The relationship between physiologic halitosis and periodontopathic bacteria of the tongue and gingival sulcus

To determine the influence of oral status on halitosis, the relationship between halitosis and periodontopathic bacteria present in plaque on the tongue and the subgingival sulcus was examined in 62 periodontally healthy adults. Halitosis indicators used were the organoleptic score; gas chromatography results [total volatile sulfur compounds (VSCs) = H₂S + CH₃SH + (CH₃)₂S]; Halimeter values; and the results of three clinical tests, plaque control record (PlCR), plaque index (PlI), and tongue coat status. Significant correlations with organoleptic scores was observed for PlCR, PlI, tongue coat status, VSC amounts, and Halimeter values, indicating that halitosis in periodontally healthy subjects tended to originate from tongue plaque deposits. Polymerase chain reaction analysis was used to detect six periodontopathic bacteria (Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis, and Treponema denticola) from the tongue and subgingival plaque. Significant effects on the organoleptic scores, tongue coat status, total VSC, H₂S and CH₃SH amounts, and Halimeter values were observed only for T. denticola and F. nucleatum and only in the tongue plaque, not in the subgingival plaque. Thus, therapies developed to inhibit the growth of these bacteria may lead to future treatments of halitosis.     

Effect of cinnamon (Cinnamomum verum) bark essential oil on the halitosis-associated bacterium Solobacterium moorei and in vitro cytotoxicity

ObjectivesHalitosis, also known as bad breath or oral malodour, is a condition affecting a large proportion of the population. Solobacterium moorei is a Gram-positive anaerobic bacterium that has been specifically associated with halitosis. In this study, we investigated the effects of essential oils, more particularly cinnamon bark oil, on growth, biofilm formation, eradication and killing, as well as hydrogen sulfide (H₂S) production by S. moorei.MethodsA broth microdilution assay was used to determine the antibacterial activity of essential oils. Biofilm formation was assessed by a crystal violet staining assay and scanning electron microscopy. The biofilm of S. moorei was characterized by enzymatic treatments. Biofilm killing was determined by a luminescence assay monitoring ATP production. H₂S production was quantified with a colorimetric assay. The biocompatibility of cinnamon oil was investigated using a gingival keratinocyte cell line.ResultsAmong the ten essential oils tested, cinnamon oil was found to be the most powerful against S. moorei with MIC and MBC values of 0.039% and 0.156%, respectively. The biofilm formed by S. moorei was then characterized. The fact that DNase I and to a lesser extent proteinase K significantly reduced biofilm formation by S. moorei and induced its eradication suggests that the extracellular matrix of S. moorei biofilm may be mainly containing a DNA backbone associated with proteins. At concentrations below the MIC, cinnamon oil reduced S. moorei biofilm formation that resulted from an attenuation of bacterial growth. It was also found that treatment of a pre-formed biofilm of S. moorei with cinnamon oil significantly decreased its viability although it did not cause its eradication. Cinnamon oil had an inhibitory effect on the production of H₂S by S. moorei. Lastly, it was found that at concentrations effective against S. moorei, no significant loss of viability in gingival keratinocytes occurred after a 1-h exposure.ConclusionsOur study brought evidence that cinnamon oil may be a promising substance to incorporate into oral hygiene products for controlling bad breath by inhibiting growth, killing biofilm, and reducing H₂S production by S. moorei. Moreover, at the effective concentrations, cinnamon oil was found to have no toxic effects on oral keratinocytes.     

