1
|
Pitchumani PK, Parekh S, Rachana Hegde, Thomas DC. Systemic Factors Affecting Prognosis in Periodontics: Part II. Dent Clin North Am 2024; 68:603-617. [PMID: 39244246 DOI: 10.1016/j.cden.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
This study gives an insight into certain systemic conditions and factors such as nutrition, age, hematological disorders, hypertension, smoking, obesity, and metabolic syndrome that have a notable effect on the periodontium. The review highlights the importance of taking these factors into consideration in periodontal therapy and their impact on the prognosis of periodontal therapies. The other systemic factors are discussed in detail elsewhere in the special issue.
Collapse
Affiliation(s)
| | | | | | - Davis C Thomas
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders and Orofacial Pain, Rutgers School of Dental Medicine, Newark, NJ, USA.
| |
Collapse
|
2
|
Kalsi AS, Bomfim DI, Hussain Z. Factors affecting decision making at reassessment of periodontitis. Part 2: interpretation of clinical findings - systemic factors. Br Dent J 2019; 227:797-801. [PMID: 31705095 DOI: 10.1038/s41415-019-0893-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This paper is the second in a four-part series outlining treatment planning at periodontal reassessment. The first article focussed on the information that should be gathered at the reassessment appointment. Treatment can involve a range of non-surgical and surgical approaches. A variety of general, practical and local site factors can affect the choice of one option over another in choosing the most predictable treatment option. Residual periodontal probing depths can be associated with both systemic and local factors. This article (part 2) outlines systemic factors that need to be assessed when faced with residual periodontal probing depths.
Collapse
Affiliation(s)
- Amardip S Kalsi
- Speciality Trainee Registrar in Restorative Dentistry, Eastman Dental Hospital, 47-49 Huntley Street, London, WC1E 6DG, UK.
| | - Deborah I Bomfim
- Consultant in Restorative Dentistry, Eastman Dental Hospital, 47-49 Huntley Street, London, WC1E 6DG, UK
| | - Zahra Hussain
- Consultant in Restorative Dentistry, Eastman Dental Hospital, 47-49 Huntley Street, London, WC1E 6DG, UK
| |
Collapse
|
3
|
Pólvora TLS, Nobre ÁVV, Tirapelli C, Taba M, Macedo LDD, Santana RC, Pozzetto B, Lourenço AG, Motta ACF. Relationship between human immunodeficiency virus (HIV-1) infection and chronic periodontitis. Expert Rev Clin Immunol 2018; 14:315-327. [PMID: 29595347 DOI: 10.1080/1744666x.2018.1459571] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Current studies show that, even in the era of antiretroviral therapies, HIV-1 infection is associated with more severe and frequent refractory chronic periodontitis. Areas covered: This review, based on a systematic analysis of the literature, intends to provide an update on factors that may be involved in the pathogenesis of periodontal disease in HIV-1-infected patients, including local immunosuppression, oral microbial factors, systemic inflammation, salivary markers, and the role of gingival tissue as a possible reservoir of HIV-1. Expert commentary: The therapeutic revolution of ART made HIV-1 infection a chronic controllable disease, reduced HIV-1 mortality rate, restored at least partially the immune response and dramatically increased life expectancy of HIV-1-infected patients. Despite all these positive aspects, chronic periodontitis assumes an important role in the HIV-1 infection status for activating systemic inflammation favoring viral replication and influencing HIV-1 status, and also acting as a possible reservoir of HIV-1. All these issues still need to be clarified and validated, but have important clinical implications that certainly will benefit the diagnosis and management of chronic periodontitis in HIV-1-infected patients, and also contributes to HIV-1 eradication.
