Rapidly Progressive Periodontitis Research Articles

Clinical Features of the Course of Rapidly Progressive Periodontitis Combined with Bronchial Asthma and the Effects of Various Modes of Complex Therapy

The aim of the research was to study the clinical features of the course of rapidly progressive periodontitis (RPР) combined with bronchial asthma and the effects of complex therapy. In the dynamics of the complex treatment, including propolis and resonance therapy against the background of basic treatment, a significant improvement in microcirculation and the degree of restoration of trophic disorders of the periodontal part of the teeth was established. Also, in these patients, the FVD indicators significantly increased.

Bacteroides gingivalis-specific serum IgG and IgA subclass antibodies in periodontal diseases

The level of serum IgM, IgG and IgA antibodies including IgG1, IgG2, IgG3, IgG4, IgA1 and IgA2 subclass-specific antibodies to Bacteroides (Porphyromonas) gingivalis fimbriae and to lipopolysaccharide (LPS) were analysed in patients with different forms of periodontal disease (PD) and control subjects by ELISA. Among PD subjects, sera obtained from adult periodontitis (AP), rapidly progressive periodontitis (RPP) and gingivitis contained high titres of fimbriae-specific IgG antibodies (7500-15,000 ELISA units) followed by IgA (90-700 units) and IgM (30-90 units). In contrast, sera from localized juvenile periodontitis (LJP) subjects exhibited much lower titres of fimbriae-specific IgG (89 +/- 11 units), IgA (31 +/- 5 units) and IgM (17 +/- 3 units) antibodies. A similar response pattern was also seen in sera from normal subjects aged 35-41 years who practice normal oral hygiene, while sera of younger adults (aged 18-24) with superior hygiene did not have any antigen-specific antibodies. Analysis of IgG subclass anti-fimbriae responses revealed that the major response was IgG3 followed by IgG1, IgG2 and IgG4 in AP, RPP and gingivitis. Although lower, a similar pattern of IgG subclass titre was seen in LJP and normal subjects aged 35-41 years. When IgA subclass responses were measured in AP and RPP, higher titres of the fimbriae-specific response were noted with IgA1 when compared with IgA2. However, lower but approximately equal levels of fimbriae-specific IgA1 and IgA2 titres were seen in other PD groups. When anti-B. gingivalis LPS-specific responses were measured, the sera of AP patients contained high levels of IgG antibodies (2265 +/- 224 units) followed by IgA (411 +/- 90 units) and IgM (214 +/- 56 units). Further, IgG anti-LPS responses were mainly IgG2 followed by IgG4, IgG3 and IgG1. For IgA subclass responses, higher titres of anti-LPS-specific antibodies were noted in IgA2 subclass over IgA1. These results showed that higher anti-B. gingivalis antibody responses occur in PD when compared with healthy individuals and protein and lipid-carbohydrate antigens of B. gingivalis induce distinct patterns of antigen-specific IgG and IgA subclass responses.

Dermatoglyphic findings in periodontal diseases

The finger-tip palm and sole prints of 13 male and 23 female, a total of 36 patients with juvenile periodontitis (JP) 24 male and 21 female, a total of 45 patients with rapidly progressive periodontitis (RPP) and 19 male and 19 female, a total of 38 patients with adult periodontitis (AP) were compared with those of 17 male and 22 female, a total of 39 periodontally healthy (PH) individuals for the aim of finding a pattern type that would identify those patients. Besides, the finger-tip and palmar patterns of the patients were compared with those of 446 male and 447 female, a total of 833 school children (SC), and the sole patterns of the patients were compared with those of 250 male and 250 female, a total of 500 SC. When, the finger-tip patterns of the patients were compared with those of PH individuals, the decreased frequencies of twinned and transversal ulnar loops on all fingers of the patients with JP, a decreased frequency of double loops on all fingers and an increased frequency of radial loops on the right second digits of the patients with RPP, and the increased frequencies of concentric whorls and transversal ulnar loops on all fingers of the patients with AP, an increased frequency of t″ triradii on the palms of the patients with JP, the increased frequencies of IV and H loops and tb triradii on the palms of the patients with RPP and an increased frequency of e triradii on the soles of the patients with JP were found. In summary, in the light of these findings dermatoglyphics could be used together with the other diagnostic methods such as clinical and radiologic investigations and in the identifying of the patients from distinct groups of PD’s.

