Periodontitis In Young Adults Research Articles

Grade C Molar-Incisor Pattern Periodontitis in Young Adults: What Have We Learned So Far?

Grade C Molar-Incisor Pattern Periodontitis in Young Adults: What Have We Learned So Far?

Does the guideline-based physical activity level for cardiovascular health also benefit periodontal health?

It is unclear about whether the guideline-based physical activity (PA) level for cardiovascular health also benefits periodontal health. Therefore, this study aimed to clarify the association between guideline-based PA levels and periodontitis in young adults. This was a cross-sectional study which included 334 military participants, aged 18-44 years in Taiwan. The PA level was assessed by total running time per week (wk) in the past 6 months from a self-reported questionnaire, and was classified as moderate intensity PA <150, 150-299, and ≥300min/wk according to the American guideline for cardiovascular health. Periodontitis was defined based on the 2017 World Workshop. Multiple logistic regression analysis was used to determine the association with adjustment for age, sex, educational level, tobacco smoking, alcohol intake, body mass index, waist circumference, blood pressure and teeth brushing frequency. As compared to the PA: 150-299min/wk, the PA <150min/wk was associated with a greater possibility of periodontitis (odds ratio (OR): 2.45 (95% confidence interval (CI): 1.24-4.82), whereas the PA ≥300min/wk was not associated with periodontitis (OR: 0.98 (95% CI: 0.13-1.09)) in young adults. The guideline-based moderate intensity PA level ≥150min/wk is found to have superior periodontal health in young adults. However, there is no additional benefit in more exercise time to obtain better periodontal health when the suggested PA level has been achieved.

Non-Insulin-Based Insulin Resistance Indices and Localized Periodontitis in Physically Active Young Male Adults: CHIEF Oral Health Study.

This study aims to examine the association between non-insulin-based insulin resistance indices and periodontitis severity in young males. Periodontitis has been reported with an association with insulin resistance in middle- and old-aged adults. The association between insulin resistance and localized periodontitis in young adults is unclear. A total of non-diabetic 1,111 military males in Taiwan were included in this study. Localized periodontitis was classified as healthy (N =665), stage I (N =130), stage II (N =161), and stage III (N =155) based on the world workshop in 2017. Insulin resistance was assessed by serum triglycerides concentrations, the triglycerides glucose (TyG) index, the product of serum triglycerides and fasting glucose, and the ratio of serum triglycerides to high-density lipoprotein cholesterol (TG/HDL-C). Multiple logistic regression analysis with adjustment for age, tobacco smoking, alcohol intake, abdominal obesity, and hypertension was used to determine the associations. Serum TG concentrations, TyG index, and TG/HDL-C ratio were dose-dependently associated with a greater risk of localized periodontitis severity (from stage I to stage III) [odds ratios and 95% confidence intervals: 1.001 (0.999-1.004), 1.003 (1.001-1.004) and 1.003 (1.002- 1.005) for TG; 1.45 (1.03-2.03), 1.65 (1.22-2.22) and 1.66 (1.22-2.26) for TyG index; 1.06 (0.99- 1.14), 1.09 (1.03-1.15) and 1.10 (1.04-1.16) for TG/HDL-C ratio]. However, the association was only found in obese individuals and those free of impaired fasting glucose. The present study confirmed that periodontitis may lead to insulin resistance in young male adults, particularly for those with obesity and without hyperglycemia. The TyG index is suggestive as the strongest indicator for the association between insulin resistance and periodontitis in young adults.

Periodontal Disease in Young Adults as a Risk Factor for Subclinical Atherosclerosis: A Clinical, Biochemical and Immunological Study.

