Dental procedures performed in the oral cavity, which normally harbours an intensive microflora, can cause bacteraemia and death may result from progressive cardiac damage or uncontrollable septicemia. Different approaches to infective endocarditis related prophylaxis were found, from periodontology departments from different countries. It is our opinion of that, periodontology departments must alert related departments regarding the importance of specific bacteria involved in periodontal disease in the development of infective endocarditis following dental procedures.
Abstract Inflammatory periodontal diseases are mediated by interactions between the dental plaque and the components of the host immune system. This study was designed to analyse the phenotypic properties of gingival lymphocytes in adult periodontitis. Biopsies were obtained from 12 patients and aged between 35 and 55 years. The tissues were processed for both histopathological and immunohistological examinations. Gingival tissue lymphocytes were identified using monoclonal and polyclonal antibodies with the immunoperoxidase technique. All speciments revealed a significant degree of CD3(+) cell infiltration beneath the pocket epithelium, which is located adjacent to the bacterial plaque, compared to that on the oral epithelial side. CD4(+) and CD8(+) cells were evenly distributed within these infiltrates. Numerous HLA-DR(+) cells were also noted. The majority of plasma cells in the central lamina propria bore IgG isotypes. These findings suggest that T-cell mediated regulatory mechanisms play an important role in the pathogenesis of adult periodontitis.
Better clarification of the long-term relationship among the various implant-related measures could improve the evaluation process for dental implants. Thus, the aim of the present study was to determine the potential correlations among the volumetric features and nitric oxide content of peri-implant sulcus fluid (PISF) and measures of implant stability, and the marginal bone loss. Completely edentulous patients (n=15) treated with dental implants and ball attachment mandibular over dentures were included. Resonance frequency analysis (RFA), marginal bone level measurements, PISF volume and spectrophotometrically determined nitrite levels were recorded for all dental implant sites. Measures for early (n=16) and delayed (n=14) loaded dental implants were comparatively analysed for a period of 18 months. Some random correlations between PISF volume and marginal bone level, PISF nitrite level and marginal bone level and PISF volume and PISF nitrite content, and RFA and PISF volume were observed. However, the only constant correlation was noticed between implant stability (RFA scores) and marginal bone level. This correlation was negative and significant for all dental implants and for delayed loaded implants (P<0.05). The pattern of loading seemed to affect the extent, but not the pattern of this relationship. While some of the implant-related measures may be strongly associated (e.g. dental implant stability and marginal bone level), not all measures from a single implant site are likely to be related. Such associations may be under the influence of a variety of factors including the loading protocol of dental implants.
Abstract An 11‐year‐old boy with clinical and radiological features of prepubertal periodontitis is presented. He had a history of recurrent upper respiratory tract infections and otitis media. Neutrophil chemotaxis was significantly reduced compared to normal. Total T‐ and B‐lymphocyte numbers were not altered. T‐lymphocyte subsets studied with monoclonal antibodies revealed that both T‐helper and T‐suppressor cell populations were reduced with a normal T H /T s ratio of 1.8. No significant changes were observed in the serum IgG, IgA and IgM values. Serum C3c and C4 levels were found to be elevated. These findings may contribute to the pathogenesis of prepubertal periodontitis.
R apidly progressive Periodontitis (RPF) has been suggested as a distinct clinical entity within the spectrum of early onset Periodontitis. Immunological mechanisms have been considered in the pathogenesis of RPP. This study was designed to evaluate the distribution and phenotypic properties of the lymphocyte populations within the affected gingival tissue of patients with RPP. Biopsies were obtained from 16 patients between 22 and 33 years of age. The tissue samples were processed for both histopathological and immunohistochemical examinations. Gingival tissue T lymphocytes (CD3 + ), helper T cells (CD4 + ), suppressor‐cytotoxic T cells (CD8 + ), and cells positive for HLA‐DR antigen were identified using monoclonal antibodies with an immunoperoxidase technique. Intracytoplasmic immunoglobulin‐containing cells were also stained immunohistochemically with polyclonal antibodies. CD3 + cells were mainly located beneath the pocket epithelium. CD4 + and CD8 + cells were evenly distributed within this T‐cell infiltrate with a CD4 + /CD8 + ratio of 1:12. Numerous HLA‐DR + cells were also observed in the lymphocytic infiltrates. The majority of mononuclear cells located throughout the stroma were IgG + plasma cells. Our results indicate that RPP patients present an IgGbearing plasma cell dominated lesion with equal participation of both T‐cell subpopulations. These findings suggest that activation and proliferation of B‐cells play an important role in the pathogenesis of periodontal diseases. J Periodontol 1993; 64:120– 127.
