Prevalence and Severity of Periodontitis in Indonesian Patients With Rheumatoid Arthritis

Background: Patients with rheumatoid arthritis (RA) may have more prevalent and severe periodontitis than healthy controls. Periodontitis may increase the systemic inflammation in RA. The aim of this study is to assess periodontitis prevalence and severity and its potential association with systemic inflammation in Indonesian patients with RA. Methods: A full‐mouth periodontal examination including probing depth, gingival recession, plaque index, and bleeding on probing was performed in 75 Indonesians with RA and 75 age‐, sex‐, and smoking‐matched Indonesian controls. A validated questionnaire was used to assess smoking, body mass index, education, and medical conditions. In addition, in all participants, the use of drugs was noted, and erythrocyte sedimentation rates and serum levels of high‐sensitivity C‐reactive protein (hsCRP), rheumatoid factor, and anti‐citrullinated protein antibodies were measured. Differences in periodontitis prevalence and 12 measures of periodontitis severity between patients with RA and controls were analyzed using univariate analyses. Results: No significant differences in periodontitis prevalence and 11 measures of periodontitis severity between patients with RA and controls were observed. Conversely, patients with RA had a significantly lower surface area of healthy pocket epithelium versus controls (P = 0.008), and a tendency toward higher hsCRP levels was observed in patients with RA with severe periodontitis compared with patients with RA with no mild or moderate periodontitis (P = 0.063). It has to be noted that all patients with RA were on anti‐inflammatory drugs, whereas none of the controls used such drugs. Conclusion: Prevalence and severity of periodontitis in Indonesian patients with RA is comparable to controls but with less healthy pocket epithelium than in controls and a tendency toward a higher inflammatory state in patients with RA and severe periodontitis.     

牙周炎伴糖尿病患者全唾液中Pro-CT含量的检测及其意义

目的:比较糖尿病合并牙周炎患者、单纯糖尿病患者、单纯牙周炎患者以及健康者全唾液中降钙素原(Pro-CT)水平,及其与血糖控制情况及牙周病炎严重程度之间的关系。方法:采用病例对照研究,纳入糖尿病合并牙周炎患者(DM+CP组)24例,单纯糖尿病患者(DM组)、单纯牙周炎患者(CP组)以及健康人群各30例,收集受检者静息全唾液,采用酶联免疫吸附试验(ELISA)检测全唾液中Pro-CT水平。结果:DM+CP组全唾液中Pro-CT水平显著高于其他3组,差异极具统计学意义(P<0.01);全唾液中Pro-CT水平随牙周炎严重程度加重而增高,随血糖控制情况的不理想而增高,差异有统计学意义;全唾液中Pro-CT水平与探诊深度(PD)、探诊出血指数(BI)、附着丧失(AL)、缺失牙数均呈正相关,且相关程度由高到低依次为PD、BI、AL、缺失牙数,差异有统计学意义(P<0.05)。结论:糖尿病患者体内的微炎症状态可能与牙周炎症有关,全唾液中Pro-CT水平既受牙周炎症影响也受全身因素的调控。     

Periodontal inflamed surface area and C-reactive protein as predictors of HbA1c: a study in Indonesia

Periodontitis may exert an infectious and inflammatory burden, evidenced by increased C-reactive protein (CRP). This burden may impair blood glucose control (HbA1c). The aim of our study was to analyze whether periodontitis severity as measured with the periodontal inflamed surface area (PISA) and CRP predict HbA1c levels in a group of healthy Indonesians and a group of Indonesians treated for type 2 diabetes mellitus (DM2). A full-mouth periodontal examination, including probing pocket depth, gingival recession, clinical attachment loss, plaque index and bleeding on probing, was performed in 132 healthy Indonesians and 101 Indonesians treated for DM2. Using these data, PISA was calculated. In addition, HbA1c and CRP were analyzed. A validated questionnaire was used to assess smoking, body mass index (BMI), education and medical conditions. In regression analyses, it was assessed whether periodontitis severity and CRP predict HbA1c, controlling for confounding and effect modification (i.e., age, sex, BMI, pack years, and education). In healthy Indonesians, PISA and CRP predicted HbA1c as did age, sex, and smoking. In Indonesians treated for DM2, PISA did not predict HbA1c. Periodontitis may impair blood glucose regulation in healthy Indonesians in conjunction with elevated CRP levels. The potential effect of periodontitis on glucose control in DM2 patients may be masked by DM2 treatment. Clinical relevance: periodontitis may impair blood glucose control through exerting an inflammatory and infectious burden evidenced by increased levels of CRP.     

