Subgingival microorganisms and bacterial virulence factors in periodontitis

Considerable information has come forth in recent years on the pathogenic organisms in human periodontitis and the sequence of events by which they produce periodontal disease. Important periodontopathogens include Bacteroides gingivalis, Bacteroides intermedius and Actinobacillus actinomycetemcomitans. Virulence factors of B. gingivalis and B. intermedius may mainly involve enzymes with potential to interfere with host defenses and to disintegrate periodontal tissues. Pathogenic properties of A. actinomycetemcomitans appear predominantly to be exerted by leukotoxin and other noxious products.     

DNA probe detection of periodontopathogens in advanced periodontitis

Species-specific DNA probes were used to determine the presence of Actinobacillus actinomycetemcomitans (A.a.), Porphyromonas (Bacteroides) gingivalis, Prevotella intermedia, Treponema denticola. Eikenella corrodens, Fusobacterium nucleatum , and Wolinella recta in subgingival plaque from deep pockets/sites of patients with advanced periodontitis. The subjects were 20 patients with severe adult periodontitis, 13 men and 7 women (mean age 45.6 ± 6.7 yr). For each subject, 9–10 subgingival sites with the deepest probing depths from each quadrant were sampled by the paper point method, a total of 198 sites, with mean probing depth 7.2 ± 1.6 mm and clinical attachment level 9.5 ± 2.7 mm. A.a . was present in at least one site in 75% of the subjects; P. gingivalis was found in 95%; P. intermedia and W. recta were found in 90%, respectively; and T. denticola, E. corrodens , and F. nucleatum were found in all subjects. In the 198 samples, A.a . was detected in 25.8%, P. gingivalis in 51.5%, P. intermedia in 64.1%, T. denticola in 60.6%, E. corrodens in 72.9%, F. nucleatum in 74.7%, and W. recta in 65.7%. The predominant combination was the simultaneous presence of P. intermedia, T. denticola, E. corrodens, F. nucleatum , and W. recta in 89.5% of the subjects and 46.8% of the sites. Of these sites, 51.1% showed the combined presence of P. gingivalis and 28.4% that of both A.a . and P. gingivalis . None of the seven bacteria could be detected in 14.4% of the total sites sampled. The present study indicates that severe destructive adult periodontitis is a multibacterial infection and that certain combinations of periodontopathogens seein to be important in the pathogenesis of the disease.     

慢性牙周炎患者的龈下微生物与吸烟状况

目的　评价慢性牙周炎患者的吸烟状况与龈下牙周致病微生物的百分比。方法　 112例慢性牙周炎患者 ,根据吸烟状况分为 :①重度吸烟组 >10支 /天 (n =32 ) ;②轻度吸烟组≤ 10支 /天 (n =18) ;③戒烟者组 (n =2 4 ) ;④非吸烟组 (n =38)。观察者口内每个象限 ,选取探诊最深的 1或 2个位点 ,纸捻法取龈下菌斑 ,厌氧培养 ;并测量该位点的探诊深度 (ProbeDepth ,PD)、附着丧失 (AttachmentLoss,AL)和探诊后出血 (Bleedingofprobe ,BOP)。结果　①取样位点临床指标的均值为PD :6 .3mm、AL :6 .5mm及BOP :89% ,各组间无显著性差异。②组间菌落形成单位和龈下微生物伴放线放线杆菌 (Actinobacillusactinomycetemcomitans,A .a)、牙龈卟啉单胞菌 (Porphyromanasgingivalis,P .g)、中间普氏菌 (Prevotellaintermedia ,P .i)、核梭杆菌 (Fusobacteriumnucleatum ,F .n)和微消化球菌(Peptostreptococcusmicros,P .m)的百分比均无差异。③方差分析显示仅轻度吸烟组福赛类杆菌 (Bacteroidesforsythus,B .f)的百分比略高于其它组 (P <0 .0 4 )。结论　慢性牙周炎患者 ,探诊深度和附着丧失相似的位点 ,吸烟组、戒烟组和非吸烟组的龈下牙周致病微生物百分比 (B .f除外 )无显著差异。     

