1/12. Endodontic infection caused by localized aggressive periodontitis: a case report and bacteriologic evaluation.A rare case of a periodontally induced endodontic lesion in a systemically healthy subject of 28 years is described. The patient, having presented with severe attachment loss on the palatal and distal aspects of his maxillary right second premolar, was diagnosed with localized aggressive periodontitis. He had never received periodontal treatment. The tooth was nonvital and showed all signs of symptomatic apical periodontitis. It was also free of any restoration. All clinical findings clearly suggested that the endodontic problem was caused by the aggressive periodontal disease. Bacteriologic screening of the pocket and the root canal, by using "checkerboard" dna-dna hybridization analysis, revealed diverse flora in the periodontal lesion. The sample obtained from the root canal exhibited dna from a limited number of species, including black-pigmented anaerobic rods. No bacterial dna was found in the root canal that was not also recovered from the periodontal pocket.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
2/12. Microbiological, immunological and genetic factors in family members with periodontitis as a manifestation of systemic disease, associated with hematological disorders.The microflora, immunological profiles of host defence functions, and human leukocyte antigen (HLA) findings are reported for a mother, son and daughter who were diagnosed as having 'periodontitis as a manifestation of systemic diseases, associated with hematological disorders'. Examinations were made of the bacterial flora from the periodontal pocket, neutrophil chemotaxis, neutrophil phagocytosis, and the genotypes (DQB1) and serotypes (DR locus) of HLA class II antigens. Phenotypic analyses of the peripheral lymphocytes were also conducted. The subgingival microflora from the mother was dominated by Gram-negative rods, especially porphyromonas endodontalis, prevotella intermedia/prevotella nigrescens and fusobacterium nucleatum. Subgingival microflora samples from the son and daughter were dominated by gram-positive cocci and gram-positive rods. Through the use of polymerase chain reaction, campylobacter rectus and capnocytophaga gingivalis were detected in all subjects, whereas porphyromonas gingivalis, P. intermedia, and treponema denticola were not detected in any subjects. All three subjects showed a remarkable level of depressed neutrophil chemotaxis to N-formyl-methionyl-leucyl-phenylalanine, although their phagocyte function levels were normal, in comparison to healthy control subjects. Each subject had the same genotype, HLA-DQB1*0601, while the mother had HLA-DR2 and HLA-DR8, and the son and daughter had HLA-DR2 only. In summary, the members of this family showed a similar predisposition to periodontitis with regard to certain host defence functions. It is suggested that the depressed neutrophil chemotaxis that was identified here could be a significant risk factor for periodontitis in this family.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
3/12. Langerhans' cell histiocytosis in a 5-year-old girl: evidence of periodontal pathogens.BACKGROUND: Langerhans' cell histiocytosis (LCH) is a rare disorder characterized by Langerhans' cell proliferation in various organs or tissues. When periodontal tissue is involved, clinical manifestations can vary from gingival recession and pocket formation to severe alveolar bone loss. This case report describes periodontal pathogens found in the pockets of involved primary teeth. methods: A 5-year-old girl with LCH presented with loose teeth. Intraoral examination and radiographs revealed deep pockets and severe bone loss around all primary molars. Bacterial samples were obtained from saliva and subgingival plaque and analyzed for the presence of five periodontopathic bacteria using a polymerase chain reaction (PCR) method. Due to severe periodontal destruction, all primary molars were extracted, and a gingival biopsy was taken from tooth T to confirm the diagnosis of LCH. RESULTS: The biopsy specimen revealed the histologic features of LCH. The patient was diagnosed as having periodontitis as a manifestation of LCH. PCR results of subgingival plaque from LCH-affected molars indicated the presence of porphyromonas gingivalis, Tannerella forsythensis, treponema denticola, and prevotella intermedia. However, actinobacillus actinomycetemcomitans was absent from these teeth. No tested bacteria were found in the non-affected anterior teeth. CONCLUSIONS: The bacteria commonly associated with periodontal disease were detected in subgingival plaque samples from this LCH patient. More microbiological data are required to understand the role of these bacteria in LCH-associated periodontal destruction.- - - - - - - - - - ranking = 2keywords = sample (Clic here for more details about this article) |
