Subgingival Microflora Research Articles

Evaluation of the effect of probiotics in the treatment of peri-implant mucositis: a triple-blind randomized clinical trial.

To determine if the treatment of mucositis with mechanical debridement, 0.12% chlorhexidine, and a further application of Lactobacillus reuteri (L. reuteri) will result in an improvement of the clinical and microbiological parameters in comparison to the treatment with mechanical debridement and 0.12% chlorhexidine alone. Fifty dental implants with mucositis in 50 patients were randomly assigned to one of the following groups: mechanical debridement, 0.12% chlorhexidine mouthwash, and the subsequent administration of a probiotic agent (test group) or mechanical debridement and 0.12% chlorhexidine mouthwash (control group). Data were analyzed to determine clinical and microbiological changes during treatment and after a follow-up period of 3months. After the administration of 0.12% chlorhexidine, all clinical parameters improved in the test and the control group, observing a significant decrease in Full Mouth Plaque Index (FMPI), full mouth bleeding on probing (FMBOP), Plaque Index (PI), and bleeding on probing (BOP) at the implant. However, following the administration of probiotics or placebo, the clinical variables, except for probing pocket depth, slightly and progressively increased up to 3months of follow-up, but without reaching baseline levels. From a microbiological point of view, no major alterations of the subgingival microflora were recorded at different time points between groups during the study. Treatment with mechanical debridement, oral hygiene reinforcement, and administration of 0.12% chlorhexidine was effective in reducing mucositis, but it did not always result in complete resolution of inflammation. The administration of probiotics did not seem to provide an additional clinical or microbiological benefit. The use of probiotics does not seem to provide an additional benefit in the treatment of peri-implant mucositis.

Ascendancy of sex hormones on periodontium during reproductive life cycle of women

Throughout the reproductive life cycle of women, fluctuating levels of sex hormones during puberty, menses, pregnancy, and menopause have direct and indirect effects on oral health and they also influence their susceptibility to periodontal disease. These physiological conditions are associated with an exaggerated inflammatory response without accompanying an increased plaque level. Changes in hormone levels also lead to alteration in the subgingival microflora, epithelial keratinization, decreased salivary flow, altered gingival crevicular fluid, effects on specific cells of periodontium and local immune system, burning sensation, halitosis, interproximal alveolar bone loss, and to a lesser extent, clinical attachment loss. The presence of maternal periodontitis has been associated with adverse pregnancy outcomes, such as preterm birth, preeclampsia, gestational diabetes, delivery of a small-for-gestational age infant, and fetal loss. The strength of these associations ranges from a 2–7-fold increase in risk. The increased risks suggested that periodontitis might be an independent risk factor for adverse pregnancy outcomes. Thus, the female body has a series of reaction to the hormonal changes seen within. Improper oral hygiene and hormonal imbalance seen during different life cycles of female patients exaggerate the oral tissue response to the plaque and other local factors, thus worsening the condition. Prevention is better than cure; hence, necessary precautions need to be taken at the earliest once the condition of the patient is known.

The Use of Benzoyl-Dl-Arginine-Naphthylamide (Bana) Test as A Screening Test for Mother at Risk for Delivery of Pre-Term and Low Birth Weight in A Rwandan Population