Subgingival temperature and microbiota in initial periodontitis

Abstract. The association between subgingival temperature, other clinical characteristics, and the subgingival microbiota was examined in adult subjects with initial periodontitis and differing levels of gingival inflammation, 43 subjects were measured at 6 sites per tooth for pocket depth, attachment level, presence of plaque, gingival redness, bleeding on probing and subgingival temperature at 3-month intervals for 1 year. Subgingival plaque was sampled from 15 initial active periodontitis sites (10 subjects), 121 gingivitis, sites (20 subjects) and 202 healthy sites (13 subjects), and included the 5 hottest and 5 coldest sites in each subject. Plaque samples were analyzed for 13 subgingival species using whole-genomic DNA probes. The major influences on the subgingival microbiota were the clinical status of sites, pocket depth, and the presence of supragingival plaque. No significant association between species and site temperature was observed. Initial active sites were associated with Bacteroides forsythus and Campylobacter rectus. and had a higher mean subgingival temperature and deeper mean pocket depth than inactive sites, A weak association between pocket depth and site temperature was noted. The major influence on subgingival temperature of sites was the anterior to posterior anatomical temperature gradient in the mandible and maxilla.     

Subgingival microbiota in adult Down syndrome periodontitis

Khocht A, Yaskell T, Janal M, Turner BF, Rams TE, Haffajee AD, Socransky SS. Subgingival microbiota in adult Down syndrome periodontitis. J Periodont Res 2012; 47: 500–507. © 2012 John Wiley & Sons A/S Background and Objective: The subgingival microbiota in Down syndrome and non‐Down syndrome adults receiving periodic dental care was examined for 40 bacterial species using checkerboard DNA–DNA hybridization and the results were related to clinical periodontal attachment loss. Material and Methods: A total of 44 Down syndrome, 66 non‐Down syndrome mentally retarded and 83 mentally normal adults were clinically evaluated. This involved, for each subject, the removal of subgingival specimens from three interproximal sites on different teeth; all subgingival samples per subject were then pooled and assessed for the presence and levels of 40 bacterial species using species‐specific whole‐genomic DNA probes and checkerboard DNA–DNA hybridization. Significant group differences in species proportions averaged across subjects were evaluated using the Kruskal–Wallis test, and associations between subgingival species and mean subject attachment loss within Down syndrome and non‐Down syndrome subject groups were quantified using Pearson correlation and multiple linear regression analysis. Results: Down syndrome subjects exhibited greater attachment loss than non‐Down syndrome subjects (p = 0.05). Most microbial species were present in Down syndrome subjects at levels similar to non‐Down syndrome subjects, except for higher proportions of Selenomonas noxia, Propionibacterium acnes, Streptococcus gordonii, Streptococcus mitis and Streptococcus oralis in Down syndrome subjects compared with non‐Down syndrome study subjects, higher proportions of Treponema socranskii in Down syndrome subjects compared with non‐Down syndrome mentally retarded subjects, and higher proportions of Streptococcus constellatus in Down syndrome subjects compared with mentally normal subjects. Down syndrome adults classified with periodontitis revealed higher subgingival levels of T. socranskii than Down syndrome subjects with no periodontitis (p = 0.02). Higher subgingival proportions of S. constellatus, Fusobacterium nucleatum ssp. nucleatum, S. noxia and Prevotella nigrescens showed significant positive correlations (r = 0.35–0.42) and higher proportions of Actinomyces naeslundii II and Actinomyces odontolyticus showed negative correlations (r = ?0.36 to ?0.40), with increasing mean subject attachment loss in Down syndrome adults. Conclusion: Individuals with Down syndrome show higher levels of some subgingival bacterial species and specific associations between certain subgingival bacterial species and loss of periodontal attachment. These findings are consistent with the notion that certain subgingival bacteria may contribute to the increased level of periodontal disease seen in Down syndrome individuals and raise the question as to the reason for increased colonization in Down syndrome.     