Although a strong relationship between periodontal disease (PD) and atherosclerosis was shown in adults, little data are published in younger PD patients. Therefore, this study aimed to investigate and correlate clinical parameters of PD, pro- and immunoregulatory cytokines in gingival crevicular fluid (GCF) and serum, biochemical and hematological parameters associated with atherosclerosis risk, and carotid intima-media thickness (IMT) in our younger study participants (n = 78) (mean age 35.92 ± 3.36 years) who were divided into two equal groups: subjects with and without PD. PD patients had higher values of IMT, hs-CRP, triglycerides, total cholesterol, and LDL; most proinflammatory and Th1/Th17-associated cytokines in GCF; and IL-8, IL-12, IL-18, and IL-17A in serum compared to subjects without PD. These cytokines in GCF positively correlated with most clinical periodontal parameters. Clinical periodontal parameters, TNF-α and IL-8 in GCF and IL-17A, hs-CRP, and LDL in serum, had more significant predictive roles in developing subclinical atherosclerosis (IMT ≥ 0.75 mm) in comparison with other cytokines, fibrinogen, and other lipid status parameters. Hs-CRP correlated better with the proinflammatory cytokines than the parameters of lipid status. Except for serum IL-17A, there was no significant association of clinical and immunological PD parameters with lipid status. Overall, these results suggest that dyslipidemia and PD status seem to be independent risk factors for subclinical atherosclerosis in our younger PD population.

Periodontal therapy for localized severe periodontitis in a patient receiving fixed orthodontic treatment: a case report

BackgroundOrthodontic treatment involves movement of teeth by compression and resorption of the alveolar bone using orthodontic forces. These movements are closely linked to the interactions between the teeth and the periodontal tissues that support them. Owing to an increase in adults seeking orthodontic treatment, orthodontists increasingly encounter patients with periodontal diseases, in whom orthodontic treatment is contraindicated. In rare cases, periodontitis may develop after treatment initiation. However, no approach for treating periodontitis after the initiation of orthodontic treatment has been established. Here, we present an approach for managing localized severe periodontitis manifesting after initiating orthodontic treatment.Case presentationA 32-year-old Japanese woman was referred to the Department of Dentistry and Oral Surgery by an orthodontist who observed symptoms of acute periodontitis in the maxillary molars that required periodontal examination and treatment. A detailed periodontal examination, including oral bacteriological examination, revealed localized severe periodontitis (stage III, grade B) in the maxillary left first and second molars and in the mandibular right second molar. After consultation with the orthodontist, the orthodontic treatment was suspended based on the results of the bacteriological examination to allow for periodontal treatment. Full-mouth disinfection was performed with adjunctive oral sitafloxacin. Periodontal and bacteriological examinations after treatment revealed regression of the localized periodontitis with bone regeneration. Thereafter, orthodontic treatment was resumed, and good progress was achieved.ConclusionsOrthodontists should recognize the risk of acute severe periodontitis in young adults. Asymptomatic patients with localized severe periodontitis may clear a screening test before orthodontic treatment but develop acute symptoms with bone resorption during orthodontic treatment. Therefore, patients requiring orthodontic treatment should be examined by their family dentist or a periodontist to rule out periodontal issues that may impede orthodontic treatment. The patients should also be informed of age-related risks. Further, periodontists, family dentists, and orthodontists who treat adults should be informed about periodontitis and the need for interdisciplinary collaboration. In patients who develop periodontitis after orthodontic treatment initiation, temporary interruption of orthodontic treatment and aggressive periodontal intervention may facilitate recovery.

Systemic immune-inflammation index in patients with generalized stage III grade C periodontitis.

