Severity Of Periodontal Destruction Research Articles

Identification of Porphyromonas gingivalis in Periodontally Healthy Adults and Chronic Periodontitis Patients Using Polymerase Chain Reaction

Context: Periodontitis, a complex multifactorial, polymicrobial infection, involves deterioration of the supporting tissues surrounding teeth. Among the polymicrobiota, Porphyromonas gingivalis is a keystone pathogen implicated in chronic periodontitis. Aim: Identification of P. gingivalis in periodontally healthy adults and chronic periodontitis patients using polymerase chain reaction (PCR). Settings and Design: This cross-sectional study was conducted at the Department of Periodontics, KLE V. K. Institute of Dental Sciences, Belgaum. The 60 patients were selected from the outpatient department considering the selection criteria, using convenience sampling. Materials and Methods: Patients were categorized into three groups: periodontally healthy, moderate, and severe periodontitis. Plaque index, probing depth, and clinical attachment level (CAL) were measured. The plaque samples were collected from patients and were cultured and analyzed for black-pigmented colonies, followed by biochemical characterization and DNA isolation. Samples showing bacterial DNA bands were further selected for PCR analysis with species-specific primer to confirm P. gingivalis. Statistical Analysis: Descriptive analysis was done using Kruskal–Wallis ANOVA, Chi-square, and Mann–Whitney U-test (P < 0.05). Results: Age and gender showed no significance in the prevalence of P. gingivalis. P. gingivalis was absent in periodontally healthy patients and detected in 10% of moderate periodontitis and 50% of severe periodontitis patients (P = 0.0001). No statistical significance with the prevalence of P. gingivalis was observed between moderate and severe periodontitis patients. In severe periodontitis patients, P. gingivalis was significantly associated with higher mean pocket probing depth scores (P = 0.0073) and CAL scores (P = 0.0022). Conclusion: The prevalence of P. gingivalis was significant in both moderate and severe periodontitis patients; however, a higher prevalence was observed in severe periodontitis patients. PCR analysis revealed a significant rise in the frequency of P. gingivalis with an increased periodontal pocket depth and clinical attachment loss, indicating a correlation with the severity of periodontal destruction.

To estimate the levels of gingival crevicular fluid YKL-40 in patients with chronic periodontitis and rheumatoid arthritis with chronic periodontitis - a clinico-biochemical study

Background and objectives: YKL-40, a C-reactive protein belongs to the positive acute-phase protein. It is also known as Human chitinase-3-like protein 1(HCI3L1) and is closely related to both acute and chronic inflammation. The present study aimed to detect and estimate the levels of YKL-40 in gingival crevicular fluid (GCF) in patients with healthy periodontium, chronic periodontitis, and rheumatoid arthritis with chronic periodontitis. Materials and methods: Forty-five patients in the age range of 25-55years were included in the study. Patients were divided into three groups: Group I-15 Periodontal healthy patients, Group II-15 Chronic Periodontitis patients, and Group III-15 Rheumatoid arthritis with chronic periodontitis patients. Clinical parameters recorded were Plaque index, Gingival index, Gingival bleeding index, probing depth, and Relative attachment level. GCF samples were analyzed using ELISA. p - value < 0.05 was considered statistically significant. Results: The highest mean YKL-40 concentration in GCF was observed in rheumatoid arthritis with Chronic periodontitis. The mean concentration of YKL-40 in GCF showed a three to four folds increase in its levels when compared to healthy controls (p < 0.001). Contrary, GCF YKL-40 levels between Group II and Group III were not significant. Conclusion: With the increase in severity of periodontal destruction from healthy periodontium to chronic periodontitis, there was a substantial increase in the concentration of YKL-40 in GCF. Correlation of GCF YKL-40 with clinical parameters demonstrated increased severity of the diseases increased its levels

Proportion and severity of periodontitis and correlation of periodontal inflamed surface area with glycemic status in patients with type 2 diabetic neuropathy with and without diabetic foot.