Antimicrobial activity of Streptococcus salivarius K12 on bacteria involved in oral malodour

ObjectiveTo investigate the antimicrobial activity of the bacteriocin-producing strain Streptococcus salivarius K12 against several bacteria involved in halitosis.DesignThe inhibitory activity of S. salivarius K12 against Solobacterium moorei CCUG39336, four clinical S. moorei isolates, Atopobium parvulum ATCC33793 and Eubacterium sulci ATCC35585 was examined by a deferred antagonism test. Eubacterium saburreum ATCC33271 and Parvimonas micra ATCC33270, which have been tested in previous studies, served as positive controls, and the Gram-negative strain Bacteroides fragilis ZIB2800 served as a negative control. Additionally, the occurrence of resistance in S. moorei CCUG39336 to S. salivarius K12 was analysed by either direct plating or by passage of S. moorei CCUG39336 on chloroform-inactived S. salivarius K12-containing agar plates.ResultsS. salivarius K12 suppressed the growth of all Gram-positive bacteria tested, but the extent to which the bacteria were inhibited varied. E. sulci ATCC35585 was the most sensitive strain, while all five S. moorei isolates were inhibited to a lesser extent. Natural resistance seems to be very low in S. moorei CCUG39336, and there was only a slight decrease in sensitivity after exposure to S. salivarius K12 over 10 passages.ConclusionOur studies demonstrate that S. salivarius K12 has antimicrobial activity against bacteria involved in halitosis. This strain might be an interesting and valuable candidate for the development of an antimicrobial therapy for halitosis.     

Characterization of volatile sulfur compound production by Solobacterium moorei

Objective

Solobacterium moorei is a Gram positive bacterium that has been specifically associated with halitosis. The aim of this study was to characterize volatile sulfur compound (VSC) production by S. moorei.

Methods

S. moorei was either grown or incubated in the presence of various supplements prior to determining VSC production with a Halimeter sulfide monitor. The effect of exogenous proteases or glycosidase inhibitors on VSC production by S. moorei was examined.

Results

We first showed that S. moorei can convert cysteine into hydrogen sulfide. The capacity of S. moorei to produce VSCs from serum, saliva, and mucin was dependent on the presence of an exogenous source of proteases such as pancreatic trypsin or Porphyromonas gingivalis gingipains. VSC production from mucin was inhibited by the presence of a β-galactosidase inhibitor, thus suggesting that deglycosylation of mucin by S. moorei is critical for VSC production.

Conclusion

Our study suggests that S. moorei can be a major source of malodorous compounds in halitosis by producing VSCs through a process involving the β-galactosidase activity of the bacterium and an exogenous source of proteases.     

Association between viral hepatitis B infection and halitosis

Objective. Oral malodor can be increased in breath of liver patients. However, no study has been performed for the association between volatile sulfur compounds (VSCs) and viral hepatitis. The aim of the present study was to determine the relationship between viral hepatitis and VSCs. Methods. This study analyzed 182 subjects and measured hydrogen sulfide (H₂S), methyl mercaptan (CH₃SH) and dimethyl sulfide [(CH₃)₂S] using the OralChroma®. Hepatitis type B was evaluated. Periodontal health was assessed using the Community Periodontal Index (CPI) and bleeding on probing (BOP). Tongue coating score (TCS) was evaluated. Multiple logistic regression analyses were conducted to evaluate the relationship. Results. Viral hepatitis had an elevated odds of dimethyl sulfide defined halitosis (OR = 9.22, 95% CI = 2.08–40.95) after controlling for age, gender, alcohol consumption, current smoking, periodontitis, BOP, TCS and tongue brushing habit. The magnitude of the association between viral hepatitis and VSCs defined halitosis attenuated with adjustment of mediators (alcohol consumption, periodontitis, BOP, TCS and tongue brushing habit for hydrogen sulfide defined halitosis; periodontitis, TCS and tongue brushing habit for methyl mercaptan defined halitosis; tongue brushing habit for dimethyl sulfide defined halitosis). Conclusions. Findings of this study suggest that viral hepatitis may be associated with methyl mercaptan defined halitosis.     