Collapse
Affiliation(s)
| | - Átila Vinícius V Nobre
- b Department of Oral & Maxillofacial Surgery, and Periodontology, School of Dentistry of Ribeirão Preto , University of São Paulo , Ribeirão Preto , Brazil
| | - Camila Tirapelli
- c Department of Dental Material and Prosthesis, School of Dentistry of Ribeirão Preto , USP - University of São Paulo , Ribeirão Preto , Brazil
| | - Mário Taba
- b Department of Oral & Maxillofacial Surgery, and Periodontology, School of Dentistry of Ribeirão Preto , University of São Paulo , Ribeirão Preto , Brazil
| | - Leandro Dorigan de Macedo
- d Division of Dentistry and Stomatology, Clinical Hospital, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil
| | - Rodrigo Carvalho Santana
- e Department of Internal Medicine, Ribeirão Preto Medical School , USP - University of São Paulo , Ribeirão Preto , Brazil
| | - Bruno Pozzetto
- f GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France
| | - Alan Grupioni Lourenço
- g Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto , University of São Paulo , Ribeirão Preto , Brazil
| | - Ana Carolina F Motta
- g Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto , University of São Paulo , Ribeirão Preto , Brazil
| |
Collapse
|
4
|
Heron SE, Elahi S. HIV Infection and Compromised Mucosal Immunity: Oral Manifestations and Systemic Inflammation. Front Immunol 2017; 8:241. [PMID: 28326084 PMCID: PMC5339276 DOI: 10.3389/fimmu.2017.00241] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/20/2017] [Indexed: 12/26/2022] Open
Abstract
Mucosal surfaces account for the vast majority of HIV transmission. In adults, HIV transmission occurs mainly by vaginal and rectal routes but rarely via oral route. By contrast, pediatric HIV infections could be as the result of oral route by breastfeeding. As such mucosal surfaces play a crucial role in HIV acquisition, and spread of the virus depends on its ability to cross a mucosal barrier. HIV selectively infects, depletes, and/or dysregulates multiple arms of the human immune system particularly at the mucosal sites and causes substantial irreversible damage to the mucosal barriers. This leads to microbial products translocation and subsequently hyper-immune activation. Although introduction of antiretroviral therapy (ART) has led to significant reduction in morbidity and mortality of HIV-infected patients, viral replication persists. As a result, antigen presence and immune activation are linked to “inflammaging” that attributes to a pro-inflammatory environment and the accelerated aging process in HIV patients. HIV infection is also associated with the prevalence of oral mucosal infections and dysregulation of oral microbiota, both of which may compromise the oral mucosal immunity of HIV-infected individuals. In addition, impaired oral immunity in HIV infection may predispose the patients to periodontal diseases that are associated with systemic inflammation and increased risk of cardiovascular diseases. The purpose of this review is to examine existing evidence regarding the role of innate and cellular components of the oral cavity in HIV infection and how HIV infection may drive systemic hyper-immune activation in these patients. We will also discuss current knowledge on HIV oral transmission, HIV immunosenescence in relation to the oral mucosal alterations during the course of HIV infection and periodontal disease. Finally, we discuss oral manifestations associated with HIV infection and how HIV infection and ART influence the oral microbiome. Therefore, unraveling how HIV compromises the integrity of the oral mucosal tissues and innate immune components of the oral cavity and its association with induction of chronic inflammation are critical for the development of effective preventive interventions and therapeutic strategies.
Collapse
Affiliation(s)
- Samantha E Heron
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta , Edmonton, AB , Canada
| | - Shokrollah Elahi
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, AB, Canada; Faculty of Medicine and Dentistry, Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
5
|
Heron SE, Elahi S. HIV Infection and Compromised Mucosal Immunity: Oral Manifestations and Systemic Inflammation. Front Immunol 2017; 8:241. [PMID: 28326084 DOI: 10.3389/fimmu.2017.00241doi|] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/20/2017] [Indexed: 05/25/2023] Open
Abstract
Mucosal surfaces account for the vast majority of HIV transmission. In adults, HIV transmission occurs mainly by vaginal and rectal routes but rarely via oral route. By contrast, pediatric HIV infections could be as the result of oral route by breastfeeding. As such mucosal surfaces play a crucial role in HIV acquisition, and spread of the virus depends on its ability to cross a mucosal barrier. HIV selectively infects, depletes, and/or dysregulates multiple arms of the human immune system particularly at the mucosal sites and causes substantial irreversible damage to the mucosal barriers. This leads to microbial products translocation and subsequently hyper-immune activation. Although introduction of antiretroviral therapy (ART) has led to significant reduction in morbidity and mortality of HIV-infected patients, viral replication persists. As a result, antigen presence and immune activation are linked to "inflammaging" that attributes to a pro-inflammatory environment and the accelerated aging process in HIV patients. HIV infection is also associated with the prevalence of oral mucosal infections and dysregulation of oral microbiota, both of which may compromise the oral mucosal immunity of HIV-infected individuals. In addition, impaired oral immunity in HIV infection may predispose the patients to periodontal diseases that are associated with systemic inflammation and increased risk of cardiovascular diseases. The purpose of this review is to examine existing evidence regarding the role of innate and cellular components of the oral cavity in HIV infection and how HIV infection may drive systemic hyper-immune activation in these patients. We will also discuss current knowledge on HIV oral transmission, HIV immunosenescence in relation to the oral mucosal alterations during the course of HIV infection and periodontal disease. Finally, we discuss oral manifestations associated with HIV infection and how HIV infection and ART influence the oral microbiome. Therefore, unraveling how HIV compromises the integrity of the oral mucosal tissues and innate immune components of the oral cavity and its association with induction of chronic inflammation are critical for the development of effective preventive interventions and therapeutic strategies.
