetemcomitans and the JP2 clone in a group of Sudanese individuals with AgP, using different analytical methods. Material and Methods A study population consisting of 19 patients with AgP was recruited from patients seeking treatment at University of Science and Technology (UST) in Khartoum. Fifteen healthy subjects were included as controls. Plaque samples were analyzed for 272 taxa using human oral microbe identification microarrays and for 26 periodontal taxa using DNA-DNA hybridization checkerboard. Conventional polymerase chain reaction (PCR) was applied for the detection of A. actinomycetemcomitans and the JP2 clone in plaque. Saliva from patients with AgP was analyzed using quantitative PCR (qPCR) for the detection of A. actinomycetemcomitans. Results Eubacterium yurii was detected more frequently in patients with AgP than in controls, and E. nodatum was found in patients with AgP only. A. actinomycetemcomitans was found in plaque samples of two (12%) patients by human oral microbe identification microarrays and in five (29%) patients with AgP by conventional PCR, as well as in six (32%) of the AgP saliva samples by qPCR. The JP2 clone was identified in only one patient. Conclusion The classical periodontal pathogens were not present in high amounts in AgP in the population studied here. Species of Eubacterium, which are not typically associated with AgP, were often detected in individuals with disease. Using laboratory methods with different sensitivities and detection levels allowed identification of variances in microbial communities. The findings reported in this study provide a basis for the further understanding of AgP.
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Affiliation(s)
- H R Z Elabdeen
- Department of Clinical Dentistry, Periodontics, University of Bergen, Bergen, Norway
| | - M Mustafa
- Department of Clinical Dentistry, Periodontics, University of Bergen, Bergen, Norway
| | - H Hasturk
- Department of Applied Oral Sciences, Center for Periodontology, The Forsyth Institute, Cambridge, MA, 02142, USA
| | - V Klepac-Ceraj
- Department of Microbiology, The Forsyth Institute, Cambridge, MA, 02142, USA.,Department of Biological Sciences, Wellesley College, Wellesley, MA, 02481, USA
| | - R W Ali
- Faculty of Dentistry, University of Science and Technology, Omdurman, Sudan
| | - B J Paster
- Department of Microbiology, The Forsyth Institute, Cambridge, MA, 02142, USA.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, 02115, USA
| | - T Van Dyke
- Department of Applied Oral Sciences, Center for Periodontology, The Forsyth Institute, Cambridge, MA, 02142, USA
| | - A I Bolstad
- Department of Clinical Dentistry, Periodontics, University of Bergen, Bergen, Norway
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97
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Tomazoni F, Zanatta FB, Tuchtenhagen S, da Rosa GN, Del Fabro JP, Ardenghi TM. Association of Gingivitis With Child Oral Health–Related Quality of Life. J Periodontol 2014; 85:1557-65. [DOI: 10.1902/jop.2014.140026] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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98
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Monje A, Alcoforado G, Padial-Molina M, Suarez F, Lin GH, Wang HL. Generalized Aggressive Periodontitis as a Risk Factor for Dental Implant Failure: A Systematic Review and Meta-Analysis. J Periodontol 2014; 85:1398-407. [DOI: 10.1902/jop.2014.140135] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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99
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Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res 2014; 93:1045-53. [PMID: 25261053 DOI: 10.1177/0022034514552491] [Citation(s) in RCA: 1281] [Impact Index Per Article: 128.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
We aimed to consolidate all epidemiologic data about severe periodontitis (SP) and, subsequently, to generate internally consistent prevalence and incidence estimates for all countries, 20 age groups, and both sexes for 1990 and 2010. The systematic search of the literature yielded 6,394 unique citations. After screening titles and abstracts, we excluded 5,881 citations as clearly not relevant to this systematic review, leaving 513 for full-text review. A further 441 publications were excluded following the validity assessment. A total of 72 studies, including 291,170 individuals aged 15 yr or older in 37 countries, were included in the metaregression based on modeling resources of the Global Burden of Disease 2010 Study. SP was the sixth-most prevalent condition in the world. Between 1990 and 2010, the global age-standardized prevalence of SP was static at 11.2% (95% uncertainty interval: 10.4%-11.9% in 1990 and 10.5%-12.0% in 2010). The age-standardized incidence of SP in 2010 was 701 cases per 100,000 person-years (95% uncertainty interval: 599-823), a nonsignificant increase from the 1990 incidence of SP. Prevalence increased gradually with age, showing a steep increase between the third and fourth decades of life that was driven by a peak in incidence at around 38 yr of age. There were considerable variations in prevalence and incidence between regions and countries. Policy makers need to be aware of a predictable increasing burden of SP due to the growing world population associated with an increasing life expectancy and a significant decrease in the prevalence of total tooth loss throughout the world from 1990 to 2010.
