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Cheng RHW, Wang M, Tong WM, Gao W, Watt RM, Leung WK. Subgingival microbial changes in Down Syndrome adults with periodontitis after chlorhexidine adjunct non-surgical therapy and monthly recalls-A 12-month case series study. J Dent 2024; 143:104907. [PMID: 38428718 DOI: 10.1016/j.jdent.2024.104907] [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] [Received: 01/07/2024] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVES Down Syndrome (DS) adults are at risk for periodontitis. Previous reports indicated difficulties in periodontopathogen reduction or eradication in DS individuals after periodontal treatment. This case series follows the subgingival microbial changes in adult DS individuals with periodontitis who received chlorhexidine adjunct non-surgical therapy plus 12-month recalls. METHODS Twenty periodontitis DS participants (7 females; 25.5 ± 5.6 years of age; 3 with generalized periodontitis) partook in a study involving non-surgical mechanical periodontal therapy, twice daily chlorhexidine gel toothbrushing, chlorhexidine mouthwash, and monthly recalls. The subgingival microbiota profile was followed at baseline, 6-, and 12-months post-operation. RESULTS Desulfobulbus, Saccharibacteria (TM7), Tannerella, and Porphyromonas were the major subgingival genera in this DS cohort. Favorable chlorhexidine adjunct non-surgical treatment outcomes were observed, with the relative abundance of Desulfobulbus sp. HMT 041, Saccharibacteria (TM7) [G-1] bacterium HMT 346 or 349, and Tannerella forsythia significantly reduced at the end of the study, but no significant reduction of Porphyromonas gingivalis or Aggregatibacter actinomycetemcomitans could be observed. Relative abundance of Desulfobulbus sp. HMT 041 and T. forsythia were also found to be significantly associated with plaque, bleeding on probing, and probing pocket depth (PPD, in mm) at a site level, while the relative abundance of Halomonas pacifica was negatively associated with PPD. CONCLUSIONS Successful chlorhexidine adjunct non-surgical treatment with hygiene care was accompanied by a subgingival microbial shift involving certain periodontopathogenic species, except P. gingivalis and A. actinomycetemcomitans. Further investigations are required to clarify the mechanism underpinning the unchanged relative abundance of the above two pathogens despite favorable clinical responses. CLINICAL SIGNIFICANCE DS adults face challenges achieving optimal home care or hygiene for periodontal healing and disease prevention. Chemical adjunct mechanical periodontal therapy plus regular recalls appeared promising clinically and microbiologically, with subgingival periodontopathogenic species reduction. The persistence of A. actinomycetemcomitans and P. gingivalis in subgingival niches post-treatment warrants further investigation.
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Affiliation(s)
- Ronald H W Cheng
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Miao Wang
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Wai Man Tong
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Wenling Gao
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Rory M Watt
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Wai Keung Leung
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China.
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Aloufi A, Abed H, Andreasson S, Newton T. Oral health characteristics of patients living with intellectual disability at transition phase from pediatric dental service to adult dental service: A systematic review. SPECIAL CARE IN DENTISTRY 2022. [PMID: 36164677 DOI: 10.1111/scd.12786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/22/2022] [Accepted: 09/12/2022] [Indexed: 11/25/2022]
Abstract
AIM A systematic review was conducted to evaluate the available literature to ascertain the oral health characteristics of patients living with intellectual disability when they transfer from pediatric dental service to adult dental service. MATERIAL AND METHODS The electronic search was performed between June 2020 and July 2020 using the following databases: MEDLINE and EMBASE. Cochrane database, gray literature, and Google Scholar were also searched. References of articles obtained from the electronic searches were scanned through. Journals and regulation agency websites were also hand searched. This systematic review used a defined search strategy keywords for all the electronic databases. The strength of evidence in these studies was evaluated using the British Medical Journal quality assessment tool. RESULTS The search process identified 45 eligible articles. Of these, 35 studies were excluded, and 10 observational studies were included. CONCLUSION It seems that a considerable percentage of patients living with intellectual disability in their transition phase, aged between 18 and 25 years, have a high prevalence of dental caries, gingivitis, and periodontal disease when compared to the general population.
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Affiliation(s)
| | - Hassan Abed
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Sam Andreasson
- Department of Sedation and Special Care Dentistry, Guy's and St Thomas' Foundation Trust, London, UK
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3
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Oral Microbiota Features in Subjects with Down Syndrome and Periodontal Diseases: A Systematic Review. Int J Mol Sci 2021; 22:ijms22179251. [PMID: 34502159 PMCID: PMC8431440 DOI: 10.3390/ijms22179251] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 12/11/2022] Open
Abstract
Down syndrome (DS) is a genetic disorder associated with early-onset periodontitis and other periodontal diseases (PDs). The present work aimed to systematically review the scientific literature reporting studies in vivo on oral microbiota features in subjects with DS and related periodontal health and to highlight any correlation and difference with subjects not affected by DS, with and without PDs. PubMed, Web of Science, Scopus and Cochrane were searched for relevant studies in May 2021. The participants were subjects affected by Down syndrome (DS) with and without periodontal diseases; the study compared subjects with periodontal diseases but not affected by DS, and DS without periodontal diseases; the outcomes were the differences in oral microbiota/periodontopathogen bacterial composition among subjects considered; the study design was a systematic review. Study quality was assessed with risk of bias in non-randomized studies of interventions (ROBINS-I). Of the 954 references retrieved, 26 studies were considered. The conclusions from the qualitative assessment of the papers revealed an increasing knowledge over the last years of the microbiota associated with DS and their periodontal diseases, in comparison with healthy subjects and subjects with other kinds of mental disabilities. Few data have emerged on the mycobiome and virobiome of DS, hence, further investigations are still necessary.