Collapse
Affiliation(s)
- Samantha E Heron
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta , Edmonton, AB , Canada
| | - Shokrollah Elahi
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, AB, Canada; Faculty of Medicine and Dentistry, Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
6
|
|
7
|
Gušić I, Medić D, Radovanović Kanjuh M, Ðurić M, Brkić S, Turkulov V, Predin T, Mirnić J. Treatment of Periodontal Disease with an Octenidine-based Antiseptic in HIV-positive Patients. Int J Dent Hyg 2015; 14:108-16. [PMID: 25847374 DOI: 10.1111/idh.12141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the effects of a periodontal therapy with subsequent application of an octenidine (OCT)-based antiseptic in HIV-positive patients receiving highly active antiretroviral therapy. METHODS HIV-positive patients with a clinically diagnosed periodontal disease were randomly divided into two groups (n = 30/group). Both groups initially received a periodontal therapy. Patients in the OCT group additionally used an OCT-based mouthwash. Subgingival plaque samples and periodontal indices were analysed prior to treatment onset as well as one and 3 months post-treatment. RESULTS Periodontal therapy has resulted in a significant decrease in the values of all periodontal indices one and 3 months following the therapy completion (P = 0.000). The effects of the two applied therapeutic protocols differed significantly in terms of the variation in the PBI (F = 4.617; P = 0.017) and the PD (F = 3.203; P = 0.044) value. In the patients in the OCT group, a more pronounced decrease in the PBI and PD was noted at 1-month follow-up as well as a greater increase in the PD value 3 months upon treatment completion. In the OCT group, no more atypical microorganisms were detectable 1 month post-treatment, while in the control group they were found in 34.5% of patients. CONCLUSIONS The periodontal therapy bears good results in HIV-positive patients. Additional administration of OCT contributes to the significant decline in the PBI and DS values and eliminates atypical microorganisms within 1 month post-treatment. However, more favourable results were not noted in the OCT group at the 3-month assessment.
Collapse
Affiliation(s)
- I Gušić
- Department of Periodontology and Oral Medicine, Clinic for Dentistry, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - D Medić
- Institute of Public Health of Vojvodina, Centre for Microbiology, Novi Sad, Serbia
| | | | - M Ðurić
- Department of Periodontology and Oral Medicine, Clinic for Dentistry, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - S Brkić
- Clinic for Infectious Diseases, Clinical Centre of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - V Turkulov
- Clinic for Infectious Diseases, Clinical Centre of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - T Predin
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - J Mirnić
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| |
Collapse
|
8
|
A Comparison of Chronic Periodontitis in HIV-Seropositive Subjects and the General Population in the Ga-Rankuwa Area, South Africa. AIDS Res Treat 2012; 2012:620962. [PMID: 22970354 PMCID: PMC3434389 DOI: 10.1155/2012/620962] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 07/19/2012] [Accepted: 07/19/2012] [Indexed: 11/17/2022] Open
Abstract
The effect of HIV infection on the prevalence and the rate of progression of chronic periodontitis is not clear. The aim of this study was to compare parameters associated with the severity of chronic periodontitis in terms of periodontal probing depths, gingival recession, plaque indexes, and bleeding indexes of HIV-seropositive subjects and healthy age-matched control subjects, and of HIV-seropositive subjects on highly active antiretroviral therapy and those not receiving such treatment. Two cohorts of subjects with chronic periodontitis were recruited for this study over a period of six months. There were 30 HIV-seropositive subjects, and 30 control subjects. Periodontal probing depths, gingival marginal recession, plaque indexes, and bleeding indexes were compared by HIV serostatus, the use of highly active antiretroviral therapy, and CD4+ T-cell counts. All participants were black persons between the age of 18 and 45 and were of a similar socioeconomic status and age. The results of this study indicate that chronic periodontitis in HIV-seropositive subjects is similar in terms of mean periodontal probing depth, gingival marginal recession, plaque index, and bleeding index to that in healthy age-matched control subjects, and a low CD4+ T-cell count does not appear to be a risk factor for increased severity of chronic periodontitis.