Immunohistological and morphometric analysis of inflammatory cells in rapidly progressive periodontitis and adult periodontitis.

The purpose of this study was to localize, characterize, and quantify in situ the inflammatory cells in the gingival connective tissue prior and subsequent to the initial therapy of ten patients with rapidly progressive periodontitis (RPP) and five patients with adult periodontitis (AP). Using immunohistological techniques, the amount of T lymphocytes, alphabeta-T lymphocytes, gammadelta-T lymphocytes, B lymphocytes, and plasma cells was determined at the beginning of the periodontal therapy (baseline) and at the time of periodontal surgery. Furthermore, the distribution of collagen types I, III, V, and VI was investigated using transmission electron microscopy. At baseline, patients with RPP revealed much higher numbers of inflammatory cells than patients with AP. During initial therapy of patients with RPP, the amount of T cells, alphabeta-T cells, and gammadelta-T cells was reduced significantly (P<0.05). Biopsies of patients with AP revealed a statistically significant reduction of all cell types, except alphabeta-T cells and gammadelta-T cells in the deep connective tissue. The transmission electron microscopy of biopsies from patients with RPP and AP with severe inflammation taken at baseline revealed that collagen types I and III were destroyed nearly completely in areas with leukocyte infiltration, whereas collagen types V and VI revealed a more pronounced labeling reaction. The results revealed that, during initial therapy, the amount of inflammatory cells was reduced significantly more in biopsies of patients with AP than in patients with RPP. At baseline, the inflamed gingival tissue consists mainly of collagen types V and VI in areas with infiltrates of inflammatory cells.

Nitric oxide synthesis is decreased in periodontitis.

In order to study the possible role of nitric oxide (NO) in the development of periodontitis, we measured the concentration of its stable metabolite nitrite (NO2-) in the saliva of patients with periodontitis and healthy subjects. We have analysed salivary NO2- concentrations in 25 subjects with rapidly progressive periodontitis (RPP), 25 with adult periodontitis (AP) and in 25 periodontally-healthy persons. The concentrations of NO2- were determined by the Griess reaction in microtitration plates. Periodontal tissue destruction was determined by measuring the attachment level loss using standard methods. Subjects with periodontitis had significantly less NO2- in saliva than healthy subjects. Subjects with RPP had lower NO2- concentrations than those with AP Parotid gland saliva contained less NO2- than sublingual gland or total saliva. Local NO production is decreased in patients with periodontitis. This effect is more pronounced in those with severe types of disease.

Microbiological characteristics of subgingival microbiota in adult periodontitis, localized juvenile periodontitis and rapidly progressive periodontitis subjects

To describe the prevalence of the cultivable subgingival microbiota in periodontal diseases and to draw attention to the polymicrobial nature of periodontic infections. The study population consisted of 95 patients, 51 females and 44 males, aged 14-62 years. Twenty-nine patients exhibited adult periodontitis (AP), six localized juvenile periodontitis (LJP), and 60 rapidly progressive periodontitis (RPP). Two to four pooled bacterial samples were obtained from each patient. Samples were collected with sterile paper points from the deepest periodontal pockets. The samples were cultured under anaerobic and microaerophilic conditions using selective and non-selective media. Isolates were characterized to species level by conventional biochemical tests and by a commercial rapid test system. Prevotella intermedia and Capnocytophaga spp. were the most frequently detected microorganisms in all diagnostic groups. Porphyromonas gingivalis and Peptostreptococcus micros were found more frequently in AP and RPP patients, while Actinobacillus actinomycetemcomitans and Eikenella corrodens were associated with AP, LJP and RPP patients. The other bacterial species, including Actinomyces spp., Streptococcus spp. and Eubacterium spp., were detected at different levels in the three disease groups. The data show the complexity of the subgingival microbiota associated with different periodontal disease groups, indicating that the detection frequency and levels of recovery of some periodontal pathogens are different in teeth affected by different forms of periodontal disease.

