Chronic Adult Periodontitis Patients Research Articles

Patterns of Salivary Analytes Provide Diagnostic Capacity for Distinguishing Chronic Adult Periodontitis from Health

Salivary biomarker discovery requires identification of analytes with high discriminatory capacity to distinguish disease from health, including day-to-day variations that occur in analyte levels. In this study, seven biomarkers associated with inflammatory and tissue destructive processes of periodontal disease were investigated. In a prospective cohort study design, analyte expression levels were determined in unstimulated whole saliva samples collected on multiple occasions from 30 healthy adults (i.e., orally and systemically) and 50 chronic adult periodontitis patients. Salivary levels of IL-1β, IL-6, MMP-8, and albumin were significantly elevated (5.4 to 12.6X) and levels of IFNα were consistently lower (8.7X) in periodontitis patients compared with the daily variation observed in healthy adults. ROC analyses of IL-1β, IL-6 and MMP-8 yielded areas under the curves of 0.963-0.984 for discriminating periodontitis from health. These results demonstrate that levels of salivary bioanalytes of patients who have periodontitis are uniquely different from normal levels found in healthy subjects, and a panel consisting of IL-1β, MMP-8 and IL-6 shows particular diagnostic potential.

HHV-6, HHV-7, HHV-8 in gingival biopsies from chronic adult periodontitis patients. A case-control study.

Recent reports have suggested that various herpesviruses may be involved in the occurrence and progression of different forms of periodontal disease. The objective of the present study was to investigate the presence of the novel herpesviruses HHV-6, HHV-7 and HHV-8 in gingival biopsies from patients affected by chronic adult periodontitis. As control, gingival biopsies from periodontally healthy subjects were analysed. Gingival biopsies were harvested from 23 volunteers: 13 patients affected by chronic adult periodontitis (CAP) and 10 periodontally healthy subjects. Each CAP patient contributed two biopsies involving the epithelium and connective tissue facing the sulcus/periodontal pockets: one biopsy from a site having a probing pocket depth (PPD) > or =5 mm and presenting with bleeding upon probing (affected site) at the time of biopsy collection, and the other biopsy from a site with PPD< or =3 mm and without bleeding on probing (nonaffected site). After DNA extraction, nested PCR was used in herpesvirus identification. HHV-6 DNA sequences were detected in one non-affected site (8%) and no affected sites (0%) of CAP patients. One biopsy (10%) in healthy subjects revealed HHV-6 positivity. Tissue specimens in 10/13 CAP patients (77%) and 7/10 healthy subjects (70%) contained HHV-7 DNA. HHV-7 prevalence in affected and nonaffected sites of CAP patients was 77% and 54%, respectively. HHV-8 was detected in 7.7% of CAP patients and 0% of healthy subjects. Gingival tissue may act as a reservoir for HHV-7. A high prevalence of HHV-7 was detected in both periodontally diseased and healthy individuals. The prevalence of HHV-6 and -8 was similarly low in both groups. Our data do not support an association of investigated herpesvirus species with destructive periodontal disease.

EFEK KLINIS APLIKASI SUBGINGIVAL RACIKAN GEL METRONIDASOL 25% DAN LARUTAN POVIDON-IODIN 10% SEBAGAI TERAPI PENUNJANG SKELING-PENGHALUSAN AKAR PADA PERIODONTITIS KRONIS

Metronidazole gel 25% as an adjunct to scaling and root planing showed clinical effect better than scaling and root-planing alone. In Indonesia metronidazole gel is not popular, since probably it is expensive and not easy to obtain. So there is an idea to make metronidazole gel 25% mixture with relatively cheaper. The purpose of the study was to evaluate clinical effect of metronidazole gel 25%. Thirty Chronic Adult Periodontitis patients possessing at least 3 teeth ≥6mm pocket depth, ≥4mm attachment loss, and bleeding on probing were selected and grouped into metronidazole 25%, PVP-I 10%, and as controle respective. After SRP of all quadrant, 3 teeth were randomly selected as respectively metronidazole gel 25% and PVP-I 10% were applied on day 0 and day 7. BOP, PPD, and clinical attachment gain were recorded at baseline and 1 month post therapy. Bleeding on probing was analyzed using Kruskal-Wallis test, pocket depth and attachment gain were analyzed using Anova test. The result showed a significant difference in each group before and after the application. However, metronidazole group was the best compared to the other two groups.