Subgingival distribution of A. actinomycetemcomitans in periodontitis

Abstract This investigation developed an experimental design that (1) detailed the distribution of A. actinomycetemcomitans in Subgingival plaque related to the level of serum antibody to this pathogen; (2) used broad based subgingival plaque sampling to allow a definition of the distribution of A. actinomycetemcomitans infection in periodontitis patients; (3) described the distribution of A. actinomycetemcomitans serotypes in patients and within sites; and, (4) assessed how this infection impacted upon local clinical symptoms of disease. We noted a significant positive relationship between the level of IgG anti-A. actinomycetemcomitans antibody and the frequency of teeth infected until nearly 13 teeth demonstrated an infection. Furthermore, the results showed a generally negative relationship between the antibody level and the burden of A. actinomycetemcomitans in the infected sites. Interproximal sites associated with first molar teeth were the predominant sites for subgingival colonization; incisors were also frequently infected in this population. The first molar teeth also exhibited the greatest level of A. actinomycetemcomitans while the incisors demonstrated a high level of A. actinomycetemcomitans in individual sites. The results clearly indicated the majority of the sites sampled were colonized by a single serotype of A. actinomycetemcomitans. We detected A. actinomycetemcomitans nearly 2 × times more frequently and a significant increase in the proportion of A. actinomycetemcomitans was found in samples obtained from teeth with bleeding on probing. The results also showed a significant trend for both pocket depth and attachment levels to be related to the presence and proportion of A. actinomycetemcomitans in the subgingival plaque. These findings detail the microbiological, immunological and clinical characteristics of a unique subset of periodontitis patients that appear to exhibit disease associated (caused?) with A. actinomycetemcomitans infection irrespective of clinical categorization. The results support a unique distribution of this microorganism in the subgingival ecology that is related to active host immune responses and clinical presentation of the tooth.     

Lack of bacterial invasion in experimental periodontitis

The present study in the beagle dog was performed to analyze whether micro-organisms from a subgingival microbiota could be translocated into or had the potential to invade the pocket epithelium and the gingival connective tissue during a phase of rapid breakdown of the attachment apparatus. An attempt was also made to assess whether tetracycline therapy suppressed the subgingival microbiota and changed the size and quality of the lesions in the gingival tissue. 5 inbred beagle dogs were used. Throughout the period of experimentation, the animals were fed a soft diet permitting gross accumulation of plaque and calculus. No mechanical plaque control measures were performed during the course of the study. On day 0, a 120-day period of periodontal tissue breakdown was initiated at the right mandibular 3rd and 4th premolars by tying cotton floss ligatures around the neck of these teeth. The process of tissue breakdown at the mandibular left 3rd and 4th premolars was started 30 days later. The ligatures were replaced once every 2 weeks during the subsequent 4-month period. On experimental day 120, the first biopsy was performed and gingival tissue sections prepared for light and electron microscopic assessment of a series of histometric characteristics. On day 120, a 30-day period of tetracycline (per os) administration was initiated. Each dog was given a dose of 500 mg tetracycline twice daily. On day 150, the biopsy procedure was repeated in the mandibular left premolar regions.(ABSTRACT TRUNCATED AT 250 WORDS)     

Analysis of serum antibody responses to periodontopathogens in early-onset periodontitis patients from different geographical locations