In-dental-office screening for diabetes mellitus using gingival crevicular blood

BACKGROUND: Diabetes mellitus (DM) is undiagnosed in approximately 1/2 of the patients actually suffering from the disease. In addition, the prevalence of DM is more than 2x as high in patients with periodontitis when compared to periodontally healthy subjects. Thus, a high number of patients with periodontitis may have undiagnosed DM. AIM: The purpose of this pilot study was to evaluate, whether blood oozing from gingival tissues during routine periodontal examination can be used for determining glucose levels. 32 non-diabetic and 13 diabetic patients with moderate to severe periodontitis were enrolled and subjected to routine clinical periodontal examination. Periodontal pocket probing was performed using a standard force. Blood oozing from gingival tissues of anterior teeth following periodontal pocket probing was collected with the stick of a glucose self-monitoring device (Elite(R) 2000, Bayer Diagnostics GmbH, Munich). As control, fingerstick capillary blood was taken. Statistical analysis was performed by Pearson's correlation coefficient. RESULTS: The patient blood glucose levels ranged from 3.57 mmol/l to 18.01 mmol/l and the values of blood samples taken from gingiva or finger tip showed a very high intrapatient correlation (r=0.98; p<0.0001). CONCLUSION: The results suggested that blood oozing during routine periodontal examination may be used for diabetes mellitus screening in a dental office setting.     

Diabetes and periodontal disease: a case-control study

BACKGROUND: Periodontitis is often associated with diabetes and might be considered one of the chronic complications of diabetes mellitus, both in Type 1 (T1DM) and Type 2 (T2DM). This case-control study was designed to evaluate the possible association between non-insulin-dependent diabetes (T2DM) and clinical and microbiological periodontal disease among adult Sardinians. METHODS: A total of 212 individuals participated in this study: 71 T2DM patients aged 61.0 +/- 11.0 years and 141 non-diabetic controls in good general health aged 59.1 +/- 9.2 years. All subjects were given a clinical periodontal examination for probing depth, attachment level, presence of calculus, bleeding on probing, and assessment of plaque. Subgingival plaque samples were obtained, and P. gingivalis, P. intermedia, and T. forsythensis were identified using multiplex polymerase chain reaction. RESULTS: T2DM patients showed a significantly lower number of teeth present (P = 0.002); a significant increase in number of probing depths >4 mm, and percent of pocket depths >4 mm (P = 0.04 and P = 0.05, respectively); periodontitis (P = 0.046); bleeding on probing (P = 0.02); and plaque index (P = 0.01). A significant association with diabetes was detected for plaque (X2= 4.46; P <0.05) and bleeding on probing (X2= 3.60; P <0.05). Concerning bacteria prevalence, a positive association was detected for P. gingivalis (X2= 2.80; P <0.05) and T. forsythensis (X2= 3.87; P <0.05). Presence of plaque was positively associated with case status (odds ratio [OR] = 1.3; 95% confidence interval [CI]: 1.2, 3.6) and with prevalence of P. gingivalis and T. forsythensis (OR = 1.2, 95% CI: 1.3, 2.2; and 1.2, 95% CI: 1.2, 1.8, respectively). CONCLUSION: Patients with T2DM undoubtedly have a susceptibility for more severe periodontal disease.     

