Chronic Periodontitis Lesions Research Articles

Retracted: The Efficacy of Minocycline Hydrochloride Combined with Multiple Antibiotic Paste in Elderly Patients with Chronic Periodontitis and Concomitant Pulp Lesions.

[This retracts the article DOI: 10.1155/2022/7604741.].

The Efficacy of Minocycline Hydrochloride Combined with Multiple Antibiotic Paste in Elderly Patients with Chronic Periodontitis and Concomitant Pulp Lesions.

Objective To explore the efficacy of Minocycline hydrochloride combined with multiple antibiotic pastes in the treatment of chronic periodontitis with concomitant pulp lesions in elderly patients, as well as to analyze the changes in the levels of inflammatory markers. Methods 100 patients suffering from chronic periodontitis with concomitant pulp lesions treated in our hospital from July 2018 to January 2020 were selected as the study subjects, and were randomly assigned to either an experimental group (n = 50) or a control group (n = 50). Patients in the experimental group were treated with Minocycline hydrochloride combined with multiple antibiotic pastes, while those in the control group were treated with Minocycline hydrochloride alone. The treatment efficacy in the two groups was then assessed using such factors as periodontal probing depth, dental plaque index, gingival index, periodontal attachment level, and the presence or absence of adverse effects. We also measured and compared the levels of inflammatory markers such as CRP, TNF-α, IL-1β, IL-5, IL-6, and others in both groups, before treatment, as well as after a week of treatment. Results There was a statistically significant difference in the treatment efficacy between the two groups (P < 0.05), with a higher treatment efficacy seen in the experimental group as compared to the control group. When compared to the control group, the experimental group had lower depths of periodontal probing, lower dental plaque indices, lower gingival indices, lower periodontal attachment levels, as well a significantly lower incidence of adverse reactions (P < 0.05). Before treatment, the levels of inflammatory markers such as CRP, TNF-α, IL-1β, IL-5, and IL-6 were elevated in both groups. After a week of treatment, there were reductions in the levels of inflammatory markers in both groups, but a more significant reduction was seen in the experimental than in the control group (P < 0.05). Conclusion Minocycline hydrochloride combined with various antibiotic pastes is more effective in the treatment of chronic periodontitis with concomitant pulp lesions in elderly patients than monotherapy with Minocycline hydrochloride alone.

Combination of platelet rich fibrin and carbonate hydroxyapatite alloplastic bone graft as periodontal tissue engineering in management of chronic periodontitis: a case report

Objective:Chronic periodontitis lesions include loss of attachment and bone and are regarded as irreversible. Conventional procedures cannot restore the periodontal tissue to its original form. Periodontal tissue engineering is regenerativemedicine novel therapy by either implanting biomaterials. Platelet Rich Fibrin (PRF) as second generation platelet and Carbonate Hydroxyapatite (CHA) alloplastic bone graft can be used in surgical therapy because ease, inexpensive method and does not need any addition of exogenous compounds and a second surgical site and procedure. This case report aims to evaluate the clinical and radiographic effectiveness combination of both for the treatment of chronic periodontitis.Methods:A 21-year-old female was reported with chief complaint tooth mobility. Initial examination revealed grade two mobility of 35 with 9 mm distobuccal and distolingual pocket depth. The Periapical radiograph revealed a large diffused periapical radiolucency in relation to 35. Periodontal surgery was done and the osseous defect was filled with CHA bone graft and PRF.Results:There was a significant change in pocket depth and grade of mobility six months after surgery to 3 mm and grade one mobility.Radiographs showed resolution of an osseous defect.Conclusion:It was concluded that combined PRF with CHA bone graft can be used to treat chronic periodontitis as simple technique periodontal tissue engineering.