Clindamycin promotes phagocytosis and intracellular killing of periodontopathogenic bacteria by crevicular granulocytes: an in vitro study.

Phagocytosis of periodontopathogenic bacteria by crevicular polymorphonuclear neutrophil granulocytes (PMNs) plays a key role in the aetiology of periodontitis. Antimicrobials such as clindamycin have been proven to be effective in treating progressive forms of this disease. Therefore, the purpose of this study was to determine the effect of clindamycin on the phagocytosing properties of gingival crevicular PMNs obtained from 16 patients with rapidly progressive periodontitis (RPP), eight with localized juvenile periodontitis (LJP), 12 with adult periodontitis (AP) and 13 periodontally healthy controls. The phagocytosis assay was performed with the two strains Porphyromonas gingivalis ATCC 33277 and Actinobacillus actinomycetemcomitans Tanner FDC 44 on a slide. Phagocytosis and intracellular killing were assessed by fluorescence microscopy after staining with acridine orange. The addition of clindamycin elevated the percentage of phagocytosing PMNs in periodontitis patients and controls regardless of whether P. gingivalis or A. actinomycetemcomitans was used as test strain. In granulocytes of healthy controls an enhancement of the intracellular killing of both strains was observed if clindamycin was added. Besides the antimicrobial effect, the enhancement of the phagocytosis might be an additional indication for treatment of periodontitis patients with clindamycin.

Prevalence of Bacteroides forsythus, Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans in subgingival microflora of Japanese patients with adult and rapidly progressive periodontitis.

This study investigated the prevalence of Bacteroides forsythus, Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans among various periodontitis patients and healthy individuals in Japan, and correlated it with clinical parameters. Subgingival plaque samples were collected from 21 patients with adult periodontitis (AP), 8 with rapidly progressive periodontitis (RPP) and 15 healthy individuals. The frequency detected in culture was as follows: B. forsythus was found in 47.6% of AP sites and in 37.5% of RPP sites. P. gingivalis was identified in 64.3% of AP and 59.4% of RPP sites. A. actinomycetemcomitans was detected in 4.8% of AP and 3.1% of RPP sites. The 3 species were detected in only 2 of the healthy individuals. The proportion of B. forsythus in the total microflora in culture was 0.07% in the healthy group, 4.1% in AP and 2.4% in RPP. The proportions of P. gingivalis were 0% in the healthy group, 18.8% in AP and 16.2% in RPP. The proportion of A. actinomycetemcomitans was very low in all 3 groups. A DNA probe detected B. forsythus in 78.6% of AP and 65.6% of RPP sites, as well as P.gingivalis in 58.3% of AP and 59.4% of RPP sites. A. actinomycetemcomitans was detected in only 1.2% of AP sites. The 3 species were undetectable in the healthy group. The prevalence and the proportion of B. forsythus and P. gingivalis were significantly correlated with clinical parameters, suggesting that B. forsythus and P. gingivalis are closely related to AP and RPP in the Japanese population.

Morphology of azurophil lysosomes in polymorphonuclear leukocytes from humans with rapidly progressive periodontitis.

Previous investigations have shown that subjects with rapidly progressive periodontitis (RPP), an early-onset aggressive form of periodontitis, have polymorphonuclear leukocytes (PMNs) with increased intracellular levels of beta-glucuronidase, a characteristic enzyme of azurophil lysosomes. The current study attempted to account for that increase. Ten healthy controls and 10 otherwise healthy subjects with RPP participated. PMNs from peripheral blood were separated, fixed and reacted for peroxidase to identify azurophil lysosomes. Using transmission electron microscopy, 20 PMNs per subject were photographed at 10,000x. Photographs were subsequently digitized and analyzed by computer. RPP PMNs had a higher percentage of the area of the cell profile occupied by azurophil lysosomes compared to control subjects' PMNs. The RPP subjects also had greater absolute numbers of azurophil lysosomes per cell. Lysosome shape was assessed visually. There were no differences between RPP and control groups for lysosome shape, with the majority of lysosomes in each group exhibiting a round or oval shape. RPP lysosomes did exhibit a significantly greater mean size.