The antimicrobial activity of alpha-bisabolol and tea tree oil against Solobacterium moorei,a Gram-positive bacterium associated with halitosis

ObjectiveTo investigate the antimicrobial effect of alpha-bisabolol and tea tree oil alone and in combination against the halitosis-associated Gram-positive bacillus Solobacterium moorei.DesignThe inhibitory activity of alpha-bisabolol and tea tree oil against the reference strain S. moorei CCUG39336 and four clinical S. moorei isolates was investigated by a direct exposure test. Additionally, the ability of alpha-bisabolol to increase the sensitivity of S. moorei was tested by pretreating the bacteria with sublethal concentrations prior to the administration of tea tree oil.ResultsA dose-dependent killing was observed for the antimicrobial agents in a direct exposure test with the reference strain S. moorei CCUG39336. Concentrations of ≥0.5% tea tree oil caused decreases in viability of >5 log colony forming units/ml even after short incubation periods, while bacterial viability was less affected by alpha-bisabolol. The combination of 0.1% alpha-bisabolol plus 0.05% tea tree oil showed a synergistic effect on S. moorei strain CCUG39336 and on two of the four clinical S. moorei isolates tested. However, incubation of S. moorei with a sublethal concentration of 0.1% alpha-bisabolol for three days prior to the administration of 0.05% tea tree oil did not enhance the antibacterial effect of tea tree oil.ConclusionHalitosis-associated bacterium S. moorei is susceptible to the antimicrobial agents tea tree oil and alpha-bisabolol, suggesting that these compounds might be beneficial in oral healthcare products.     

Value of some laboratory and clinical measurements in the treatment plan for advanced periodontitis

Abstract In our previous study, we reported that only 13 of 46 adult patients with advanced periodontitis responded well to initial non-surgical periodontal therapy. In the present follow-up study, the remaining 33 patients were randomly treated further using either modified Widman flap surgery or systemic metronidazole. The patients responding unsatisfactorily to this 2nd treatment phase, received supplementary systemic chemotherapy or surgery, respectively. By using this study design, we determined which baseline clinical variables and/or laboratory findings predicted the treatment outcome in these study patients. Clinical variables included the assessment of bleeding, suppuration, probing pocket depth, furcation lesions, relative attachment level and radiographic infrabony defects. Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis were cultured from subgingival plaque samples. The specific IgG and IgA antibody levels against 5 serotypes of A. actinomycetemcomitans were determined in serum and saliva. Elastase-like. trypsin-like and general protease activities were assessed from saliva. The bivariate statistical analyses showed that the most pronounced difference between the patients responding well to initial non-surgical therapy (group MC n=13), to either supplementary surgery or chemotherapy (group FT1, n=11). or those responding to the complex therapy (group FT2, n=17), was the prior extent of periodontal destruction expressed as the proportion of ≥6 mm deep periodontal pockets. When multiple linear regression was used to investigate the influence of clinical and laboratory findings on the variation of treatment response between the 3 groups, the most significant explanatory factor was the simultaneous presence of subgingival A. actinomycetemcomitans and multiple deep periodontal pockets. None of the immunological or biochemical variables used had any further influence in the model. Pretreatment microbiological examination, especially for the detection of A. actinomycetemcomtians. seems to be a valuable laboratory screening method for identifying complex treatment need in adult patients with advanced periodontitis. However, the evaluation of the extent and pattern of periodontal breakdown remains crucial for choosing the treatment strategy including surgery and/or chemotherapy in A. actinomycetemcomitans-infected adult periodontitis patients.     