Collapse
|
9
|
Nussbaum G, Shapira L. How has neutrophil research improved our understanding of periodontal pathogenesis? J Clin Periodontol 2011; 38 Suppl 11:49-59. [PMID: 21323704 DOI: 10.1111/j.1600-051x.2010.01678.x] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Neutrophils are the predominant cells responsible for host defence against bacterial infection. Loss of neutrophil defence, due either to deficient number or function, strongly predisposes to bacterial infections such as periodontitis. Yet, the neutrophil oxidative and proteolytic arsenal has also been implicated in perpetrating periodontal tissue damage in periodontitis. AIM In this review, we focus on recent developments that shed light on these two aspects of neutrophil function in periodontitis. METHODS Primary search: using PubMed search for "neutophil", "periodontal", and "periodontitis". Secondary search: using references from the articles found in the first stage. RESULTS Early histological studies showed that infiltrating neutrophils form a wall of cells abutting the junctional epithelium in periodontal inflammatory lesions. The chronic standoff between these neutrophils and the bacterial community suggests that bacterial evasion of neutrophil clearance is a major characteristic of periodontitis. Indeed, not all functional neutrophil deficiencies increase the risk of periodontitis, an observation that points the way towards identification of particular anti-bacterial pathways essential for protection against periodontal pathogens. The net result in the majority of periodontitis patients who exhibit normal neutrophil number and function, is that neutrophils accumulate in the periodontal tissue where they are available to participate in tissue destruction. Diminished neutrophil clearance further contributes to the persistence of activated neutrophils in the periodontal tissue. CONCLUSIONS Data on the role of neutrophils in the pathogenesis of periodontitis are mixed. Neutrophils are a critical arm of the defence against periodontitis, but bacterial evasion of the neutrophil microbicidal machinery coupled with delayed neutrophil apoptosis may transform the neutrophil from defender to perpetrator. At this stage of knowledge, attempts to induce host modulation through neutrophil suppression or activation are premature.
Collapse
Affiliation(s)
- Gabriel Nussbaum
- Institute of Dental Sciences, Faculty of Dental Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | | |
Collapse
|
10
|
The effect of recombinant granulocyte colony-stimulating factor on oral and periodontal manifestations in a patient with cyclic neutropenia: a case report. Int J Dent 2010; 2009:654239. [PMID: 20339570 PMCID: PMC2836918 DOI: 10.1155/2009/654239] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2009] [Revised: 07/28/2009] [Accepted: 11/30/2009] [Indexed: 11/17/2022] Open
Abstract
Cyclic Neutropenia (CN) is characterized by recurrent infections, fever, oral ulcerations, and severe periodontitis as result of the reduced host defences. The previous studies have established the effectiveness of recombinant granulocyte colony-stimulating factor (GCSF) to increase the number and the function of neutrophils in the peripheral blood in this disease. In a 20-year-old Caucasian female with a diagnosis of cyclic neutropenia, oral clinical examination revealed multiple painful ulcerations of the oral mucosa, poor oral hygiene conditions, marginal gingivitis, and moderate periodontitis. The patient received a treatment with G-CSF (Pegfilgrastim, 6 mg/month) in order to improve her immunological status. Once a month nonsurgical periodontal treatment was carefully performed when absolute neutrophil count (ANC)
was ≥500/μL. The treatment with G-CSF resulted in a rapid
increase of circulating neutrophils that, despite its short
duration, leaded to a reduction in infection related events and
the resolution of the multiple oral ulcerations. The disappearance
of oral pain allowed an efficacy nonsurgical treatment and a
normal tooth brushing that determined a reduction of probing depth
(PD ≤ 4 mm) and an improvement of the oral hygiene conditions recorded at 6-month follow-up.