Peranan Terapi Awal dan Terapi Pemeliharaan pada Rapidly Progressive Periodontitis Type 1

Rapidly Progressive Periodontitis (RPP) is a severe form of a periodontal disease which starts since a puberty age. The disease if a generalized periodontal destruction without a specific distribution mode: it develops more progressively but does not in accordance to local factors. The first step to the RPP treatment is initial therapy: i.e. DHE, scaling and root planing, and eliminating predisposing local factors and continued with a maintence therapy which will support the success of a surgery later. A study case: a 21-year old RPP woman showed hyperaemia, an abscess, a 10 mm mesial pocket depth, a 5 mm distal pocker depth, a 5 mm buccal pocket depth, a 2 nd degree tooth mobility and a 3 mm buccal recession on 25. In the initial therapy she was given an amoxicillin, a metronidazole for killing a supra and subgingival baterial, vitamins B and C, and also a chlorhexidine 0.2% mouth wash for a week. After a week the abscess and the inflammation decreased, but the mobility was still in the same condition and the DHE was still evaluated because of the patient's social factor, the FO was delayed. The next visit was done every 2 monts for a year for maintenance care. The clinical result showed the gingival inflammation and the tooth mobility disappeared. Radiographically, the alveolar bone showed more radiopaque and the lamina dura was seen. In conclusio, the initial and the maintenance therapy was seen to heal the RPP.

Kombinasi Pemberian Tetracycline dengan Metronidazole pada Perawatan Rapidly Progressive Periodontitis Metode Baru

Systemic combination metronidazole and tetracycline were compare as adjunctive agents in the treatment of rapidly progressive periodontitis (RPP), 30 patients with RPP were treated with scaling and root planing, control of oral hygiene and periodontal surgery if indicated. The patients were randomly divided into 3 equal groups: the first group had metronidazole 200 mg x 3 x 10 days, and then to be continued with tetracycline 250 mg x 4 x 12 days. The second group had tetracycline 250 mg x 4 x 12 days and then to be continued with metronidazole 200 mg x 3 x 10 days. The third group as control received no medication. All the group had not periodontal surgery after received medications. Gingival Index (GI), Probing Depth (PD), Suppuration and Ginigival Bleeding after probing (GB) registered. All parameters were monitored at 10, 12, and 22 days after treatment. By the end of the research all groups showed improvement. In conclusion: treatment of RPP with tetracycline to be continued with metronidazole were more effective than metronidazole to be continued with tetracycline to produce better clinical results.

IgG subclass-dependent Recognition of Porphyromonas Gingivalis Antigens in the Early-onset Periodontitis

Studies of the IgG subclass responses in earlyonset periodontitis(EOP) have frequently demonstrated elevated levels of total IgG or IgG2 to whole cell antigens, outer membrane proteins, and/or lipopolysaccharides(LPS) of Actinobacillus actinomycetemcomitans(Aa)1,2) or Porphyromonas gingivalis(Pg)3 according to the disease type. (Hammarstrom et al., 1986) IgG1, IgG3 and IgG4 antibodies are primarily reactive to protein antigens and IgG2 to bacterial carbohydrates, such as LPS or capsular polysaccharides(CPS). Moreover, each IgG subclass response has been studied in the context of the genetic control of an individual. Immunodominant antigens of Aa in localized juvenile periodontitis(LJP) were reported to include the 29-kd, 40-kd and 75-kd outer membrane proteins, and capsular carbohydrates(CPS) as well as LPS, while those of Pg in rapidly progressive periodontitis(RPP) were fimbriae, 75-kd protein, CPS, and LPS5). There have been controversies in regard to the bacterial antigens being recognized as immunodominant especially in the case of outer rnembrane proteins, presumably due to individual differences in IgG subclass responsiveness or to the complexities of the bacterial antigens. There has also been some debate regarding bacterial LPS or CPS in terms of their immunodominant nature in the pathogenesis of EOP. A previous investigation from our laboratory has focused on the various patterns of elevated IgG sunbclasses to Pg 381 in LJP or RPP patients6). To better understand the immunodominant antigens recognized by a panel of IgG subclass antibodies, we performed dot immunoblot analysis of selected bacterial antigens of Pg that are recognized by either a single or by various combinations of IgG subclasses in early-oneset periodontitis.

