Occurrence of Periodontopathic and Superinfecting Bacteria in Chronic and Aggressive Periodontitis Subjects in a Colombian Population
Javier Enrique BoteroAdolfo ContrerasGloria Inés LafaurieAdriana JaramilloMarisol Betancourt-QuirozRoger M. Arce
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Background: Differences in the composition of subgingival microbiota in periodontitis have been observed in different geographic locations. Some of these microbial differences could have clinical significance. This study describes clinical parameters and the composition of the subgingival microbiota in chronic periodontitis (CP) and aggressive periodontitis (AgP) patients in a Colombian population. Methods: Clinical parameters (probing depth, clinical attachment level, bleeding on probing, and plaque index) and plaque samples from 68 CP, 12 AgP, and 30 periodontally healthy subjects were analyzed. Subgingival samples were processed using culture, biochemical tests, and polymerase chain reaction for the detection of periodontal and superinfecting pathogens. The analysis of variance, χ 2 , and Kruskal‐Wallis tests were used to evaluate differences between groups for clinical parameters and microbiologic composition ( P ≤0.05). Results: Clinical parameters were significantly increased in CP and AgP patients compared to healthy subjects ( P <0.001), but no differences were found between periodontitis groups. Porphyromonas gingivalis , Tannerella forsythensis , and Eikenella corrodens showed higher frequencies in AgP compared to CP and healthy subjects ( P <0.05). Extension (localized and generalized) of the periodontal destruction had no effect on the composition of the subgingival microbiota. Gram‐negative enteric rods were more frequent in AgP patients ( P <0.01). Conclusions: This study demonstrated a high prevalence of P. gingivalis , T. forsythensis , and E. corrodens in AgP patients. Gram‐negative enteric rods were frequent in AgP and CP patients. Differences in the composition of subgingival microbiota in periodontitis patients need to be taken into account when considering the best therapeutic approach for each individual, including the use of antibiotics.Keywords:
Aggressive periodontitis
Eikenella corrodens
Clinical attachment loss
Bleeding on probing
Aggressive periodontitis
Bleeding on probing
Clinical attachment loss
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Bleeding on probing
Clinical attachment loss
Gingival recession
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Abstract Periodontal sites of shallow initial probing depth often seem to lose probing attachment following various types of periodontal therapy, including non‐surgical therapy. The susceptibility to this treatment‐associated probing attachment loss may conceivably be related to gingival architecture as well as to the inflammatory status of the tissues. This study was designed to study the relationship of buccolingual gingival thickness and bleeding on probing in shallow buccal sites ( 3.5 mm probing depth) to loss of probing attachment following nonsurgical therapy. 3 months following treatment consisting of oral hygiene instruction and supra‐ and subgingival debridement, thin ( 1.5 mm), initially non‐bleeding sites displayed a mean loss of probing attachment of 0.3 mm. Thick ( 2.0 mm), non‐bleeding sites displayed a less noticable mean loss of probing attachment, whereas bleeding sites of both categories of gingival thickness showed a tendency towards gains in probing attachment levels. It may be concluded that the mean loss in probing attachment levels, commonly seen for shallow sites post‐therapy, may be primarily due to the changes in shallow, thin healthy areas.
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Periodontal disease ranges from simple gums inflammation to major damage to the periodontal tissues, even losing teeth. Severe periodontitis has a world overall prevalence of 11.2%. These are evaluated with periodontal probes and oral epidemiological indices. Our aim is to estimate the prevalence and severity of periodontal disease of a Spanish military population according to the 2013 WHO criteria.
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Objective To determine whether there is some relationship between sulcular sulfide level and severity of periodontitis.Methods Fifteen systemically healthy subjects diagnosed with aggressive periodontitis(AgP) and sixteen systemically healthy subjects diagnosed with chronic periodontitis(CP) were included in this study.Clinical periodontal parameters such as plaque index,probing depth,attachment loss,bleeding on probing(BOP) et al,were recorded.The volatile sulphur compounds (VSC) level in periodontal pockets was measured using a portable monitor in a digital score ranging from 0.0 to 5.0 in increments of 0.5.All of 5220 sites for 870 teeth were included in this study.Results For both AgP and CP subjects,the clinical periodontal parameters were found significantly higher in VSC-positive sites than in VSC-negative sites(P0.001).The VSC level has significantly positively correlated with clinical periodontal parameters(P0.001).The VSC level and percentage of VSC-positive sites were found significantly higher in moderate-to-deep pocket sites than in shallow pocket sites(P0.001).The VSC level and percentage of VSC-positive sites were higher in sites with attachment loss than those in sites without attachment loss in the same probing depth group.Conclusion The VSC level may be a potential indicator for detecting severity of both AgP and CP.
