Generalized juvenile periodontitis: report of a familial case followed for 5 years

Massive osteolysis of the mandible: report of a case with multifocal bone loss

Osteolysis of the jaws has been reported in association with infection, cysts, neoplasia, and metabolic, endocrine, or hematologic abnormalities. Rare cases of idiopathic osteolysis have also been recorded. We report the case of a 10-year-old girl with mandibular basal and alveolar bone resorption that has continued over a period of 9 years. The patient has subsequently developed bilateral resorption of the ascending rami and condyles. The maxilla is uninvolved. Investigations included radiology, computerized tomography, scintigraphy, hematology, serum chemistry, endocrinology, histopathology, microbiology, and immunology. Neutrophil chemotaxis, chemiluminescence, and random migration values were low but within the normal range. These findings are interpreted as indicating an unusual variant of massive osteolysis.

Periodontal status and selected cultivable anaerobic microflora of insulin-dependent juvenile diabetics

The periodontal status and subgingival microflora of insulin-dependent juvenile diabetic (JD) patients (n = 16, mean age = 11.3) were compared with that of their non-diabetic cohabiting healthy siblings (HS, n = 16, mean age = 13.2). JD patients were monitored every 3 months for levels of glycosylated hemoglobin (HbA1c) and clinical and microbial parameters were measured 6 weeks before drawing blood for levels of HbA1c (M% = 8.76). Clinical indices, measured for the entire permanent dentition, included: probing depth (PD), attachment level (AL), sulcus bleeding index (SBI), and plaque index (PI). Subgingival plaque samples were obtained at 2 sites from each subject; whenever possible, the site with the deepest probing depth and the mesial aspect of the maxillary right first molar were used. Microbial analyses were determined by cultural characteristics and biochemical tests. No significant differences were detected in any of the clinical indices for the entire dentition. The mean AL for JD sites was 2.32 +/- 0.83 mm and for HS sites was 2.2 +/- 0.85 mm. Mean percentage of total cultivable anaerobic microflora included Capnocytophaga spp. (JD, 13.21%; HS, 11%) and Porphyromonas gingivalis (JD, 5.1%; HS, 7.9%). Differences between the two groups were not statistically significant. When cluster analysis was performed on sampled sites, one cluster group in JD patients showed significantly elevated P. gingivalis and lower Capnocytophaga spp. levels as compared to the overall mean. The clinical parameters of this cluster were characterized by statistically significant greater loss of attachment and probing depth. These data would suggest few differences between JD patients and their HS in this population.

Epidemiology and transmission of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans among children and their family members. A report of 4 surveys

The distribution and transmission of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans in 4 families were studied. The families were included, based on the isolation of P. gingivalis from a young child or adolescent. The probands of these 4 families were: a 5-year old periodontally healthy boy; a 17-year old girl with severe generalized juvenile periodontitis; an 11-year old girl with prepubertal periodontitis; 2 sisters, 5 and 17-years old, with untreated severe periodontitis as a component of the Papillon-Lefèvre syndrome. All members of the 4 families were examined clinically and microbiologically for the presence of P. gingivalis and A. actinomycetemcomitans. Most of the parents appeared to be adult periodontitis patients; the parents of one proband were edentulous. Results showed that in all cases at least one of the parents was positive for P. gingivalis. On the basis of indistinguishable restriction endonuclease patterns (REPs) of P. gingivalis and A. actinomycetemcomitans isolates from parents and their children, and distinct REPs from unrelated individuals, the present study indicates that P. gingivalis and A. actinomycetemcomitans were transmitted between parents and their children.