Actinobacillus actinomycetemcomitans,Capnocytophaga and Porphyromonas gingivalis in subgingival plaque of adolescents with Down's syndrome

Levels of Actinobacillus actinomycetemcomitans, Capnocytophaga and Porphyromonas gingivalis were determined in subgingival plaque samples from 37 adolescents with Down's syndrome and 37 healthy controls matched with respect to age and sex. Gingival inflammation, supra- and subgingival calculus, periodontal pockets (>4 mm) and alveolar bone loss were registered. Alveolar bone loss was more frequent in Down's syndrome subjects (32%) than in the controls (3%). A. actinomycetemcomitans was detected in the subgingival plaque in 35% of the Down's syndrome adolescents and in 5% of the controls. On site level, A. actinomycetemcomitans and Capnocytophaga were more frequent in the subgingival plaque samples of Down's syndrome children than in those of controls. Comparing Down's syndrome subjects positive or negative for A. actinomycetemcomitans and Capnocytophaga, no significant differences were found in terms of gingival inflammation, periodontal pockets (>4 mm) or number of sites with alveolar bone loss. The results indicate an altered microbial composition of the subgingival plaque of Down's syndrome subjects compared with healthy controls, with higher frequency of A. actinomycetemcomitans.     

Expression of HLA class II antigens in marginal periodontitis of patients with Down's syndrome

The expression of HLA Class II antigens on the surfaces of immunocompetent cells and the presence of CDla⁺ cells (Langerhans cells) are important components of antigen presentation. Quantitative variations in HLA class II expression on antigen-presenting cells play a role in immune regulation. An indirect irnmunofluorescent technique was used on cryostat sections to reveal such differences qualitatively or quantitatively between chronic marginal periodontitis (CMP) in patients with Down's syndrome (DS) and in otherwise normal patients (NP). We found increased frequency of HLA Class II (HLA-expression on inflammatory cells and on keratinocytes of the oral gingival epithelium) in CMP of DS patients compared to sections from NP. The expression of HLA-DR was more frequent on the keratinocytes of the pocket epithelium in NP than in DS. There were significantly higher numbers of CD1a+ cells and ratios of HLA-DR+/CD1a⁺ cells and HLA-DP⁺/CD1a⁺ cells in the DS group compared to the NP group. Our conclusion is that there is a more pronounced inflammatory process in the gingival sites with CMP of DS patients compared to CMP in NP. The findings also indicate that there is a highly activated immune response in CMP of DS patients.     

Effect of periodic preventive care on the progression of periodontal disease in young adults with Down's syndrome

OBJECTIVES: To examine the effect of periodic preventive care on the progression of periodontal disease in 24 young adults with Down's syndrome (DS) (mean age+/-SD: 20.8+/-5.6 years) MATERIAL AND METHODS: Subjects were divided into two groups: 13 subjects who had frequently visited our clinic (mean interval between visits: 3.7+/-1.3 months; managed group) and 11 subjects who had not visited our clinic for more than 1 year (mean duration of no visits: 27.5+/-10.1 months; interrupted group). The progression of periodontal disease in the subjects was evaluated clinically, microbiologically and roentgenologically. RESULTS: Clinical parameters (probing depth, frequency of the presence of a pathological periodontal pocket, alveolar bone loss, frequency of the incidence of pathological bone loss, and modified total PMA (M-PMA)) and benzoyl-DL-arginine-naphthylamide (BANA) scores in the interrupted group were significantly higher than those in the managed group. Subject age showed significant positive correlations with probing depth and alveolar bone loss. BANA scores showed significant positive correlations with probing depth, alveolar bone loss and M-PMA in the interrupted group. CONCLUSIONS: The results suggest that periodic preventive care is effective for suppressing the progression of periodontal disease in young adults with DS.     

Periodontal status in oral mucous membrane pemphigoid: initial results of a case‐control study

Oral Diseases (2010) 17 , 90–94 Objective: To evaluate the periodontal status of mucous membrane pemphigoid (MMP) patients and compare it with that of healthy controls. Methods: A prospective study was undertaken to examine the impact of gingival MMP lesions on the human periodontium of 29 patients. Parameters evaluated included full mouth plaque score (FMPS), full mouth bleeding upon probing scores, probing depths (PD), gingival recession, clinical attachment level (CAL), mobility score, furcation involvement, number of missing teeth and Machtei criteria. Results: All periodontal parameters recorded were increased in cases when compared to controls in univariate statistics. The mean differences between groups in PD (0.8 ± 0.2 mm, 95% CI 0.3–1.3), CAL (1.3 ± 0.4 mm, 95% CI 0.4–2.2), FMPS (41.0 ± 6.2%, 95% CI 28.7–53.4), FMBS (16.2 ± 6.6%, 95% CI 3.0–29.4) and tooth loss (2 ± 1 teeth, 95% CI 1–3) were all statistically significant (P < 0.01 for all). Substantial differences in domiciliary oral hygiene routines were observed (P < 0.0001). In multivariate models when FMPS was included as covariate the difference between groups in all clinical periodontal parameters was no longer statistically significant. Conclusions: Our results showed that periodontal status is worse in MMP patients if compared with healthy controls due to a substantial difference in oral hygiene. Oral health should be promoted in MMP.     