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Willis JR, Iraola-Guzmán S, Saus E, Ksiezopolska E, Cozzuto L, Bejarano LA, Andreu-Somavilla N, Alloza-Trabado M, Puig-Sola A, Blanco A, Broglio E, Carolis C, Hecht J, Ponomarenko J, Gabaldón T. Oral microbiome in down syndrome and its implications on oral health. J Oral Microbiol 2020; 13:1865690. [PMID: 33456723 PMCID: PMC7782466 DOI: 10.1080/20002297.2020.1865690] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Introduction: The oral cavity harbors an abundant and diverse microbial community (i.e. the microbiome), whose composition and roles in health and disease have been the focus of intense research. Down syndrome (DS) is associated with particular characteristics in the oral cavity, and with a lower incidence of caries and higher incidence of periodontitis and gingivitis compared to control populations. However, the overall composition of the oral microbiome in DS and how it varies with diverse factors like host age or the pH within the mouth are still poorly understood. Methods: Using a Citizen-Science approach in collaboration with DS associations in Spain, we performed 16S rRNA metabarcoding and high-throughput sequencing, combined with culture and proteomics-based identification of fungi to survey the bacterial and fungal oral microbiome in 27 DS persons (age range 7–55) and control samples matched by geographical distribution, age range, and gender. Results: We found that DS is associated with low salivary pH and less diverse oral microbiomes, which were characterized by lower levels of Alloprevotella, Atopobium, Candidatus Saccharimonas, and higher amounts of Kingella, Staphylococcus, Gemella, Cardiobacterium, Rothia, Actinobacillus, and greater prevalence of Candida. Conclusion: Altogether, our study provides a first global snapshot of the oral microbiome in DS. Future studies are required to establish whether the observed differences are related to differential pathology in the oral cavity in DS.
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Affiliation(s)
- Jesse R Willis
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain.,Barcelona Supercomputing Centre (BSC-CNS) and Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Susana Iraola-Guzmán
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain.,Barcelona Supercomputing Centre (BSC-CNS) and Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Ester Saus
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain.,Barcelona Supercomputing Centre (BSC-CNS) and Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Ewa Ksiezopolska
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain.,Barcelona Supercomputing Centre (BSC-CNS) and Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Luca Cozzuto
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Luis A Bejarano
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Nuria Andreu-Somavilla
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Miriam Alloza-Trabado
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Anna Puig-Sola
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Andrea Blanco
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Elisabetta Broglio
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Carlo Carolis
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Jochen Hecht
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Julia Ponomarenko
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Toni Gabaldón
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain.,Barcelona Supercomputing Centre (BSC-CNS) and Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
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5
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Nuernberg MAA, Ivanaga CA, Haas AN, Aranega AM, Casarin RCV, Caminaga RMS, Garcia VG, Theodoro LH. Periodontal status of individuals with Down syndrome: sociodemographic, behavioural and family perception influence. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:1181-1192. [PMID: 31062454 DOI: 10.1111/jir.12629] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 03/09/2019] [Accepted: 03/26/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The aim of the present study was to assess the periodontal condition of individuals with Down syndrome and the association with sociodemographic and behavioural characteristics and family perception of oral health. METHODS This cross-sectional observational study was performed at a referral centre for dental assistance to disabled persons in Araçatuba, Brazil. Parents of the individuals were interviewed, and the visible plaque index, bleeding on probing, probing pocket depth and clinical attachment level were recorded by one periodontist in six sites per tooth of all teeth. The individual was the unit of analysis. The significance level was set at 5%. RESULTS Sixty-four subjects (23.8 ± 8.3 years old) were included. Eighteen (28.1%) were diagnosed with gingivitis and 46 (71.9%) with periodontitis. In the multiple logistic regression final model, age and self-reported oral hygiene practices were associated with the occurrence of periodontitis. The chance of having periodontitis was 4.7 times higher among individuals older than 20 years and approximately 4 times higher in patients whose oral hygiene was performed by themselves and their parents, compared with those who performed oral hygiene alone. Sex, follow-up time in the centre, education, degree of participants' dependence, flossing and family history of periodontal disease were not associated with the occurrence of periodontitis. Higher levels of plaque and bleeding were observed for participants with parents reporting bad gingival health (76.2% and 46.9%) and deficient oral hygiene (79.5% and 47.3%). The perception of parents regarding gingival bleeding was correlated with higher bleeding detected clinically (P = 0.01; 50.1%). CONCLUSIONS The prevalence of periodontitis in individuals with Down syndrome is high and increases with age, even in the face of the parents' perception about their children's oral condition.
