Severe Aggressive Periodontitis Research Articles

From 32-year follow-up of a patient with generalized severe aggressive periodontitis

From 32-year follow-up of a patient with generalized severe aggressive periodontitis

A case report: One-stage full-mouth scaling root planing in combination with azithromycin, periodontal regenerative and implant therapies could lead to improve severe aggressive periodontitis

A case report: One-stage full-mouth scaling root planing in combination with azithromycin, periodontal regenerative and implant therapies could lead to improve severe aggressive periodontitis

Periodontal Diseases and Lipid Profile in Systemic Sclerosis: an EUSTAR Cohort Experience

Dental pathology is commonly described among patients with systemic sclerosis (SSc), a multisystem autoimmune disorder, and assumed to be multifactorial. We aimed to evaluate the periodontal status and to identify potential relation with SSc-specific parameters as well as serum lipid profile in a cross-sectional study on consecutive SSc. Standard assessments comprised dual, rheumatologic (disease subtype, clinical spectrum, inflammatory, immunological, lipid metabolism - total cholesterol and fractions, triglycerides), and dental evaluation (plaque index, bleeding on probing, pocket depth, clinical attachment level). 70.96% SSc developed oral manifestations, 51.61% periodontal disease, while one third severe aggressive periodontitis, particularly in diffuse SSc (p[0.05). Abnormal lipid pattern (low serum HDL- and high LDL-cholesterol, increased serum triglycerides, without significant modification in total cholesterol level) significantly correlated with diffuse SSc and skin involvement, disease duration, anti-topoisomerase 1 positivity, SSc activity and severity, as well as periodontitis (p[0.05). Our results clearly define an association between the presence and severity of periodontal disease and lipid anomalies in SSc, suggesting a potential link with early atherosclerosis via gingival inflammation and altered lipid metabolism.

Generalized gingival enlargement associated with aggressive periodontitis in a 20-year-old patient: case report and literature review

The association of a pronounced gingival enlargement (GE) and severe aggressive periodontitis (AP) without underlying diseases or syndromes is rarely reported. We aimed to report a rare case of such association in a young female patient and to review the literature regarding the coexistence of these two diseases. A 20-year-old female patient was referred due to an extensive and generalized gingival enlargement along with teeth mobility with one-year length. Medical and family histories were non-contributory. Intraoral examination revealed a diffuse and smooth-surfaced overgrowth, normal in color with fibrous consistence covering nearly all molars crowns of both upper and lower arches. Histopathological examination revealed excessive amounts of collagen fibers and mild inflammation. The clinical and histopathological features did not fit in any known syndrome or disease. Thus, the diagnosis of generalized idiopathic gingival enlargement associated with severe aggressive periodontitis was concluded and the patient was referred to specialized periodontal treatment. The real meaning of the association between GE and AP remains unknown. Further investigation is desirable to understand the coexistence of these two diseases.

Arterial stiffness and pulse wave reflection are increased in patients suffering from severe periodontitis.

AimThis single blind cross-sectional study compared the vascular health of subjects suffering from severe chronic periodontitis, severe aggressive periodontitis and periodontal healthy controls by evaluating pulse wave velocity (PWV), augmentation index (AIx) and pulse pressure amplification (PPA).Material and MethodsIn a total of 158 subjects, 92 suffering from severe periodontitis and 66 matched periodontal healthy controls, PWV, AIx, central and peripheral blood pressure were recorded using an oscillometric device (Arteriograph).ResultsSubjects suffering from severe chronic or aggressive periodontitis exhibited significantly higher PWV (p = 0.00004), higher AIx (p = 0.0049) and lower PPA (p = 0.028) than matched periodontal healthy controls.ConclusionsThe results of this study confirm the association between periodontal inflammation and increased cardiovascular risk shown by impaired vascular health in case of severe periodontitis. As impaired vascular health is a common finding in patients suffering from severe periodontal disease a concomitant routine cardiovascular evaluation may be advised.

Outcomes of nonsurgical periodontal therapy in severe generalized aggressive periodontitis.

PurposeAggressive periodontitis, especially in its severe form, was traditionally considered to have an unfavourable prognosis. It required a complex treatment and its stabilization was often achieved by surgical therapy. The aim of this study was to investigate the results of nonsurgical periodontal treatment in severe generalized forms of aggressive periodontitis.MethodsPatients with advanced generalized aggressive periodontitis were included in the study. Probing depth (PD) of pockets ≥7 mm and clinical attachment level (CAL) of sites with attachment loss ≥5 mm were measured at baseline before nonsurgical periodontal treatment, at re-evaluation, and after treatment. The following other parameters were recorded: resolution of inflammation and bone fill. We compared the baseline values with re-evaluation and posttreatment values using the Friedman test. The Wilcoxon test with the Bonferroni correction was used for both re-evaluation and posttreatment values.ResultsSeven patients with 266 periodontal sites were examined. A significant difference was found between values, reported as medians with interquartile ranges, for PD at baseline (7.94 [7.33-8.19] mm) and both re-evaluation (4.33 [3.63-5.08] mm) and posttreatment (3.54 [3.33-4.11] mm) values (P=0.002). A significant difference was also found between values for CAL at baseline (9.02 [7.5-9.2] mm) and both re-evaluation (6.55 [6.30-6.87] mm) and posttreatment (6.45 [5.70-6.61] mm) (P=0.002). Inflammation was resolved and angular bone defects were repaired in all cases.ConclusionsThese therapeutic results suggest that this form of periodontitis could have positive outcomes after nonsurgical periodontal treatment. The reparative potential of tissue affected by severe aggressive periodontitis should encourage clinicians to save apparently hopeless teeth in cases of this form of periodontitis.Graphical