Neutrophil Dysfunctions, IL-8, and Soluble L-Selectin Plasma Levels in Rapidly Progressive Versus Adult and Localized Juvenile Periodontitis: Variations According to Disease Severity and Microbial Flora

We used flow cytometry to analyze the expression of adhesion molecules and the oxidative burst of whole-blood polymorphonuclear neutrophils (PMN) from 26 patients with periodontitis. Three different clinical entities were studied: adult periodontitis (AP), localized juvenile periodontitis (LJP), and rapidly progressive periodontitis (RPP). Unstimulated PMN from the patients showed reduced Lewis x, sialyl-Lewis x, and L-selectin expression relative to those from healthy control subjects. These alterations were present whatever the severity of periodontal disease. However, PMN from RPP patients showed increased basal H2O2 production and decreased L-selectin shedding. These latter impairments, which correlated with increased IL-8 plasma levels, could contribute to initial vascular damage. In addition, decreased IL-8 priming of H2O2 production by PMN from RPP patients could account for a lower bactericidal capacity of PMN, leading to the large number of bacteria in the subgingival region of RPP patients. Soluble L-selectin plasma levels were also decreased in the RPP group, indicating more severe or diffuse endothelial damage. These abnormalities were not found in the patients with less destructive forms of periodontitis (AP and LJP). Porphyromonas gingivalis, a bacterial pathogen known to increase IL-8 production by PMN, was found in the periodontal pockets of RPP patients only. These results show links among PMN abnormalities, the clinical form of periodontitis, and the gingival bacterial flora.

Psychosocial factors, dental plaque levels and smoking in periodontitis patients.

Psychological disturbances may lead patients to neglect oral hygiene. This study investigated whether a number of psychosocial factors (depression, state and trait anxiety, total and average perceived stress, and loneliness) could predict dental plaque levels in patients with adult onset rapidly progressive periodontitis (RPP) and routine chronic adult periodontitis (RCAP), before periodontal treatment. It was also examined whether RPP and RCAP patients differed on plaque and smoking. Plaque was scored in a sample of 6 teeth in each of 80 subjects, 40 with RPP, 40 with RCAP, before psychosocial questionnaire completion. Multiple regression was performed between plaque as the dependent and psychosocial factors, gender, education, form of periodontitis and smoking as independent variables. Only gender contributed significantly to prediction of plaque, t=-2.70, p=0.01, partial regression coefficient -0.37, 95% CI: -0.64 to -0.10, indicating that plaque was on average 0.37 lower for females than males, after adjusting for the other predictor variables. It was confirmed that RPP and RCAP patients did not differ significantly on plaque, univariate t-test(69.99)= 0.65, p=0.13. However, RPP patients smoked significantly more than RCAP patients t(69.72)=2.36, p=0.02. There was also a marginally significant correlation between depression and smoking, r=0.16, p=0.07. One possible reason advanced for the lack of an association between psychosocial factors and plaque, and the absence of a difference in plaque between RPP and RCAP patients is the fact that the patients involved in the present study were seen as secondary referrals. The gender difference in plaque levels and the greater incidence of smoking in RPP patients may be of significance in planning interventions with patients with periodontitis.

Molecular epidemiology of oral treponemes associated with periodontal disease.