Oral infections can act as the site of origin for dissemination of periodonto-bacteria and their toxins as well as induce inflammatory mechanisms to distant body sites, thus linking periodontal diseases to pre-term delivery of low birth weight (PLBW) infants. Periodontal disease is an infection of the tissues surrounding and supporting the teeth. Researchers showed that between 18 and 50 % of all pre-term deliveries are associated with periodontal disease. Porphyromonasgingivalis, Treponema denticola and Tannerella forsythia are among the subgingival microflora most frequently associated with periodontal disease. The presence of these bacteria can be identified by their ability to hydrolyse BANA. BANA is a rapid and effective diagnostic aid shown to correlate well with the clinical indices used to diagnose periodontal disease. The objective of this study was to investigate the association between the presence of member of the red complex (BANA positive species) in subgingival plaque and pre-term delivery of low birth weight in a Rwandan population. Three clinical indices (PI,GI and PD) were measured for each patient. Plaque sample were collected by inserting a sterile probe into the base of the pocket and this served for the measurement of the BANA enzyme test. The age of the population study was between 18 and 47 years with a mean of 30.8 (± 5.34). Among the 450 women examined, 57.1 % had a PI score of 2, 56.0 % had GI score of 2 and 89.6 % had a PD between 4-6 mm. At a level of 5%, a significant association of p-value=0.000 was found between PI vs BANA, GI vs BANA and PD vs BANA. No significant association (p-value=0.073) was found between BANA and mothers who delivered preterm of low birth weight (PLBW). In conclusion, findings of this study showed that BANA cannot be used for now as screening test for mother at risk for preterm delivery, while waiting for a multicenter study which will help to verify the cause of these discrepancies of results. In the other hand we can recommend BANA to be used as a routine test for the detection of periodontal disease due it strong relationship with clinical indices used to diagnose periodontal disease.

Microbiocenosis of subgingival biofilm and intestinal content in chronic periodontal disease in patients with metabolic syndrome

The aim of the study was to assess correlations of subgingival biofilm and intestinal microbiota in patients with chronic periodontal disease (CPD) and metabolic syndrome (MS). The study included 80 patients divided in 2 groups: 40 healthy individuals with no signs of periodontal disease and 40 patients with CPD and MS. Oral and intestinal microbial consortia compositions were revealed using deep sequencing libraries of 16S rDNA. The study showed than the qualitative composition of the intestinal microbiome in patients with CPD differ significantly from the microbiome of controls. Real-time PCR of subgingival microflora in CPD patients revealed high content of P. gingivalis, T. forsythia and T. denticola, while in intestinal microbiome dominated representatives of Enterobacteriaceae and Eubacteriaceae families with signs of intestinal dysbiosis mostly associated with the decrease of protective species.

Treponema species in the subgingival microflora of ovine periodontitis

Dental changes are one of the main reasons for slaughtering sheep early before the end of their regular breeding period, resulting in increased costs due to the need to purchase...

Evaluation of moxifloxacin-hydroxyapatite composite graft in the regeneration of intrabony defects: A clinical, radiographic, and microbiological study.

Background:The formation of new connective periodontal attachment is contingent upon the elimination or marked reduction of pathogens at the treated periodontal site. An anti-microbial agent, i.e. moxifloxacin has been incorporated into the bone graft to control infection and facilitate healing during and after periodontal therapy.Materials and Methods:By purposive sampling, 15 patients with at least two contralateral vertical defect sites were selected. The selected sites in each individual were divided randomly into test and control sites according to split-mouth design. Test site received moxifloxacin-hydroxyapatite composite graft and control site received hydroxyapatite-placebo gel composite graft. Probing depth (PD) and Clinical attachment level (CAL) were assessed at baseline, 3, 6, 9, and 12 months. Bone probing depth (BPD) and hard tissue parameters such as amount of defect fill, percentage of defect fill, and changes in alveolar crest were assessed at baseline, 6, and 12 months. Changes in subgingival microflora were also assessed by culturing the subgingival plaque samples at baseline and at 3-month follow-up. The clinical, radiographic, and microbiological data obtained were subjected to statistical analysis using descriptive statistics, paired sample t-test, independent t-test, and contingency test.Results:On intragroup comparison at test and control sites, there was a significant improvement in all clinical and radiographic parameters. However, on intergroup comparison of the same, there was no statistically significant difference between test and control sites at any interval. Although test sites showed slightly higher amount of bone fill, it was not statistically significant. There was a significant reduction in the counts of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis at both sites from baseline to 3 months. In addition, there was a significant reduction at test sites as compared to control sites at 3-month follow-up (P = 0.003 and P = 0.013).Conclusion:The reduction in microbial counts found in test sites at 3-month follow-up could not bring similar significant improvements in the clinical and radiographic parameters though the test sites showed slightly higher bone fill.