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Aggressive periodontitis
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Albandar JM, Olsen I, Gjermo P. Associations between six DNA probe-detected periodontal bacteria and alveolar bone loss and other clinical signs of periodontitis. Acta Odontol Sand 1990;48:415-423. Oslo. ISSN 0001-6357.The purpose of the present study was to assess the associations between the presence and amounts of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, B. intermedius, Eikenella corrodens, Wolinella recta, and Fusobacterium nucleatum in the periodontal pocket and the degree of alveolar bone loss and other clinical signs of periodontitis, such as probing pocket depth, attachment level, and presence of bleeding on probing at the same site. The study material comprised 16 subjects with or without approximal sites showing longitudinal alveolar bone loss who were selected from a group of 142 subjects monitored radiographically over the past 4 years. In this group 105 sites were examined, of which 58 showed recent alveolar bone loss ⩾ 1 mm. Subgingival plaque was collected with absorbent paper points and hybridized with 32P-Iabeled DNA probes specific for the above-mentioned bacteria. The amount of each bacterial species was correlated with the degree of bone loss over time and the three clinical measurements by means of Spearman rank correlation. A. actinomycetemcomitans showed poor correlations with all three clinical signs of periodontal inflammation, whereas B. gingivalis and W. recta demonstrated significant positive correlations with the three clinical measurements and with attachment level and pocket depth, respectively. In addition, the amount of A. actinomycetemcomitans, B. gingivalis and W. recta showed significant positive correlation with the extent of alveolar bone loss at the site. In contrast, the amounts of B. intermedius, E. corrodens, and F. nucleatum showed negative correlations with all four measurements. B. gingivalis and W. recta demonstrated stronger associations when their amounts in the pocket were combined and when proportions relative to the amount of B. intermedius, E. corrodens, and F. nucleatum at the site were assessed. Thus, the results support the concept that specific combinations and relations of organisms rather than single organisms may play an important role in the pathogenesis of periodontitis.
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Clinical attachment loss
Fusobacterium nucleatum
Actinobacillus
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Abstract The aim of this study was to assess the prevalence and severity of periodontal destruction in regular dental attenders in Northern Ireland. 132 individuals aged between 20 and 49 years who had recently had a course of routine treatment in the General Dental Service completed a questionnaire and had a periodontal examination. Measurements of plaque, subgingival calculus, bleeding, probing pocket depth and periodontal attachment level were made at 4 proximal sites per tooth. Plaque was present at an average of 17%, subgingival calculus at 13%, and bleeding on probing at 34% of interproximal surfaces examined. The mean probing pocket depth was 2.7 mm and the mean probing attachment level was 1.0 mm. Incipient periodontal destruction was common with all subjects having at least 1 pocket of ≥ 3 mm and 90% having at least 1 site with ≥ 2 mm attachment loss. Only 24 (18%) of those examined had deep pocketing or severe loss of periodontal attachment (≥ 6 mm). The extent of deep pocketing and severe attachment loss was low at only 0.2% and 0.6%, respectively, of the sites examined. It was concluded that gingivitis and incipient periodontitis were prevalent and extensive in the regular dental attenders investigated, but that severe periodontal destruction was uncommon.
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Bleeding on probing
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Abstract The purpose of the present study was to investigate the clinical differences between individuals highly susceptible and individuals insusceptible to periodontal breakdown. The susceptible group consisted of 7 patients with a diagnosis of juvenile periodontitis. The insusceptible group consisted of 7 individuals selected on the basis of age (52 years or older), presence of at least 18 teeth, no evidence of extractions due to periodontal breakdown, no loss of attachment, shallow pockets, gross amounts of plaque and no history of interdental cleaning. Results showed that the susceptible group had more bleeding, less plaque and deeper pockets than the insusceptible group. Since the 2 groups seem to behave differently with regard to bleeding upon probing and amount of plaque, bleeding plaque ratios were calculated. Testing showed a highly significant difference between the 2 groups. The same results were obtained if only sites with shallow pockets were included in the analysis. On the basis of these results, it is hypothesized that a high value of the ratio between bleeding and plaque may act as a prognostic indicator for periodontal breakdown.
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Interdental consonant
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Abstract The purpose of this study was to monitor clinical attachment levels, using a constant force probe, in patients with untreated periodontal disease, and to use darkfield microscopy to monitor changes in subgingival plaque. 10 patients with untreated disease were studied over 12 weeks. The parameters measured at baseline and every 4 weeks were probing depth, attachment level and bleeding. The subgingival microflora of the deepest site in each quadrant was examined by darkfield microscopy, using a Hellber counting chamber, at baseline and 12 weeks. The subgingival plaque from any site which lost more than 2 mm clinical attachment was also sampled and the microflora examined. Analysis of the results shows that 91 % of probing depths and attachment levels remained the same or within ± 1 mm. 3.5% of probing depths and 3.7% of attachment levels became deeper by 2 mm. 6.9% of probing depths and 4.5% of attachment levels became shallower by 2 mm. Only 6 sites out of 1029 showed loss of clinical attachment > 2 mm. Darkfield microscopy showed no differences in the proportion of microorganisms at the 6 sites which lost more than 2 mm of clinical attachment, compared with the baseline value. A surprising result was the tendency for probing depths and attachment levels to decrease, especially in deeper pockets. This study showed that none of the parameters monitored, i.e., probing depth. attachment level, bleeding or subgingival microflora. indicated which sites would lose attachment over a 12‐week period.
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Periodontal sites which had undergone probing attachment loss were identified in 16 advanced periodontitis patients subjected to initial periodontal treatment and monitored every 3rd month for 42 months. Many sites with probing attachment loss showed no increase in probing depth and bled on probing at a few of the examinations during maintenance. Others showed increase in depth, frequent bleeding and suppuration. An arbitrary classification of 'questionable periodontitis' sites was used and included sites with the following characteristics: probing depth at 42 months < or = 3.5 mm + bleeding on probing at no more than 5 of the 14 examinations 3-42 months + no suppuration on probing 3-42 months. The % sites in this category ranged from 21-35%, depending upon method used to determine probing attachment loss. Widely varying characteristics of sites identified with probing attachment loss were evident for all surface locations and all subgroups of initial probing depth. From a traditional viewpoint, a significant proportion of the losing sites might not have been afflicted with periodonitis. On the other hand, deterioration does not necessarily have to be coupled with obvious inflammation, particularly following therapy.
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Gingival inflammation
Aggressive periodontitis
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