The association between diabetic neuropathy with and without diabetic foot and periodontitis remains unaddressed in the literature. The present study was conducted to evaluate the frequency of patients with periodontitis and its severity, and to correlate clinical attachment loss (AL) and periodontal inflamed surface area (PISA) with HbA1c in Type 2 Diabetic Neuropathy (T2DN) patients with and without diabetic foot. In this cross-sectional study 310 patients with type 2 diabetic neuropathy (T2DN) were randomly selected, and the study comprised of 120 patients with T2DN with diabetic foot and 155 patients with T2DN without diabetic foot. All patients were assessed for periodontal parameters (bleeding on probing, probing depth, clinical AL, oral hygiene index-simplified), plaque index, and PISA) and systemic parameters (HbA1c, fasting blood glucose, post prandial blood glucose, urinary albumin creatine ratio, erythrocyte sedimentation rate, and high-sensitivity C-reactive protein).Unpaired t-test and Chi-Square test were used to analyze quantitative data and qualitative data, respectively. The frequency of patients with periodontitis in patients with T2DN with and without diabetic foot was 91.7% and 88.4%, respectively. The severity of periodontitis, PISA, and clinical AL were higher in the diabetic foot group. Clinical AL and PISA were significantly related with HbA1c in patients with T2DN with and without diabetic foot. Percentage of patients with periodontitis and the severity of periodontal destruction were high in type 2 diabetic neuropathy with diabetic foot. A significant correlation of PISA, clinical AL with glycemic status was found in patients with T2DN with and without diabetic foot.

Patterns of Periodontal Destruction among Smokeless Tobacco Users in a Central Indian Population.

Background: Findings of studies testing the association between smokeless tobacco (SLT) use and periodontal health have shown varying results in different populations. Considering the high prevalence of SLT use in India, the present study was conducted to understand the pattern of periodontal destruction within different areas of the dentition among SLT users. Methods: Age, gender, oral hygiene habits, the frequency and duration of SLT consumption, the type of SLT product used, and the site of retention of the SLT product in the oral cavity were recorded among 90 SLT users. Probing depth (PD), recession (REC), and clinical attachment loss (CAL) at SLT-associated and non SLT-associated teeth of the mandibular arch were compared based on the site of retention of the SLT product, the type of product used, and the duration of the habit. Results: REC and CAL were significantly higher at the SLT-associated zones compared to non SLT-associated zones and at both interproximal and mid-buccal sites of SLT-associated teeth. Among individuals who had the habit for more than 5 years and also among those who had the habit for 5–10 years, PD, REC, and CAL were significantly higher at SLT-associated teeth than at non SLT-associated teeth. Significantly greater periodontal destruction was observed at SLT-associated teeth among khaini users and gutkha users. Conclusions: Smokeless tobacco consumption resulted in greater destruction of periodontal tissues. The severity of periodontal destruction at SLT-associated sites differed depending on the type of smokeless tobacco used, the site of retention of the SLT, and the duration of the habit.

Role of smoking and its impact on periodontium

Smoking is a major risk factor for increasing the prevalence and severity of periodontal destruction. Multiple cross-sectional and longitudinal studies have demonstrated that pocket depth, attachment loss, and alveolar bone loss are more prevalent and severe in patients who smoke as compared with nonsmokers. Smoking exerts a major effect on the protective elements of the immune response, resulting in an increase in the extent and severity of periodontal destruction. Several tobacco intervention approaches can be useful in helping the patient deal with the nicotine withdrawal symptoms and psychological factors associated with smoking cessation. In addition, pharmacotherapeutic treatments such as nicotine replacement therapy and sustained bupropion administration have proved effective.

The utility of gingival crevicular fluid matrix metalloproteinase-8 provides site-specific diagnostic value for periodontal grading.

IntroductionMatrix metalloproteinase-8 (MMP-8), and its active form aMMP-8, was identified as a potential biomarker of periodontal tissue destruction. It is present at different concentrations in various oral fluids.Material and methodsGingival crevicular fluid (GCF) samples were collected from periodontal pockets ≥ 6 mm of 24 untreated patients using paper points and clinical parameters were recorded. 12 subjects were diagnosed with periodontitis stage III grade B, and 12 others with periodontitis stage III grade C. After thorough preparations, samples were collected following manufacturers’ instructions and analyzed using a commercially available test system for aMMP-8 evaluation (aMMP-8 Test) and Periotron 8000 together with Quantikine kits for assessment of total MMP-8 concentration (controls). Microbiological evaluation of the same pockets was carried out using real-time polymerase chain reaction.ResultsConcentrations of both total MMP-8 and aMMP-8 in GCF were higher in the case of periodontitis grade C, compared to periodontitis grade B, but reached statistical significance only in the case of total MMP-8 (77.17 ng/ml and 18.73 ng/ml respectively; p = 0.0104). Positive correlations were found between total MMP-8 and aMMP-8 levels and the prevalence of Fusobacterium nucleatum, mean probing pocket depth of all pockets, % of pockets ≥ 6 mm, as well as probing pocket depth of pocket from which GCF samples were collected.ConclusionsGCF concentration levels of both total MMP-8 and aMMP-8 correlated with severity of periodontal destruction, whereas total MMP-8 appeared to be a preferable method for differentiation of periodontal grading. However, the aMMP-8 Test was easier and more convenient to handle.