Clinical and microbiological effects of a subantimicrobial dose of oral doxycycline on periodontitis in dogs

Doxycycline is regarded as an effective treatment for periodontal inflammation. In humans, it has been shown that the long-term administration of a subantimicrobial dose of doxycycline (SDD) does not induce antimicrobial effects on the subgingival microflora and furthermore does not affect antimicrobial susceptibility. The present study was designed to evaluate the influence of oral administration of SDD on normal periodontal microflora and antimicrobial susceptibility in dogs. Experimental periodontitis was induced in 12 experimental dogs using a silk and wire-twisted ligature for 60 days. After the periodontitis induction period, the ligature was removed, and dental cleaning (subgingival and supragingival ultrasonic scaling) was performed. The dogs were randomly assigned to one of two groups: an SDD group with six dogs receiving 2 mg/kg PO once daily and a control group with six dogs receiving a placebo. At weeks 0, 4 and 8, clinical periodontal parameters were evaluated. After the clinical assessments, subgingival plaque was sampled and then cultured in an anaerobic system for one week, and the total anaerobes, Porphyromonas spp., Bacteroides spp. and Pasteurella spp. counts were investigated. Using the agar dilution method, the minimum bactericidal concentration of doxycycline was evaluated and the resistance for doxycycline was monitored during this experimental phase.The clinical periodontal status of the SDD group was significantly improved compared to the control group (P < 0.05). Bacterial counts were not significantly different between the two experimental groups (P > 0.05), and antibacterial resistance was not established in the SDD group during the experimental periods (P < 0.05). These results suggest that the once daily oral regimen of 2 mg/kg of doxycycline could serve as a SDD in dogs.

Probiotic supplements and debridement of peri-implant mucositis: A randomized controlled trial

Objective. The aim of this double-blind randomized placebo-controlled trial was to evaluate the effects of probiotic supplements in adjunct to conventional management of peri-implant mucositis. Materials and methods. Forty-nine adult patients with peri-implant mucositis were consecutively recruited after informed consent. After initial mechanical debridement and oral hygiene instructions, the patients received a topical oil application (active or placebo) followed by twice-daily intake of lozenges (active or placebo) for 3 months. The active products contained a mix of two strains of Lactobacillus reuteri. Patients were clinically monitored and sampled at baseline and after 1, 2, 4, 12 and 26 weeks. The clinical end-points were pocket-probing depth (PPD), plaque index (PI) and bleeding on probing (BOP). In addition, the subgingival microbiota was processed with checkerboard DNA-DNA hybridization and samples of gingival crevicular fluid (GCF) were analyzed for selected cytokines with the aid of multiplex immunoassays. Results. After 4 and 12 weeks, all clinical parameters were improved in both the test and the placebo group. PPD and BOP were significantly reduced compared with baseline (p < 0.05), but no significant differences were displayed between the groups. The clinical improvements persisted 3 months after the intervention. No major alterations of the subgingival microflora were disclosed and the levels of inflammatory mediators in GCF did not differ between the groups. Conclusions. Mechanical debridement and oral hygiene reinforcement resulted in clinical improvement of peri-implant mucositis and a reduction in cytokine levels. Probiotic supplements did not provide added benefit to placebo.

Treponema denticola in microflora of bovine periodontitis

Periodontitis in cattle is an infectious purulent progressive disease associated with strict anaerobic subgingival biofilm and is epidemiologically related to soil management at several locations of Brazil. This study aimed to detect Treponema species in periodontal pockets of cattle with lesions deeper than 5mm in the gingival sulcus of 6 to 24-month-old animals considered periodontally healthy. We used paper cones to collect the materials, after removal of supragingival plaques, and kept frozen (at -80°C) up to DNA extraction and polymerase chain reaction (PCR) using T. amylovorum, T. denticola, T. maltophilum, T. medium and T. vincentii primers. In periodontal pocket, it was possible to identify by PCR directly, the presence of Treponema amylovorum in 73% of animals (19/26), T. denticola in 42.3% (11/26) and T. maltophilum in 54% (14/26). Among the 25 healthy sites, it was possible to identify T. amylovorum in 18 (72%), T. denticola in two (8%) and T. maltophilum in eight (32%). Treponema medium and T. vincentii were not detected over all 51 evaluated samples. The presence of Treponema amylovorum, T. maltophilum and, in particular, the widely recognized T. denticola in subgingival microflora brings an original and potencially important contribution in studies of the bovine periodontitis.

