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Nomura Y, Morozumi T, Saito A, Yoshimura A, Kakuta E, Suzuki F, Nishimura F, Takai H, Kobayashi H, Noguchi K, Takahashi K, Tabeta K, Umeda M, Minabe M, Fukuda M, Sugano N, Hanada N, Yoshinari N, Sekino S, Takashiba S, Sato S, Nakamura T, Sugaya T, Nakayama Y, Ogata Y, Numabe Y, Nakagawa T. Prospective Longitudinal Changes in the Periodontal Inflamed Surface Area Following Active Periodontal Treatment for Chronic Periodontitis. J Clin Med 2021; 10:jcm10061165. [PMID: 33802109 PMCID: PMC7998532 DOI: 10.3390/jcm10061165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 02/27/2021] [Accepted: 03/08/2021] [Indexed: 12/13/2022] Open
Abstract
Periodontal disease is a chronic inflammatory disease of the periodontal tissue. The periodontal inflamed surface area (PISA) is a proposed index for quantifying the inflammatory burden resulting from periodontitis lesions. This study aimed to investigate longitudinal changes in the periodontal status as evaluated by the PISA following the active periodontal treatment. To elucidate the prognostic factors of PISA, mixed-effect modeling was performed for clinical parameters, tooth-type, and levels of periodontal pathogens as independent variables. One-hundred-twenty-five patients with chronic periodontitis who completed the active periodontal treatment were followed-up for 24 months, with evaluations conducted at 6-month intervals. Five-times repeated measures of mean PISA values were 130+/−173, 161+/−276, 184+/−320, 175+/−417, and 209+/−469 mm2. Changes in clinical parameters and salivary and subgingival periodontal pathogens were analyzed by mixed-effect modeling. Plaque index, clinical attachment level, and salivary levels of Porphyromonas gingivalis were associated with changes in PISA at the patient- and tooth-level. Subgingival levels of P. gingivalis and Prevotella intermedia were associated with changes in PISA at the sample site. For most patients, changes in PISA were within 10% of baseline during the 24-month follow-up. However, an increase in the number of bleeding sites in a tooth with a deep periodontal pocket increased the PISA value exponentially.
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Affiliation(s)
- Yoshiaki Nomura
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; (Y.N.); (N.H.)
| | - Toshiya Morozumi
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 238-8580, Japan;
- Correspondence: ; Tel.: +81-46-822-8855
| | - Atsushi Saito
- Department of Periodontology, Tokyo Dental College, Tokyo 101-0061, Japan;
| | - Atsutoshi Yoshimura
- Department of Periodontology and Endodontology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan;
| | - Erika Kakuta
- Department of Oral Microbiology, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan;
| | - Fumihiko Suzuki
- Division of Dental Anesthesiology, Department of Oral Surgery, Ohu University School of Dentistry, Koriyama 963-8611, Japan;
| | - Fusanori Nishimura
- Section of Periodontology, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan;
| | - Hideki Takai
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Matsudo 271-8587, Japan; (H.T.); (Y.N.); (Y.O.)
| | - Hiroaki Kobayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;
| | - Kazuyuki Noguchi
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan; (K.N.); (T.N.)
| | - Keiso Takahashi
- Division of Periodontics, Department of Conservative Dentistry, Ohu University School of Dentistry, Koriyama 963-8611, Japan;
| | - Koichi Tabeta
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8514, Japan;
| | - Makoto Umeda
- Department of Periodontology, Osaka Dental University, Hirakata 573-1121, Japan;
| | - Masato Minabe
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 238-8580, Japan;
| | - Mitsuo Fukuda
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan;
| | - Naoyuki Sugano
- Department of Periodontology, Nihon University School of Dentistry, Tokyo 101-8310, Japan;
| | - Nobuhiro Hanada
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; (Y.N.); (N.H.)
| | - Nobuo Yoshinari
- Department of Periodontology, School of Dentistry, Matsumoto Dental University, Shiojiri 399-0781, Japan;
| | - Satoshi Sekino
- Department of Periodontology, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo 102-8159, Japan; (S.S.); (Y.N.)