The levels of volatile sulfur compounds in mouth air from patients with chronic periodontitis

Background and Objective: Volatile sulfur compounds may be the main source of oral malodor. The aim of this study was to clarify the relationship between periodontal parameters and volatile sulfur compounds and to evaluate the improvement of several halitosis‐related outcomes by tongue scraping, nonsurgical periodontal treatment (including oral hygiene instruction) and oral hygiene instruction/chlorhexidine + cetyl pyridinium gargling. Material and Methods: Seventy‐two chronic periodontitis patients with heavy tongue coating were assessed for oral malodor and periodontal status. Oral malodor was evaluated by measuring the levels of volatile sulfur compounds using OralChroma? and the organoleptic test score. Thirty participants were selected for the subsequent experiments: tongue scraping; nonsurgical periodontal treatment; and oral hygiene instruction/chlorhexidine + cetyl pyridinium gargling. Twenty‐five participants completed all experimental stages. Results: Significant correlations were observed between the organoleptic test score and hydrogen sulfide (H₂S), methyl mercapton (CH₃SH), tongue coating score and volatile sulfur compounds, which was also significantly correlated with bleeding on probing percentage and tongue coating score. Tongue scraping significantly reduced the levels of volatile sulfur compounds. Further reduction of volatile sulfur compounds after nonsurgical periodontal treatment and oral hygiene instruction/chlorhexidine + cetyl pyridinium gargling were noted compared with baseline. Conclusion: Volatile sulfur compounds, with H₂S and CH₃SH as the main components, in mouth air are the prominent elements of malodor. Volatile sulfur compounds were decreased by more than 50% after tongue scraping. Nonsurgical periodontal treatment and oral hygiene instruction/chlorhexidine + cetyl pyridinium gargling maintained a significantly lower level of malodor compared with baseline.     

Influence of IL-6 haplotypes on clinical and inflammatory response in aggressive periodontitis

Objectives

The aim of this study was to investigate the inflammatory response in aggressive periodontitis (AgP) patients after periodontal therapy and associate these changes to subjects’ interleukin-6 (IL-6) genetic variants.

Materials and methods

Twelve non-smoking UK Caucasian patients with AgP were selected based on their IL6 haplotypes (six haplotype positive and six haplotype negative based on polymorphisms rs 2069827 and rs 2069825) and underwent full mouth non-surgical periodontal therapy, followed by open flap surgery. Gingival crevicular fluid (GCF) and peripheral blood samples were taken at baseline and at six different time points after treatment. Gingival biopsy samples were harvested during surgery and underwent immunohistochemical analysis for identification of IL-6.

Results

An overall improvement in clinical periodontal parameters was observed following periodontal therapy. Haplotype status was associated with clinical presentation, Aggregatibacter actinomycetemcomitans counts in subgingival plaque samples, white cell count, neutrophils, red cell count and haemoglobin. GCF IL-6 concentrations increased dramatically 1 day after surgery and IL-6 haplotype-positive subjects exhibited a higher magnitude in this increase.

Conclusions

IL6 haplotypes may have an effect on clinical presentation and magnitude and kinetics of local and systemic inflammatory responses following non-surgical and surgical periodontal therapy in aggressive periodontitis.

Clinical relevance

Detecting IL-6 haplotype-positive periodontitis patients might become helpful in identifying subjects prone to excessive inflammatory response and increased periodontal breakdown.     

Detection of Prevotella intermedia in subgingival plaque of adult periodontitis patients by polymerase chain reaction

A PCR assay was developed that could specifically amplify DNA from the periodontal pathogen Prevotella intermedia. A pair of primers was selected from regions of the 16S rRNA gene of P. intermedia that were both divergent in sequence at their 3′ ends with respect to the corresponding regions of the 16S rRNA gene of P. nigrescens, its most closely related species, and used in the PCR assay. Positivity was indicated by amplification of an 855 bp product. Using purified genomic DNA from these 2 species, assay conditions were determined under which only P. intermedia DNA and not P. nigrescens DNA was amplifiable. Absolute specificity of the assay was confirmed by the fact that no amplification products were obtained when using DNA from several other important periodontal organisms. The optimized PCR assay was used to identify P. intermedia in subgingival plaque samples of patients with adult periodontitis. Confirmation of amplification of P. intermedia DNA was achieved by digestion of PCR products with the restriction endonuclease Rsal, which gives different restriction patterns for P. intermedia and P. nigrescens. Of the 97 samples analysed, 38 (39%) were positive for P. intermedia. The results obtained confirm P. intermedia as a possible aetiological agent of adult periodontitis. Additionally, PCR primers targeting the corresponding region of the 16S rRNA gene of P. nigrescens were shown to be specific for the organism when used in a PCR assay, although P. nigrescens was not detectable in any of the subgingival plaques analysed.     