Mechanisms of Bone Resorption in Periodontitis.

Alveolar bone loss is a hallmark of periodontitis progression and its prevention is a key clinical challenge in periodontal disease treatment. Bone destruction is mediated by the host immune and inflammatory response to the microbial challenge. However, the mechanisms by which the local immune response against periodontopathic bacteria disturbs the homeostatic balance of bone formation and resorption in favour of bone loss remain to be established. The osteoclast, the principal bone resorptive cell, differentiates from monocyte/macrophage precursors under the regulation of the critical cytokines macrophage colony-stimulating factor, RANK ligand, and osteoprotegerin. TNF-α, IL-1, and PGE2 also promote osteoclast activity, particularly in states of inflammatory osteolysis such as those found in periodontitis. The pathogenic processes of destructive inflammatory periodontal diseases are instigated by subgingival plaque microflora and factors such as lipopolysaccharides derived from specific pathogens. These are propagated by host inflammatory and immune cell influences, and the activation of T and B cells initiates the adaptive immune response via regulation of the Th1-Th2-Th17 regulatory axis. In summary, Th1-type T lymphocytes, B cell macrophages, and neutrophils promote bone loss through upregulated production of proinflammatory mediators and activation of the RANK-L expression pathways.

Quantification of Selenomonas sputigena in Chronic Periodontitis in Smokers Using 16S rDNA Based PCR Analysis.

Selenomonas species have been associated with chronic periodontitis and have been implicated in converting periodontal health to disease. Scanty literature is available in Indian population. Hence, the objective of the study was to detect the prevalence of Selenomonas sputigena in healthy and chronic periodontitis by polymerase chain reaction (PCR) in Indian population and to check whether smoking affects the subgingival microflora of this organism in chronic periodontitis. A total of 60 subjects with severe chronic periodontitis with or without smoking and periodontal healthy subjects underwent clinical and microbiological assessment. A deep subgingival plaque sample was collected and genomic DNA was extracted from each sample and analysed for detection of Selnomonas sputigena using PCR. The frequency and quantification of bacteria were also estimated. All groups differed statistically significant in the frequency of detection of Selenomonas sputigena. On comparison of patients with chronic periodontitis in smokers and non-smokers, there was no statistically significant difference. When the results were quantified, statistically non-significant results were seen among all groups. Plaque index, gingival index, probing pocket depth and clinical attachment level were statistically non-significant in chronic periodontitis with smokers and non-smokers. Prevalence of Selenomonas sputigena showed significant differences with respect to the frequency of detection when comparing the disease group to the healthy population. But no significant difference was seen when the results were quantified. Smoking has no influence on number of Selenomonas sputigena. This study highlights presence as well as quantity of the organism is very important in elucidating its role in causation and progression of the disease.

Subgingival microbial profiles of Sudanese patients with aggressive periodontitis.

Background and ObjectiveAggressive periodontitis (AgP) is prevalent and shows a rapid course in African individuals. Although a strong focus has been placed on Aggregatibacter actinomycetemcomitans, new methods support the existence of a complex subgingival microflora in AgP. The purpose of the present study was to map the subgingival microbiota as well as explore the presence of A. actinomycetemcomitans and the JP2 clone in a group of Sudanese individuals with AgP, using different analytical methods.Material and MethodsA study population consisting of 19 patients with AgP was recruited from patients seeking treatment at University of Science and Technology (UST) in Khartoum. Fifteen healthy subjects were included as controls. Plaque samples were analyzed for 272 taxa using human oral microbe identification microarrays and for 26 periodontal taxa using DNA-DNA hybridization checkerboard. Conventional polymerase chain reaction (PCR) was applied for the detection of A. actinomycetemcomitans and the JP2 clone in plaque. Saliva from patients with AgP was analyzed using quantitative PCR (qPCR) for the detection of A. actinomycetemcomitans.ResultsEubacterium yurii was detected more frequently in patients with AgP than in controls, and E. nodatum was found in patients with AgP only. A. actinomycetemcomitans was found in plaque samples of two (12%) patients by human oral microbe identification microarrays and in five (29%) patients with AgP by conventional PCR, as well as in six (32%) of the AgP saliva samples by qPCR. The JP2 clone was identified in only one patient.ConclusionThe classical periodontal pathogens were not present in high amounts in AgP in the population studied here. Species of Eubacterium, which are not typically associated with AgP, were often detected in individuals with disease. Using laboratory methods with different sensitivities and detection levels allowed identification of variances in microbial communities. The findings reported in this study provide a basis for the further understanding of AgP.