| | - Shogo Takashiba
- Department of Pathophysiology-Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8525, Japan;
| | - Soh Sato
- Department of Periodontology, School of life Dentistry at Niigata, The Nippon Dental University, Niigata 951-8580, Japan;
| | - Toshiaki Nakamura
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan; (K.N.); (T.N.)
| | - Tsutomu Sugaya
- Division of Periodontology and Endodontology, Department of Oral Health Science, Hokkaido University Graduate School of Dental Medicine, Sapporo 060-8586, Japan;
| | - Yohei Nakayama
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Matsudo 271-8587, Japan; (H.T.); (Y.N.); (Y.O.)
| | - Yorimasa Ogata
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Matsudo 271-8587, Japan; (H.T.); (Y.N.); (Y.O.)
| | - Yukihiro Numabe
- Department of Periodontology, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo 102-8159, Japan; (S.S.); (Y.N.)
| | - Taneaki Nakagawa
- Department of Dentistry and Oral Surgery, School of Medicine, Keio University, Tokyo 160-8582, Japan;
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Carvalho AS, Napimoga MH, Coelho-Campos J, Silva-Filho VJ, Thedei G. Photodynamic Therapy Reduces Bone Resorption and Decreases Inflammatory Response in an Experimental Rat Periodontal Disease Model. Photomed Laser Surg 2011; 29:735-40. [DOI: 10.1089/pho.2010.2969] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
| | - Marcelo H. Napimoga
- Biopathology and Molecular Biology Laboratory, University of Uberaba, Uberaba, MG, Brazil
- Immunology and Molecular Biology Laboratory, São Leopoldo Mandic Center for Dental Research, Campinas, SP, Brazil
| | - Jozafá Coelho-Campos
- Biopathology and Molecular Biology Laboratory, University of Uberaba, Uberaba, MG, Brazil
| | - Vilmar J. Silva-Filho
- Biopathology and Molecular Biology Laboratory, University of Uberaba, Uberaba, MG, Brazil
| | - Geraldo Thedei
- Microorganism Biochemistry Laboratory, University of Uberaba, Uberaba, MG, Brazil
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Sardi JCO, Almeida AMF, Mendes Giannini MJS. New antimicrobial therapies used against fungi present in subgingival sites--a brief review. Arch Oral Biol 2011; 56:951-9. [PMID: 21676377 DOI: 10.1016/j.archoralbio.2011.03.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 03/16/2011] [Accepted: 03/17/2011] [Indexed: 01/14/2023]
Abstract
Although the main reservoir of Candida spp. is believed to be the buccal mucosa, these microorganisms can coaggregate with bacteria in subgingival biofilm and adhere to epithelial cells. The treatment of periodontal disease includes scaling and root planning (SRP) associated with proper oral hygiene. However, some patients may have negative responses to different therapeutic procedures, with a continuous loss of insertion, so the use of antimicrobials is needed as an adjuvant to SRP treatment. The use of a broad-spectrum antibiotic, such as tetracycline and metronidazole, as an aid in periodontal treatment has also been a factor for the development of superinfections by resistant bacteria and Candida species, even in patients with HIV. In the dental practice, the most commonly used antifungals are nystatin and fluconazole. However, the introduction of new drugs like the next generation of azoles is essential before the onset of emergent species in periodontal disease. Plants are good options for obtaining a wide variety of drugs. This alternative could benefit a large population that uses plants as a first treatment option. Plants have been used in medicine for a long time and are extensively used in folk medicine, because they represent an economic alternative, are easily accessible and are applicable to various diseases. Herein, we briefly review the literature pertaining the presence of Candida sp. in periodontal pockets, the conventional antifungal resistance and new therapies that include natural antifungal agents are reviewed.