Collapse
|
11
|
Lerman MA, Laudenbach J, Marty FM, Baden LR, Treister NS. Management of oral infections in cancer patients. Dent Clin North Am 2008; 52:129-53, ix. [PMID: 18154868 DOI: 10.1016/j.cden.2007.10.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The myelosuppressive and mucosal-damaging consequences of cancer and cancer therapies place patients at high risk for developing infectious complications. Bacterial, fungal, and viral infections are all commonly encountered in the oral cavity, contributing to both morbidity and mortality in this patient population. Prevention, early and definitive diagnosis, and appropriate management are critical to ensure optimal treatment outcomes. With the majority of cancer patients treated as outpatients in the community setting, oral health care professionals play an important role in managing such infectious complications of cancer therapy.
Collapse
Affiliation(s)
- Mark A Lerman
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | | | | | | | | |
Collapse
|
12
|
Vasanthan A, Dallal N. Periodontal treatment considerations for cell transplant and organ transplant patients. Periodontol 2000 2007; 44:82-102. [PMID: 17474927 DOI: 10.1111/j.1600-0757.2006.00198.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Asvin Vasanthan
- Department of Periodontics, School of Dentistry, University of Missouri-Kansas City, USA
| | | |
Collapse
|
13
|
O'Donnell MJ, Tuttlebee CM, Falkiner FR, Coleman DC. Bacterial contamination of dental chair units in a modern dental hospital caused by leakage from suction system hoses containing extensive biofilm. J Hosp Infect 2005; 59:348-60. [PMID: 15749324 DOI: 10.1016/j.jhin.2004.10.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2004] [Accepted: 10/06/2004] [Indexed: 11/27/2022]
Abstract
Within six months of opening of the new Dublin Dental Hospital in September 1998, areas of corrosion were observed on many of the baseplates of the hospital's 103 dental chair units (DCUs) at the site of attachment of the suction hoses. The corroded areas were heavily contaminated with Pseudomonas spp. and related genera posing a risk of cross-infection, particularly for immunocompromised patients. These species were used as marker organisms to investigate the source of the contamination. P. aeruginosa was the predominant species recovered from 41 selected DCU baseplates (61% prevalence), whereas P. putida (46% prevalence) and P. aeruginosa (43% prevalence) were predominant at the attachment ends of 37 selected high-volume suction hoses. Forty-one selected isolates of P. aeruginosa from 13 DCU baseplates, 16 high-volume suction hoses and 12 coarse filter housings (another suction system site) from 19 separate DCUs were serotyped to determine the similarity of isolates at each site. The majority of isolates (68.3%) belonged to serotype O:10, while the remainder belonged to serotypes O:6 (7.3%), O:11 (7.3%), O:14 (9.8%) and O:5/O:16 (7.3%). Of the isolates from DCU baseplates, additional isolates with the same serotype were recovered from other suction system sites in 10/13 (77%) cases. Isolates of only one serotype were recovered from each of the 19 DCUs investigated. Forty-one serotyped isolates were also subject to computer-assisted analysis of SpeI-generated DNA fingerprint profiles, and similarity coefficient (S(AB)s) values were calculated for each pairwise combination of isolate profiles. The data obtained showed that the isolates consisted of two distinct main populations, each containing separate clades corresponding to specific serotypes. Serotype O:6 (three isolates), O:11 (three isolates) and O:5/O:16 (three isolates) belonged to a single strain in each case. Serotypes O:14 (four isolates) and O:10 (28 isolates) belonged to two strains in each case. The two serotype O:10 strains, termed fingerprint groups I (four isolates from three DCUs) and II (24 isolates from 10 DCUs), were the most distantly related of all the strains identified. These findings demonstrated that the hospital DCUs had become colonized with a small number of P. aeruginosa strains, one of which (serotype O:10, fingerprint group II) predominated. These results also confirmed that DCU baseplate contamination was most likely to be due to leakage from suction system hoses at the baseplate attachment sites, probably due to loosening during use. Replacement hose connectors that firmly retained the suction hoses in the attachment sites so that they could not be loosened by movement of the suction hoses solved this problem, and eliminated further contamination of the DCU baseplates.