Systemic immune-inflammation index (SII) is a novel, inflammatory biomarker whose role in predicting several chronic systemic diseases has been recently identified. However, its association with generalized stage III grade C periodontitis in young adults remains unknown. The study is a multicentered, double-blind, hospital-based case-control clinical study. Periodontal examination comprised of recording plaque index, sites with bleeding on probing, pocket depth and clinical attachment loss for patients with generalized stage III grade C periodontitis and periodontally healthy group. Complete blood counts were obtained and used for calculating SII, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio. Collected data were then subjected to statistical analyses. SII was significantly higher in patients with generalized stage III grade C periodontitis compared to periodontally healthy individuals (723.87 vs. 537.74 × 109 /L, p < 0.0001). SII is associated with severe periodontitis in young adults (odds ratio [OR]:11.86, 95% CI 9.61-20.76, p < 0.0001) after adjusting for factors found significant in univariate analysis. Receiver operative curve analysis demonstrated a fair predictive validity of SII in detecting generalized stage III grade C periodontitis in young adults (AUC: 0.766, 95%CI 0.731-0.799, p < 0.0001, sensitivity 81.27%, specificity 76.50% and diagnostic accuracy 78.89%). SII did not exhibit superior predictive validity when compared with NLR in the context of generalized stage III grade C periodontitis (AUC for SII: 0.766, 95%CI 0.731-0.799, AUC for NLR: 0.788, 95% CI 0.754-0.819; p=0.28). SII is associated with generalized stage III grade C periodontitis in young adults.

Associations of decayed and filled teeth with localized stage II/III periodontitis in young adults: The CHIEF oral health study

Background/purposeTo investigate the associations between treated and untreated dental caries and periodontitis in young adults.Materials and methodsThe study enrolled 1289 participants aged 18–45 years in Taiwan. Localized periodontitis was categorized into healthy and stage II/III (n = 936 and n = 353, respectively) based on the 2017 criteria of the World Workshop. Multivariable logistic regression analysis with adjustments for sex, age, tobacco smoking status, betel nut consumption status, metabolic syndrome, and total white blood cell count was used to determine the associations.ResultsDecayed tooth numbers were positively associated with localized stage II/III periodontitis [odds ratio (OR): 1.15 (95% confidence intervals (CI): 1.06–2.25)], while filled tooth numbers were inversely associated with localized stage II/III periodontitis in young adults [OR: 0.96 (95% CI: 0.92–0.99)].ConclusionOur study confirms the relationship between dental caries and periodontitis by direct evidence that the more decayed teeth there are, the higher the risk of periodontitis and by indirect evidence that the more treated decayed teeth there are, the lower the risk of periodontitis in young adults.

Associations between metabolic biomarkers and localized stage II/III periodontitis in young adults: The CHIEF Oral Health study.

To investigate the associations between metabolic risk factors and periodontitis in young adults. The study included 1123 participants, aged 19-40 years, in Taiwan. Metabolic syndrome components were defined by the International Diabetes Federation criteria. Localized periodontitis was graded to healthy (n= 828) and stage II/III (n= 295) according to the 2017 criteria of the World Workshop. Multiple logistic regression analysis with adjustment for sex, age, betel nut consumption, and smoking were used to determine the associations. Greater waist circumference, serum triglycerides, and serum uric acid were associated with higher localized stage II/III periodontitis risk [odds ratio (OR) and 95% confidence interval (CI): 1.04 (1.02-1.05), 1.004 (1.002-1.006), and 1.10 (1.00-1.21), respectively]. There were no associations for total cholesterol, high-density lipoprotein, and blood pressure. There was a non-linear association between fasting glucose and localized stage II/III periodontitis, where the turning point was 105 mg/dl [OR: 0.97 (0.95-0.99) and 1.06 (1.00-1.13) when the levels were <105 and ≥105 mg/dl, respectively]. The risks of localized stage II/III periodontitis vary with metabolic components, in which waist circumference, serum triglycerides, and serum uric acid are the risk factors, whereas plasma glucose shows a non-linear relationship in young adults.