EFEK IRIGASI TUNGGAL LARUTAN TETRASIKLIN HCl 10% SETELAH SKELING DAN PENGHALUSAN AKAR TERHADAP PERUBAHAN KLINIS PERIODONTITIS KRONIS POKET 4-6 MM

Chronic adult periodontitis (CAP) is the most common type of periodontal disease. Treatment of moderate CAP has primarily been directed at the physical removal of bacterial plaque, calculus and contaminated cementum by scaling and root planing (SRP) with or without surgical access. Irrigation solutions reach the apical portion of the pocket has flushing action properties and easy to apply. Tetracycline HCl (TTC HCl) solutions demonstrated its antimicrobial activity against subgingival microflora, shown to be substantive to dentin surface and subsequently released in active form, also has anti-collagenase properties. This study evaluates the clinical outcomes of treatment with locally TTC HCl 10% irrigation as an adjunct to SRP in subset of moderate CAP patients. The data examined were obtained from 24 patients. All patient were scaled and root planed prior to baseline measurement. The patients were monitored by parameters ; bleeding on probing (BOP), probing pocket depth (PPD), and attachment loss (LA). 56 contralateral surface exhibiting residual pocket depths 4-6mm were randomly assigned as test or control sites. After baseline measurement, each subgingival root surface was irrigated with approximately 10ml for 1 minute either with TTC HCl 10% solution (test), or Aquabides solution (control). The clinical parameters were assessed at baseline and weeks 3. The two sites resulted in significant statistical and clinical improvement in all parameters. BOP was not significantly reduced in test site compared to control site. PPD and LA was significantly reduced at test site compared to control site. The result indicate that subgingival irrigation with TTC HCl 10% solution 10ml for 1 minute may have a role in the management of moderate CAP. This treatment reduces surgical needs.

Apoptosis in chronic adult periodontitis analyzed by in situ DNA breaks, electron microscopy, and immunohistochemistry.

Apoptosis is an evolutionary form of physiological cell death. Previous studies suggest that apoptosis is involved in the pathogenesis of periodontal diseases. Therefore, we studied the apoptotic events in the gingival tissue of chronic adult periodontitis patients. Gingival tissue biopsies from 22 patients with chronic adult periodontitis and from 11 healthy controls were obtained. Criteria for patient inclusion in the periodontitis group were a minimum of 14 natural teeth, excluding third molars, with at least 10 posterior teeth; 5 to 6 sites with probing depth > or = 5 mm; attachment loss > or = 3 mm; and extensive radiographic bone loss. The control group included healthy subjects with no prior history of periodontal disease. Apoptosis was determined using the terminal TdT-mediated dUTP-biotin nick end labeling (TUNEL) technique; electron microscopic analysis; and expression of Caspase-3, Fas, FasL, Bcl-2, and p53 by immunohistochemistry. TUNEL-positive cells and cells exhibiting chromatin condensation by electron microscopy were observed in the inflammatory infiltrate of biopsies obtained from periodontitis patients. Most of the TUNEL-positive cells belonged to neutrophil cell populations as they were stained with anti-myeloperoxidase. Positive staining for active-caspase 3, Fas, FasL, and p53 was only observed in the inflammatory infiltrate from periodontitis biopsies, whereas Bcl-2 cells were present in both periodontitis patients and healthy controls. Our findings establish that apoptosis is induced in the periodontal tissue by host and microbial factors and support the hypothesis that apoptotic mechanisms could be implicated in the inflammatory process associated with gingival tissue destruction observed in adult periodontitis patients.