Collapse
Affiliation(s)
- M J O'Donnell
- Microbiology Research Unit, Department of Oral Surgery, Oral Medicine and Oral Pathology, School of Dental Science & Dublin Dental Hospital, University of Dublin, Trinity College, Lincoln Place, Dublin 2, Republic of Ireland
| | | | | | | |
Collapse
|
14
|
Affiliation(s)
- Sinem E Sahingur
- Department of Oral Biology, and Periodontics & Endodontics, Schoolof Dental Medicine, University at Buffalo, Buffalo, New York, USA
| | | |
Collapse
|
15
|
Abstract
Immunocompromised individuals present a challenge to oral health care providers. As the spectrum of patients with dysfunctional immune responses continues to broaden, practitioners should be able to identify these patients, understand the potential for complications, and manage their dental care safely and effectively. This article reviews various immune deficiencies, addresses complications that may result from an individual's immune status, and discusses dental considerations for these patients.
Collapse
Affiliation(s)
- Ernesta Parisi
- Division of Oral Medicine, University of Medicine and Dentistry of New Jersey, 110 Bergen Street, D-860, Newark, NJ 07103, USA.
| | | |
Collapse
|
16
|
Holmstrup P, Poulsen AH, Andersen L, Skuldbøl T, Fiehn NE. Oral infections and systemic diseases. Dent Clin North Am 2003; 47:575-98. [PMID: 12848466 DOI: 10.1016/s0011-8532(03)00023-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
An association between periodontal infection and CVD has been revealed in some epidemiologic studies, whereas other studies were unable to demonstrate such an association. A link between the two diseases may be explained by shared established or nonestablished risk factors. Future studies with extended control of confounding factors and intervention studies may add to the understanding of a possible relationship between the diseases. In some cases, IE is caused by dental plaque bacteria. Several studies are suggestive of oral bacteria causing respiratory infection. The pathogenesis and course of a number of other diseases including DM and rheumatoid arthritis have been associated wish periodontitis, but more research is necessary to elucidate possible pathogenic interactions.
Collapse
Affiliation(s)
- Palle Holmstrup
- Department of Periodontology, School of Dentistry, University of Copenhagen, 20 Nørre Allé DK-2200, Copenhagen, Denmark.
| | | | | | | | | |
Collapse
|
17
|
Fine DH, Tofsky N, Nelson EM, Schoen D, Barasch A. Clinical implications of the oral manifestations of HIV infection in children. Dent Clin North Am 2003; 47:159-74, xi-xii. [PMID: 12519012 DOI: 10.1016/s0011-8532(02)00057-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The authors hypothesized that patients infected with HIV at birth would be more vulnerable to oral diseases such as periodontal disease and caries because of their compromised immune system. As a result, they designed a 3-year, longitudinal, case-controlled study that examined HIV-infected children as compared with their normal noninfected household peers. Over 100 HIV-infected participants ages 2 to 15 years were examined at 6-month intervals; no differences were found with respect to caries or periodontal disease prevalence and incidence when the two groups were compared. Although the level of oral disease was similar in the two groups, both groups had more caries than the national norm. Thus, failure to use a control group would have led to the erroneous conclusion that children with HIV infection had a high level of caries. In addition, the authors discovered that tooth eruption was delayed in the HIV-infected group, suggesting some developmental impediment. The HIV-infected group also showed more oral lesions that included candidiasis, linear gingival erythema, and medial rhomboid glossitis. Overall, oral lesions were not valid predictors of the serious consequences of AIDS. The authors speculated, however, that examinations at intervals more frequent than every 6 months might be required to determine whether oral lesions can predict frank AIDS and lowered CD4 cell counts.
Collapse
Affiliation(s)
- Daniel H Fine
- Dental Research Center, University of Medicine and Dentistry of New Jersey, New Jersey Dental School, Health Sciences Building, Room C-636, 185 South Orange Avenue, Newark, NJ 07103, USA.
| | | | | | | | | |
Collapse
|