Healing following ultrasonic debridement and PVP-iodine in individuals with severe chronic periodontal disease: A randomized,controlled clinical study

Objective. Antiseptics and antibiotics delivered either locally or systemically have been used as an adjunct to scaling and root planing procedures in order to control the subgingival biofilm and thereby enhancing the treatment outcome. The results presented in the literature are, however, inconclusive. Povidone-iodine (PVP-iodine) has a bactericidal effect and is effective against most bacteria, including putative periodontal pathogens. The aim of the present study was to evaluate the clinical effect of PVP-iodine as an adjunct to ultrasonic scaling in the treatment of severe chronic periodontitis. Material and Methods. Twenty patients were recruited to the study. Each test site and the related quadrant were randomly assigned to one of four different treatment modalities: ultrasonic scaling?+?subgingival irrigation with 0.5% PVP-iodine for 5 min/tooth, ultrasonic scaling?+?subgingival irrigation with sterile saline solution for 5 min/tooth, subgingival irrigation with sterile saline solution for 5 min/tooth, and subgingival irrigation with 0.5% PVP-iodine for 5 min/tooth. The individuals were followed longitudinally for 6 months. Results. The present study showed that non-surgical periodontal therapy by means of an ultrasonic device was effective in attaining a healthy periodontal status in patients with severe periodontal lesions. No additive effect was found when PVP-iodine was included. Conclusions. Ultrasonic debridement using Odontogain® is effective in controlling infection in patients with severe chronic periodontitis. PVP-iodine does not add any clinical benefit to the ultrasonic debridement alone under these circumstances.     

Microbiological effect of the use of an ultrasonic device and iodine irrigation in patients with severe chronic periodontal disease: A randomized controlled clinical study

Objective. Instrumentation of the subgingival area is aimed at removing as much as possible of the bacterial biofilm and subgingival calculus. Since mechanical root debridement is a technically demanding procedure, antiseptics and antibiotics delivered either locally or systemically have been used as adjunct to scaling and root-planning procedures in order to control the subgingival biofilm and thereby enhance the treatment outcome. Our aim was to study the microbiological effect of ultrasonic debridement with or without povidone-iodine (PVP-iodine) in the treatment of severe chronic periodontitis. Material and Methods. Twenty patients were recruited to the study. Each test site and the related quadrant were randomly assigned to one of four different treatment modalities: ultrasonic scaling+subgingival irrigation with 0.5% PVP-iodine for 5 min/tooth, ultrasonic scaling+subgingival irrigation with sterile saline solution for 5 min/tooth, subgingival irrigation with sterile saline solution for 5 min/tooth and subgingival irrigation with 0.5% PVP-iodine for 5 min/tooth. The individuals were followed longitudinally for 6 months. Results. The present study showed that non-surgical periodontal therapy with the use of an ultrasonic device was effective in reducing the analyzed putative periodontal bacteria. No statistically significant difference between ultrasonic+saline and ultrasonic+PVP-iodine was found. Conclusions. Ultrasonic debridement reduced the periodontal markers in patients with severe chronic periodontitis. The reduction was selective. A concentration of 0.5% PVP-iodine did not add any anti-microbiological effect compared to ultrasonic debridement alone.     