Analysis of In Situ Protease Activity in Chronic Adult Periodontitis Patients: Expression of Activated MMP‐2 and a 40 kDa Serine Protease

Periodontitis is characterized by extensive destruction of the gingival tissues and associated supporting structures of the teeth. Although the pathogenesis of the various forms of this disease is not completely understood, host-derived proteases are believed to have an important role. In this study, we analyzed human tissue samples from chronic adult periodontitis patients to assess the levels of specific proteases and determine the effect of pH and tetracyclines on their activity. Gingival tissue samples were obtained from patients with chronic adult periodontitis (probing depths ranged from 5 to 9 mm) and periodontally healthy controls. Tissue extracts were prepared and analyzed for protease activity by zymography and Western blotting. Maximal protease activity from clinically normal and diseased tissues was observed at pH 8. Latent matrix metalloproteinase (MMP)-9 and MMP-2 were expressed in all samples examined, while active MMP-2 was detected only in tissues obtained from patients with clinical disease. The MMP activities were differentially inhibited by derivatives of tetracycline. At pH 6, a protease with a mass of approximately 40 kDa was observed in diseased samples. The enzymatic activity was inhibited by phenylmethylsulfonyl fluoride, suggesting it is a serine protease. The results of the current study substantiate the proposed role of host-derived proteases in the pathogenesis of chronic adult periodontitis. Specifically, they indicate that activated MMP-2 and a 40 kDa serine protease are involved in tissue destruction associated with this form of periodontal disease and also suggest that tissue pH influences protease activity in situ.

Long-term monitoring of adult periodontitis patients in supportive periodontal therapy: correlation of gingival crevicular fluid proteases with probing attachment loss.

The aim of this retrospective study was to determine if a chairside assay for neutral protease activity in gingival crevicular fluid (GCF) could provide an early indication of site-specific disease activity, as defined by probing attachment loss. Clinical measures and assay data were collected at 6-month intervals over an average period of 26 months (range from 24 to 36 months). 38 subjects were selected from a pool of previously-treated chronic adult periodontitis patients who were in periodontal maintenance at intervals of 3 to 6 months. GCF samples were collected from a total of 71 tooth sites exhibiting prior attachment loss, and analyzed for neutral protease activity (NPA). Positive BOP and positive NPA scores were classified as true positives if sites subsequently lost at least 1 mm of attachment over the next 12 months, as confirmed by linear regression analysis. As a predictor of breakdown, the NPA assay had an accuracy of 94% and a risk ratio of 37.6 as compared to values of 58% and 1.5 for BOP. When only the subset of sites > or = 7 mm were considered, the NPA assay had a calculated accuracy of 92% versus a value of 50% for BOP. These results indicate that the assay appears to differentiate between bleeding at sites exhibiting only chronic inflammation with no attachment loss and bleeding at sites undergoing active attachment loss.

Effects of Chronic Adult Periodontitis and Endotoxin (LPS) on Gingival Fibroblast Plasma Membrane Ca -Pump

Gingival fibroblasts from patients with chronic adult periodontitis are known to produce cytokines in response to changing levels of bacterial lipopolysaccharide (LPS). Cytokine production is one of numerous cell processes that involve calcium dependent enzymes. It is possible that inflammation may induce changes in the amount of the Ca++-pump protein in gingival fibroblasts which could alter Ca++-dependent activities in these cells including the production and release of cytokines. The purpose of this study was to determine if differences exist in the amount of Ca++-pump protein in the gingival fibroblasts of periodontitis patients relative to control individuals without periodontal disease. Fibroblast explants from healthy tissue and from inflamed tissue from patients with chronic adult periodontitis, grown in culture, were analyzed for quantitative differences in the amount of Ca++-pump protein. Fibroblasts from chronic adult periodontitis patients exhibited significantly lower levels of Ca++-pump protein than fibroblasts from healthy subjects (p = 0.0015). However, fibroblasts from chronic adult periodontitis patients, when activated with LPS, did not exhibit significant differences in the amounts of Ca++-pump protein as compared to untreated controls (p = 0.2177). Similarly, cells from healthy subjects did not show significant reduction in Ca++-pump protein following activation with LPS (p = 0.1732). Our results suggest that plasma membrane Ca++-pump is significantly reduced in fibroblasts derived from patients with chronic periodontitis. However, factors other than LPS may be involved in the down-regulation of Ca+ -pump protein.