4/12. Periodontal therapy in siblings with Papillon-Lefevre syndrome and tinea capitis: a report of two cases.OBJECTIVE: Report of clinical and microbiological periodontal findings before and 6 months after treatment of two siblings with Papillon-Lefevre syndrome (PLS) and tinea capitis. methods: Two brothers, RG 3 years and NG 5 years of age, were referred for treatment due to premature mobility of their deciduous teeth. Probing depths (PPD), attachment levels (PAL-V), and furcation involvements were examined clinically. Panoramic radiographs were taken. Subgingival plaque samples within the deepest pocket of each tooth were taken and analysed by real-time polymerase chain reaction (PCR) for actinobacillus actinomycetemcomitans (AA), porphyromonas gingivalis, Tannerella forsythensis, treponema denticola, fusobacterium nucleatum, and prevotella intermedia. One-stage full-mouth scaling and extraction of hopeless teeth were performed under general anaesthesia, followed by systemic amoxicillin and metronidazole for 7 days. Clinical and microbiological analyses were performed 6 months after treatment. RESULTS: Before treatment, both siblings had exhibited PPD of up to 13 mm, Class III furcation defects at four teeth, and marginal suppuration. AA was detected in both patients and at all teeth at levels ranging from 3.0 x 10(2) to 5.1 x 10(6). Both patients exhibited palmar and plantar hyperkeratosis. Seven teeth were extracted from RG, and nine from NG. Six months after treatment, PPD had been reduced to- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
5/12. Healing of human suprabony lesions treated with guided tissue regeneration and coronally anchored flaps. case reports.Teflon membranes were interposed between soft tissue flaps and roots in 4 human suprabony lesions affecting the mandibular incisor teeth in 1 volunteer patient. 4 suprabony lesions affecting the mandibular incisor teeth were used as comparisons in a 2nd patient. All roots were debrided using ultrasonic and manual instruments and the most apical positioned calculus/site on the facial surface was notched. Flaps were sutured as coronally as possible using orthodontic brackets as anchors. Tissue blocks were removed 2 to 3 months after procedures and the facial aspects of all teeth were examined histologically. New attachment in the form of new "cementum with functionally oriented fibers" was seen within the calculus notch in 3 out of 4 membrane-treated sites and immediately apical to the notch at 1 site. The 4 comparison sites showed no evidence of new attachment within or adjacent to the notch. Rather, the gingival margins were located apical to the notch. Our observations suggest that guided tissue regeneration techniques improved coronal attachment responses in human suprabony lesions within the sample described.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
6/12. Human clinical and histologic responses to the placement of HTR polymer particles in 11 intrabony lesions.Eleven intrabony periodontal lesions in five volunteer patients received surgical debridement followed by site implantation of a porous particulate polymeric composite (HTR polymer). These patients were observed over time periods varying from 4 weeks to 26 weeks. At the end of the individual observation periods, treated sites were surgically removed in block for histologic analysis. Clinical observations indicated a reduction in pocket depth following treatment which consisted of both gingival recession and gain in clinical closure. No untoward effects were observed clinically in any treated patient during the observation periods. Histologic responses varied from gain in closure by epithelial adhesion to new attachment of varying magnitude. Such varied responses were seen within the same patient and between patients. Graft particles were present at sites from 4 weeks to 26 weeks after implantation and were surrounded by connective tissue capsules. At the periphery of some particles, limited bone formation was present. The alveolar bed was remodeling, at times surrounding specific particles. In our sample, HTR polymer, therefore, appeared to be a well tolerated synthetic graft material when implanted in human intrabony lesions.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
7/12. Clinical, microbiological and immunological studies of post-juvenile periodontitis.The present study includes the clinical, microbiological and immunological examinations of 2 patients with post-juvenile periodontitis. bacteroides intermedius was the predominant isolate from periodontal pockets with post-localized juvenile periodontitis. bacteroides gingivalis, bacteroides forsythus and actinobacillus actinomycetemcomitans were detected in samples from periodontal pockets with post-generalized juvenile periodontitis. IgG antibody levels to B. gingivalis were significantly higher in the patients than these of periodontally healthy group. Spirochetes, including treponema denticola, were found at very high frequencies in all samples from the patients.- - - - - - - - - - ranking = 2keywords = sample (Clic here for more details about this article) |