Bilateral radicular cyst of mandible-mimicking odontogenic keratocyst treated using alloplastic calcium phosphate bone cement: An unusual case report

Inflammatory dental cysts of mandible are an incessant group of osteolytic lesions arising from the odontogenic epithelium having uncharacteristic appearances. The radicular cyst is, by far, the most comprehended inflammatory jaw cyst found mostly at the apices of the tooth (periapical cyst), lateral surface of the roots (lateral radicular cyst) and remains in the jaw after the removal of the offending tooth (residual cyst). They advance sluggishly and asymptomatically unless infected. Because of this, they can extent to big dimensions. Although bilateral symmetrical representation of these cysts is rare, many times, it is baffling to segregate radicular cysts from the obligatory preexisting chronic periapical periodontitis lesions or benign asymptomatic, osteolytic neoplasms radiographically, and hence, may create a challenge for the diagnosis. Herein, we describe the case of a 45-year-old female patient who presented with pain over the right and left side of the mandible. Orthopantomogram showed large, well-defined, corticated, and unilocular radiolucencies over the bilateral molar region. Fine-needle aspiration cytology was performed, and the patient was treated with beta-lactam antibiotics trailed by surgical enucleation of cystic sac, extraction of the transgressing tooth, and rehabilitation using the alloplastic graft as bone void filler. The patient responded well to prompt systemic antibiotics and local surgical measures with a complete resolution of the infection and spontaneous bone regeneration.

Effect of Diode Laser on Human Cytomegalovirus and Epstein - Barr Virus in Chronic Periodontitis Patients – A Quantitative Real-Time Polymerase Chain Reaction Study

Background and aims: Studies have investigated the occurrence of Human cytomegalovirus (HCMV) and Epstein Barr Virus (EBV) in samples of both chronic and aggressive periodontitis lesions and their role in the pathogenesis of the disease have been suggested. It is important to determine the role and presence of these viruses in chronic generalized periodontitis patients after Scaling and root planing (SRP) alone and in conjunction with diode laser application. Thus the aim of the present study was to determine the prevalence of human cytomegalovirus (HCMV), Epstein–Barr virus(EBV) in gingival crevicular fluid (GCF) samples obtained from chronic generalised periodontitis patients.&#x0D; Materials (Subjects) and Methods: A total of 30 patients were included in the study based on the inclusion and exclusion criteria as follows: Group I – 15 chronic generalized periodontitis patients who received treatment with scaling and root planing. Group II – 15 chronic generalized periodontitis patients who received treatment with scaling and root planing and Diode laser. In each patient GCF samples were collected at baseline, 7 days and 21 days after treatment. Clinical parameters like gingival index, probing pocket depth and clinical attachment level were recorded and as GCF samples collected.&#x0D; Results: Correlation between quantification of EBV values with clinical parameters such as gingival index, probing pocket depth and clinical attachment loss in two groups showed statistical significance (P &lt; 0.001). Relative quantification of EBV was statistically significant, whereas HCMV was significantly absent. The mean values of GI, PPD and CAL parameters at different time interval was found to be statistically significant in both group (P &lt; 0.001)&#x0D; Conclusions: Only EBV was detected more frequently in patients with CGP, but HCMV was not detected with similar frequency in the groups studied. We also found that group with application of diode laser showed statistical significant results.

Antimicrobial susceptibility profiles of oral Treponema species

Treponemes occur in the microflora of the dental plaque. Certain Treponema species that are frequently isolated from chronic periodontitis lesions are involved in its initiation and progression. In addition to mechanical instrumentation, antimicrobial agents are used as an adjunctive treatment modality for periodontitis. Despite its importance for successful antimicrobial treatment, information about susceptibility is limited for Treponema species. The aim of this study was to assess the susceptibility of Treponema denticola strains, Treponema socranskii, and Treponema vincentii to eleven antimicrobial agents. The minimum inhibitory and minimum bactericidal concentrations of these antimicrobial agents revealed strain-specific variation. Doxycycline, minocycline, azithromycin, and erythromycin were effective against all Treponema species tested in this study, whereas fluoroquinolones only exhibited an equivalent effectiveness on T. socranskii. The susceptibility of one T. denticola strain, T. socranskii, and T. vincentii to kanamycin was influenced by prior exposure to aerobic conditions. The susceptibility to quinolone drugs varied among strains of T. denticola, although they share an amino acid sequence identity of greater than 99% for DNA gyrase (type II topoisomerase) subunit A. In addition, an ATP-binding cassette (ABC) transporter inhibitor assay for T. denticola indicated that the transport of quinolone drugs is partially related to this transporter, although there may be parallel transport mechanisms. Our results provide important insights into antimicrobial agent-Treponema dynamics and establish a basis for developing an appropriate adjunctive therapy for periodontal disease.