Periodontitis, a disease responsible for tooth loss worldwide, is characterized by chronic inflammation of the periodontium, eventually leading to destruction of periodontal ligaments and supporting alveolar bone. Spirochetes, identified by dark-field microscopy as being the most predominant bacteria in advanced lesions, are thought to play a causative role. Various spirochetal morphotypes were observed, but most of these morphotypes are as yet uncultivable. To assess the role of these organisms we designed oligonucleotide probes for the identification of both cultivable and so far uncultivable spirochetes in periodontitis patients. Subgingival plaque specimens taken from diseased sites (n = 200) and healthy control sites (n = 44) from 53 patients with rapidly progressive periodontitis (RPP) were submitted to direct in situ hybridization or dot blot hybridization after prior amplification with eubacterial primers. Spirochetes were found in all patients, but their distributions varied considerably. Parallel use of oligonucleotide probes specific for cultivable or so far uncultivable treponemes suggested the presence of novel yet unknown organisms at a high frequency. These uncultivable treponemes were visualized by fluorescence in situ hybridization, and their morphologies, sizes, and numbers could be estimated. All RPP patients included in this study harbored oral treponemes that represent either novel species, e.g., Treponema maltophilum, or uncultivable phylotypes. Therefore, it is necessary to include these organisms in etiologic considerations and to strengthen efforts to cultivate these as yet uncultivable treponemes.

Reduced CD8+ peripheral blood T lymphocytes in rapidly progressive periodontitis

The peripheral blood T-cell phenotype of patients with rapidly progressive periodontitis (RPP) was determined in order to investigate whether there were T-cell imbalances or not. Twenty patients aged 21–39 yr were selected for this study. Bone resorption and probing pocket depth were measured. All the patients had 10 or more teeth showing bone loss of 50% or more. As controls, 12 periodontally healthy, age-matched individuals were selected. Blood samples were obtained by venipuncture, and lymphocytes were isolated. Two-colour flow cytometric analysis was done with monoclonal antibodies against human CD4, CD8, and CD45RA antigens. The RPP patients were found to have significantly lower percentage of CD8+ T cells (Mann-Whitney's U-test, p < 0.01) and an increased CD4/CD8 ratio (Mann-Whitney's U-test, p < 0.01) compared with healthy individuals. On the other hand, there were no significant differences in the percentages of CD4+ T cells and CD4 + CD45RA+ T cells between RPP patients and healthy individuals. No correlations between the clinical findings and T-cell subsets were found. These findings suggest that imbalances of peripheral blood T lymphocytes, especially a tendency to decreased CD8+ T cells, exist in RPP patients, and that cellular immune responses mediated by CD8+ T cells may play a part in the pathogenesis of RPP.

Studies on the phenotypic and functional characterization of peripheral blood lymphocytes from patients with early-onset periodontitis.

Juvenile and rapidly progressive periodontitis are grouped under the heading of patients with early-onset periodontitis (EOP). Many studies have investigated host risk factors in the etiology of EOP patients but these remain inconclusive. This study was undertaken to assess the possibility that an abnormality in the systemic lymphocyte subpopulation or function is involved in the etiology of EOP patients. Fourteen (14) patients with juvenile periodontitis (JP), 18 with rapidly progressive periodontitis (RPP), 22 with adult periodontitis (AP), and 33 with a healthy periodontium (HP) participated in this study. Lymphocyte subsets were determined by using panels of monoclonal antibodies (mAbs) and fluorescent flow cytometry. T cell blastogenesis was evaluated by [3H]-thymidine uptake. Pokeweed mitogen induced immunoglobulin G (IgG) and IgM synthesis were detected by sandwich enzyme-linked immunosorbent assay. There were wide distributions of values in all examinations among subjects. No significant difference could be found between the periodontitis patients and HP groups with the exception of a high CD4/CD8 ratio in all patient groups (P < 0.0001) and the depressed percentages of CD3 positive cells noted in the AP patient group (P < 0.0001). These results suggest that the majority of EOP patients do not show significantly different lymphocyte profiles from AP patients and HP subjects, and that lymphocyte cell dysfunctions are not always seen, even in EOP patients.