Investigating the Association Between Obstructive Sleep Apnea and Periodontitis

Background: Obstructive sleep apnea (OSA) is a sleep disorder characterized by disruptions of normal sleep architecture. Chronic periodontitis is a chronic disease of the periodontium that elicits a general inflammatory response to local dental plaque. It has been suggested that periodontal disease may increase in severity with increasingly severe OSA because both disease entities share common inflammatory pathways, acting synergistically to alter the host response. The aim of this study is to analyze the association between severity of OSA and the prevalence/severity of periodontitis. Methods: One hundred patients from a large veterans administration sleep study center (n = 26 normal, n = 21 mild, n = 19 moderate, n = 34 severe) diagnosed with an overnight polysomnogram underwent a comprehensive periodontal examination. Periodontal parameters measured included the following: 1) mean periodontal probing depth (PD); 2) clinical attachment level (CAL); 3) gingival recession; and 4) percentage of sites with bleeding on probing, plaque, PD ≥5 mm, and CAL ≥3 mm. Results: Seventy‐three percent of the sampled population had moderate/severe periodontal disease. χ² analyses revealed no significant differences in the prevalence of periodontal disease between the apnea–hypopnea index (AHI) groups, with a negligible Spearman correlation coefficient of 0.246 between AHI severity and periodontal disease severity categories. Analysis of covariance indicated a significant association between AHI severity categories and percentage of sites with plaque, after adjusting for age. Multivariable logistic regression analysis predicting moderate/severe periodontitis with AHI score, age, and smoking status indicated a significant association with age (P = 0.028) but no significant association with the other two predictors. Conclusion: OSA was not significantly associated with the prevalence of moderate/severe periodontitis and the periodontal parameters examined, except percentage plaque.     

Association of salivary levels of cortisol and dehydroepiandrosterone with periodontitis in older Japanese adults

BACKGROUND: The relationship between periodontitis and psychoneuroimmunologic variables, such as stress-related hormones, is poorly understood. The purpose of this cross-sectional study was to investigate the associations between two kinds of stress-related hormones, cortisol and dehydroepiandrosterone (DHEA), and periodontitis in healthy community-dwelling elderly subjects aged > or =60 years. METHODS: A total of 171 subjects (85 males and 86 females) participated in this study. The subjects were independently living elderly people with a mean age of 68.4 (+/- 4.46) years. Stimulated whole saliva samples were collected, and hormone levels were determined. A medical questionnaire regarding medical conditions, lifestyle, and psychosocial stress also was administered. The clinical examinations included probing depth (PD), bleeding on probing, and clinical attachment level (CAL). RESULTS: There was a positive correlation between hormone levels and PD and CAL values. When the subjects were divided into two groups based on periodontitis severity, hormone levels were significantly higher in subjects with severe PD or CAL. Multiple regression analysis showed that higher cortisol and DHEA levels were associated significantly with greater numbers of teeth with severe PD or CAL, after adjusting for confounding variables. CONCLUSIONS: These results suggested close relationships between the extent and severity of periodontitis and salivary levels of cortisol and DHEA in healthy elderly subjects. To the best of our knowledge, this is the first report on the association between the levels of DHEA and extensive periodontitis.     

Distribution of genotypes of Porphyromonas gingivalis in type 2 diabetic patients with periodontitis in Mexico

OBJECTIVE: To determine and compare the distribution of Porphyromonas gingivalis fimA genotypes in type 2 diabetes mellitus (T2DM) patients affected by periodontitis, using non-diabetic subjects with and without periodontitis as control groups. MATERIAL AND METHODS: This study involved 75 subjects divided into three groups of 25 subjects each: Group 1 (non-T2DM without periodontitis), Group 2 (non-T2DM with periodontitis) and Group 3 (T2DM with periodontitis). The outcome variable was periodontitis, and explanatory variables were age, sex, T2DM and specific P. gingivalis fimA genotypes. RESULTS: In non-T2DM subjects with healthy periodontal tissues, type I fimA was the most frequently detected individually (40%) or in combinations (40%). In non-T2DM subjects with periodontitis, the most frequently detected type was Ib individually (20%) or in combinations (36%). In T2DM patients with periodontitis, the most frequently detected types were types I (20%) and III (20%), but there was no statistical difference (p>0.05) with non-T2DM periodontitis subjects. CONCLUSIONS: Type I genotype was more frequently detected in periodontally healthy sites from non-T2DM subjects than in periodontitis sites from either subjects with or without T2DM. However, in sites affected by periodontitis from T2DM subjects the predominating types were I and III, which are less virulent strains of P. gingivalis.     