Porphyromonas gingivalis lipopolysaccharide inhibits trophoblast invasion in the presence of nicotine

IntroductionPeriodontitis is a chronic infectious disease associated with Gram-negative subgingival microflora. In pregnant women, periodontitis is thought to be associated with adverse pregnancy outcomes, although the pathophysiology is unknown. Additionally, smoking is an established risk factor for adverse pregnancy outcomes. In the present study, we examined the direct effects of Porphyromonas gingivalis lipopolysaccharides (PGLPS) and nicotine on a trophoblast cell line. MethodsHTR-8/SVneo cells were plated on Matrigel chambers with or without PGLPS and nicotine. The invasive activity of the cells was directly evaluated using microscopy. ResultsPGLPS alone did not reduce the invasive activity of the HTR-8/SVneo cells. The co-administration of nicotine with PGLPS significantly reduced the invasive activity of the cells. DiscussionOur results suggest that although the direct pathogenic effects of P. gingivalis alone on trophoblast invasion may be limited, concurrent smoking reduces trophoblast invasion into the myometrium and inhibits maternal vascular reconstruction.

Effects of systemic administration of sitafloxacin on subgingival microflora and antimicrobial susceptibility profile in acute periodontal lesions

The aim of this study was to assess the effect(s) of systemic administration of sitafloxacin on subgingival microbial profiles of acute periodontal lesions. Antimicrobial susceptibility of clinical isolates was also investigated. Patients with acute phases of chronic periodontitis were subjected to clinical examination and microbiological assessment of their subgingival plaque samples by culture technique. Sitafloxacin was then administered (100 mg/day for 5 days) systemically. The clinical and microbiological examinations were repeated 6–8 days after administration. Susceptibilities of clinical isolates to various antimicrobials were determined using the broth and agar dilution methods. From the sampled sites in 30 participants, a total of 355 clinical isolates (34 different bacterial species) were isolated and identified. Parvimonas micra, Prevotella intermedia and Streptococcus mitis were the most prevalent cultivable bacteria in acute sites. Systemic administration of sitafloxacin yielded a significant improvement in clinical and microbiological parameters. Among the antimicrobials tested, sitafloxacin was the most potent against the clinical isolates with an MIC90 of 0.12 μg/ml at baseline. After administration, most clinical isolates were still highly susceptible to sitafloxacin although some increase in MICs was observed. The results suggest that systemic administration of sitafloxacin is effective against subgingival bacteria isolated from acute periodontal lesions.

Changes in subgingival microflora after placement and removal of fixed orthodontic appliances

The placement of fixed orthodontic appliances may lead to increased plaque accumulation and changes in subgingival microflora. The aim of this study was to examine the changes in frequency of subgingival microflora that occur after placement and removal of fixed orthodontic appliance using polymerase chain reaction (PCR). This study included 33 orthodontic patients, who were divided into two groups. Subgingival plaque samples were collected from the right upper incisor (U1) and right upper first molar (U6). In group A, the samples were taken three times: before placement appliance (T1), after one month (T2), and after 3 months (T3). In group B the samples were also taken three times: before appliance removal (T1), after one month (T2), and after three months (T3). PCR method was used to determine the presence of P. gingivalis, A. actinomycetemcomitans, T. forsythia, and P. intermedia. In group A the frequency of P. gingivalis showed statistically significant decrease at U1 (p = 0.049) and U6 (p = 0.008), from T1 to T2, and at U1 (p = 0.048) from T1 to T3. In group B only the frequency of T. forsythia showed a statistically significant decrease, at U6 (T1 vs.T2, p = 0.004; T1 vs.T3, p = 0.0003). Regarding other analyzed bacteria, changes in the presence were noticed but no statistical significance was found. Placement of fixed appliances may have an impact on subgingival microflora, but in the first months after the placement and removal of the appliance changes were not significant, probably due to good oral hygiene.