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Affiliation(s)
- N J Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - E Bernabé
- Division of Population and Patient Health, King's College London Dental Institute, London, UK
| | - M Dahiya
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - B Bhandari
- Division of Population and Patient Health, King's College London Dental Institute, London, UK
| | - C J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - W Marcenes
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Haubek D, Johansson A. Pathogenicity of the highly leukotoxic JP2 clone of Aggregatibacter actinomycetemcomitans and its geographic dissemination and role in aggressive periodontitis. J Oral Microbiol 2014; 6:23980. [PMID: 25206940 PMCID: PMC4139931 DOI: 10.3402/jom.v6.23980] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 07/03/2014] [Accepted: 07/07/2014] [Indexed: 02/01/2023] Open
Abstract
For decades, Aggregatibacter actinomycetemcomitans has been associated with aggressive forms of periodontitis in adolescents. In the middle of the 1990s, a specific JP2 clone of A. actinomycetemcomitans, belonging to the cluster of serotype b strains of A. actinomycetemcomitans and having a number of other characteristics, was found to be strongly associated with aggressive forms of periodontitis, particularly in North Africa. Although several longitudinal studies still point to the bacterial species, A. actinomycetemcomitans as a risk factor of aggressive periodontitis, it is now also widely accepted that the highly leukotoxic JP2 clone of A. actinomycetemcomitans is implicated in rapidly progressing forms of aggressive periodontitis. The JP2 clone strains are highly prevalent in human populations living in Northern and Western parts of Africa. These strains are also prevalent in geographically widespread populations that have originated from the Northwest Africa. Only sporadic signs of a dissemination of the JP2 clone strains to non-African populations have been found despite Africans living geographically widespread for hundreds of years. It remains an unanswered question if a particular host tropism exists as a possible explanation for the frequent colonization of the Northwest African population with the JP2 clone. Two exotoxins of A. actinomycetemcomitans are known, leukotoxin (LtxA) and cytolethal distending toxin (Cdt). LtxA is able to kill human immune cells, and Cdt can block cell cycle progression in eukaryotic cells and thus induce cell cycle arrest. Whereas the leukotoxin production is enhanced in JP2 clone strains thus increasing the virulence potential of A. actinomycetemcomitans, it has not been possible so far to demonstrate such a role for Cdt. Lines of evidence have led to the understanding of the highly leukotoxic JP2 clone of A. actinomycetemcomitans as an aetiological factor of aggressive periodontitis. Patients, who are colonized with the JP2 clone, are likely to share this clone with several family members because the clone is transmitted through close contacts. This is a challenge to the clinicians. The patients need intense monitoring of their periodontal status as the risk for developing severely progressing periodontal lesions are relatively high. Furthermore, timely periodontal treatment, in some cases including periodontal surgery supplemented by the use of antibiotics, is warranted. Preferably, periodontal attachment loss should be prevented by early detection of the JP2 clone of A. actinomycetemcomitans by microbial diagnostic testing and/or by preventive means.
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Affiliation(s)
- Dorte Haubek
- Section for Pediatric Dentistry, Department of Dentistry, Health, Aarhus University, Aarhus, Denmark
| | - Anders Johansson
- Department of Molecular Periodontology, Umea University, Umea, Sweden
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