The vasculature in chronic adult periodontitis: a qualitative and quantitative study.

Blood vessel features in periodontal pocket soft tissues may be significant in the pathogenesis and progression of chronic periodontitis. The aim of this study was to make a quantitative histological assessment of the vasculature in soft tissue biopsies from patients with chronic adult periodontitis and patients with healthy periodontal tissues. We have also investigated changes in tissue morphology at both the histological and ultrastructural level. Twelve interdental biopsies were obtained, 6 from chronic adult periodontitis patients and 6 from healthy volunteers. The specimens were sliced, fixed in 3% glutaraldehyde, postfixed in 1% buffered osmium tetroxide, dehydrated, and embeded in araldite. One micron semithin sections were differentially stained with a dichromatic technique. The number of blood vessels (BV) for sub-epithelial, superficial and deep connective tissue layers were then assessed. Only in the sub-epithelial connective tissue layer was there a significant increase in the number of blood vessels (95% Confidence interval [CI]) in the chronic adult periodontitis specimens when compared to healthy specimens. The results of this study seem to indicate that a dichromatic staining technique facilitates the identification and quantification of blood vessels in epoxy resin embedded specimens at light microscope level, and that there is an increase in the number of blood vessels in the chronic adult periodontitis lesions.

Local and systemic chemotherapy in the management of periodontal disease: an opinion and review of the concept

Periodontal disease appears to arise from the interaction of pathogenic bacteria with a susceptible host. The main aims of disease management have been to establish a high standard of oral hygiene and to professionally and thoroughly debride the root surface Chemical agents could be considered for both aspects of management. Chemoprevention using supragingivally delivered agents such as chlorhexidine may be questioned for value in the pre-treatment hygiene phase but have well-established efficacy immediately preoperatively and during the post-operative weeks. Long-term maintenance use of chlorhexidine is problematic due to local side effects. Antiplaque toothpastes show modest benefits to gingivitis but are not proven to prevent recurrence of periodontitis. Chemotherapy may be directed at subgingival plaque, using antimicrobials, or at the host response using anti-inflammatory agents. Antimicrobials can be locally or systemically delivered. In most cases antimicrobial chemotherapy should be considered adjunctive to mechanical debridement. The advantages of local and systemic chemotherapy must be balanced against the disadvantages and potential side effects of agents. Antimicrobial chemotherapy offers little or no benefit to the treatment of most chronic adult periodontitis patients and should be reserved for the more rapid or refractory types of disease, and after the debridement phase. Despite the large number of studies there are insufficient comparative data to support any one local delivery system or systemic regimen as superior to another. Systemic versus local antimicrobials have not been compared to date. Host response modifying drugs such as non-steriodal anti-inflammatory drugs (NSAIDS) offer the potential to reduce breakdown and promote healing, including bone regeneration. However until more data are available, NSAIDs should not be used in the management of chronic periodontal diseases, there being no specific agent(s) or regimen established for use. Chemotherapy has an important place in the management of chronic periodontal diseases but routine use must be considered as an over prescription of these valuable agents.

The Effect of Initial Periodontal Therapy on Salivary Platelet‐Activating Factor Levels in Chronic Adult Periodontitis