Viral serological and molecular data on possible involvement of herpes viruses in periodontal disease

BackgroundRecent studies have suggested that latent herpes virus infections can be associated with chronic periodontal sites that exhibit a predisposition to disease progression.The aim of this study was to identify the possible relationship between infections with CMV and EBV and the severity of periodontal disease. Materials and methodsFifty two patients aged between 27 and 70 years, diagnosed with periodontal disease were enrolled in the study after giving informed consent. Quantitative immunoenzymatic assays were used to determine the concentration of anti CMV and EBV antibodies. The presence of CMV and EBV DNA was tested in biopsies from periodontal tissues using an in-house PCR adapted after a method described previously. Results and conclusionsHigher titers of the anti CMV antibodies appear to be correlated with the severity of the periodontal lesions (p<0, 05). These correlations have not been found for anti EBV antibodies. Higher titers of specific anti CMV and EBV antibodies were correlated with a history of periodontal treatment (p<0, 05). Only two samples were positive for the viral genome. Both samples were collected from female patients diagnosed with very advanced forms of periodontal disease.Although the molecular biology data from the present study do not support the pathogenic involvement of EBV or CMV in the development of chronic periodontitis lesions, the serological data might be important markers for the evolution and severity of the periodontal disease

Management of an Infected Maxillary Periapical (Radicular) Cyst through Nasal Antrostomy

ABSTRACT The radicular cyst is an inflammatory cyst that is formed as a consequence of pulpal necrosis mostly due to caries, which is often found and associated with periapical inflammation. Most of the times, radicular cysts resemble the preexisting chronic periapical periodontitis lesions radiographically. In this paper, a case of radicular cyst in the maxillary anterior region is discussed. How to cite this article Nalini MS, Kumar B, Shroff S. Management of an Infected Maxillary Periapical (Radicular) Cyst through Nasal Antrostomy. J Health Sci Res 2016;7(2):58-62.

Dentilisin involvement in coaggregation between Treponema denticola and Tannerella forsythia

Periodontitis arises from a biofilm consisting of gram-negative anaerobic rods and spirochetes. Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, termed the Red complex, have been co-isolated with high frequency from chronic periodontitis lesions, and these microorganisms are thought to be major pathogens of the disease. Coaggregation is an important strategy in the colonization of dental plaque biofilm by these bacteria. In the present study, we investigated the coaggregation of T. denticola strains with T. forsythia ATCC 43037 by use of visual grading or spectrophotometry. T. denticola ATCC 35405 coaggregated with T. forsythia, reaching a plateau at approximately 60 min. This coaggregation was inhibited by heat treatment of T. denticola ATCC 35405, but not of T. forsythia. Disaccharides such as sucrose, maltose, and lactose inhibited coaggregation by approximately 50%. The coaggregation reaction varied among T. denticola strains. There was somewhat less coaggregation between T. denticola ATCC 33520 and T. forsythia than between T. denticola ATCC 35405 and T. forsythia, although this difference was not statistically significant; T. denticola ATCC 33521 showed a trace level of coaggregation with T. forsythia. The magnitude of coaggregation among the three T. denticola strains was proportional to their dentilisin activities. Inactivation of dentilisin abolished coaggregation activity, but inactivation of the major outer sheath protein did not. In addition, phenylmethylsulfonyl fluoride did not affect coaggregation. These results indicate that dentilisin is involved indirectly in the coaggregation between T. denticola and T. forsythia, because its proteolytic activity is not required, possibly via ligand maturation.