Detection of antigenic proteins in Porphyromonas gingivalis using two-dimensional electrophoresis and western blots.

Using two-dimensional (2D) electrophoresis and western blot assay, we analyzed antigenic proteins in Porphyromonas gingivalis uniquely recognized by antibodies in sera of periodontitis subjects. Proteins in the total membrane fraction of P. gingivalis 381 were resolved into at least 70 protein spots by 2D electrophoresis. In the gel stained with silver, the substance around 47 kDa protein on the acidic side (at an isoelectric point of about 4.5) was stained as a smear. Antigenic substances were characterized using purified IgGs from sera of 16 adult periodontitis (AP), 19 rapidly progressive periodontitis (RPP) and 14 periodontally healthy volunteers. Western blots demonstrated that 75 kDa protein reacted with IgGs from 75% of AP patients (p < 0.001), the antigenic substance around acidic 47 kDa protein reacted with IgGs from 81.3% of AP (p < 0.01) and 68.4% of RPP patients (p < 0.01) and the acidic 47 kDa protein reacted with 87.5% of AP (p < 0.01) and 78.9% of RPP patients (p < 0.01). The reaction frequency was significantly different from that of the healthy volunteers. Also 51 kDa and 41 kDa proteins reacted with 47 and 43 of 49 IgG samples, respectively. The substance around acidic 47 kDa protein reacted with mouse antiserum to P. gingivalis-LPS. After treatment with pronase or heat, the antigenic reactions disappeared not only from the proteins, but also from the area around the acidic 47 kDa protein. When the fraction was digested with lipase, the antigenic reaction of the area decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial‐Stimulated Cytokine Production of Peripheral Mononuclear Cells From Patients of Various Periodontitis Categories

Periodontitis is a general term for disease categories, including juvenile periodontitis (JP), rapidly progressive periodontitis (RPP), and adult periodontitis (AP), which may or may not share a common etiology and pathogenesis. These disease categories are characterized by differences in progression of tissue destruction and differences in age group susceptibility, but not, to our knowledge, by differences in cytokine responses of inflammatory cells. The present study examined blood cell counts and interindividual variation in the ability of PBMC of patients in three different categories of periodontitis to produce cytokines after stimulation with different oral bacterial species in vitro. The AP group had a significantly lower production of IL-1ra when stimulated with Porphyromonas gingivalis (P.g.) and Actinobacillus actinomycetemcomitans (A.a.) (P < 0.05). Streptococcus sanguis (S.s.), which is associated with normal periodontal conditions, induced extremely high levels of IL-1 alpha and TNF alpha production in all groups. The RPP group had a significantly higher number of monocytes (MC) than the AP group (P < 0.05). Additionally, JP patients had a significantly higher concentration of polymorphonuclear granulocytes compared to juvenile controls (P < 0.05). In conclusion, IL-1 alpha, TNF alpha, or IL-6 production by peripheral blood MC after in vitro stimulation with oral bacterial type stains may not distinguish different categories of periodontitis. The results support the hypothesis that the cytokine IL-1ra is produced in different concentrations in the two groups: RPP and AP. Furthermore, elevated MC concentration in the RPP group compared to the AP group may be an important pathogenic feature in RPP.

Predominant microflora of severe, moderate and minimal periodontal lesions in young adults with rapidly progressive periodontitis

The purpose of this investigation was to study the microflora of severe, moderate and minimal periodontal lesions, in young adults with rapidly progressive periodontitis (RPP). Subgingival plaque samples were taken from 142 periodontal lesions in 10 young adults aging 25 to 35 years. The examination of the subgingival microflora indicated that certain species, including Porphyromonas gingivalis, Bacteroides forsythus, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, and Campylobacter species were found to be predominant in severe periodontal lesions. B. forsythus, P. gingivalis, Prevotella intermedia, F. nucleatum, Capnocytophaga ochracea, were predominant in medium lesions while Streptococcus species and Actinomyces species, C. ochracea, Haemophilus segnis and Veillonella parvula, were found in higher levels in minimal periodontal lesions.