Platelet-activating factor (PAF), a potent phospholipid inflammatory mediator, is increased in the mixed saliva of subjects with periodontal disease and correlates with the extent of oral inflammation. The present study was designed to provide a longitudinal evaluation of the effect of initial periodontal therapy (home care instruction, prophylaxis, and scaling/root planing) on salivary PAF levels in chronic adult periodontitis patients (n = 15). Mixed saliva was collected prior to, during, and after initial therapy and was utilized to assess PAF levels after lipid extraction and fractionation as well as to histologically assess the number of polymorphonuclear leukocytes (PMN). PAF activity was determined in bioassay relative to authentic PAF (1-O-hexadecyl-2-acetyl-sn-glycero-3-phosphocholine; 16:0-alkyl-PAF). Initial salivary PAF levels (12.1 +/- 2.8 pmole equivalents of 16:0-alkyl-PAF/ml saliva; mean +/- SE) decreased following supragingival plaque control (9.6 +/- 2.4) and were further reduced following scaling and root planing (5.7 +/- 1.4). In parallel, salivary PMN levels were significantly reduced and clinical estimates of periodontal disease were significantly improved; i.e., there was a decrease in the percentage of sites with both bleeding on probing (from 46.1 +/- 4.6% of sites at pretreatment to 25.9 +/- 2.6% after scaling and root planing) and probing depths > or = 4 mm (from 16.7 +/- 1.9% of sites to 10.3 +/- 1.2%). Thus, initial periodontal therapy reduced salivary PAF levels in concert with improvements in clinical estimates of marginal and submarginal periodontal inflammation suggesting that PAF may participate in inflammatory events during periodontal tissue injury and disease.

Analysis of cultivable Porphyromonas gingivalis with trypsin‐like protease enzyme activity and serum antibodies in chronic adult periodontitis

Trypsin-like protease (TLPase) enzyme produced by Porphyromonas gingivalis has been implicated as a virulence factor in the pathogenesis of periodontal disease. The aims of this study were to investigate the relationship between cultivable P. gingivalis, TLPase enzyme activity (BANA hydrolysis) and serum antibody levels against cell sonicate and a purified TLPase antigen from P. gingivalis W50. Sub-gingival plaque samples were cultured for levels of P. gingivalis together with a chairside analysis of TLPase enzyme activity (Perioscan) from periodontitis and gingivitis sites of adult periodontitis patients. A TLPase from P. gingivalis was purified by gel filtration and ion exchange chromatography from the vesicle fraction for use as a test antigen. Elevated levels of P. gingivalis were found at periodontitis sites, however, there was no correlation with sub-gingival plaque TLPase enzyme activity. Adult periodontitis patients had higher levels of IgG and IgA against cell sonicate and TLPase antigens than did controls. Those patients who were P. gingivalis culture-positive demonstrated an elevated immune response against both cell sonicate and TLPase when compared to P. gingivalis culture-negative patients. Treatment resulted in an improvement of clinical indices and no cultivable P. gingivalis could be recovered from the treated sites and there was a concomitant decrease in IgG levels against the TLPase. There was no significant difference in BANA hydrolysis at gingivitis sites or periodontitis sites after treatment. Further longitudinal studies are suggested to investigate the role of the TLPase in the response to treatment of chronic adult periodontitis patients.

Cloning, characterization, and antigen specificity of T-lymphocyte subsets extracted from gingival tissue of chronic adult periodontitis patients

Chronic periodontitis is characterized by dense infiltrations of B and T lymphocytes within the gingival connective tissue. Distinct anaerobic gram-negative bacteria as well as autoimmunity to collagen have been reported to play a role in the etiology and the pathogenesis of this disease. Here we describe the cloning and characterization of CD4+ and CD8+ T lymphocytes isolated from inflamed gingival tissue obtained from four patients with chronic periodontitis. Clones were raised with phytohemagglutinin and interleukin-2 and tested for proliferation in response to whole-cell antigens of Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans, human collagen type I, and two bacterial heat shock proteins. CD4+ T-cell clones reactive with collagen type I were obtained from all four patients. Eighty percent of these clones had phenotypes resembling the mouse type 2 T helper (Th) phenotype, i.e., they produced high levels of interleukin-4 and low levels of gamma interferon. No collagen-type-I-reactive CD8+ clones were obtained. Bacterial-antigen-reactive CD4+ and/or CD8+ T-cell clones were also obtained from each patient, and the majority of the clones showed a Th0-like cytokine pattern and produced equal amounts of interleukin-4 and gamma interferon. Although most clones were reactive with P. intermedia, it seems that the immune response is not strictly directed against this particular microorganism, as clones reactive with one of the other bacteria were also obtained from two patients. We propose that collagen-specific CD4+ Th2-like T cells contribute to the chronicity of periodontitis but that their modes of activation might be controlled by Th0-like T cells specific for periodontitis-associated bacteria.