Oral lichen planus may enhance the expression of Th17-associated cytokines in local lesions of chronic periodontitis

This study aims to compare the expression levels of interleukin (IL)-17 and IL-23 in local periodontal tissues from patients with both chronic periodontitis and oral lichen planus (CP-OLP), patients with chronic periodontitis (CP) only, patients with oral lichen planus (OLP) only, and healthy controls (HC). The periodontal tissues were collected from 15 CP-OLP patients, 15 CP patients, 15 OLP patients, and 10 healthy controls. Immunohistochemistry (IHC) and real-time quantitative PCR (qPCR) was performed to investigate the protein and mRNA expression level of IL-17 and IL-23 in periodontal lesions from these four groups. IHC statistical analysis showed that the expression level of IL-17- and IL-23p19-positive cells significantly increased in CP-OLP group compared with that in CP (P < 0.01) and OLP groups (P < 0.05), showing intense staining reaction in local lamina propria lesions. Meanwhile, qPCR result showed higher IL-17 mRNA level in CP-OLP compared with that in CP and OLP groups and demonstrated a significant increase than OLP group (P < 0.05). Moreover, it was found that IL-17 mRNA expression level in erosive CP-OLP patients was significantly correlated with probing depth and attachment loss (P < 0.05). This study indicated that there was an increased expression level of IL-17 and IL-23 in periodontal tissues from periodontitis patients with oral lichen planus, which might aggravate the inflammatory response in local lesions. Oral lichen planus and chronic periodontitis may have interaction in disease pathogenesis, while IL-17 detection in local lesions may be helpful in identifying the disease severity in periodontitis patients with oral lichen planus.

B‐1a cells and plasma cells in periodontitis lesions

Host response mechanisms in periodontal tissues are complex and involve numerous systems of interactions between cells. The B-cell lineage seems to predominate in chronic periodontitis lesions. The aim of the present investigation was to study the correlation between inflammatory cells and some functional markers in gingival lesions obtained from subjects with severe chronic periodontitis. Thirty-eight Caucasian subjects volunteered to take part in the study. A gingival biopsy from one randomly selected diseased proximal site (probing pocket depth > 6 mm and bleeding on probing positive) was obtained from each patient. Immunohistochemical preparation was used to identify inflammatory cells and functional markers. Correlations between the different percentages of cell markers were analyzed by pairwise correlation. B cells (B-1a and B-2 cells) occurred in larger proportions than T cells and plasma cells. A statistically significant correlation was found between the percentage of B-1a cells and plasma cells and between all B lymphocytes and plasma cells. About 60% of B lymphocytes exhibited autoreactive features. It is suggested that B-1a cells constitute a significant part of the host response in periodontitis lesions and that plasma cells may develop from both B-2 and B-1a cells.

Strong and persistent microbial and inflammatory stimuli overcome the genetic predisposition to higher matrix metalloproteinase‐1 (MMP‐1) expression: a mechanistic explanation for the lack of association of MMP1‐1607 single‐nucleotide polymorphism genotypes with MMP‐1 expression in chronic periodontitis lesions

Our objective was to evaluate the association between the MMP1-1607 single-nucleotide polymorphism (SNP), periodontopathogens and inflammatory cytokines with matrix metalloproteinase-1 (MMP-1) mRNA levels in vitro and in vivo. This study investigated the influence of genetic (MMP1-1607 SNP), microbial (Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Actinobacillus actinomycetemcomitans) and inflammatory [tumour necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta)] factors on the determination of MMP-1 mRNA levels in periodontal tissues of non-smoker chronic periodontitis (CP, N=178) and control (C, N=190) groups. The effects of single and repeated lipopolysaccharide (LPS) and inflammatory cytokine stimulation of macrophages with distinct MMP1-1607 SNP genotypes were also investigated. In healthy tissues, the MMP1-1607 2G allele was associated with higher MMP-1 levels while in CP MMP-1 levels were associated with the presence and load of periodontopathogens, and also with TNF-alpha and IL-1beta expression irrespective of the MMP1-1607 genotype. In vitro data demonstrate that in 2G macrophages low- and intermediate-dose LPS and TNF-alpha+IL-1beta stimulation was associated with increased MMP-1 expression, while strong and repeated stimulation resulted in higher MMP-1 levels irrespective of the MMP1-1607 genotype. Our data demonstrate a limited role for MMP1-1607 SNP in periodontitis, where the extensive chronic antigenic challenge exposure overcomes the genetic control and plays a major role in the determination of MMP-1 expression.