8/12. The effect of amoxicillin on destructive periodontitis. A case report.In a 22-year-old female patient, advanced localized periodontal destruction was observed. The planned treatment consisted of oral hygiene instructions, professional plaque control, deep scaling and root planning and finally modified Widman flap surgery. One molar had to be extracted but was left untreated initially as a control. During the treatment period of 9 months and during 1 year thereafter, samples were taken of the subgingival plaque for dark-field microscopy. The unplanned use of amoxicillin by the patient for a middle ear infection resulted in a suppression below detection level of spirochetes at the investigated sites. At the nontreated control site, the absence of spirochetes was accompanied by a 3-mm reduction of pocket depth and a 2-mm gain in clinical probing attachment, while some formation of new alveolar bone was observed. At the treated sites, clinical improvement was observed. However, a distinction between the effect of the periodontal therapy and the nonscheduled use of amoxicillin could not be made at the treated sites. It is concluded that a single course of systematically administered amoxicillin changed the composition of the subgingival microflora over a long period of time (17 months) and had a beneficial effect upon the status of the periodontium.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
9/12. Distribution of morphologically different micro-organisms associated with active periodontal lesions.The morphological composition of the subgingival plaque associated with active periodontitis lesions and comparable inactive control lesions were determined in a 36-year-old patient with advanced periodontal disease. Monthly measurements of the clinical attachment level were subjected to linear regression analysis as a function of time. Attachment loss was recorded during the monitoring period at 10 sites, with loss of 2 mm or more at 6 sites. Plaque samples taken from these 6 sites and from 6 control sites with similar clinical conditions were not of uniform composition. Active lesions harboured on average 46% more cocci and twice as many large spirochetes as inactive control lesions. A linear regression analysis of the proportions of different morphotypes in the subgingival plaque versus the calculated monthly attachment loss rate at the time of sampling provided only very weak correlations, if at all. The observations made in the patient under investigation suggest that there is no great probability of suspected differences in the floras of active and inactive lesions being detected by dark-field analysis alone. The role of motile rods and spirochetes may have been over-rated hitherto.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
10/12. Clinical, microbiological and immunological features associated with the treatment of active periodontosis lesions.Clinical, microbiological and immunological factors were examined using data from a subject with periodontosis. The subject was monitored at bimonthly intervals for 26 months at 6 sites per tooth for redness, plaque, suppuration, bleeding on probing, pocket depth, and attachment level. Using attachment level measurements and the tolerance method of analysis, sites with active disease and control (inactive) sites of equal pocket depth were selected. Subgingival plaque samples were taken from these sites for predominant cultivable and dark field evaluation before, and 5 and 13 months after treatment by Widman flap surgery and systemic tetracycline. 50 isolates from each of 5 sites monitored before and after treatment were characterized and, if possible, identified. Active sites showed between 2 and 6 mm of attachment loss prior to therapy and "gained" between 2 and 9 mm of attachment after therapy. The control sites "gained" 0 to 1 mm of attachment after therapy. Bleeding on probing was significantly reduced after treatment, whereas plaque accumulation increased significantly in the sampled sites. Similar changes were seen in the remaining sites. The proportions of actinobacillus actinomycetemcomitans and selenomonas sputigena were elevated in active sites, while proportions of bacteroides intermedius were elevated in control sites. 5 months after treatment, proportions of A. actinomycetemcomitans, S. sputigena and eikenella corrodens were significantly decreased in the previously active sites and proportions of B. intermedius and E. corrodens were significantly decreased in the control sites. 13 months after therapy, the proportions of fusobacterium nucleatum and capnocytophaga species had increased. Multiple linear regression analysis was used to examine models which could "predict" the outcome, attachment level change in the previous monitoring period. The proportions of A. actinomycetemcomitans and S. sputigena, which were associated with destruction, coupled with the proportions of streptococcus sanguis II and Campylobacter concisus which were associated with "gain" could predict prior attachment level change with an r2 of 0.93. Humoral antibody response to A. actinomycetemcomitans and C. sputigena significantly increased in a period in which multiple actively breaking down sites were detected. Antibody responses to 20 other species tested did not significantly change during the course of monitoring. Crevicular fluid and tissue levels of antibody to A. actinomycetemcomitans were elevated in 5 of 6 active destructive lesions prior to therapy.(ABSTRACT TRUNCATED AT 400 WORDS)- - - - - - - - - - ranking = 2keywords = sample (Clic here for more details about this article) |
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