Abstract. Serum antibody specificity to oral micro-organisms was used to delineate the pathogens associated with early-onset periodontal diseases in a Turkish population. Additionally, comparison of the findings to those derived from a clinically similar US patient population described differences in bacterial specific antibody between these 2 geographic regions. Serum from 89 (LJP), 86 (RPP) and 94 (normal) subjects was analyzed (ELISA) to determine IgG antibody to 14 oral micro-organisms. All LJP patients from Turkey exhibited elevated antibody levels to A. actinomycetemcomitans (serotypes c and a significantly increased), while antibody levels to A. actinomycetemcomitans Y4 and JP2 (serotype b) were significantly higher in US LJP patients. 50% of the Turkish RPP patients also showed elevated anti- A. actinomycetemeomitans antibody, although the US RPP patients exhibited significantly higher antibody levels and frequency of elevated antibody to the A. actinomycetemcomitans serotypes. Healthy subjects and LJP and RPP patients from the US exhibited higher antibody levels to all 3 P. gingivalis serogroups compared to those from Turkey, although, the frequency of elevated antibody to the P. gingivalis serogroups was significantly higher in LJP and RPP patients from Turkey than from the US. Interestingly, 87% and 77% of the LJP patients in the Turkish population had elevated antibody responses to P. gingivalis and E. corrodens , respectively, which was not observed in the US LJP patients. These data suggested that considerable variation exists in the systemic antibody levels to periodontopathogens between these 2 countries. This supports potential differences in subgingival colonization or antigenic composition of these pathogens between patient populations from different geographical regions.     

Subgingival bacterial clusters and serum antibody response as markers of extent and severity of periodontitis in adult Chinese

This study evaluated the associations between clinical, microbiological, and antibody activity manifestations of periodontitis in 123 adult rural Chinese subjects with no dental intervention. All participants were registered for full‐mouth clinical attachment level (CAL) and pocket probing depth (PD) measurements, and microbial samples were taken from four sites and analyzed for 18 different bacterial species using the ‘checkerboard’. Serum from each individual was analyzed to determine the antibody activity against the same 18 species. Exploratory factor analysis disclosed two microbial factors – Factor 1, consisting of seven species associated with periodontal health (‘early colonizers’); and Factor 2, consisting of eight species associated with periodontitis (‘putative periodontopathogens’) – which explained 87% of the variation among the microbial variables. Factor 2 was consistently associated with disease‐severity measures, whereas the ‘early colonizer’ factor was not. The antibody response showed weak or no correlations with bacterial load or with disease severity. We conclude that the bacteria investigated are resident in the subgingival plaque; that their load and proportions in the pocket may be ecologically driven; and that the antibody response is based on bacterial carrier state rather than on disease. The different antibody‐response pattern found between the individuals may suggest that each individual could be classified as a good or a weak immune responder.     

Subgingival distribution of periodontal pathogenic microorganisms in adult periodontitis.

The association between specific plaque microorganisms and periodontal diseases has been the subject of much recent interest due to its potential importance in the diagnosis and classification of these diseases. In order to optimize microbiological tests in periodontal therapy, it is important to know how many subgingival plaque samples must be assayed from a single patient in order to ascertain infection with a periodontal pathogen. To answer this question the present study assessed the distribution of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus, and Prevotella intermedia in multiple subgingival plaque samples. The samples were quantitatively assessed for specific bacteria by indirect immunofluorescence, a technique previously found to correlate well with cultural assessment of these same organisms. Subgingival plaque from the mesial pockets/sulci of all teeth except third molars was sampled in 12 patients with adult periodontitis, 22 to 28 sites/patient for a total of 315 samples. These patients demonstrated an average mesial probing depth and loss of attachment of 3.7 +/- 1.2 mm and 3.1 +/- 1.5 mm, respectively (mean +/- SD). P. gingivalis, P. intermedia, and B. forsythus were demonstrated in one or more sites from all patients, while A. actinomycetemcomitans was found in one or more sites in 8 of 12 patients. The proportion of positive sites per subject varied, but it was, on average, similar for the 3 black-pigmented organisms and ranged from 44% to 54%. In contrast, A. actinomycetemcomitans was identified, on average, in only 11.4% of the sites in these same patients.(ABSTRACT TRUNCATED AT 250 WORDS)     

Subgingival microbiota in healthy, well-maintained elder and periodontitis subjects