Smoking and Periodontal Diseases

treatment. Evidence Acquisition: A web-based search in PubMed and Google Scholar was performed to identify publications regarding the effects of smoking on various aspects of the periodontal disease process and to find an explanation for the possible association between smoking and the progression of periodontitis. We evaluated the articles published in English language between 1990 and 2013 with the search terms ‘‘periodontal health and smoking’’, ‘‘periodontal treatment and smoking’’, and ‘‘tobacco smokers and oral hygiene’’. Results: Of the total yield of 145 identified publications, 72 were selected for this literature review. The results of the selected papers reflect the effect of smoking on oral hygiene, gingival inflammation and vasculature, gingival crevicular fluid, subgingival microflora in periodontitis, fibroblast function, genetic polymorphism, initiation and progression of periodontal disease and its effect on passive smokers, and host response to periodontal treatment. Conclusions: Smoking is a significant risk factor for impaired periodontal health and treatment.

Assessing the Antimicrobial Effect of the Essential Oil of Myrtus communis on the Clinical Isolates of Porphyromonas gingivalis: An in vitro Study

One of the major diseases affecting the oral health is periodontal disease. Various therapeutic methods have been introduced to eliminate the periodonto-pathic subgingival microflora. Among these, Porphyromonas gingivalis (P. gingivalis) has a major role in the pathogenesis of different forms of periodontal diseases. The present study investigated the antimicrobial effect of the essential oil of Myrtus communis on Porphyromonas gingivalis (P. gingivalis) as the most destructive periodontal pathogens. The subjects included 27 male and 3 female patients with advanced chronic periodontitis. The mean age of the patients was 47.6 ± 2.0 years old. P. gingivalis was isolated from the samples and identified by various diagnostic tests, including Gram staining, Indol test, and fluorescent test. Minimum inhibitory concentration (MIC) of the essential oil against isolated P. gingivalis was determined by broth micro-dilution method. In this study, 0.12 - 64 μL/mL Myrtus communis essence were used for 30 P. gingivalis isolates and the MIC50 and MIC90 concentration of Myrtus communis essence against the isolates was equal to 1 and 8 μL/mL respectively. The results showed that Myrtus communis has antimicrobial effects against P. gingivalis. Further studies are suggested to include this essence in therapeutic protocols of periodontal disease.

A chlorhexidine-loaded biodegradable cellulosic device for periodontal pockets treatment

Absorbent points widely used in endodontic therapy were transformed into bioresorbable chlorhexidine delivery systems for the treatment of the periodontal pocket by preventing its recolonization by the subgingival microflora. These paper points (PPs) were first oxidized to promote their resorption, then grafted with β-cyclodextrin (CD) or maltodextrin (MD) in order to achieve sustained delivery of chlorhexidine. We investigated the oxidation step parameters through the time of reaction and the nitric and phosphoric acid ratios in the oxidizing mixture, and then the dextrin grafting step parameters through the time and temperature of reaction. A first selection of the appropriate functionalization parameters was undertaken in relation to the degradation profile kinetics of the oxidized (PPO) and oxidized–grafted samples (PPO-CD and PPO-MD). Samples were then loaded with chlorhexidine digluconate (digCHX), a widely used antiseptic agent in periodontal therapy. The release kinetics of digCHX from PPO-CD and PPO-MD samples were compared to PP, PPO and to PerioChip® (a commercial digCHX containing gelatine chip) in phosphate buffered saline (pH 7.4) by ultraviolet spectrophotometry. The cytocompatibility of the oxidized–grafted PP was demonstrated by cell proliferation assays. Finally, the disc diffusion test from digCHX loaded PPO-MD samples immersed in human plasma was developed on pre-inoculated agar plates with four common periodontal pathogenic strains: Fusobacterium nucleatum, Prevotella melaninogenica, Aggregatibacter actinomycetem comitans and Porphyromonas gingivalis. To conclude, the optimized oxidized-dextrin-grafted PPs responded to our initial specifications in terms of resorption and digCHX release rates and therefore could be adopted as a reliable complementary periodontal therapy.

