Abstract
ObjectiveImmunological processes in the etiopathogenesis of periodontitis, especially the aggressive form, are not well understood. This study examined clinical as well as systemic immunological and local microbiological features in healthy controls and patients with different forms of periodontitis.Materials and Methods14 healthy subjects, 15 patients diagnosed with aggressive periodontitis, and 11 patients with chronic periodontitis were recruited. Periodontal examination was performed and peripheral blood was collected from each patient. Lymphocyte populations as well as the release of cytokines by T-helper cells were determined by flow cytometry and enzyme linked immunosorbent spot assay. Subgingival plaque samples were taken from each individual and immediately cultivated for microbiological examination.ResultsWhen stimulating peripheral blood mononuclear cells (PBMCs) with lipopolysaccharide, a higher IL-1β release was found in patients with moderate chronic periodontitis compared to the other groups (p<0.01). Numbers of B-cells, naïve and transitional B-cells, memory B-cells, and switched memory B-cells were within the reference range for all groups, but patients with chronic periodontitis showed the highest percentage of memory B-cells without class switch (p = 0.01). The subgingival plaque differed quantitatively as well as qualitatively with a higher number of Gram-negative anaerobic species in periodontitis patients. Prevotella denticola was found more often in patients with aggressive periodontitis (p<0.001) but did not show an association to any of the systemic immunological findings. Porphyromonas gingivalis, which was only found in patients with moderate chronic periodontitis, seems to be associated with an activation of the systemic immune response.ConclusionDifferences between aggressive periodontitis and moderate chronic periodontitis are evident, which raises the question of an inadequate balance between systemic immune response and bacterial infection in aggressive periodontitis.
Highlights
Periodontitis is an inflammatory disease affected by a variety of factors
When stimulating peripheral blood mononuclear cells (PBMCs) with lipopolysaccharide, a higher IL-1b release was found in patients with moderate chronic periodontitis compared to the other groups (p,0.01)
Differences between aggressive periodontitis and moderate chronic periodontitis are evident, which raises the question of an inadequate balance between systemic immune response and bacterial infection in aggressive periodontitis
Summary
Periodontitis is an inflammatory disease affected by a variety of factors. Smoking and age as well as diabetes mellitus, which seems to be in a bidirectional relationship with periodontitis [1], and stress are known risk factors. Periodontal inflammation seems to promote cardiovascular diseases, stroke, and pneumonia [5,6,7]. Especially severe forms of periodontitis are of common and interdisciplinary interest. Chronic periodontitis is a quite common disease in adult patients characterized by pocket formation and/or recession [8]. While progressive loss of periodontal attachment occurs slowly to moderately [9], local risk factors, e.g. bacterial plaque and calculus, accelerate loss of attachment rapidly [10]
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