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Affiliation(s)
- Janaina Cássia Orlandi Sardi
- Faculty of Pharmaceutical Sciences of Araraquara, Department of Clinical Analysis, Laboratory of Clinical Mycology, Univ Estadual Paulista, UNESP, Araraquara, SP, Brazil
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Pereira CV, Stipp RN, Fonseca DC, Pereira LJ, Höfling JF. Detection and clonal analysis of anaerobic bacteria associated to endodontic-periodontal lesions. J Periodontol 2011; 82:1767-75. [PMID: 21513472 DOI: 10.1902/jop.2011.110063] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Microbial agents in root canal systems can induce periodontal inflammation. The aims of this study are to detect anaerobic microorganisms in endodontic-periodontal lesions, determine the genetic diversity among them, and assess the simultaneous colonization of the pulp and periodontal microenvironments by a single clone. METHODS Twenty-seven teeth of patients with endodontic-periodontal lesions were selected. Samples were spread on an agar-blood medium, the detection of each species was performed using a polymerase chain reaction, and the determination of the simultaneous presence of the same species in the microenvironments by one or more clones was determined using arbitrarily primed PCR. RESULTS Prevotella intermedia (Pi) was the most prevalent species of the colonies in periodontal pockets, whereas Porphyromonas gingivalis (Pg) and Pi were the more prevalent in root canals. Isolates of Pi and Pg were simultaneously identified in root canals and periodontal pockets. Eighteen percent of teeth exhibited the simultaneous colonization by Pg, Tannerella forsythia (previously T. forsythensis), and Porphyromonas endodontalis in the pulp and periodontal microenvironments. The presence of these species was noted even in niches from which no colonies were isolated. Seventeen different genotypes were found in periodontal and pulp sites, with the majority of sites colonized by one or two different genotypes. A high degree of genotype similarity was found for samples of Pg isolated from only one site as well as for those isolated from both microenvironments. CONCLUSION Different clones of Pi and Pg with a high intraspecific genotype similarity were found to colonize the same anatomic sites in endodontic-periodontal infections.
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Affiliation(s)
- Cássio V Pereira
- Department of Microbiology and Immunology, Lavras University Center, Lavras, MG, Brazil
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Kubota M, Tanno-Nakanishi M, Yamada S, Okuda K, Ishihara K. Effect of smoking on subgingival microflora of patients with periodontitis in Japan. BMC Oral Health 2011; 11:1. [PMID: 21208407 PMCID: PMC3020163 DOI: 10.1186/1472-6831-11-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2010] [Accepted: 01/05/2011] [Indexed: 11/20/2022] Open
Abstract
Background Smoking is a risk factor for periodontitis. To clarify the contribution of smoking to periodontitis, it is essential to assess the relationship between smoking and the subgingival microflora. The aim of this study was to gain an insight into the influence of smoking on the microflora of Japanese patients with periodontitis. Methods Sixty-seven Japanese patients with chronic periodontitis (19 to 83 years old, 23 women and 44 men) were enrolled in the present study. They consisted of 30 smokers and 37 non-smokers. Periodontal parameters including probing pocket depth (PPD) and bleeding on probing (BOP) and oral hygiene status were recorded. Detection of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Fusobacterium nucleatum/periodonticum, Treponema denticola and Campylobacter rectus in subgingival plaque samples was performed by polymerase chain reaction. Association between the detection of periodontopathic bacteria and smoking status was analyzed by multiple logistic regression analysis and chi-square test. Results A statistically significant association was found between having a PPD ≥ 4 mm and detection of T. denticola, P. intermedia, T. forsythia, or C. rectus, with odds ratios ranging from 2.17 to 3.54. A significant association was noted between BOP and the detection of C. rectus or P. intermedia, and smoking, with odds ratios ranging from 1.99 to 5.62. Prevalence of C. rectus was higher in smokers than non-smokers, whereas that of A. actinomycetemcomitans was lower in smokers. Conclusions Within limits, the analysis of the subgingival microbial flora in smokers and non-smokers with chronic periodontitis suggests a relevant association between smoking and colonization by the specific periodontal pathogens including C. rectus.
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Affiliation(s)
- Michiya Kubota
- Oral Health Science Center, Tokyo Dental College, Chiba, Japan
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