Clinical and diagnostic significance of blood leukocyte ratios in young patients with stage III grade C periodontitis

Objectives Blood leukocyte ratios have been recently proposed as simple, rapid, cheap and easily accessible biomarkers of systemic inflammation. However, little is known about the relationship of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) with periodontitis, which might not only serve as the potential biomarkers of systemic inflammation but also aid in diagnosis/screening of severe periodontitis. Hence, the purpose of this study was to evaluate the differences in the serum levels of these leukocyte ratios in healthy subjects and patients with generalized stage III Grade C periodontitis, and their applicability in identifying patients with the risk of developing severe periodontitis. Material and methods The subjects were categorized into case and control group. Clinical parameters including Plaque index (PI), modified Gingival Index (mGI), Mean ratio of bleeding sites, Probing Pocket depth (PPD) and the clinical attachment loss (CAL) were assessed in both the groups. Venous blood samples were collected from subjects from both groups for the biochemical analysis and blood leukocyte ratios- NLR, PLR and LMR were calculated. The values were then subjected to statistical analysis. Results The results showed significantly higher NLR and lower LMR values in patients with generalized stage III grade C periodontitis. Both the blood leukocyte ratios were moderately associated with increasing clinical parameters of periodontal disease. However, the values of PLR, although found to be higher in the periodontitis group, did not make a significant difference when compared with periodontally healthy subjects. The cut-off value of >2.15 for NLR and <7.16 for LMR fairly predicted the risk of severe periodontitis in young adults. Conclusions NLR and LMR can provide a new insight into the relationship between periodontitis and systemic diseases and can be of potential diagnostic value in identifying patients with severe periodontitis of younger age group.

Oral health-related quality of life in elderly and young patients with periodontal diseases

Objective: Due to the increase in the prevalence of periodontal diseases, quality of life decreases with aging. The purpose of this study was to investigate the quality of life and periodontal disease in young adults and elderly individuals. Materials and Method: A total of 104 individuals, including 52 elderly patients with periodontal disease (Test group; 37 with gingivitis and 15 with periodontitis) (mean age 67.56 ± 3.12) and 52 young adult patients with periodontal disease (Control group; 37 with gingivitis and 15 with periodontitis) (mean age 27.88 ± 6.59), were included in the study. The patients’ quality of life was determined by the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Clinical periodontal parameters (gingival index (GI), plaque index (PI), clinical attachment loss (CAL), and probing pocket depth (PPD)) were used in the evaluation. Results: In periodontitis, there was no difference in total OHIP scores between the groups (p&amp;gt;0.05), whereas, in gingivitis, OHIP scores were higher in elderly patients (p&amp;lt;0.05). While GI was significantly higher in elderly patients, PPD and CAL were significantly higher in young adult patients with periodontitis (p&amp;lt;0.05). OHIP sub-groups’ scores for "physical pain, psychological discomfort, and psychological disability" were significantly higher in elderly patients (p&amp;lt;0.05). Conclusion: Oral health-related quality of life was significantly lower in elderly patients with periodontal disease. While gingivitis had a significantly higher effect on the quality of life in elderly patients compared to younger patients, it was observed that there was no difference in both age groups in the presence of periodontitis. Improving oral health with atraumatic and effective treatment applications at early ages can prevent periodontal problems that may occur in advanced ages and increase the quality of life.

Comparisons of various anthropometric indexes with localized Stage II/III periodontitis in young adults: The CHIEF oral health study.