Indoleamine 2,3‐Dioxygenase Expression and Regulation in Chronic Periodontitis

Indoleamine 2,3-dioxygenase (IDO) is an intracellular tryptophan-oxidizing enzyme with immunosuppressive characteristics. Its expression and regulation in periodontal tissues are unknown. The aim of this study was to determine IDO expression in healthy gingiva and chronic periodontitis lesions. In addition, the effect of inflammatory cytokines and bacterial products on the expression and activity of DOI in human gingival fibroblasts (HGFs) was assessed. Human gingival tissue samples were obtained from patients who underwent periodontal surgery. IDO expression in healthy gingiva and periodontitis lesions was determined by immunohistochemistry. HGF cells were treated with interferon-gamma (IFN-gamma), interleukin (IL)-1beta, tumor necrosis factor-alpha (TNF-alpha), and lipopolysaccharides from Porphyromonas gingivalis (PgLPS). IDO mRNA expression was determined by reverse transcription-polymerase chain reaction. The IDO enzymatic activity was determined by measuring the kynurenine level using a colorimetric method. In gingival tissues, IDO expression was detected in epithelial cells, fibroblasts, endothelial cells, and inflammatory mononuclear cells. IDO expression was higher in periodontitis lesions than in healthy gingiva. HGFs did not constitutively express IDO. IFN-gamma strongly induced IDO expression and activity in HGFs, in a dose-dependent manner. IL-1beta, TNF-alpha, and PgLPS were also able to induce IDO expression in HGF cells. IFN-gamma in combination with IL-1beta, TNF-alpha, or PgLPS showed enhanced IDO expression. IDO was expressed in human gingiva, and the expression was upregulated in chronic periodontitis. The increased IDO expression in periodontitis lesions may be due, in part, to the activation of HGFs by inflammatory cytokines and bacterial products.

Step‐wise treatment of two periodontal‐endodontic lesions in a heavy smoker

To report a clinical case of two advanced periodontal-endodontic lesions with a focus on treatment issues related to tobacco use. A 53-year-old Caucasian male was referred to the School of Dentistry, Basel, Switzerland, for periodontal treatment. The major diagnoses were chronic (smoker) periodontitis and advanced combined periodontal-endodontic lesions on the mandibular left lateral incisor and right incisor. Conventional root canal treatment was performed, and subsequently led to reduced radiolucencies around the affected roots after 14 months. The remaining osseous defect was augmented by guided tissue regeneration using bovine bone substitute and resorbable membrane. The follow-up revealed a stable situation from clinical (probing depth 2-4 mm) and radiological points of view 32 months after initiation of treatment. Treatment considerations related to tobacco use are discussed. * After conventional root canal treatment, osseous healing should occur before further complementary therapy is taken into account. * Issues related to tobacco use have to be considered before treatment is initiated.

Local Expression of Interleukin‐10 and mCD14 in Relation to the −1087 IL‐10 and −159 CD14 Gene Polymorphisms in Chronic Periodontitis

Associations between different gene polymorphisms and severe chronic periodontitis have been demonstrated. However, the influence of such genetic variations on the production of related proteins needs to be clarified. The aim of the present investigation was to study the local expression of interleukin (IL)-10 and membrane-bound CD14 (mCD14) in relation to the -1087 IL-10 and -159 CD14 gene polymorphisms in subjects with chronic periodontitis. Fifty-three white subjects with generalized and severe chronic periodontitis volunteered. Twenty milliliters of blood was collected by venipuncture from each subject. DNA was isolated, and genotype analysis of the -1087 IL-10 and -159 CD14 gene polymorphisms was performed using polymerase chain reaction and restriction endonuclease mapping techniques. A gingival biopsy from one randomly selected diseased proximal site was also obtained from each subject. The biopsies were embedded, snap frozen, and prepared for immunohistochemical analysis. The inflammatory lesion was identified in the sections, and the proportions of IL-10+ and CD14+ cells were determined. The proportion of IL-10+ cells in the peripheral area of the periodontitis lesions was significantly larger in subjects with the -1087 IL-10 GG genotype than in subjects with the AG or AA genotype. However, the local expression of the mCD14 receptor did not vary between subjects with different -159 CD14 genotypes. It is suggested that IL-10 expression in chronic periodontitis lesions is associated with a distinct genotype. The observation adds to our understanding of interactions between genetic and environmental factors in the development of human diseases.