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Affiliation(s)
- M A A Nuernberg
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - C A Ivanaga
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - A N Haas
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - A M Aranega
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - R C V Casarin
- Department of Prosthodontics and Periodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil
| | - R M S Caminaga
- Department of Morphology, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - V G Garcia
- Post Graduate Program, Latin American Institute of Dental Research and Education (ILAPEO), Curitiba, Brazil
| | - L H Theodoro
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
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Domingues NB, Mariusso MR, Tanaka MH, Scarel-Caminaga RM, Mayer MPA, Brighenti FL, Zuanon ÂCC, Ibuki FK, Nogueira FN, Giro EMA. Reduced salivary flow rate and high levels of oxidative stress in whole saliva of children with Down syndrome. SPECIAL CARE IN DENTISTRY 2017; 37:269-276. [PMID: 29231976 DOI: 10.1111/scd.12258] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
AIM To investigate salivary parameters between children with Down Syndrome (DS) and without DS. MATERIALS AND METHODS Stimulated whole saliva was collected from 18 children with DS and 23 without DS. Salivary flow rate, pH, and salivary buffering capacity were determined. Cariogenic microorganisms were quantified by culture, and periodontopathogens by quantitative real-time polymerase chain reaction. The antioxidant profile was quantified spectrophotometrically, while malondialdehyde (MDA) was quantified by high-performance liquid chromatography. Data were analyzed by Mann-Whitney test and Spearman correlation (α = 0.05). RESULTS Salivary flow rate was significantly lower in DS than in controls (p < 0.0001). Significant higher difference was observed for total protein dosage (p < 0.0001), superoxide dismutase activity (SOD) (p = 0.0002), and MDA (p < 0.001) in DS group. CONCLUSIONS Reduced salivary flow rate might be an important factor in oral diseases development. High salivary levels of SOD and MDA show the significant influence of the oxidative stress and the early-onset periodontal disease in DS people.
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Affiliation(s)
- Natália Bertolo Domingues
- Department of Orthodontics and Pediatric Dentistry, Araraquara Dental School, Universidade Estadual Paulista, UNESP, Araraquara, São Paulo, Brazil
| | - Matheus Racy Mariusso
- Department of Orthodontics and Pediatric Dentistry, Araraquara Dental School, Universidade Estadual Paulista, UNESP, Araraquara, São Paulo, Brazil
| | - Marcia Hiromi Tanaka
- Department of Microbiology, Institute of Science and Technology of São José dos Campos, Universidade Estadual Paulista, UNESP, São José dos Campos, São Paulo, Brazil
| | | | - Marcia Pinto Alves Mayer
- Department of Microbiology, Institute of Biomedical Sciences, Universidade de São Paulo, USP, São Paulo, São Paulo, Brazil
| | - Fernanda Lourenção Brighenti
- Department of Orthodontics and Pediatric Dentistry, Araraquara Dental School, Universidade Estadual Paulista, UNESP, Araraquara, São Paulo, Brazil
| | - Ângela Cristina Cilense Zuanon
- Department of Orthodontics and Pediatric Dentistry, Araraquara Dental School, Universidade Estadual Paulista, UNESP, Araraquara, São Paulo, Brazil
| | - Flávia Kazue Ibuki
- Department of Biomaterials and Oral Biology, Universidade de São Paulo, USP, São Paulo, São Paulo, Brazil
| | - Fernando Neves Nogueira
- Department of Biomaterials and Oral Biology, Universidade de São Paulo, USP, São Paulo, São Paulo, Brazil
| | - Elisa Maria Aparecida Giro
- Department of Orthodontics and Pediatric Dentistry, Araraquara Dental School, Universidade Estadual Paulista, UNESP, Araraquara, São Paulo, Brazil
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Altintas NY, Kilic S, Altintas SH. Oral Rehabilitation with Implant-Retained Overdenture in a Patient with Down Syndrome. J Prosthodont 2017; 28:e617-e621. [PMID: 28118519 DOI: 10.1111/jopr.12596] [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] [Accepted: 12/01/2016] [Indexed: 11/30/2022] Open
Abstract
Down syndrome, known as trisomy 21, is the most common chromosomal disorder. The disorder affects mental and systemic development as well as oral structure, including dental anomalies, high susceptibility of periodontal disease, and poor quality of alveolar bone. This report presents a case of dental rehabilitation by means of dental implants of a patient with Down syndrome. Two titanium dental implants were placed in the maxilla, and three titanium dental implants were installed in the mandible. One implant was lost during the osseointegration period. The prosthetic rehabilitation was performed with implant-retained maxillary and mandibular overdentures with the Locator attachment system. After a 2-year follow-up period, the patient was doing well, and all implants were clinically stable with no signs of bone loss or inflammation. The present study emphasizes that implant-retained overdentures with Locator attachment system could be a therapeutic option even for patients with Down syndrome. This therapy prevents crestal bone loss around the implants, improves functional and esthetic outcomes, and provides optimum oral hygiene for patients with mild mental impairment. Careful patient selection and education of patients and caregivers are essential considerations for a successful and safe treatment with dental implants in Down syndrome patients.