A J-shaped relationship of body mass index (BMI) with severe periodontitis has been reported. However, it is unknown for other anthropometric indexes in young adults. A cross-sectional study examined the relationships in 325 military men and women, aged 20 to 45 years in Taiwan. Anthropometric indexes included BMI, waist circumference (WC), and waist-to-height ratio (WHtR). The severity of localized periodontitis was defined as healthy (n=42), Stage I (initial) (n=228), and Stage II/III (moderate/severe) (n=55) according to the 2017 Periodontal Diseases Classification. Smooth curve fitting and multiple logistic regression analyses adjusting for age, sex, betel nut consumption, and smoking were used to determine the threshold effect between various anthropometric and the risk of localized Stage II/III periodontitis. In the spline smoothing plot, the turning points for BMI, WC, and WHtR were 26.1kg/m2 , 90.0cm, and 0.50, respectively, and a J-shaped relationship was found for BMI (the likelihood ratio test, P<0.001). In the multiple logistic regressions, BMI ≥27.0kg/m2 , WC ≥90.0cm and WHtR ≥0.50 were associated with higher risk of localized Stage II/III periodontitis than their counterparts (24.0 to 26.9kg/m2 for BMI) (odds ratios [OR] and 95% confidence intervals: 4.16 [1.39 to 12.49], 2.65 [1.01 to 7.11], and 2.95 [1.20 to 7.24], respectively; all P values<0.05). However, the risk for BMI<24.0kg/m2 was not significant (OR, 1.47 [0.47 to 4.54]). In young adults, obesity defined by various anthropometrics was consistently associated with localized Stage II/III periodontitis and a J-shaped association was suggestive for BMI.

Is overweight/obesity a risk factor for periodontitis in young adults and adolescents?: a systematic review.

Obesity in young adults and adolescents is associated with chronic co-morbidities. This project investigated whether being overweight or obese is a risk factor for periodontitis in adolescents (13-17years) and young adults (18-34years). A search of 12 databases was conducted using Medical Subject Headings/Index and Emtree terms. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, articles published between 2003 and 2016 were screened that reported periodontal and anthropometric measures. The Newcastle-Ottawa Scale was used to appraise the quality of studies. Of 25 eligible studies from 12 countries, 17 showed an association between obesity and periodontitis (odds ratios ranged from 1.1 to 4.5). The obesity indicators of body mass index, waist circumference, waist-hip ratio and body fat percentage were significantly associated with measures of periodontitis of bleeding on probing, plaque index, probing depths, clinical attachment loss, calculus, oral hygiene index and community periodontal index. Two prospective cohort studies in the review showed no significant association between obesity and periodontitis, but these studies had limitations of study design and used inappropriate epidemiological diagnostic measures of periodontitis. There was evidence to suggest that obesity is associated with periodontitis in adolescents and young adults. Systematic Review Registration: PROSPERO Registration Number: CRD42016046507.

Prediction of Periodontitis Occurrence: Influence of Classification and Sociodemographic and General Health Information.

Prediction of periodontitis development is challenging. Use of oral health-related data alone, especially in a young population, might underestimate disease risk. This study investigates accuracy of oral, systemic, and socioeconomic data on estimating periodontitis development in a population-based prospective cohort. General health history and sociodemographic information were collected throughout the life-course of individuals. Oral examinations were performed at ages 24 and 31 years in the Pelotas 1982 birth cohort. Periodontitis at age 31 years according to six classifications was used as the gold standard to compute area under the receiver operating characteristic curve (AUC). Multivariable binomial regression models were used to evaluate the effects of oral health, general health, and socioeconomic characteristics on accuracy of periodontitis development prediction. Complete data for 471 participants were used. Periodontitis classifications with lower thresholds yielded superior predictive power. Calculus, pocket, or bleeding presence at age 24 years separately presented fair accuracy. Accuracy increased using multivariable models; for example, the Beck et al. classification AUC from 0.59 to 0.75 combining proportion of teeth with calculus, bleeding, or pocket with income; number of lost teeth; sex; education; people living in the house; prosthetic needs; or number of decayed, missing, or filled teeth (DMFT). Proportion of teeth with pocket, bleeding, or calculus; number of DMFT; toothbrushing frequency; blood pressure; sex; and income were most frequently associated. Choice of classification might have an impact on accuracy to predict periodontitis occurrence. Regardless of the classification, predictive value for development of periodontitis in young adults might be increased by combining periodontal information, sociodemographic information, and general health history.