Dental Implant Sites in Healthy versus Diabetic Subjects: A Two-Year Clinical and Bacteriological Assessment

The aim of this study was to analyze by Real-Time Polymerase Chain Reaction (PCR) possible differences in periimplant microbiota of patients without significant systemic diseases versus patients affected by non-insulin-dependent diabetes mellitus (NIDDM), both treated with dental implants with the same implant-abutment system. Patients suffering from NIDDM, and those with no history of major systemic diseases, treated with dental implants at the Prosthodontics Operative Unit of “Sapienza” University of Rome in the period February 2009 - March 2010 were considered. Clinical parameters as well as microbiological profile were evaluated for each implant site at 3, 6,12, and 24 month follow-up. Crevicular fluid was collected for microbial sampling and analyzed by Real-Time PCR in order to identify the possible presence of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum and Prevotella intermedia. Eight patients suffering from NIDDM and 22 with no history of major systemic diseases were included in the present investigation, each having received one to three dental implants. All the implants had been loaded 3 months after surgery, and the average follow-up after implant placement was 26.37±3.86. Clinical parameters showed no noticeable difference between the two groups, except for the Implant Stability Quotient (ISQ) that showed significantly lower values in NIDDM patients. A slightly higher amount of the considered pathogenic bacteria were retrieved in samples collected from patients with NIDDM (7.38×105) in comparison with those of healthy subjects (6.78×105), though the differences were below statistical significance. Within the limitations of the present study, a slight correlation was empirically detected between gene expression profiles of microbial populations and history of NIDDM, which however remained below the statistical significance. Further well-designed clinical studies may be useful to conclusively clarify the impact of subgingival microflora on the increased susceptibility of diabetic patients to periimplantitis.

Quantification of Subgingival Microflora in a Peri Implantitis Patient Using RTPCR - A Case Report

Background and aims . Peri-implantitis is a chronic progressive marginal infection which is defined as an inflammato-ry reaction affecting the tissues surrounding osseointegrated dental implants resulting in loss of supporting bone. Microflora of patients with implants who are edentulous mainly consists of gram positive facultative cocci and non motile rods. Pre-dominantly, Streptococcus sanguis, Streptococcus mitis while motile rods, Spirochetes, Fusiforms and filaments are infre-quently found in a healthy, stable implant. Microbiota around the failing implant in edentulous patients usually consists of gram negative anaerobic rods. In partially edentulous patients, peri implant microorganisms are increased in proportion of motile rods, Spirochetes and cocci in a stable implant. In a failing implant, in partially edentulous patients high proportions of P.micros, P.intermedia, C.rectus and Fusobacterium species were observed. The concept that the composition of subgin-gival microflora around implants in partially edentulous patients was said to be resultant of composition of flora around the teeth, based on this principle we set out to identify the presence of putative periodontal pathogens on teeth in a predominantly edentulous arch with a metallic coping with periodontitis and a site in the same mouth with peri implantitis site. Materials and methods . Subgingival plaque samples were collected from a partially edentulous patient using a paper point from the periimplantitis lesion with a probing depth of 8-9mm and a tooth with deepest pocket with a probing depth of 6mm and we analyzed the five putative periodontal pathogens namely, P.gingivalis, P.intermedia, P.nigrecens, T.denticola and T.forcythia using Real Time Polymerised Chain Reaction (RTPCR) technique. Results . P.Gingivalis and P.Intermedia , P.Nigrecens had a 3 fold increase and T.Denticola had 1 fold increase when compared to the periodontitis ( teeth) site, and T.Forsythia was found in trace amounts at the peri implantit is site and was completely absent at the periodontitis( teeth) site. Conclusion . Proper periodontal infection control before the placement of dental implants in partially edentulous individ-uals may prevent early bacterial complications and also continuous monitoring of partially edentulous teeth site making it infection free will help in the longevity of the implant. Key words : Dental Implants, Periimplantitis, Subgingival Microflora, Overdenture.