Effect of Menopause on Periodontium - Is There A Link?

Introduction: Menopause is associated with important systemic and oral changes. Many researchers have tried to evaluate the influence of hormonal changes associated with menopause in the periodontium, however results are still contradictory.
 Objective: The aim of the present study was to evaluate the effect of menopause on the severity of periodontal destruction.
 Methods: In the present study 25 systemically healthy women age ranges from 30 to 65 with generalised chronic periodontitis were included. They were divided into 2 groups based on their menstrual history. Group I (control group) included 8 women with normal menstrual cycle and Group II (test group) included 17 postmenopausal women. Clinical parameters Plaque Index, Gingival Index, periodontal probing pocket depth (PPD) and DMFT Index was recorded. The level of bone present was evaluated radiographically.
 Results: There were no significant differences between subjects of both the control and test groups in the percentages of sites for presence of plaque (p > 0.37), gingival index (p > 0.161) and DMFT index (p > 0.099). However deeper pockets (p < 0.001) and reduced bone support (p < 0.00) was observed in Group II as compared to Group I.
 Conclusion: The findings of the present study suggest, that postmenopausal women have more severe periodontal destruction as compared to premenopausal women.

The effect of luteolin in prevention of periodontal disease in Wistar rats.

Periodontal disease is the chronic infectious disease of the periodontium. Because of irreversibility, prevention of disease is one of the most important goals of periodontal treatment. The aim of this study was to evaluate the effect of luteolin, a powerful anti-inflammatory agent, on the prevention of experimental periodontitis by determining morphological and histological tissue alterations. This study consisted of 28 rats and four experimental groups: healthy control group (C, n = 6); periodontitis group (P, n = 6); periodontitis and 50 mg/kg luteolin administered group (L-50, n = 8); and periodontitis and 100 mg/kg luteolin administered group (L-100, n = 8). Experimental periodontitis was induced via ligature method around lower right first molar teeth. All rats were euthanized 11 days after. The severity of periodontal destruction was determined by measuring alveolar bone loss under a stereomicroscope. Osteoblast and inflammatory cell counts were counted on hematoxylin-eosin-stained slides and osteoclasts were counted on tartrate-resistant acid phosphatase-stained slides. The levels of inducible nitric oxide synthase (iNOS), bone morphogenetic protein (BMP)-2, matrix metalloproteinase (MMP)-8, tissue inhibitor of MMP (TIMP)-1, receptor activator of nuclear factor κB ligand (RANKL), and osteoprotegerin (OPG) were determined by immunohistochemistry. The highest alveolar bone loss was observed in the periodontitis group and the luteolin administration decreased bone loss in both groups. Osteoblast cell number was higher and osteoclast and inflammatory cell numbers were lower in the P group compared to C, L-50, and L-100 groups. Luteolin, dose-dependently increased osteoblast cell counts. Luteolin attenuated periodontal inflammation in both L-50 and L-100 groups. Like osteoblast cell numbers, BMP-2 expressions were also elevated in luteolin groups. Both doses of luteolin significantly increased TIMP-1 and BMP-2 expressions and decreased MMP-8 levels. iNOS expressions increased in P group and L-100 significantly decreased iNOS levels. RANKL increased and OPG decreased in P group and 100 mg/kg luteolin increased OPG and decreased RANKL levels significantly. Within the limits of present experimental study, luteolin successfully improved periodontal health in a ligature-induced experimental periodontitis model in Wistar rats. The decrease in inflammation, osteoclastic and collagenase activity and increase in osteoblastic activity are possibly involved in this process.