Abstract. This investigation compared the site prevalence of 40 subgingival species in 30 periodontally healthy (mean age 36±9 years). 35 elders with a well-maintained periodontium (mean age 77±5) and 138 adult periodontitis subjects (mean age 46± 11). Subgingival plaque samples were taken from the mesial aspect of each tooth (up to 28 samples) in the 203 subjects at baseline. The presence and levels of 40 subgingival taxa were determined in 5003 plaque samples using whole genomic DNA probes and checkerboard DNA-DNA hybridization. Clinical assessments including dichotomous measures of gingival redness, bleeding on probing, plaque accumulation and suppuration, as well as duplicate measures of pocket depth and attachment level, were made at 6 sites per tooth. The % of sites colonized by each species (prevalence) was computed for each subject. Differences in prevalence and levels among groups were sought using the Kruskal-Wallis test. Commonly detected species, such as Actinomyces naeslundii genospecies 2, Streptococcus sanguis and Streptococcus oralis did not differ significantly among subject groups. After adjusting for multiple comparisons, 4 species were significantly elevated and at greater prevalence in the periodontitis group. Mean % of sites (±SEM) colonized by Bacteroides forsythus was 10±3, 12±2 and 40±2 (p<0.001) for healthy, elder and periodontitis groups respectively. The odds ratio was 14.4:1 that a subject had periodontitis when B. forsythus was detected at ≥5% of sampled sites. Mean prevalence for Porphyromonas gingivalis in healthy, elder and periodontitis subjects was 4±2, 5±2 and 23±2 respectively (p<0.001); for Treponema denticola 12±4, 10±3 and 30±2 (p<0.001) and for Selenomonas noxia 6±2, 7±2 and 19±2 (p<0.01). Similar differences among subject groups were observed when only sites with PD 0-4 mm were analyzed. The data suggest an etiologic role for B. forsythus, P. gingivalis, T. denticola and S. noxia in adult periodontitis.     

牙髓炎及根尖周病患牙微生物的超微结构观察

目的扫描电镜观察牙髓炎和根尖周病患牙微生物的超微结构。方法收集健康牙（n=6）、不可复性牙髓炎（n=10）、牙髓坏死（n=20）、慢性根尖周炎（n=20）及难治性根尖周炎（n=6）病例共62例,分为2组,每组各31例,采用扫描电镜观察根管内牙本质面（A组）和根尖周牙骨质面（B组）的微生物形态和定植模式。结果①A组：3例健康牙根管内没有细菌存在;其余28例感染根管内均能观察到被胶状基质包裹的菌落构成生物膜,其中26例（92.9%）可见细菌不同程度侵入牙本质小管;2例难治性根尖周炎样本根管内发现真菌感染。②B组：健康组、不可复性牙髓炎组、牙髓坏死组（共18例）根尖仅见牙周膜胶原纤维网,无细菌生物膜结构;其余13例根尖周炎的患牙均出现根尖骨质吸收纤维破坏以及斑块状根尖生物膜;3例难治性根尖周炎超充牙胶尖表面亦覆盖细菌生物膜。生物膜的超微结构由于基质的多寡和细菌组成不同而表现各异。结论口腔微生物在牙髓炎和根尖周病患牙中主要以生物膜的方式定植,并可侵入牙本质小管或隐匿于牙骨质吸收腔隙中。     

Subgingival microbial consortia and the clinical features of periodontitis in adolescents

This study aimed to investigate the association between microbial consortia and the clinical features of periodontitis using a multilevel modeling approach. A total of 958 sites in 87 adolescents with periodontitis (cases) and 73 controls were microbiologically sampled and clinically examined. Associations between each of the clinical parameters clinical attachment, probing depth, supragingival plaque, calculus, bleeding on probing, and each of 18 bacterial species; and between the same clinical parameters and each of two microbial consortia identified, were investigated using mixed-effects regression modeling. Higher counts of Tannerella forsythia, Campylobacter rectus, and Porphyromonas gingivalis were all statistically significantly associated with higher values of clinical attachment level, probing depth, and bleeding on probing in the sampled site, when both case status and between-subject variance were accounted for. Higher counts for the consortium comprising the putative periodontopathogens were statistically significantly associated in a dose-response manner with both higher clinical attachment levels and with increased pocket depth. The counts for the consortium predominantly comprising the early-colonizer species were statistically significantly negatively associated with the presence of supragingival calculus, but positively associated with the presence of supragingival plaque. The study demonstrates a relationship between the counts of putative periodontopathogens and clinical attachment levels and probing pocket depths, even for low levels of these clinical parameters.     