МЕТАБОЛІЧНЕ ТА СТРУКТУРНЕ ПІДГРУНТЯ ЗМІН ФУНКЦІОНАЛЬНОЇ АКТИВНОСТІ ТКАНИН ПАРОДОНТА ЗА РОЗВИТКУ ГЕНЕРАЛІЗОВАНОГО ПАРОДОНТИТУ У ОСІБ МОЛОДОГО ВІКУ

МЕТАБОЛІЧНЕ ТА СТРУКТУРНЕ ПІДГРУНТЯ ЗМІН ФУНКЦІОНАЛЬНОЇ АКТИВНОСТІ ТКАНИН ПАРОДОНТА ЗА РОЗВИТКУ ГЕНЕРАЛІЗОВАНОГО ПАРОДОНТИТУ У ОСІБ МОЛОДОГО ВІКУ

Association of Some Vitamins and Minerals with Periodontitis in a Nationally Representative Sample of Korean Young Adults.

The purpose of this study was to investigate whether the intakes of some kinds of vitamins and minerals are associated with periodontitis in a nationally representative sample of young adults. This study comprised 2049 young adults aged 19-39years who took both periodontal examination and nutrition survey. The vitamin and mineral intakes were calculated from dietary intake data gained by complete one-day 24-h recall interviews, and the intake levels for each nutrient were classified by the Recommended Nutrient Intake (RNI) in Dietary Reference Intakes for Koreans and median values. Periodontitis was assessed using Community Periodontal Index (CPI). Multivariate logistic regression analyses were performed in a whole sample and subgroups with the strata of gender or smoking, following a complex sampling design. In analyses according to RNI, a lower intake of niacin was significantly associated with periodontitis in young adults (odd ratio [OR] 1.47, 95% confidential interval [CI] 1.09-2.00) and in its subgroup of women (OR 1.70; 95% CI 1.10-2.64) and current non-smokers (OR 1.75; 95% CI 1.22-2.51). Whereas, in analyses according to median intake values, there were significant associations of periodontitis with a lower intake of niacin in women (OR 1.58; 95% CI 1.02-2.46) and current non-smokers (OR 1.50; 95% CI 1.01-2.22), with lower intake of vitamin C in women (OR 1.66; 95% CI 1.04-2.64) and in current non-smokers (OR 1.49; 95% CI 1.04-2.14), with lower intake of iron in women (OR 1.85; 95% CI 1.11-3.07), and with lower intake of vitamin A marginally in women (OR 1.56; 95% CI 1.00-2.44). In young adults, periodonitis is significantly associated with the lower intakes of niacin, vitamin C, and iron, especially in women and current non-smokers.

Selection of immunostimulatory drugs in the complex treatment of generalized periodontitis in young adults

In the complex treatment of generalized periodontitis immunomodulators of different structure and mechanism of action and Immunal were used. The received clinical results showed that Imudon had a higher efficiency than Immunal.

Added sugars and periodontal disease in young adults: an analysis of NHANES III data

Added sugar consumption seems to trigger a hyperinflammatory state and may result in visceral adiposity, dyslipidemia, and insulin resistance. These conditions are risk factors for periodontal disease. However, the role of sugar intake in the cause of periodontal disease has not been adequately studied. We evaluated the association between the frequency of added sugar consumption and periodontal disease in young adults by using NHANES III data. Data from 2437 young adults (aged 18-25 y) who participated in NHANES III (1988-1994) were analyzed. We estimated the frequency of added sugar consumption by using food-frequency questionnaire responses. We considered periodontal disease to be present in teeth with bleeding on probing and a probing depth ≥3 mm at one or more sites. We evaluated this outcome as a discrete variable in Poisson regression models and as a categorical variable in multinomial logistic regression models adjusted for sex, age, race-ethnicity, education, poverty-income ratio, tobacco exposure, previous diagnosis of diabetes, and body mass index. A high consumption of added sugars was associated with a greater prevalence of periodontal disease in middle [prevalence ratio (PR): 1.39; 95% CI: 1.02, 1.89] and upper (PR: 1.42; 95% CI: 1.08, 1.85) tertiles of consumption in the adjusted Poisson regression model. The upper tertile of added sugar intake was associated with periodontal disease in ≥2 teeth (PR: 1.73; 95% CI: 1.19, 2.52) but not with periodontal disease in only one tooth (PR: 0.85; 95% CI: 0.54, 1.34) in the adjusted multinomial logistic regression model. A high frequency of consumption of added sugars is associated with periodontal disease, independent of traditional risk factors, suggesting that this consumption pattern may contribute to the systemic inflammation observed in periodontal disease and associated noncommunicable diseases.