Suppression of the periodontopathic microflora in localized juvenile periodontitis by systemic tetracycline

Abstract. Since recent studies have implicated Actinobacillus actinomycetemcomitans in the etiology of localized juvenile periodontitis, this investigation determined the effectiveness of subgingival debridement, topical Betadine Solution®, and systemic tetiacycline in suppressing subgingival A. actinomycetemcomitans and other microorganisms. A total of 20 deep periodontal pockets and 10 normal periodontal sites of 6 localized juvenile periodontitis patients was included in the study. Each patient was treated in 3 stages over a period of 22 weeks, and the result of treatment was monitored for an additional 38 weeks. The first stage of treatment included plaque control, as well as thorough scaling and root planing, composed of at least 6 h of debridement. No concomitant periodontal surgery was performed. In the second stage, Betadine saturated cotton gauze was inserted into the periodontal pockets for 10 min. Stage 3 involved systemic tetracycline therapy (1 g/day) for J4 days. The subgingival microflora was determined at frequent intervals by selective culturing of A. actinomycetemcomitans and Capnocytophaga and by direct microscopic examination. The clinical effect was assessed by measuring changes in probing periodontal attachment level, probing periodontal pocket depth, radiographic alveolar bone mass, and other relevant clinical parameters. Scaling and root planing reduced the total subgingival bacterial counts and the proportions of certain Gram-negative bacteria, but no periodontal pocket became free of A actinomycetemcomitans. Betadine application had little or no effect on the subgingival microflora. In contrast, tetracycline administered via the systemic route suppressed. A actinomycetemcomitans, Capnocytophaga, and spirochetes to low or undetectable levels in all test periodontal pockets. A, actinomycetemcomitans reappeared in 9 of the deep periodontal pockets after the administration of tetracycline. Most of these 9 pockets became free of detectable A. actinomycetemcomitans during the second week of tetracycline administration, whereas pockets which yielded no A. actinomycetemcomitans after tetracycline therapy became free of the organisms during the first week of tetracycline treatment. This data suggests that systemic tetracycline therapy of localized juvenile periodontitis should, as a practical rate, be continued for 3 weeks. Periodontal destruction continued in 4 deep pockets which all showed high posttetracycline A, actinomycetemcomitans counts. All 6 pockets which demonstrated a marked gain in periodontal attachment yielded no cultivable A. actinomycetemcomitans. No association was found between periodontal disease status and subgingival Capnocytophaga, spirochetes or motile rods. The present study indicates that A. actinomycetemcomitans is an important etiologic agent in localized juvenile periodontitis. Also, this study demonstrates that the effectiveness of therapy can be monitored by subgingival A. actinomycetemcomitans counts, and that periodontal A, actinomycetemcomitans infections cannot be resolved by root surface debridement alone but can be cured by systemic tetracycline therapy.     

Characterization of oral bacteria in the tongue coating of patients with halitosis using 16S rRNA analysis

Abstract

There are many studies on the relationship between the tongue coating and halitosis, but few have evaluated the bacterial community present in the tongue coating. This study identified bacteria in the tongue coating in individuals with and without halitosis using 16S rRNA analysis. Forty subjects (mean age, 46.1?±?15.8?years) who visited the halitosis clinic at the University Dental Hospital between 2016 and 2017 were divided into halitosis (n?=?32) and non-halitosis (n?=?8) groups according to results from an organoleptic test (OT). Additional measurements via gas chromatography (GC) and the Breathtron® instrument confirmed the groupings as the H₂S, CH₃SH, (CH₃)₂S, and total volatile sulphur compounds (VSC) levels were significantly higher in the halitosis group than in the non-halitosis group. Bacterial diversity was higher in the halitosis group; the median (quartile) values of the Shannon index were 4.46 (4.21, 4.67) in the halitosis group and 3.80 (3.45, 4.30) in the non-halitosis group. Additionally, the median (quartile) values of the Chao-1 index were 84.0 (77.2, 95.0) in the halitosis group and 71.3 (65.0, 81.5) in the non-halitosis group. These differences in bacterial composition and diversity may further the understanding of causes and treatments for halitosis.     