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Affiliation(s)
- Nuray Yilmaz Altintas
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | | | - Subutay Han Altintas
- Department of Prosthodontics, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
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8
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Ferreira R, Michel RC, Greghi SLA, de Resende MLR, Sant’Ana ACP, Damante CA, Zangrando MSR. Prevention and Periodontal Treatment in Down Syndrome Patients: A Systematic Review. PLoS One 2016; 11:e0158339. [PMID: 27355338 PMCID: PMC4927059 DOI: 10.1371/journal.pone.0158339] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 06/14/2016] [Indexed: 11/18/2022] Open
Abstract
The aim of this systematic literature review was to evaluate which type of periodontal preventive and therapeutic approaches presents superior outcomes in patients with Down syndrome (DS). Studies reporting different methods of periodontal care from DS patients were considered eligible. Included clinical studies should indicate at least two periodontal parameters in different periods of assessment. Screening of the articles, data extraction and quality assessment were conducted independently and in duplicate. Electronic search according to the PICO search, with both Key-words and MESH terms were conducted in MEDLINE, EMBASE and CENTRAL databases until March 2016. Manual search was conducted in four journals, namely Journal of Periodontology, Journal of Clinical Periodontology, Journal of Periodontal Research and Special Care in Dentistry and their electronic databases were searched. Electronic and manual search resulted in 763 papers, and of them 744 were excluded after title/abstract assessment. The full text of 19 potentially eligible publications was screened and 9 studies met inclusion criteria. The results demonstrated the importance to introduce youngest DS patients in preventive programs, as well as participation of parents, caregivers or institutional attendants in supervising/performing oral hygiene. In studies with higher frequency of attendance, all age groups presented superior preventive and therapeutic results, irrespective of the therapeutic approach used (surgical/nonsurgical/periodontal care program). The important factors for reducing periodontal parameters were the frequency of the appointments and association with chlorhexidine/plaque disclosing agents as adjuvant treatment. This systematic review demonstrated that early introduction in periodontal care, participation of parents/caregivers/institutional attendants, frequency of attendance and association with chemical adjuvants (independently of the periodontal treatment adopted) seems to improve periodontal outcomes in preventive and periodontal treatment of DS patients. Registration number (Prospero): CRD42016038433.
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Affiliation(s)
- Rafael Ferreira
- Division of Periodontics, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Raphaella Coelho Michel
- Division of Periodontics, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Sebastião Luiz Aguiar Greghi
- Division of Periodontics, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Maria Lúcia Rubo de Resende
- Division of Periodontics, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | | | - Carla Andreotti Damante
- Division of Periodontics, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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9
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Ahmed N, Parthasarathy H, Arshad M, Victor DJ, Mathew D, Sankari S. Assessment of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in Down's syndrome subjects and systemically healthy subjects: A comparative clinical trial. J Indian Soc Periodontol 2015; 18:728-33. [PMID: 25624629 PMCID: PMC4296457 DOI: 10.4103/0972-124x.147408] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 04/09/2014] [Indexed: 12/02/2022] Open
Abstract
Objectives: To compare and quantify the presence of periodontal pathogens Aggregatibacter actinomycetemcomitans (Aac) and Porphyromonas gingivalis (Pg) in Down's syndrome (DS) and systemically healthy subjects with periodontitis and gingivitis. Materials and Methods: Fifty-nine age-matched subjects were categorized into four groups; Group I: DS subjects with gingivitis, Group II: DS subjects with periodontitis, Group III: Systemically healthy subjects with gingivitis and Group IV: Systemically healthy subjects with periodontitis. Plaque samples from all the four groups were collected and analyzed to evaluate the presence of Aac and Pg using real time polymerase chain reaction. The indices used were oral hygiene index simplified, community periodontal index for treatment needs and plaque index. Results: This study showed a statistically significant detection in the levels of both Aac (<0.001) and Pg (<0.001) in DS subjects with periodontitis when compared with the healthy controls with periodontitis; moreover, there was a statistically significant increase in Pg levels compared to Aac in DS gingivitis group. Conclusion: There was a statistically significant presence of Pg and Aac in both DS gingivitis and DS periodontitis over control groups with increased levels of Pg compared with Aac in DS gingivitis group.
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Affiliation(s)
- Nizar Ahmed
- Department of Periodontics, Thai Moogambigai Dental College, Chennai, Tamil Nadu, India
| | | | - Mohamed Arshad
- Department of Periodontics, Thai Moogambigai Dental College, Chennai, Tamil Nadu, India
| | - Dhayanand John Victor
- Department of Periodontics, Thai Moogambigai Dental College, Chennai, Tamil Nadu, India
| | - Danny Mathew
- Department of Periodontics, Thai Moogambigai Dental College, Chennai, Tamil Nadu, India
| | - Siva Sankari
- Department of Periodontics, Thai Moogambigai Dental College, Chennai, Tamil Nadu, India
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Norderyd J, Lillvist A, Klingberg G, Faulks D, Granlund M. Oral health, medical diagnoses, and functioning profiles in children with disabilities receiving paediatric specialist dental care – a study using the ICF-CY. Disabil Rehabil 2014; 37:1431-8. [DOI: 10.3109/09638288.2014.964374] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Zizzi A, Piemontese M, Gesuita R, Nori A, Berlin RS, Rocchetti R, Carle F, Rubini C, Aspriello SD. Periodontal status in the Down's syndrome subjects living in central-eastern Italy: the effects of place of living. Int J Dent Hyg 2013; 12:193-8. [DOI: 10.1111/idh.12062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2013] [Indexed: 12/13/2022]
Affiliation(s)
- A Zizzi
- Department of Biomedical Sciences and Public Health; Section of Pathologic Anatomy and Histopathology; Polytechnic University of Marche; Ancona Italy
| | - M Piemontese
- Department of Clinical Special and Dental Science, Periodontology; Polytechnic University of Marche; Ancona Italy
| | - R Gesuita
- Centre of Epidemiology; Biostatistic and Medical Statistics; Polytechnic University of Marche; Ancona Italy