Influence of dental diseases of pregnant women on newborns’ health state

Aim. To study the connection between various dental diseases of inflammatory nature in pregnant women and body weight of newborns depending on the presence or absence of systemic inflammatory reaction in the mother's organism and severity of the main symptoms of periodontal lesions.
 Methods. We examined 207 pregnant patients with tooth caries, 72 patients with gingivitis and 93 women with chronic generalized periodontitis, 31 healthy pregnant women with no dental and somatic pathology and no complications of gestational period. The dental status of the patients was studied in the third trimester of pregnancy (36-40 weeks of gestation). Body weight was measured in newborn babies from pregnant women with dental pathology and without it. In peripheral, umbilical and retroplacental blood, the concentration of the inflammatory mediator interleukin-6 was evaluated by enzyme-linked immunosorbent assay, and C-reactive protein was evaluated by latex immune turbidimetry.
 Results. The decrease in weight of newborns from mothers suffering from chronic generalized periodontitis, is caused not only by severity of periodontal destruction but also by the course of the disease in pregnancy, damaged integrity and permeability of histochematic barrier, increased concentration of inflammatory mediators in the peripheral, umbilical and retroplacental blood. The risk of having a baby with low birth weight in women suffering from chronic generalized periodontitis with the depth of periodontal pockets is 6 mm, gingival bleeding during probing and increased concentration of systemic inflammatory mediators in peripheral circulation is extremely high and is 0.96.
 Conclusion. In mothers suffering from severe gingivitis, moderate chronic generalized periodontitis during pregnancy in case of progressive course of chronic generalized periodontitis, the body weight of newborns is lower compared to body weight of newborns from healthy women without dental pathology.

Effect of Atorvastatin and Remifemin on Glucocorticoid Induced Osteoporosis in Rats with Experimental Periodontitis. A Comparative Study

Periodontitis is a progressive destructive disease affecting the tooth supporting structures. Osteoporosis can enhance the rate and severity of periodontal destruction. In osteoporosis, lowering of the estrogen level leads to imbalance between bone formation and resorption. Different drugs were utilized to manage osteoporosis. Statins are cholesterol lowering drugs. Different studies have shown that statins have an anti-resorptive effect. Furthermore, Remifemin is a herbal drug that demonstrated certain favorable effects on bone integrity. The present study was performed to compare the impact of Atorvastatin and Remifemin in osteoporotic rats with induced periodontitis. Materials and Methods: Fifty male albino rats weighing 300 ± 50 gm were enrolled in the current study. The rat population was divided into five groups, ten rats each: control group (Group I), Group II with ligature induced periodontitis, Group III with induced periodontitis and osteoporosis, the Atorvastatin-treated group (Group IV) and finally the Remifemin-treated group (Group V). Rats were sacrificed after five weeks. Histological and histomorphometric examinations were performed. Results: Alveolar bone in Group V exhibited more bone formation with regular bone surface compared to Group IV. Histomorphometric results revealed that both treated groups showed substantial improvement in bone volume and in osteoblast count compared to Group II and III. However better results were noted in Group V. Conclusion: Superior results were demonstrated with Remifemin concerning bone volume. The authors suggested utilization of Remifemin as a beneficial therapeutic drug.

The immunopathogenic and immunomodulatory effects of interleukin-12 in periodontal disease.

Interleukin 12 (IL-12) is an inflammatory cytokine that promotes the response of the immune system. This cytokine has been implicated as a potent stimulator of several diseases characterized by inflammatory-induced bone destruction, such as rheumatoid arthritis and periodontitis. Yet, the exact role of IL-12 in the development and progress of periodontitis has not been clarified. Several studies have demonstrated a positive correlation between the level of IL-12 and the severity of periodontal destruction. Deletion of IL-12 in mice with periodontitis significantly suppressed the level of bone destruction. Interestingly, next to a role in modulating the pathogenesis, IL-12 also has immunological-regulatory properties. This cytokine induces expression of immunosuppressive molecules, such as indoleamine-pyrrole 2,3-dioxygenase (IDO). Thus, these findings suggest both negative and positive influences of IL-12 in periodontal disease. It is currently proposed that the diversity of action of cytokines is a molecular key which regulates biological development and homeostasis. Accordingly, the actions of IL-12 might be one of the mechanisms that regulate homeostasis of periodontal tissue during and following inflammation. Therefore, this article aims to review both destructive and protective functionalities of IL-12 with an emphasis on periodontal disease.