Association of T CD4 lymphocyte levels and chronic periodontitis in HIV-infected brazilian patients undergoing highly active anti-retroviral therapy: clinical results

BACKGROUND: Controversial data regarding the association between immunosuppression and prevalence/ severity of periodontal diseases in HIV infection have been reported. Thus, the aim of this study was to test the hypothesis that lower T CD4 lymphocyte levels are not related to a higher prevalence of chronic periodontitis in HIV-infected Brazilians undergoing highly active anti-retroviral therapy (HAART). METHODS: Sixty-four HIV-infected patients under HAART were classified as having chronic periodontitis; i.e., > or = three sites with probing depth (PD) and/or clinical attachment level (CAL) > or = 5 mm or periodontal healthy (no sites with PD > 3 mm and/or CAL > 4 mm). All subjects received conventional periodontal therapy. Bleeding on probing, plaque accumulation, PD, and CAL were registered at six sites/tooth at baseline and 4 months after therapy. Epidemiological features and levels of T CD4 lymphocytes were obtained from medical records. Significance of differences in periodontal clinical parameters within and between groups were determined using Wilcoxon signed-rank and Mann-Whitney or independent sample t tests. Associations between T CD4 levels and clinical parameters were determined using the chi square test. RESULTS: Sixty-one percent of the HIV-infected patients represented AIDS cases, although 69% of them were periodontally healthy. The overall T CD4 lymphocyte mean levels was 333 +/- 254 cells/mm3 and viral load was 12,815 +/- 24,607 copies/mm3. Yet the prevalence of chronic periodontitis was relatively low (36%). In addition, patients with periodontitis presented a moderate disease (mean PD = 2.2 +/- 0.10; mean CAL = 2.6 +/- 0.13) and responded successfully to periodontal therapy. These subjects showed higher levels of T CD4 cells, but lower counts of neutrophils than periodontally healthy patients. Among periodontally healthy and chronic periodontitis patients, 41.7% and 22.9%, respectively, had low levels of T CD4 lymphocytes. No significant differences between periodontal status and epidemiological and immunological parameters were observed. CONCLUSION: Based on these results, the hypothesis that lower T CD4 lymphocyte levels are not associated with higher prevalence of chronic periodontitis in HIV-infected Brazilians under HAART cannot be rejected.     

Prevalence and risk variables for peri-implant disease in Brazilian subjects

OBJECTIVES: The aim of this study was to verify the prevalence of peri-implant disease and analyse possible risk variables associated with peri-implant mucositis and peri-implantitis. The study group consisted of 212 partially edentulous subjects rehabilitated with osseointegrated implants. MATERIAL AND METHODS: The implants placed were examined clinically and radiographically to assess the peri-implant status. The degree of association between peri-implant disease and various independent variables was investigated using a multinomial regression analysis. RESULTS: The prevalence of peri-implant mucositis and peri-implantitis were 64.6% and 8.9%, respectively. In univariate modelling, healthy peri-implant subjects presented lower plaque scores, less periodontal bleeding on probing, and less time elapsed since placement of supra-structures. In multivariate analyses, the risk variables associated with increased odds for having peri-implant disease included: gender, plaque scores, and periodontal bleeding on probing. Presence of periodontitis and diabetes were statistically associated with increased risk of peri-implantitis. The only two factors, which did not contribute to the presence of the disease, were the time elapsed since placement of supra-structures and the frequency of visits for maintenance care. CONCLUSION: Our data suggest that subjects with periodontitis, diabetes, and poor oral hygiene were more prone to develop peri-implantitis.     

Detection of major putative periodontopathogens in Korean advanced adult periodontitis patients using a nucleic acid-based approach