The detection of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia using an ELISA in an adolescent population with early periodontitis

Abstract The aim of the study was to compare the occurrence and levels of A. actinomycetemcomitans. P. gingivalis, and P. intermedia in the subgingival plaque from sites with and without early periodontitis in adolescents using an ELISA. 47, 15- to 16-year-old adolescents (39 Indo-Pakistani. 8 white Caucasian) were examined for clinical attachment level, probing depth, supragingival plaque, subgingival calculus and bleeding on probing on the mesio-buccal and disto-buccal aspects of the 1st molars and the incisors. Based on the clinical data, 2 sites per subject were selected for subgingival plaque sampling 3 weeks later: in 32 subjects with loss of attachment mm, a diseased site (D) and a healthy comparison control site (C) were sampled: in 15 subjects in whom loss of attachment had not yet developed. 1 of the upper molar sites was selected, called the at-risk site (R), together with a C site. The presence and levels of A. actinomycetemcomitans, P. gingivalis, and P. intermedia were determined using an ELISA. The loss of attachment subgroup had significantly more pockets 4 mm, subgingival calculus and bleeding on probing (p<0.05). Significantly more of the D than C sites had P. gingivalis both at detectable and at measurable levels (p<0.05). In subjects who had no loss in clinical attachment levels, fewer sampled sites harboured any of the suspected peridontopathogens investigated, and no significant differences were found between the R or C sites (p>0.05). Although there was a significantly higher prevalence and extent of loss of attachment 1 mm in the Indo-Pakistani subjects compared with the Caucasians (p<0.05), no differences could be identified in the distribution of the bacteria. It is concluded that monitoring of the subgingival plaque may be useful in studies of early periodontitis in adolescents, and the role of P. gingivalis needs to be elucidated in prospective longitudinal investigations.     

Subgingival microbiome in smokers and non‐smokers in Korean chronic periodontitis patients

Smoking is a major environmental factor associated with periodontal diseases. However, we still have a very limited understanding of the relationship between smoking and subgingival microflora in the global population. Here, we investigated the composition of subgingival bacterial communities from the pooled plaque samples of smokers and non‐smokers, 134 samples in each group, in Korean patients with moderate chronic periodontitis using 16S rRNA gene‐based pyrosequencing. A total of 17,927 reads were analyzed and classified into 12 phyla, 126 genera, and 394 species. Differences in bacterial communities between smokers and non‐smokers were examined at all phylogenetic levels. The genera Fusobacterium, Fretibacterium, Streptococcus, Veillonella, Corynebacterium, TM7, and Filifactor were abundant in smokers. On the other hand, Prevotella, Campylobacter, Aggregatibacter, Veillonellaceae GQ422718, Haemophilus, and Prevotellaceae were less abundant in smokers. Among species‐level taxa occupying > 1% of whole subgingival microbiome of smokers, higher abundance (≥ 2.0‐fold compared to non‐smokers) of seven species or operational taxonomic units (OTUs) was found: Fusobacterium nucleatum, Neisseria sicca, Neisseria oralis, Corynebacterium matruchotii, Veillonella dispar, Filifactor alocis, and Fretibacterium AY349371. On the other hand, lower abundance of 11 species or OTUs was found in smokers: Neisseria elongata, six Prevotella species or OTUs, Fusobacterium canifelinum, Aggregatibacter AM420165, Selenomonas OTU, and Veillonellaceae GU470897. Species richness and evenness were similar between the groups whereas diversity was greater in smokers than non‐smokers. Collectively, the results of the present study indicate that differences exist in the subgingival bacterial community between smoker and non‐smoker patients with chronic moderate periodontitis in Korea, suggesting that cigarette smoking considerably affects subgingival bacterial ecology.     