Molecular Detection of Porphyromonas gingivalis in Chronic Periodontitis Patients

In the current study, Porphyromonas gingivalis was identified in chronic periodontitis patients and healthy subjects by polymerase chain reaction (PCR) and its presence correlated with the severity of clinical periodontal parameters. Subgingival plaque samples were collected with sterile curette and subjected to deoxyribonucleic acid (DNA) extraction and subsequent PCR for detection of P. gingivalis. Porphyromonas gingivalis was detected in 60% of patients of group II (pocket depth up to 5 mm), and in 93.33% of patients of group III (pocket depth more than 5 mm). One periodontally healthy subject in group I (probing depth < 3 mm) showed the presence of P. gingivalis. Detection frequency of bacterium increased significantly with increase in probing pocket depth (PPD), loss of attachment (LOA), and gingival index (GI). Porphyromonas gingivalis is strongly associated with chronic periodontitis and its detection frequency positively correlates with the severity of periodontal destruction.

Dimensional Evaluation of Root Resorption Areas in Differing Severity of Chronic Periodontitis: A Scanning Electron Microscopic Study.

Aim:The aim of this study was to evaluate root surface alterations in terms of location, length, and depth of root resorption in the gingival, middle, and apical third of the mesial and distal surfaces of the root in healthy and periodontally affected teeth with chronic periodontitis.Materials and Methods:Teeth diagnosed with differing severity of chronic periodontitis, as assessed by clinical and radiographic parameters of bone destruction, were observed under a scanning electron microscope. Existence and location of root resorption areas, as well as length and depth of the resorption on each radicular third of the teeth, were determined.Results:Totally 27 teeth (60%) among all the groups exhibited root resorption. The number of teeth showing root resorption in each group was divided into the following groups; Group I: 2 teeth (13.33%); Group II: 11 teeth (73.33%); and Group III: 14 teeth (93.33%). The most affected teeth were the mandibular incisors. The apical one-third of the root was the most affected and the gingival third of the root was the least affected with respect to the length and depth of the root resorption. The mesial surface of the root was more commonly affected when compared to the distal surface of the root.Conclusion:It may thus be concluded that the existence and extent of root resorption depend on the severity of periodontal destruction.

The detection of BANA micro-organisms in adult periodontitis before and after scaling and root planing by BANA-Enzymatic TM test kit: An in vivo study

Background:Many paraclinical methods are available today for an accurate assessment of the periodontal status prior and during the periodontal treatment. The microbial-enzymatic N-benzoyl-DL-arginine-2-napthylamide (BANA) test is one of the modern alternatives to bacterial cultures. It detects the presence of three periodontal pathogens in the subgingival plaque (Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia).Aims and Objective:The aim and objective of this study was to detect the presence of BANA micro-organisms and also to determine the effect of scaling and root planning in adult periodontitis patients.Materials and Methods:A total number of 20 patients (80 sites) all having periodontitis were selected. Four test sites (permanent molar from each quadrant) were selected from each patient and assessed for plaque index, bleeding index and pocket depth before and after scaling and root planning. BANA test was used for the detection and prevalence of the “red complex” bacteria in plaque samples.Results:Showed that the BANA tests are statistically correlated with the severity of periodontal destruction. There was a significant correlation between the BANA test results and the quantity of bacterial plaque, the test being influenced by the composition of bacterial plaque.Conclusion:This study encourages the use of such chair-side tests for a proper diagnosis of periodontal disease and for a good evaluation of the treatment results.

Qualitative assessment of red blood cell parameters for signs of anemia in patients with chronic periodontitis.

Aim:Anemia of chronic disease is defined as anemia occurring in chronic infections and inflammatory conditions that is not caused by marrow deficiencies or other diseases and in the presence of adequate iron stores and vitamins. The present case control study was aimed to assess the red blood cell parameters for signs of anemia in patients with mild, moderate, and severe chronic periodontitis.Materials and Methods:A simple random sampling method was used to select 80 healthy male patients, who were divided into four groups based on full mouth periodontal examination as follows: group I patients comprised the control group (n = 20), which included patients with a clinically healthy periodontium, group II patients (n = 20) were diagnosed with mild chronic periodontitis, group III (n = 20) included moderate chronic periodontitis patients, and patients with severe chronic periodontitis formed group IV (n = 20). Laboratory blood investigations included total number of erythrocytes, hemoglobin concentration, packed cell volume, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration.Results:Data analysis showed a statistically significant decrease in red blood cell parameters with increase in different grades of periodontitis.Conclusion:Results of the present study show a substantial decrease in red blood cell parameters with increase in the severity of periodontal destruction.