T he aim of this study was to compare hydroxyproline (Hyp) and total protein levels both in the gingiva and gingival crevicular fluid (GCF) from juvenile (JP), rapidly progressive (RPP), and adult periodontitis (AP) patients and periodontally healthy controls (C). A total of 60 individuals, 15 from each group, were studied. GCF was obtained before gingival sampling. Clinical measurements were recorded. The gingival samples were harvested by full thickness flap operation from patients and immediately after the extraction of the teeth for orthodontic reasons from controls. The samples were analyzed biochemically. GCF Hyp levels were significantly higher in the AP group than those of the RPP and C groups. The strong positive correlations between gingival and GCF Hyp levels were determined in the disease groups. Total protein levels in both the gingiva and GCF were significantly higher in disease groups. However, the differences between the disease groups were not statistically significant. Correlations between the clinical parameters and Hyp levels in gingiva and GCF were determined. The findings indicate that Hyp and total protein levels both in the gingiva and GCF appeared to be increased in the disease groups. These findings suggest that both the synthesis and degradation of collagen and total protein are elevated in periodontal disease. However, our findings do not support the concept that measurement of either Hyp or total protein levels in gingiva or GCF is a suitable or reliable criterion in determination of disease activity. J Periodontol 1993; 64:323–329 .
Abstract Background: Although it is well‐described that proteoglycans (PGs) are among the major non‐collagenous components of the matrix which are degraded during periodontal diseases, the relationship between PG metabolism and seventy of periodontal breakdown, the extent of degradation of PGs together with the resulting end‐products, and the elimination pathways of these catabolic end‐products is likely to need further clarification. Objective: The main aim of the present study was to analyze the possible impact of severity of periodontal destruction on PG metabolism of gingiva and gingival crevicular fluid (GCF). Material and methods: For this purpose, gingiva and GCF samples obtained from patients ( n =45) exhibiting sites ( n =57) with moderate periodontal breakdown (MP) or severe periodontal breakdown (SP) were analyzed for PG metabolism via spectrophotometric determination of uronic acid levels. Gingiva and GCF samples were obtained from the same sites in every patient to analyze the possible relationship between uronic acid content of gingival tissue and GCF. Results: No significant differences were found in uronic acid levels between sites with MP and SP ( p >0.05). The uronic acid content of GCF and gingiva showed significant overlaps between MP and SP sites and uronic acid levels did not present any constant correlation with the clinical parameters ( p >0.05). In a similar manner, uronic acid content of GCF and gingival tissue was not correlated ( p >0.05). Conclusion: The lack of a significant correlation between the uronic acid content of gingival tissue and GCF may suggest that the passage of PG metabolites from gingiva to GCF is likely to be under the influence of multifactorial interactions rather than being linear. As a general measure of PG metabolism, uronic acid levels do not seem to be related with the severity of periodontal destruction and tend to act as different measures when compared to traditional clinical parameters.
Mean levels of myeloperoxidase (MPO) activity were determined in samples of gingival crevicular fluid (GCF), whole saliva and peripheral blood neutrophils from patients with rapidly progressive periodontitis (RPP) and adult periodontitis (AP) using a spectrophotometric method. The mean neutrophil MPO activity in the RPP group was 563.1 +/- 137.05 U/l x 10(6)/ml, that in the AP group was 483.3 +/- 88.81 U/l x 10(6)/ml, and that in the control group was 220.6 +/- 26.7 U/l x 10(6)/ml. The mean GCF MPO activity in the RPP group was 15.13 +/- 2.34 U/mg, which was significantly higher than in the other two groups. The mean whole saliva MPO activity in the RPP group was 0.14 +/- 0.04 U/ml, that in the AP group was 0.11 +/- 0.02 U/ml, and that in the control group was 0.05 +/- 0.06 U/ml. MPO activity detected in the samples was significantly increased in the patient groups when compared to the healthy subjects. The highest MPO activity was found in the RPP group. The present findings suggest a relationship between MPO activity and the pattern and severity of periodontal breakdown. Also the increased MPO activity in periodontally diseased patients can be attributed to the increased number of neutrophils, the degranulation of these cells and also their hyperactive state in the presence of chronic antigenic stimulation.
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