Periodontal disease as reservoir for multi-resistant and hydrolytic enterobacterial species

This investigation aimed to isolate enteric rods from subgingival sites of patients presenting chronic periodontitis lesions, and to assess antimicrobial resistance and expression of hydrolytic enzymes. Enterobacteriaceae were isolated from 20% patients, and assayed for antimicrobial susceptibility and hydrolytic enzymes with specificity to different substrates. Isolates comprised seven Enterobacter cloacae (43.75%), five Serratia marcescens (31.25%), one Klebsiella pneumoniae (6.25%), one Enterobacter aerogenes (6.25%), one Pantoea agglomerans (6.25%), and one Citrobacter freundii (6.25%). Gelatinase activity was observed for 75% strains; caseinase and elastase was produced by six and two strains, respectively. DNase, lecithinase and lipase were expressed by S. marcescens. Most of strains were resistant to ampicillin (93.75%) and amoxicillin/clavulanic acid (81.25%). The majority of strains were susceptible to cephalosporins and aztreonam. Enterobacteria remained susceptible to imipenem, streptomycin and fluoroquinolones. Resistance to gentamicin, amikacin, sulfamethoxazole/thrimethoprim, tetracycline, and chloramphenicol were also observed. Eight strains presented multiple drug resistance. Subgingival sites from periodontal diseases contain multi-resistant and hydrolytic enzyme-producing enterobacteria that may contribute to overall tissue destruction and spreading. Enterobacteria isolated from patients generally considered as healthy individuals poses periodontal diseases as reservoir for systemic infections particularly in immunocompromised and hospitalized hosts.

Prevalence of "non-oral" pathogenic bacteria in subgingival biofilm of subjects with chronic periodontitis

The oral cavity may act as a reservoir for several pathogens related to systemic infections. Therefore, the purpose of this study was to determine the prevalence and levels of pathogenic bacteria in the subgingival biofilm of chronic periodontitis lesions and healthy periodontal sites using the checkerboard DNA-DNA hybridization technique. 200 samples of subgingival biofilm from sites with periodontitis (probing pocket depth > 4 mm and /or clinical attachment level > 4 mm) and 200 samples from healthy sites of 14 patients with chronic periodontitis, as well as 200 samples from 3 periodontally healthy patients were obtained. The presence and levels of 11 pathogenic bacteria were determined using whole genomic DNA probes and the checkerboard method, computed for each site and then across sites within each subject group. Significance of differences in clinical and microbiological parameters among groups were examinated using the Mann-Whitney and Wilcoxon sign tests. The predominant species in all 600 samples included Corynebacterium diphtheriae, Enterococcus faecalis, Staphylococcus aureus,Acinetobacter baumannii and Escherichia coli. In general, most of the species were detected in greater prevalence and levels in sites with and without disease from patients with periodontitis in comparison to the periodontally healthy group. In particular, C. diphtheriae, E. coli, E. faecalis, P. aeruginosa and S. aureus were significantly more prevalent and detected in higher counts in diseased sites of patients with periodontal disease compared to healthy subjects (p < 0.05). Clinical signs of disease presented a positive correlation with the species A. baumannii, Streptococcus pyogenes, E. coli, S. aureus and P. aeruginosa. In conclusion, non-oral pathogenic bacteria are detected in high prevalence and levels in periodontal sites of chronic periodontitis patients.

Identification of oral bacteria associated with crevicular epithelial cells from chronic periodontitis lesions