Quantitative analysis of microbiota in saliva, supragingival, and subgingival plaque of Chinese adults with chronic periodontitis

Objective

The aim of this study was to determine the profiles of periodontopathogenic bacteria in a Chinese population using quantitative real-time polymerase chain reaction (qRT-PCR).

Materials and methods

Twenty-four periodontally healthy Chinese subjects and 60 patients with chronic periodontitis (CP) were enrolled in this cross-sectional study. qRT-PCR was used to quantify Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis, and Prevotella intermedia as well as total bacterial counts from 252 samples collected from the saliva, supragingival plaque, and subgingival plaque of all 84 subjects.

Results

The detection frequency of A. actinomycetemcomitans was less than 50%. F. nucleatum was detected in all subjects and CP patients had higher bacterial loads than healthy subjects. The median proportion of F. nucleatum was significantly higher in subgingival plaque than in supragingival plaque and saliva. P. gingivalis and P. intermedia had higher detection frequencies and bacterial loads in CP patients than in healthy subjects. The median proportion of P. gingivalis was significantly different among the three intraoral locations in the CP group and its proportion in subgingival plaque was 9.01%. Moreover, strong positive Spearman’s correlations were found in A. actinomycetemcomitans, P. gingivalis, and P. intermedia counts across the three intraoral locations.

Conclusion

The presence and bacteria loads of these four bacteria in this Chinese population are similar to those from other populations.

Clinical relevance

Examination of bacterial detection frequency and loads in Chinese adults may assist microbial studies of periodontal disease and will shed light on periodontal disease diagnosis and treatment using antibiotics in the Chinese population.     

超声龈下刮治术与替硝唑液局部冲洗在牙周治疗中的临床分析

目的观察超声龈下刮治术后替硝唑液局部冲洗在牙周基础治疗中的临床效果。方法选取慢性牙周炎患者80例,随机分成两组,每组40例,作超声龈下刮治术后实验组给予替硝唑液局部冲洗,对照组给予过氧化氢液局部冲洗,一周后进行对比观察。结果术后一周复诊,探针出血、牙周袋深度、口腔异味、牙龈肿痛、咀嚼疼痛等牙周病常见症状两组均有显著性好转,两组差异无显著性。结论超声龈下刮治术配合龈下冲洗是行之有效的牙周基础治疗方法,替硝唑液作为冲洗液有明显效果。     

盐酸米诺环素对牙周袋内硫化物水平的影响

目的评价口臭的牙周炎患者局部应用盐酸米诺环素软膏对牙周袋内硫化物水平的影响。方法对15例以口臭为主诉的慢性牙周炎患者采用分口（split-mouth）设计,同一患者的一侧半口随机采用刮治和根面平整术（scaling and root planing,SRP）,另一侧采用SRP辅助用盐酸米诺环素软膏治疗。基线、治疗后6周、3个月时检查牙周袋内硫化物（sulfide in periodontal pockets,pS）水平、探诊深度（probing depth,PD）、临床附着水平（clinical attachment level,CAL）、出血指数（bleeding index,BI）、菌斑指数（plaque index,PLI）,在基线、治疗后6周刚果红涂片进行龈下微生物计数。结果在治疗后6周、3个月,SRP＋米诺环素组与单纯SRP组的各项临床指标均较治疗前明显改善（P〈0.05）;比较两组间pS值、PD、CAL、PLI、BI、龈下螺旋体比例,差异均无统计学意义。结论对于口臭的牙周炎的患者,盐酸米诺环素辅助SRP较单纯的SRP并未显示很大的优势;牙周治疗可持续3个月降低袋内硫化物水平。     

Anabolic steroids affect human periodontal health and microbiota

Objectives

This study aims to evaluate periodontal microbiological differences between systemically healthy nonsmoker males taking anabolic androgenic steroids (AASs) and non-AAS users and to find associations between disease severity and AAS use.