Subgingival microbial profiles in chronic periodontitis patients from Chile, Colombia and Spain

Aim: To investigate the subgingival microbiota of distinct periodontitis patient populations, in Chile, Colombia and Spain, using identical clinical and bacteriological methods. Material and Methods: In this multicentre study, 114 chronic periodontitis patients were selected. Patients were examined using an identical clinical protocol and pooled subgingival samples were obtained from each patient. Samples were processed in the three laboratories by means of culturing under identical clinical and microbiological protocols. Total anaerobic counts and frequency of detection and proportions of nine periodontal pathogens were calculated. Variables were analysed by means of anova , χ², Kruskal–Wallis and Dunn's multiple comparison tests. Results: The Colombian population demonstrated greater severity of periodontitis, with significantly deeper mean probing pocket depth, and had a significantly lower percentage of current smokers. When comparing samples from the three patient populations, the total counts were significantly higher in the Colombian patients. The numbers of putative pathogens differed among groups. Tannerella forsythia was found less frequently in Chilean samples, while Parvimonas micra and enteric rods differed significantly among the three population groups. Conclusion: Significant differences among Chile, Colombia and Spain existed regarding the frequency and proportions of specific periodontal pathogens in the subgingival microbiota of periodontitis patients.     

Subgingival occurrence and antimicrobial susceptibility of enteric rods and pseudomonads from Brazilian periodontitis patients

The occurrence and in vitro antimicrobial sensitivity of isolates of enteric rods and pseudomonads were examined in 80 periodontitis patients, 17 to 58 years of age, in S?o Paulo, Brazil. Speciation and in vitro antimicrobial susceptibility testing were performed using the BBL Crystal enteric/nonfermenter system and the Etest for amoxicillin/clavulanic acid, ciprofloxacin and doxycycline. A total of 30 strains were isolated from 25 (31.2%) of the study subjects. Pseudomonas aeruginosa occurred in nine patients, Serratia marcescens in seven, and five other species were recovered in lower prevalence. All study organisms demonstrated high susceptibility to ciprofloxacin but exhibited variable susceptibility patterns to the other antimicrobial agents tested. In conclusion, the high occurrence of enteric rods and pseudomonads in these subjects may be important in the pathogenesis of periodontitis, and ciprofloxacin might be the antibiotic of choice to eradicate these pathogens from periodontal pockets.     

Longitudinal evaluation of the development of periodontal destruction in spouses

Abstract The aim of the present investigation was to study longitudinally the periodontal condition of married couples. The data are derived from a longitudinal study in a young population living in a remote village in Indonesia and showing a relatively high prevalence of periodontal destruction. In 23 married couples, clinical measurements were carried out in 1987 and 1994. During the latter examination, a pooled gingival sample was obtained for microbiological evaluation. In 1994. the mean age of the group was 29.1 years and the couples were married for on the average 10 years. In each couple, the partner showing in 1994 the highest score for mean loss of attachment (LA) was classified as the diseased proband and the other partner as the spouse. Evaluation of the clinical data showed that: (11 the diseased probands already had in 1987 a worse periodontal condition compared to that of the spouses; (2) in both groups the mean LA increased during the 7-year period;13) the difference in mean LA between diseased probands and spouses increased between 1987 and 1994. The microbiological evaluation revealed a relatively high prevalence of Actinobadllus actinomycetemcomitans (50%). Porphyromonas gingivalis (67%) and Prevotella intermedia 61%. Analysis showed no differences in microbiota between diseased probands and spouses. The 23 Actinobadllus actinomycetemcomitans positive subjects included 2 positive couples. Furthermore, the 31 Porphyrormmas gingivalis and 28 Prevotella intermedia positive subjects included 9 and 7 positive couples respectively. In conclusion, 10 years of cohabitation showed no influence on the periodontal condition of the spouses.