| | - A Nori
- SOD of Odontostomatological and Special Surgery; United Hospital of Ancona; Ancona Italy
| | - RS Berlin
- SOD of Odontostomatological and Special Surgery; United Hospital of Ancona; Ancona Italy
| | - R Rocchetti
- Department of Biomedical Sciences and Public Health; Section of Pathologic Anatomy and Histopathology; Polytechnic University of Marche; Ancona Italy
| | - F Carle
- Centre of Epidemiology; Biostatistic and Medical Statistics; Polytechnic University of Marche; Ancona Italy
| | - C Rubini
- Department of Biomedical Sciences and Public Health; Section of Pathologic Anatomy and Histopathology; Polytechnic University of Marche; Ancona Italy
| | - SD Aspriello
- Department of Clinical Special and Dental Science, Periodontology; Polytechnic University of Marche; Ancona Italy
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Cavalcante LB, Tanaka MH, Pires JR, Henrique Apponi L, Aparecida Giro EM, Roberto Valentini S, Palomari Spolidório DM, Capela MV, Rossa C, Scarel-Caminaga RM. Expression of the Interleukin-10 Signaling Pathway Genes in Individuals With Down Syndrome and Periodontitis. J Periodontol 2012; 83:926-35. [DOI: 10.1902/jop.2011.110056] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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13
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Khocht A, Yaskell T, Janal M, Turner BF, Rams TE, Haffajee AD, Socransky SS. Subgingival microbiota in adult Down syndrome periodontitis. J Periodontal Res 2012; 47:500-7. [PMID: 22221039 DOI: 10.1111/j.1600-0765.2011.01459.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVE The subgingival microbiota in Down syndrome and non-Down syndrome adults receiving periodic dental care was examined for 40 bacterial species using checkerboard DNA-DNA hybridization and the results were related to clinical periodontal attachment loss. MATERIAL AND METHODS A total of 44 Down syndrome, 66 non-Down syndrome mentally retarded and 83 mentally normal adults were clinically evaluated. This involved, for each subject, the removal of subgingival specimens from three interproximal sites on different teeth; all subgingival samples per subject were then pooled and assessed for the presence and levels of 40 bacterial species using species-specific whole-genomic DNA probes and checkerboard DNA-DNA hybridization. Significant group differences in species proportions averaged across subjects were evaluated using the Kruskal-Wallis test, and associations between subgingival species and mean subject attachment loss within Down syndrome and non-Down syndrome subject groups were quantified using Pearson correlation and multiple linear regression analysis. RESULTS Down syndrome subjects exhibited greater attachment loss than non-Down syndrome subjects (p=0.05). Most microbial species were present in Down syndrome subjects at levels similar to non-Down syndrome subjects, except for higher proportions of Selenomonas noxia, Propionibacterium acnes, Streptococcus gordonii, Streptococcus mitis and Streptococcus oralis in Down syndrome subjects compared with non-Down syndrome study subjects, higher proportions of Treponema socranskii in Down syndrome subjects compared with non-Down syndrome mentally retarded subjects, and higher proportions of Streptococcus constellatus in Down syndrome subjects compared with mentally normal subjects. Down syndrome adults classified with periodontitis revealed higher subgingival levels of T. socranskii than Down syndrome subjects with no periodontitis (p=0.02). Higher subgingival proportions of S. constellatus, Fusobacterium nucleatum ssp. nucleatum, S. noxia and Prevotella nigrescens showed significant positive correlations (r=0.35-0.42) and higher proportions of Actinomyces naeslundii II and Actinomyces odontolyticus showed negative correlations (r=-0.36 to -0.40), with increasing mean subject attachment loss in Down syndrome adults. CONCLUSION Individuals with Down syndrome show higher levels of some subgingival bacterial species and specific associations between certain subgingival bacterial species and loss of periodontal attachment. These findings are consistent with the notion that certain subgingival bacteria may contribute to the increased level of periodontal disease seen in Down syndrome individuals and raise the question as to the reason for increased colonization in Down syndrome.
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Affiliation(s)
- A Khocht
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA 19140, USA.
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Khocht A, Janal M, Turner B. Periodontal health in Down syndrome: Contributions of mental disability, personal, and professional dental care. SPECIAL CARE IN DENTISTRY 2010; 30:118-23. [DOI: 10.1111/j.1754-4505.2010.00134.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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FAULKS D, COLLADO V, MAZILLE MN, VEYRUNE JL, HENNEQUIN M. Masticatory dysfunction in persons with Down’s syndrome. Part 1: aetiology and incidence. J Oral Rehabil 2008; 35:854-62. [DOI: 10.1111/j.1365-2842.2008.01877.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Etiologic factors of early-onset periodontal disease in Down syndrome. JAPANESE DENTAL SCIENCE REVIEW 2008. [DOI: 10.1016/j.jdsr.2008.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Oliveira AC, Czeresnia D, Paiva SM, Campos MR, Ferreira EF. Uso de serviços odontológicos por pacientes com síndrome de Down. Rev Saude Publica 2008; 42:693-9. [DOI: 10.1590/s0034-89102008000400016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Accepted: 03/10/2008] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Tendo como perspectiva a prática da integralidade, o objetivo do estudo foi analisar os fatores relacionados à atenção odontológica recebida por crianças e adolescentes com síndrome de Down. MÉTODOS: Foi realizado um estudo transversal com 112 pares de mães com filhos sindrômicos de 3 a 18 anos, recrutados em ambulatório de genética de um hospital público, sem atendimento odontológico local, no Rio de Janeiro (RJ), 2006. Os dados foram coletados por meio de um questionário aplicado às mães e do exame bucal dos filhos. Para análise dos dados utilizou-se a regressão logística múltipla. Analisou-se a "atenção odontológica da criança ou adolescente com síndrome de Down", em função de características demográficas, socioeconômicas e comportamentais. RESULTADOS: A maioria dos sindrômicos (79,5%) já tinha ido pelo menos uma vez ao dentista (IC 90%: 72,3; 87,8). A experiência odontológica das crianças foi associada às variáveis: mães que afirmaram receber orientação de algum profissional, que assiste seu filho, para que o levasse ao dentista (OR=6,1 [2,5; 15,1]), crianças/adolescentes com história prévia de cirurgia (OR=2,5 [0,9; 7,1]) e idade entre 12 e 18 anos (OR=13,1 [2,0; 86,9]). CONCLUSÕES: A atenção odontológica recebida pelas crianças e adolescentes com síndrome de Down foi relacionada à orientação dos profissionais de saúde que os assistem, caracterizando um atendimento integral por parte da equipe de saúde.