Methods

Ninety-two men practicing bodybuilding were included in the study. They were divided into AAS users and a matched control nonuser group and subgrouped based on their most severe periodontal condition. Pooled subgingival samples from each individual were cultured to evaluate specific periodontopathogen infection.

Results

AAS users had significantly higher prevalence of severe periodontitis. AAS users had greater gingival inflammation and clinical attachment loss of ≥3 mm than nonusers (odds ratio (OR)?=?2.4; p?=?0.09; 95 % confidence interval (CI) 0.8–6.4). AAS users were 4.9 times more likely to be infected with Prevotella intermedia than AAS nonusers (OR?=?4.9; p?=?0.003; 95 % CI 1.6–14.7). The OR of presenting subgingival Aggregatibacter actinomycetemcomitans was 8.2 times higher in AAS users (OR?=?8.2; p?=?0.03; 95 % CI 0.9–70.8). AAS users were 5.6 times more likely to present subgingival Candida spp. than nonusers (OR?=?5.6; p?=?0.02; 95 % CI 1.1–27.1). AAS users were 14.8 times more likely to present subgingival Candida parapsilosis than nonusers (OR?=?14.8; p?<?0.0001; 95 % CI 3.1–69.2). The likelihood of AAS users presenting subgingival Candida tropicalis was 4.3 times higher than nonusers (OR?=?4.3; p?=?0.03; 95 % CI 1.1–16.9). A. actinomycetemcomitans was mostly isolated in individuals with severe periodontitis and was associated with subgingival Porphyromonas gingivalis, P. intermedia, and Candida spp.

Conclusions

AAS use may increase the risk for severe periodontitis and may cause a subgingival selection of certain Candida species. Specific periodontopathogens, such as Candida dubliniensis and Candida albicans, seem to be negatively affected by AAS use. The higher risk for disease progression in AAS users may be explained by the significantly higher proportions of A. actinomycetemcomitans, P. gingivalis, P. intermedia, and Candida species as compared to controls.

Clinical significance

Data on the influence of AAS on subgingival periodontopathogens and disease progression are scarce. Higher proportions of specific periodontopathogens are plausible in AAS users. AAS users had a higher prevalence of severe periodontitis, gingival inflammation, and clinical attachment loss. Men taking AAS are at greater risk of periodontitis and specific periodontopathogen infection.     

Real-time polymerase chain reaction quantification of human cytomegalovirus and Epstein-Barr virus in periodontal pockets and the adjacent gingiva of periodontitis lesions

BACKGROUND: Genomic sequences of human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV), two herpesviruses, can frequently be detected in periodontal pockets of progressive periodontitis lesions, but the prevalence and load of the two viruses in gingival tissue are unknown. This study determined levels of HCMV and EBV DNA in the periodontal pocket and in the adjacent gingiva of periodontitis lesions using a real-time polymerase chain reaction (PCR) assay. MATERIAL AND METHODS: A total of 20 systemically healthy periodontitis patients participated in the study. Nine patients below 35 years of age were tentatively diagnosed as having aggressive (early onset) periodontitis, and 11 patients 36-56 years of age as having chronic (adult) periodontitis. Clinical parameters were evaluated using established methods. Using periodontal curettes, specimens were harvested from 6-10 mm periodontal pockets and from the adjacent inflamed periodontal pocket wall. A 5'-nuclease (TaqMan) real-time PCR assay was used to identify and quantify genomic copies of periodontal HCMV and EBV. RESULTS: HCMV DNA was detected in 78% of subgingival and 33% of gingival tissue samples from aggressive periodontitis lesions, but only in 46% of subgingival and 9% of gingival tissue samples from chronic periodontitis lesions. In aggressive periodontitis, HCMV subgingival and gingival tissue counts were positively correlated with periodontal pocket depth and probing attachment loss at sample sites (p6 mm, but none of 14 patients having mean pocket depth at sample teeth相似文献