Bacterial invasion of host epithelial cells plays an important role in the pathogenesis of periodontal diseases; however, the interactions between subgingival species and the gingival crevice cells are not fully understood. This study determined the prevalence of a group of oral bacterial species on or in epithelial cells derived from periodontal pockets and the gingival crevice of subjects with periodontitis. Samples of epithelial cells were obtained from 120 sites with periodontal pockets > or =4 mm and 92 periodontally healthy sites from 49 patients (mean age 46.3+/-1.4 years; 43% males) with chronic periodontitis. Bacteria in or on epithelial cells were separated from unattached bacteria by Percoll density-gradient centrifugation. The presence and levels of 33 oral species were determined in epithelial cell samples by whole genomic DNA probes and the checkerboard method. The most frequently detected species were Porphyromonas gingivalis (42%), Treponema denticola (38%), Prevotella intermedia (37%), Streptococcus intermedius (36%), Campylobacter rectus (35%), Streptococcus sanguinis (35%) and Streptococcus oralis (34%). Species of Actinomyces were found in low prevalence and levels. The data indicated that there were more micro-organisms on or in epithelial cells obtained from periodontal pockets than from healthy sulci; however, no significant differences regarding the percentage and level of any specific species were found between these sites. Veillonella parvula, S. oralis, Streptococcus gordonii and Streptococcus mitis tended to be more prevalent in sites without disease. These findings demonstrated that a wide range of oral species may be detected on or in crevicular epithelial cells from sites with periodontitis and from periodontally healthy sulci.

Correlation between infection of different glycoprotein B genotypes of human cytomegalovirus and human chronic periodontitis

To investigate the correlation between infection of different human cytomegalovirus (HCMV) glycoprotein B (gB) genotypes and human chronic periodontitis. A nested-polymerase chain reaction (nPCR) was employed to detect HCMV gB gene in the subgingival plaque samples from 65 chronic periodontitis patients and in the gingival crevicular fluid samples from 24 periodontally healthy control. The amplification fragments of gB gene were further genotyped by restriction fragment length polymorphism (RFLP). The correlation among infection with the different HCMV genotypes and the severity of periodontal lesion were evaluated. In terms of teeth examined, the prevalence of HCMV (59.23%, 154/260) in the chronic periodontitis lesions was significantly higher than that of HCMV (32.29%, 31/96) in the periodontally healthy control (P < 0.01). Of the HCMV DNA positive samples from the chronic periodontitis lesions, 11.7% (18/154) was genotyped as gB I, 80.5% (124/154) as gB II, and 7.8% (12/154) as gB I and gB II co-infection, and of the HCMV DNA positive samples from the periodontal healthy control, 45.2% (14/31) was genotyped as gB I, 38.7% (12/31) as gB II, and 16.1% (5/31) as gB I and gB II co-infection. The gB II genotype was more dominant among the chronic periodontitis lesions compared with that among the periodontally healthy control (P < 0.01). In chronic periodontitis, no statistical significance could be found between infection of different HCMV gB genotypes and the different clinical parameters of CAL, PD and GI (P > 0.05). Subgingival infection with HCMV is closely associated with chronic periodontitis. Infection of HCMV may not correlate directly with severity of periodontitis. However, gB II may be the dominant genotype of HCMV, which is associated with the chronic periodontitis.

Involvement of Periodontopathic Anaerobes in Aspiration Pneumonia.

Increasing evidence has linked the anaerobic bacteria forming periodontopathic biofilms with aspiration pneumonia in elderly persons. In experiments designed to eliminate the potent respiratory pathogens forming biofilms in the oral cavity, we have shown that the mechanical and chemical oral cleansing using povidone-iodine effectively reduced the detection rates and numbers of methicillin-sensitive Staphylococcus species, Streptococcus pneumoniae, and Haemophilus influenzae in patients scheduled to undergo oral surgery requiring endotracheal intubation. We confirmed the pathogenicity of periodontopathic anaerobic bacteria for aspiration pneumonia in an experimental mouse model. Based upon the finding of the coexistence of Porphyromonas gingivalis with Treponema denticola in chronic periodontitis lesions, we innoculated a mixed culture of P. gingivalis and T. denticola into the mouse trachea; the resulting infection induced inflammatory cytokine production and caused pneumonia. In another series of investigations, professional oral health care (POHC), mainly cleansing administered by dental hygienists once a week for 24 months to elderly persons requiring daily care, resulted in the reduction of the number of total anaerobes, Candida albicans, and Staphylococcus species and in the number of cases of fatal aspiration pneumonia. We also found that the POHC treatment of elderly persons for 6 months in the winter season reduced the salivary levels of protease, trypsin-like activity, and neuraminidase and also decreased the frequency of influenza cases.