The association of crevicular albumin level with the severity of periodontal destruction in chronic periodontitis patients after initial periodontal treatment

Background: Gingival crevice fluid (GCF) is a mixture of substances derived from serum, leukocytes, and structural cells of periodontium and oral bacteria. These substances possess a great potential for serving as indicators of periodontal disease and healing after therapy the main purpose of this study was to find if there is a difference in albumin concentration between healthy and diseased periodontal tissues and to compare between diseased group according to pocket depth Materials and methods: total sample composed of 60 pockets found in 35 patients all of them had no history of any systemic disease, The samples were divided in to three main group that include two diseased groups divided according to the depth of the periodontal pocket (group I were the pocket depth less than 6mm and group II were the pocket depth is equal or more than 6mm) and one healthy group (group III). Sampling of GCF were taken from patients in the second visits of periodontal treatment A previously weighed strips of filter paper size 30 were gently inserted in to the selected pocket depth until resistance was felt the filter paper left in place for 30 seconds and after removal they were weighed on a chemical balance. The difference between the weights of filter paper before and after absorption of exudates was calculated and each filter strips was placed in a tube containing o.3ml of normal saline then transferred and stored at -20C.on the day of analysis the samples were centrifuged at 10.000rpm for 20 minutes .the supernatant was used for assessment of Albunim colorimetrically similar to that of blood. Results: Comparison for gingival fluid weight were shown a non significant difference in the weight between group I&II at a P values >0.05 while there were a highly significant difference between group I&III and between group II&III at P values 0.05 intra groups correlation between albumin content in gingival fluid and periodontal parameter there were a significant negative correlation between plaque index and albumin in group I and II while anon significant correlation in group III also a significant and highly significant correlation were found between albumin and weight of gingival fluid in group I and II while anon significant differences in group III as shown in the table while there were anon significant differences between albumin content of gingival fluid and the gingival index, probing pocket depth and clinical attachment loss. Conclusion: the gingival crevicular fluid is an aqueous component in which is true trasudate and inflammatory exudates after the initial periodontal treatment in which it increased in weight as the inflammation present but the concentration of albumin may became a no significantly different compared with clinically healthy gingiva. As the initial periodontal treatment took place for each patients.

Prevelance of periodontopathogenic bacteria in subgingival biofilm and atherosclerotic plaques of patients undergoing coronary revascularization surgery

Aim:The objective of the present study was to detect the presence of specific periodontopathogenic bacteria in the coronary plaque of patients with coronary artery disease and to find out the significant association between the periodontal status and the presence of pathogenic bacteria in the coronary plaque.Materials and Methods:The study population consisted of 51 patients with chronic generalized periodontitis undergoing coronary artery bypass grafting. Periodontal parameters were recorded and deoxyribonucleic acid was extracted from the subgingival plaque and coronary atherosclerotic plaque samples of the same patients. Polymerase chain reaction was used to amplify the part of 16S ribosomal ribonucleic acid (rRNA) gene to detect the presence of Aggregatibacter actinomycetemcomitans (Aa), Tannerella forsythia (Tf), Porphyromonas gingivali (Pg), Porphyromonas gingivalis (fimA) gene and Treponema denticola (Td).Results:Aa, Tf, Pg, Pg (fimA) gene and Td were detected in 0%, 31.4%, 45.1% 39.2% and 51% of atherosclerotic plaque samples, respectively. Tf was detected in 19.6%, Pg in 39.2%, Pg (fimA) gene in 33.3% and Td in 35.3% of both, subgingival plaque and atherosclerotic plaque samples. Periodontal parameters correlated with the presence of bacteria in coronary plaque. Aa could not be detected in coronary plaque samples.Conclusions:The study confirmed the detection of Red complex bacteria in coronary plaque samples and these bacteria correlated with the severity of periodontal destruction.