Identification and possible function of cathepsin G in gingival crevicular fluid from chronic adult periodontitis patients and from experimental gingivitis subjects.

The levels of cathepsin G in gingival crevicular fluid (GCF) from chronic adult periodontitis patients and experimental gingivitis subjects were determined both by activity measurement using N-benzoyl-(DL)-phenylalanine-2-naphthyl ester as a substrate and by enzyme immunoassay using anti-human cathepsin G IgG. The activity level of cathepsin G in GCF of both periodontitis and experimental gingivitis has no significant correlation with all measured clinical parameters. Western immunoblotting using antibodies specific for cathepsin G or alpha 1-proteinase inhibitor revealed that the difficulty in demonstrating the association of its activity with the severity of these diseases was due largely to formation of the enzyme-inhibitor complexes. By contrast, statistically significant positive correlation was found between cathepsin G content in GCF of periodontitis, which was determined by enzyme immunoassay, and such clinical parameters as the GCF volume, the gingival index and probing depth. The increased cathepsin G content with increasing severity of periodontal inflammation was markedly diminished by the initial treatment. Although no significant activity was detectable in GCF of experimental gingivitis, a rapid increase of the immunoreactive cathepsin G was found in GCF at 3-5 d after refraining from oral hygiene measures, which rapidly decreased by 10 d. The progressively increased cathepsin G between 10th and 21st d rapidly decreased by cleaning of the teeth. The results indicate that cathepsin G is involved in the host's defensive mechanism against the invasion of etiologic microbes and/or the development of either periodontitis or gingivitis.

Short‐Term Microbiological and Clinical Effects of Subgingival Irrigation With an Antimicrobial Mouthrinse

Fifty chronic adult periodontitis patients completed a 6-week controlled, double-blind, split mouth clinical study to determine the effects of subgingival irrigation with an antimicrobial mouthrinse on periodontal microflora, supragingival plaque, and gingivitis when used as an adjunct to normal oral hygiene. Qualifying subjects had at least four sites, two on each side of the mouth, with probing depths between 4 and 6 mm, which bled on gentle probing. Following baseline examinations, subjects received a half mouth scaling and prophylaxis and full mouth subgingival irrigation with either the antimicrobial mouthrinse or sterile colored water control professionally delivered. Subjects continued irrigation at home once daily for 42 days with their assigned rinse delivered via a subgingival delivery system. All sites in the mouth were scored at baseline and at day 42 for supragingival plaque, bleeding on probing, and redness. For the four selected periodontitis sites, probing depth and attachment level were measured at baseline and on day 42; additionally, supragingival plaque and gingival redness were scored on days 7 and 21. Subgingival plaque samples for microbiological analysis were harvested from the selected periodontal sites at baseline and on days 7, 21, and 42. Microbiologically, irrigation with the antimicrobial mouthrinse resulted in statistically significant reductions compared to control in putative periodontopathogens, including black pigmenting species, which persisted at 42 days. Clinically, subgingival irrigation with the antimicrobial mouthrinse produced a significant reduction in supragingival plaque (P < 0.001), bleeding on probing (P = 0.019), and redness (P = 0.017) compared to the control, whether or not the area irrigated received a prophylaxis.(ABSTRACT TRUNCATED AT 250 WORDS)

Enhanced superoxide production with no change of the antioxidant activity in gingival fluid of patients with chronic adult periodontitis.