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Reuland-Bosma W, Van Der Reijden WA, Van Winkelhoff AJ. Absence of a specific subgingival microflora in adults with Down’s syndrome. J Clin Periodontol 2008. [DOI: 10.1111/j.1600-051x.2001.281103.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Cheng RH, Leung WK, Corbet EF. Non-Surgical Periodontal Therapy With Adjunctive Chlorhexidine Use in Adults With Down Syndrome: A Prospective Case Series. J Periodontol 2008; 79:379-85. [DOI: 10.1902/jop.2008.070247] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Morgan J. Why is periodontal disease more prevalent and more severe in people with Down syndrome? SPECIAL CARE IN DENTISTRY 2007; 27:196-201. [PMID: 17990479 DOI: 10.1111/j.1754-4505.2007.tb00346.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Periodontal disease has been found to be significantly more prevalent and more severe in people with Down syndrome. A series of studies have reported a prevalence of between 58% and 96% for persons younger than 35 years of age. This phenomenon cannot simply be attributed to poor oral hygiene. The etiology of periodontal disease in persons with Down syndrome is complex. In recent years, much focus has been placed on the altered immune response resulting from the underlying genetic disorder. This paper presents an overview of contemporary knowledge on periodontal disease in patients with Down syndrome.
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Zigmond M, Stabholz A, Shapira J, Bachrach G, Chaushu G, Becker A, Yefenof E, Merrick J, Chaushu S. The outcome of a preventive dental care programme on the prevalence of localized aggressive periodontitis in Down's syndrome individuals. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2006; 50:492-500. [PMID: 16774634 DOI: 10.1111/j.1365-2788.2006.00794.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Periodontal disease in Down's syndrome (DS) individuals develops earlier and is more rapid and extensive than in age-matched normal individuals. The present study evaluated a group of DS patients, who had been participating in a 10-year preventive dental programme, for the impact of the programme on their periodontal status. METHODS Thirty DS patients (mean age 23.3 +/- 4 years) were compared with 28 age-matched healthy controls (mean age 22.8 +/- 5 years). The hygiene level, gingival condition and periodontal status (periodontal probing depth, clinical attachment level and radiographic alveolar bone loss) were determined. RESULTS In spite of similar oral hygiene and gingival measures, DS patients, as opposed to the control ones, had a severe periodontal disease. The prevalence, extent and severity of periodontitis in the DS group were significantly greater than in the control group. The teeth most commonly and severely affected were the lower central incisors and the upper first molars. DS patients lost significantly more teeth due to periodontitis. CONCLUSIONS The clinical and radiographic picture found in the present DS group is characteristic of localized aggressive periodontitis. Within the limitations of this study, it seems that the preventive dental programme had no effect on periodontal destruction progression of localized aggressive periodontitis in DS individuals and that impaired oral hygiene plays a relatively minor role in the pathogenesis of this disease. Future controlled studies are needed to assess the effectiveness of different preventive dental programmes in preventing the progression of periodontitis in DS patients.
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Affiliation(s)
- M Zigmond
- Hadassah School of Dental Medicine, Institute of Dental Sciences, Hebrew University, Jerusalem, Israel.
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22
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Abstract
Periodontal diseases are chronic inflammatory disorders encompassing destructive and nondestructive diseases of the periodontal supporting tissues of teeth. Gingivitis is a nondestructive disease ubiquitous in populations of children and adults globally. Aggressive periodontitis is characterized by severe and rapid loss of periodontal attachment often commencing at or after the circumpubertal age and is more prevalent among Latin Americans and subjects of African descent, and least common among Caucasians. Chronic periodontitis is a common disease and may occur in most age groups, but is most prevalent among adults and seniors world-wide. Approximately 48% of United States adults have chronic periodontitis, and similar or higher rates have been reported in other populations. Moderate and advanced periodontitis is more prevalent among the older age groups, and rates of 70% or more have been reported in certain populations. Chronic and aggressive periodontitis are multifactorial diseases caused primarily by dental plaque microorganisms, and with important modifying effects from other local and systemic factors. The study of the significance of demographic, environmental, and biologic variables is important for risk assessment and the control of periodontal diseases.
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Affiliation(s)
- Jasim M Albandar
- Department of Periodontology, Temple University School of Dentistry, 3223 North Broad Street, Philadelphia, PA 19140, USA.