Association between obesity and periodontal disease in young adults: a population‐based birth cohort

AimTo evaluate the association between obesity and periodontal disease and the mediating effect of oral hygiene, systemic inflammation and carbohydrate intake.Material and methodsSubjects born in 1982 in Pelotas, Brazil (n = 5,914), have been followed for several times. Oral health was assessed in a representative sample of 720 individuals at 24 years. Obesity, waist circumference and number of episodes with obesity between 15 and 23 years of age were the main exposures. Mediating effect of oral hygiene, C-reactive protein level and carbohydrate consumption was also assessed.ResultsObese individuals were more likely to have ≥2 teeth with gingival bleeding. However, after adjusting for confounders, the association was not statistically significant [OR (obese × 2 or more teeth) 1.72 (95% CI: 0.95, 3.11)] and adjustment for potential mediators decreased the OR (OR = 1.38). The risk of presenting calculus in obese subjects was 10% higher [PR 1.10 (95% CI: 1.02, 1.18)]. The number of episodes of obesity between 15 and 23 years was associated with dental calculus. Periodontal pockets were not associated with obesity.ConclusionSystemic inflammation and oral hygiene may be mediating the association between obesity and gingivitis. Obesity was not associated with periodontal pockets in young adults in this cohort.

Evaluation of periodontal disease in dental students

A cross-sectional study was conducted on dental students at Bahadurgarh, Haryana, for the assessment of periodontal health and possible associated factors. A total of 329 students were examined clinically by periodontists. Students with bleeding on probing and attachment loss ≥ 2 mm were assessed further for extent of bone loss radiographically. The awareness of disease and knowledge of management was also assessed. Sixty-three (19.1%) students showed clinical signs of disease and 21 (6.3%) had cemento-enamel junction (CEJ) to the bone crest distance of ≥2 mm. Proximal carious lesions were observed in nine cases of attachment loss. Mottled enamel with a roughened surface had association with attachment loss. The clinical students showed reasonable knowledge of disease and management. The need to strengthen the diagnostics for early detection of periodontal disease in young adults is suggested.

Presence of Aggregatibacter actinomycetemcomitans in young individuals: a 16‐year clinical and microbiological follow‐up study

To look for clinical signs of periodontal disease in young adults who exhibited radiographic bone loss and detectable numbers of Aggregatibacter actinomycetemcomitans in their primary dentition. Periodontal status and radiographic bone loss were examined in each of the subjects 16 years after the baseline observations. Techniques for anaerobic and selective culture, and checkerboard, were used to detect periodontitis-associated bacterial species. The isolated A. actinomycetemcomitans strains were characterized by polymerase chain reaction. Signs of localized attachment loss were found in three out of the 13 examined subjects. A. actinomycetemcomitans was recovered from six of these subjects and two of these samples were from sites with deepened probing depths and attachment loss. Among the isolated A. actinomycetemcomitans strains, serotypes a-c and e, but not d or f, were found. None of the isolated strains belonged to the highly leucotoxic JP2 clone, and one strain lacked genes for the cytolethal distending toxin. This study indicates that the presence of A. actinomycetemcomitans and early bone loss in the primary dentition does not necessarily predispose the individual to periodontal attachment loss in the permanent dentition.