Soluble CD14 in periodontitis

Lipopolysaccharide (LPS) binds to soluble (s)CD14. We investigated which factors contribute to variations in sCD14 levels in periodontitis, a chronic infectious disease of tooth-supporting tissues associated with endotoxemia and leading to inflammation and subsequently loss of teeth. The sCD14 levels were determined by ELISA in healthy controls (n=57) and untreated patients (59 moderate and 46 severe) and their relation with markers of systemic inflammation (C-reactive protein levels, and leukocyte, neutrophil and lymphocyte counts) was assessed. Anti-Aggregatibacter actinomycetemcomitans and anti-Porphyromonas gingivalis IgG levels were established by ELISA and CD14(-260) genotype was determined in a TaqMan allelic discrimination assay. Increased levels of sCD14 were more frequent among periodontitis patients (P=0.026) and showed a severity-dependence with increasing levels of periodontal breakdown (P=0.008). In patients, levels of sCD14 correlated positively with CRP (P=0.043), leukocyte numbers (P=0.011) and negatively with anti-A. actinomycetemcomitans IgG (P=0.007). In a multivariate analysis, sCD14 levels were predicted by ethnicity, age, educational level, and in Caucasian subjects also by the severity of periodontal destruction, but not by anti-P. gingivalis IgG or the CD14(-260) genotype. Periodontitis is associated with elevated levels of sCD14.

Systemic Inflammation Markers in Patients With Aggressive Periodontitis: A Pilot Study

The association between periodontitis and systemic health is evident; however, until recently, there was a lack of scientific evidence to define the relationship between aggressive periodontitis (AgP) and systemic conditions. The aim of this study was to explore the characteristics of peripheral blood cellular and serum protein parameters in patients with AgP. Patients with AgP (n = 150) and healthy controls (n = 94) were recruited. Clinical parameters, including probing depth (PD), clinical attachment level (CAL), and percentage of severe sites, were examined. Blood cell variables, including leukocyte, neutrophil, and lymphocyte counts, as well as serum protein parameters, including total protein, albumin, globulin, and albumin/globulin ratio, were analyzed. Elevated neutrophil numbers and serum globulin levels were observed in patients with AgP compared to controls (4.22 +/- 1.81 x 10(9)/l versus 3.20 +/- 0.91 x 10(9)/l and 29.20 +/- 3.75 g/l versus 27.17 +/- 3.32 g/l, respectively; P <0.01). Albumin level and albumin/globulin ratio were lower in the AgP group than in the control group (47.65 +/- 2.45 g/l versus 48.88 +/- 2.13 g/l and 1.66 +/- 0.24 versus 1.83 +/- 0.24, respectively; P <0.01). In the AgP group, neutrophil counts and serum globulin levels were positively correlated with clinical parameters, including mean values for PD, CAL, and percentage of severe sites (P <0.05); the albumin level and albumin/globulin ratio were inversely correlated with the clinical parameters as described above (P <0.05). Patients with AgP may have elevated peripheral leukocyte numbers and serum globulin levels as well as decreased serum albumin levels and albumin/globulin ratios compared to controls. These changes might be associated with the severity of periodontal destruction.

Periodontal Disease in Hispanic Americans With Type 2 Diabetes

Diabetes is a major risk factor for the development of periodontal disease in certain populations. The prevalence of type 2 diabetes is increased in Hispanic Americans, but its impact on the extent and severity of periodontal disease in this population has not been determined. Sixty-three Hispanic Americans, aged 33 to 72 years, from South Texas were grouped based on the presence or absence of type 2 diabetes. Past medical histories, including smoking, were obtained. Periodontal status was evaluated by measuring probing depth (PD), clinical attachment level (CAL), plaque, bleeding on probing, visual gingival inflammation, and calculus. Type 2 diabetes was associated frequently with major medical complications in this population. Diabetes was associated with significantly more calculus formation and tooth loss and an increased extent and severity of periodontitis. Subjects with diabetes had nearly three times the mean CAL and frequency of PD >6 mm than subjects without diabetes and nearly twice the frequency of moderate to advanced attachment loss (> or =3 mm). Smoking and diabetes had significant independent effects on mean CAL and the frequency of deep pockets. Diabetes and smoking combined were associated with a significantly higher frequency of sites with CAL > or =3 mm compared to healthy non-smokers, healthy smokers, and non-smokers with diabetes. Hispanic Americans with type 2 diabetes had more supra- and subgingival calculus, an increased extent and severity of periodontal destruction, and an increased frequency of tooth loss due to periodontitis. An additive/synergistic contribution of type 2 diabetes and smoking for increasing the extent of periodontal disease was observed.