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Yoshihara T, Morinushi T, Kinjyo S, Yamasaki Y. Effect of periodic preventive care on the progression of periodontal disease in young adults with Down's syndrome. J Clin Periodontol 2005; 32:556-60. [PMID: 15882211 DOI: 10.1111/j.1600-051x.2005.00712.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine the effect of periodic preventive care on the progression of periodontal disease in 24 young adults with Down's syndrome (DS) (mean age+/-SD: 20.8+/-5.6 years) MATERIAL AND METHODS Subjects were divided into two groups: 13 subjects who had frequently visited our clinic (mean interval between visits: 3.7+/-1.3 months; managed group) and 11 subjects who had not visited our clinic for more than 1 year (mean duration of no visits: 27.5+/-10.1 months; interrupted group). The progression of periodontal disease in the subjects was evaluated clinically, microbiologically and roentgenologically. RESULTS Clinical parameters (probing depth, frequency of the presence of a pathological periodontal pocket, alveolar bone loss, frequency of the incidence of pathological bone loss, and modified total PMA (M-PMA)) and benzoyl-DL-arginine-naphthylamide (BANA) scores in the interrupted group were significantly higher than those in the managed group. Subject age showed significant positive correlations with probing depth and alveolar bone loss. BANA scores showed significant positive correlations with probing depth, alveolar bone loss and M-PMA in the interrupted group. CONCLUSIONS The results suggest that periodic preventive care is effective for suppressing the progression of periodontal disease in young adults with DS.
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Affiliation(s)
- Toshihiro Yoshihara
- Department of Pediatric Dentistry, School of Dentistry, Kagoshima University, Kagoshima 890-8544, Japan.
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Sakellari D, Arapostathis KN, Konstantinidis A. Periodontal conditions and subgingival microflora in Down syndrome patients. A case-control study. J Clin Periodontol 2005; 32:684-90. [PMID: 15882231 DOI: 10.1111/j.1600-051x.2005.00737.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The periodontal conditions and the subgingival microflora of children, adolescents and young adults (8-28 years old) with Down syndrome were investigated in the present cross-sectional study and compared with those of healthy individuals and subjects with cerebral palsy. MATERIAL AND METHODS Seventy Down syndrome patients, 121 age-matched healthy individuals and 76 patients with cerebral palsy participated in the present study. Full-mouth recordings of clinical parameters (probing depth, probing attachment level, bleeding on probing, hygiene index) and the community periodontal index of treatment needs were assessed and subgingival plaque samples were taken from the Ramfjord teeth and analysed for 14 species using "checkerboard" DNA-DNA hybridization. RESULTS Clinical indices of periodontal inflammation and treatment needs were statistically significant higher among Down syndrome patients compared with the other two groups (ANOVA, p=0.000). Important periodontal pathogens colonize these subjects earlier and at higher levels (chi-squared test, p=0.000). DISCUSSION Down syndrome patients display more severe periodontal destruction earlier, and heavier colonization with periodontal pathogens compared with age-matched healthy individuals and patients with cerebral palsy.
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Affiliation(s)
- D Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Greece.
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25
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Sasaki Y, Sumi Y, Miyazaki Y, Hamachi T, Nakata M. Periodontal management of an adolescent with Down's syndrome--a case report. Int J Paediatr Dent 2004; 14:127-35. [PMID: 15005701 DOI: 10.1111/j.1365-263x.2004.00529.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A case of periodontitis in a young adolescent Japanese girl with Down's syndrome is presented in this report. The patient received a monthly preventive course of dental care consisting of mechanical plaque control and oral hygiene instruction. After 2.5 years she recovered from progression of periodontal disease both clinically and microbiologically. The importance of clinical care for periodontitis in Down's syndrome patients is discussed.
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Affiliation(s)
- Y Sasaki
- Section of Pediatric Dentistry and Section of Preventive Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka 812-8582, Japan.
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López-Pérez R, Borges-Yáñez SA, Jiménez-García G, Maupomé G. Oral hygiene, gingivitis, and periodontitis in persons with Down syndrome. SPECIAL CARE IN DENTISTRY 2002; 22:214-20. [PMID: 12790229 DOI: 10.1111/j.1754-4505.2002.tb00274.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study was conducted to determine and compare the prevalence, severity, and extent of gingivitis and periodontitis in patients with Down syndrome and patients who did not have Down syndrome. The authors also assessed the relationship of these conditions and compared them to the age, gender, and oral hygiene profiles in both groups. Using a case-control study design, the authors examined 32 individuals with Down syndrome (DS) and matched each with a participant from the control group (CG) according to age and gender. Researchers determined the Simplified Oral Hygiene Index, Gingival Index, and measured the level of gingival attachment for each participant. The authors found that the relationship between the presence of dental plaque and the severity of gingivitis was moderate among participants with DS. While the overall characteristics of the periodontal and gingival health status were not markedly different between the two groups, the extent and severity of gingivitis and the extent of periodontitis were greater in the group with DS than in the CG.
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Affiliation(s)
- Rubén López-Pérez
- Department of Dental Public Health, Dental School, Universidad Nacional Autónoma de México, D.F., México.