The periodontal status of patients with Sjögren''s syndrome

Abstract Sjögren's syndrome (SS) is a chronic inflammatory disease characterized by xerostomia. Although a common observation in SS is increased susceptibility to caries, the level of periodontal disease has not been described in these individuals. The purpose of this study was to determine the periodontal status of 14 SS female subjects who had a mean age of 52.9±11.6 years. Plaque, gingival, and calculus indices as well as probing depth (PD) and attachment level (AL) were determined on 7 index teeth in each subject. Result indicated that individuals with Sjögren's Syndrome did not exhibit significant periodontal disease.     

Periodontal pathogens in subgingival plaque of HIV‐positive subjects with chronic periodontitis

Many putative periodontal pathogens associated with periodontal disease in human immunodeficiency virus (HIV)‐infected patients also occur in non‐HIV‐infected individuals. This study examined the prevalence of eight periodontal pathogens in HIV‐positive and HIV‐negative patients with chronic periodontitis using the 16s RNA polymerase chain reaction technique. The results showed a significant prevalence of Porphyromonas gingivalis and Treponema denticola among HIV‐negative patients compared to HIV‐positive patients. Sixty percent of the patients in both groups were colonized by five to six species. Odds ratio analysis revealed a statistically significant positive association between three of the 28 possible combinations in the HIV‐positive group. They included Prevotella nigrescens/Campylobacter rectus, P. nigrescens/P. gingivalis and P. nigrescens/T. denticola. Although the prevalence of periodontal pathogens is similar in both the groups, the combination of certain periodontal pathogens may be responsible for chronic periodontitis seen in HIV‐infected adults.     

Periodontal status and treatment needs in the Chiangmai/Lamphun provinces of Thailand

As part of an oral health survey concerned with the evaluation of a collaborative primary oral health care program, the CPITN system was used to determine the periodontal status and treatment needs of 2009 Thai people aged 12-44 yr. Calculus dominated the CPITN scores. The percentage of persons with healthy periodontal tissues was small, ranging from 0.7% at age 35-44 to 4.1% at age 12. Ranges for other highest scores were bleeding-0.4% at age 35-44 yr to 6.1% at age 12 yr; calculus-62% at age 35-44 yr to 92.6% at age 17-18 yr. Pocketing did not occur to any significant extent until age 35-44 where 23.9% had 3-5 mm pockets and 12.8% had pockets 6 mm or deeper. 15-18-yr-olds who had received prior care from a Village Scaler had a significantly higher number and proportion of healthy sextants than those who had not received such care. No such effect was demonstrated in 35-44-yr-olds. The need for caution in the interpretation of this result is stressed. Attention is drawn to the desirability of differentiating between supra- and sub-gingival calculus in the CPITN scoring system and to the excessive treatment requirements that arise from classifying everyone with calculus as requiring prophylaxis and scaling. A great deal of improvement will need to be affected if the Thai national and global goals for periodontal health are to be achieved in the districts covered by this survey.     

Periodontal status of teeth with crown–root fractures: results two years after adhesive fragment reattachment

Aim: This series of case reports evaluated the impact of adhesive crown–root fragment reattachment in periodontally healthy teeth suffering from crown–root fractures on various parameters of periodontal health over a time course of 2 years.
Material and Methods: A total of 20 teeth with crown–root fractures in 18 periodontally healthy subjects were evaluated. After open-flap access, crown–root fragments were adhesively reattached to the root stub. In all cases, the vertical difference between the alveolar bone crest and the fracture line was 1 mm, i.e. violating the biological width. Subsequently, clinical attachment level (CAL), probing pocket depth (PPD), bleeding on probing (BoP) and gingival index (GI) scores were recorded at 6, 12 and 24 months postoperatively for the restored teeth as well as plaque index (PlI) and periodontal screening index (PSI) values for the whole dentition.
Results: Two years after therapy, recorded CAL, PPD, BoP, GI, PlI and PSI scores revealed healthy periodontal conditions in 18 out of 20 treated teeth. Two teeth had suffered again from fragment fracture due to new traumata.
Conclusions: Adhesive fragment reattachment in periodontally healthy teeth affected by crown–root fractures had no detrimental impact on periodontal health over a time course of 2 years.     

Oral health status of adults with Down syndrome in Hong Kong

The aim of this survey was to study the oral health status of Hong Kong Chinese adults with Down syndrome (DS). Sixty‐five community‐dwelling adults with DS (aged 17 to 42 years, 26.8±6.4) and age‐and gender‐matched contrais attending a dental hospital were included in a cross‐sectional survey. The subjects with DS had fewer filled (2.4±4.6 vs. 2.7±3.1, p=0.017) and fewer decayed (1.1±2.5 vs. 1.7±2.4, p=0.007) teeth than the control subjects. Significantly more peg‐shaped maxillary lateral incisors and retained primary teeth (p<0.001) were observed in subjects with DS, compared to the control subjects. Adults who had DS had a significantly higher percentage of surfaces with detectable plaque (81.5±19.1 vs. 61.9±16.0. p<0.001) and a higher percentage of sites with bleeding on probing (76.3±25.8 vs. 55.6±21.4, p<0.001). A higher proportion of subjects with DS showed one or more occurrences where probing pocket depth was ≥6mm than control subjects (49%vs. 24.5%, p<0.021). In conclusion, while having fewer caries, Hong Kong Chinese adults with DS had poorer periodontal health than age‐ and gender‐matched control subjects.