In the gingival crevicular fluid (GCF) of control and chronic adult periodontitis (CAP) patients there is a spontaneous release of O2- radicals from polymorphonuclear leukocytes (PMN). The addition of the exogenous stimuli phorbol myristate acetate (PMA) decreased the O2-. formation in control GCF, while in CAP patients produced a marked enhancement of O2-. generation. The circulating PMN of control subjects did not show a spontaneous O2-. formation, differently from CAP patients. On the contrary, a similar O2-. production was measured when the circulating PMN were stimulated with PMA. Moreover, the antioxidant activity measured in 10 microliters of cell free gingival supernatant (GS) of control and CAP patients had the same values by inhibiting 12.6% and 18.9% respectively of the O2- formation supported by a xanthine/xanthine oxidase system. Probably, the protective or destructive effect of PMN in GCF of CAP patients depends on the variations of the rate of O2- formation in respect to the intrinsic antioxidant property of GS.

Granulocyte medullasin levels in gingival crevicular fluid from chronic adult periodontitis patients and experimental gingivitis subjects

The concentration of medullasin, an elastase-like serine proteinase, in gingival crevicular fluid (GCF) from chronic adult periodontitis patients and experimental gingivitis subjects was determined by the highly sensitive immunoassay method. In periodontitis patients, the medullasin content increased with increase of the GCF volume and then attained a maximum value at a relatively mildly inflamed stage. The value was maintained through more serious stages of disease activity. However, the medullasin content was independent of the probing depth. The medullasin content of the patients was markedly decreased after periodontal treatment, indicating that the enzyme participates in the development of the chronic periodontitis. Large amounts of medullasin were also detected in GCF from experimental gingivitis subjects, although it was not detected by the activity measurements. There was a rapid increase in the medullasin content during the 4-day period after abstention from oral hygiene measures, which corresponded to those of severely inflamed periodontitis patients. The peak value decreased up to the 7th-d followed by a gradual increase during the 21-d experimental period. The increased medullasin level rapidly decreased following resumption of oral hygiene measures. The results suggest that medullasin plays important roles both in the defence mechanism against the gingival inflammation and in the development of the acute inflammation.

Cathepsins B, H and L activities in gingival crevicular fluid from chronic adult periodontitis patients and experimental gingivitis subjects

To clarify roles of lysosomal cysteine proteinases cathepsins B, H and L in pathological destructive process of periodontal tissues, levels of their enzymatic activities were determined in gingival crevicular fluid (GCF) from chronic adult periodontitis patients and from experimental gingivitis subjects. In periodontitis patients, higher levels of cathepsins B, H and L activities were found at sites with more serious signs of the disease activity. The total activity of each enzyme (per unit time) was positively correlated with the GCF volume. However, it had little or no correlation with the probing depth (PD). In contrast, the specific activity of each enzyme in GCF (activity units per mg protein), which reflects the selectivity of enzyme exudation, was negatively correlated with the GCF volume. These results suggest that the cysteine proteinases are selectively released into gingival crevices at a relatively mild stage of periodontitis. In experimental gingivitis subjects, no significant activity of each enzyme was detected in GCF, even when the quantity of GCF was comparable to that from periodontitis patients. These data suggest that no significant amounts of these enzymes are released at experimental gingivitis sites or that a homeostatic mechanism, including regulation by protease inhibitors, may control activities of these enzymes in GCF with acute inflammation.

Eubacterium yurii subsp. schtitka subsp. nov.: Test Tube Brush Bacteria from Subgingival Dental Plaque

Representative strains of the test tube brush bacterium Eubacterium yurii, previously recovered from subgingival dental plaque of chronic adult periodontitis patients, were examined by determining their serological reactivities, protein electrophoretic patterns, deoxyribonucleic acid homologies, and bone resorptive activities in vitro. Our results indicate the existence of a third subspecies, E. yurii subsp. schtitka subsp. nov., in addition to the two previously described subspecies, E. yurii subsp. yurii and E. yurii subsp. margaretiae. The third subspecies is phosphatase negative and asaccharolytic and does not stimulate bone resorption in vitro. The type strain of E. yurii subsp. schtitka is strain ATCC 43716.

Crevicular fluid collagenase activity in healthy, gingivitis, chronic adult periodontitis and localized juvenile periodontitis patients.

Crevicular fluid collagenase activity in healthy, gingivitis, chronic adult periodontitis and localized juvenile periodontitis patients.