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Sakellari D, Belibasakis G, Chadjipadelis T, Arapostathis K, Konstantinidis A. Supragingival and subgingival microbiota of adult patients with Down's syndrome. Changes after periodontal treatment. ORAL MICROBIOLOGY AND IMMUNOLOGY 2001; 16:376-82. [PMID: 11737662 DOI: 10.1034/j.1399-302x.2001.160610.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In this longitudinal study, five adult Down's syndrome patients with periodontitis were placed on a frequent recall visit schedule (every 6 weeks) after treatment, in order to investigate: 1) the microbiological status, both supragingivally and subgingivally, and the changes that occurred after treatment and 2) the effect of frequent professional supragingival plaque control on the subgingival microbiota and clinical variables in these patients. The clinical variables recorded were probing pocket depth, probing attachment level, bleeding on probing and presence of plaque (full mouth, six surfaces per tooth). Microbiological examination was performed separately for supragingival and subgingival samples from the same site for 14 species, using whole genomic DNA probes and the "checkerboard" DNA-DNA hybridization technique. The findings indicate that, although a reduction of periodontal indices was noticed, plaque levels remained high (60%) even at the end of the experimental period. Periodontal pathogens including Porphyromonas gingivalis, Bacteroides forsythus and Actinobacillus actinomycetemcomitans were frequently detected both supragingivally and subgingivally (>30%). The presence of a species supragingivally and the presence at the same time points subgingivally were correlated. This finding suggested that supragingival plaque acts as a reservoir for reinfection of treated sites. A reduction of the percentages of detection of these species was noticed 1 month after an oral hygiene period as well as at 3 and 6 months after treatment. Inadequate oral hygiene as performed by these patients probably affected supragingival, and consequently subgingival, plaque composition.
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Affiliation(s)
- D Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, 54006, Greece
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Reuland-Bosma W, van der Reijden WA, van Winkelhoff AJ. Absence of a specific subgingival microflora in adults with Down's syndrome. J Clin Periodontol 2001; 28:1004-9. [PMID: 11686820 DOI: 10.1034/j.1600-051x.2001.281103.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Periodontal disease in Down's syndrome (DS) is generally characterized by a high degree of bone loss. Bone loss of 5 mm or more is observed in 70% of these subjects. Among DS subjects, considerable differences in disease progression occur. So far, no studies have been conducted in which specific properties of the subgingival microflora have been related to the condition observed. AIMS To investigate (1) the subgingival microflora in DS subjects and other mentally retarded (control) individuals which were matched to the utmost and (2) to investigate the subgingival microflora of a "low-risk" and a " high-risk" group formed in DS subjects. MATERIAL AND METHODS 17 DS subjects and 17 control subjects were matched with respect to age, plaque level and bleeding on probing. In addition, the DS group was divided in a "low-risk" group (0-2 teeth lost due to periodontal disease n=6) and a "high-risk"group (6-13 teeth lost due to periodontal disease n=11). Prevalence and proportions of the putative periodontal pathogens Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Bacteroides forsythus, Peptostreptococcus micros, Fusobacterium nucleatum and Campylobacter rectus in the subgingival plaque were determined using anaerobic culture techniques. No differences in the prevalence of distinct suspected periodontopathic bacteria and bacterial subgingival composition between the DS group and the control group could be established. Also no differences in the prevalence of the seven investigated microbial species between the "low-risk" and the "high-risk" group were observed. CONCLUSIONS Because of the lack of differences in microflora between the DS group and the control group, a specific effect of the microbiological composition in the periodontal status of subjects with DS can be excluded in this population. Host factors constitute the more likely explanation of the differences observed in DS.
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Affiliation(s)
- W Reuland-Bosma
- Stichting Bijter, Centre for Special Care Dentistry, Rotterdam, The Netherlands.
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Loesche WJ, Grossman NS. Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment. Clin Microbiol Rev 2001; 14:727-52, table of contents. [PMID: 11585783 PMCID: PMC89001 DOI: 10.1128/cmr.14.4.727-752.2001] [Citation(s) in RCA: 274] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Periodontal disease is perhaps the most common chronic infection in adults. Evidence has been accumulating for the past 30 years which indicates that almost all forms of periodontal disease are chronic but specific bacterial infections due to the overgrowth in the dental plaque of a finite number of mostly anaerobic species such as Porphyromonas gingivalis, Bacteroides forsythus, and Treponema denticola. The success of traditional debridement procedures and/or antimicrobial agents in improving periodontal health can be associated with the reduction in levels of these anaerobes in the dental plaque. These findings suggest that patients and clinicians have a choice in the treatment of this overgrowth, either a debridement and surgery approach or a debridement and antimicrobial treatment approach. However, the antimicrobial approach, while supported by a wealth of scientific evidence, goes contrary to centuries of dental teaching that states that periodontal disease results from a "dirty mouth." If periodontal disease is demonstrated to be a risk factor for cardiovascular disease and stroke, it will be a modifiable risk factor since periodontal disease can be prevented and treated. Since the antimicrobial approach may be as effective as a surgical approach in the restoration and maintenance of a periodontally healthy dentition, this would give a cardiac or stroke patient and his or her physician a choice in the implementation of treatment seeking to improve the patient's periodontal condition so as to reduce and/or delay future cardiovascular events.
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Affiliation(s)
- W J Loesche
- Department of Microbiology and Immunology, School of Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA.
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Abstract
Systemic diseases affecting the host response as primary immunodeficiencies or secondary defects caused by lack of nutrients or changes in the local tissues are very often accompanied by early-onset prepubertal periodontitis. Local treatment in combination with systemic antibiotics may in milder forms improve the situation, but in many cases the success is questionable and premature loss of teeth occurs. Since the genetic basis of many of the diseases has been identified, future developments permit the correction of at least some of these defects by gene therapy.
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Affiliation(s)
- J Meyle
- Department of Periodontology, Zentrum für Zahn-, Mund und Kieferheilkunde, Universität Giessen, Giessen, Germany
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