Confirmation of oxidative stress and fatty acid disturbances in two further Papillon–Lefèvre syndrome families with identification of a new mutation

We have previously reported oxidative and fatty acids disturbances in one Papillon-Lefèvre syndrome (PLS) family. This Mendelian condition characterized by palmar plantar keratosis and severe aggressive periodontitis, is caused by mutations in the cathepsin C (CTSC) gene. In this study, we have analysed two further unrelated PLS families to confirm this association. Mutations were identified by direct sequencing of CTSC. Biochemical analyses were performed in probands and their relatives in order to determine plasma levels of vitamin E, CoQ10 , lipid hydroperoxides (HP) and fatty acid patterns. Pathogenic CTSC mutations were identified in both families including a new mutation (c504C>G). Both probands showed low levels of vitamin E and CoQ10 , and high levels of lipid HP, and also very low levels of docohexaenoic acid. The previously reported oxidative and fatty acids disturbances were confirmed as a feature of this condition in two further families. There are low levels of antioxidant markers and high levels of oxidative markers, in addition of low levels of some anti-inflammatory fatty acids in persons suffering PLS and some of their relatives.

The Possible Effect of an Accessory Root‐Like Structure on Periodontitis: A Clinical and Histologic Case Report

Introduction: Tooth‐related factors, such as cemento‐enamel projections and furcations, are contributing factors to periodontal disease. Tooth morphologic variations in the anterior teeth are less frequently reported.Case Presentation: A 25‐year‐old female patient was referred to our clinic with generalized severe aggressive periodontitis. An accessory root‐like structure on the mesio‐labial surface of the root of tooth #9 was identified. This root‐like structure was ≈7 mm long and had a sharp tip. Clinical examination revealed tooth #9 had Miller Class III mobility, a 7‐mm‐deep periodontal pocket on the mesio‐labial aspect of the tooth, and a clinical attachment loss of 12 mm. Although periodontal destruction could also be observed at other tooth sites, the destruction on tooth #9 was more prominent. After initial periodontal treatment, tooth #9 was deemed hopeless, extracted, and then replaced with a provisional removable partial denture.Conclusions: Although developmental dental anomalies are important contributing factors for the development and progression of periodontitis, they are frequently undiagnosed. Therefore, early recognition of the abnormal dental morphology is of great clinical significance in effectively treating periodontitis.

Aggressive periodontitis in a young Pakistani female with laryngo-onycho-cutaneous syndrome

The periodontal status of patients with laryngo-onycho-cutaneous syndrome is unknown. This study describes a case of severe aggressive periodontitis in a 19-year-old American-Pakistani female with laryngo-onycho-cutaneous syndrome. The patient showed abundant dental plaque and calculus accumulations, suppuration and hemorrhage from virtually all gingivae and interdental papillae, and extensive radiographic alveolar bone loss and vertical mobility of several teeth. Subgingival plaque samples revealed a variety of major periodontal pathogens. The patient was scheduled for full-mouth tooth extraction.

Screening for periodontopathogenic bacteria in severe chronic periodontitis in a Moroccan population

ObjectiveBacteria play an important role in destructive periodontitis. The aim of this study was to screen for five highly pathogenic bacteria: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola, in Moroccan patients presenting with severe chronic periodontitis and to compare results with those of patients presenting with severe aggressive periodontitis. Materials and methodsTwenty-three patients were included at the periodontology unit (School of dental medicine, University Mohammed 5 Souissi, Rabat, Morocco). The study was made on two groups: a test group of patients presenting with severe chronic periodontitis, and a control group of patients presenting with severe aggressive periodontitis. Plaque sampling was performed at the four deepest sites in each patient. The five studied bacteria were detected by PCR. ResultsThe prevalence of A. actinomycetemcomitans and T. denticola was relatively low in the test group (13.3% and 20% respectively) compared with controls (37.5% and 37.5% respectively), without any statistical difference between the two groups. Furthermore, P. gingivalis and T. forsythia were frequently detected in both groups, without any statistical difference. ConclusionThe results of this preliminary study proved the presence of the studied periodontopathogenic bacteria both in severe chronic periodontitis and severe aggressive periodontitis.

Functional Cathepsin C mutations cause different Papillon–Lefèvre syndrome phenotypes

The autosomal-recessive Papillon-Lefèvre syndrome (PLS) is characterized by severe aggressive periodontitis, combined with palmoplantar hyperkeratosis, and is caused by mutations in the Cathepsin C (CTSC) gene. This study aimed to identify CTSC mutations in different PLS phenotypes, including atypical forms and isolated pre-pubertal aggressive periodontitis (PAP). Thirteen families with different phenotypes were analysed by direct sequencing of the entire coding region and the regulatory regions of CTSC. The function of novel mutations was tested with enzyme activity measurements. In 11 of 13 families, 12 different pathogenic CTSC mutations were found in 10 typical PLS patients, three atypical cases and one PAP patient. Out of four novel mutations, three result in protein truncation and are thus considered to be pathogenic. The homozygous c.854C>T nucleotide exchange (p.P285L) was associated with an almost complete loss of enzyme activity. The observed phenotypic heterogeneity could not be associated with specific genotypes. The phenotypic variability of the PLS associated with an identical genetic background may reflect the influence of additional genetic or environmental factors on disease characteristics. CTSC mutation analyses should be considered for differential diagnosis in all children suffering from severe aggressive periodontitis.