BACKGROUND: Although extensive microbial analyses have been performed from subgingival plaque samples of periodontitis patients, systematic analysis of subgingival microbiota has not been carried out in a Korean population so far. The purpose of this study was to describe the prevalence of major putative periodontopathogens in Korean patients by culture-independent methods. METHODS: A total of 244 subgingival plaque samples (5 sites in each participant) were taken from 29 advanced adult periodontitis (AP) patients and 20 periodontally healthy subjects. AP samples were obtained from the 4 deepest periodontal pockets (> or =6 mm probing depth [PD]) and 1 healthy site (< or =3 mm PD) in each patient. Polymerase chain reaction (PCR) of 16S ribosomal DNA (rDNA) of subgingival plaque bacteria was performed with eubacterial primers. Aliquots of PCR products were then applied on nylon membranes and hybridized with specific oligonucleotide probes labeled with digoxigenin. RESULTS: All diseased sites harbored Fusobacterium sp., while Porphyromonas gingivalis, Treponema sp., and Bacteroides forsythus were detected in more than 96% of 116 diseased sites. Peptostreptococcus micros, Actinobacillus actinomycetemcomitans, and Prevotella intermedia were present in 82%, 74%, and 71% of diseased sites, respectively. In sites of periodontally healthy subjects, Fusobacterium sp. was present in the highest proportion (58%). Treponema sp., P. gingivalis, and B. forsythus were detected in 22%, 18%, and 18% of healthy sites, respectively. P. micros, P. intermedia, and A. actinomycetemcomitans were found in 8%, 2%, and 1% of healthy sites, respectively. The prevalence of the periodontopathogens, with the exceptions of Fusobacterium sp. and B. forsythus, was significantly higher in the healthy sites of periodontitis subjects than in the healthy sites of periodontally healthy subjects (P <0.05). CONCLUSIONS: Using highly sensitive methods relying on 16S ribosomal RNA-based oligonucleotide probes, we confirmed the strong association of 7 putative periodontopathogens with AP patients in a Korean population. With the exceptions of Fusobacterium sp. and B. forsythus, all the periodontopathogens were significantly more associated with the healthy sites of periodontitis subjects than in the healthy sites of periodontally healthy subjects.     

EB病毒和牙龈卟啉单胞菌协同感染与妊娠期慢性牙周炎的相关性研究

目的：研究妊娠期女性EB病毒（Epstein?Barr virus,EBV）和牙龈卟啉单胞菌（Porphyromonas gingivalis, Pg）的协同感染情况和牙周炎严重程度的关系。方法收集36例患慢性牙周炎（妊娠期慢性牙周炎组）的妊娠期女性和36例牙周健康（妊娠期牙周健康组）的妊娠期女性唾液样本,应用巢式PCR技术检测EBV感染率,应用16S rRNA为基础的PCR技术检测Pg感染率,结合口腔临床检查收集的牙周临床指标,对EBV和Pg的协同感染与牙周炎严重程度的相关性加以分析。结果妊娠期慢性牙周炎组和妊娠期牙周健康组EBV、Pg感染率的检出率差异无统计学意义（P＞0.05）,2组EBV和Pg协同感染的检出率差异具有统计学意义（χ2=4.800,P=0.028）。EBV和Pg协同感染与探诊出血指数相关（t=3.058,P=0.003）,与牙周袋深度和附着丧失无关（P＞0.05）。结论 EBV和Pg协同感染与妊娠期慢性牙周炎的相关性仍需进一步研究。     

白细胞介素1基因多态性与四川地区慢性牙周炎相关关系的研究

目的检测II-I基因型在不同牙周健康状态汉族人群中的分布,分析III 1等位基因与慢性牙周炎的相关关系。方法选取汉族慢性牙周炎患者182例,检查全口临床牙周附着丧失量,牙周袋深度;同时选取牙周健康对照者89例。棉拭子刮取颊勃膜脱落细胞,用PCR-RFLI,法和PCR法检测II- 1+3953,IIr1A-889,IIr1B-511和IL- 1RN (intron2) VNTR基因型分布。结果重度慢性牙周炎患者组II, 1A-889, IL, l B十3953和ILIlB-511等位基因II以及II- I A-889和II- 1 B-511复合等位基因II , III I B + 3953和IL I B-511复合等位基因H基因频率均显著高于健康对照组 ( P < 0.05) ,II,1RN(intron2) VNTR等位基因的基因型和等位基因频率在各组间的分布无显著性差异(P > 0.05)。结论III 1基因多态性与慢性牙周炎有相关关系,ILII B + 3953,II-IA-889和ILIIB-511等位基因B以及II-IA-889和 II-1B-511复合等位基因II, IIII B + 3953和ILIlB-511复合等位基因II可能是部分慢性牙周炎患者易感性的遗传标志。同时提示II- I基因型在不同地域、不同人种中的分布是不相同的。     

Influence of Dyslipidemia and Diabetes Mellitus on Chronic Periodontal Disease

Background: Periodontal disease is closely related to certain systemic conditions, such as type 2 diabetes mellitus (DM2), and, as recently described, dyslipidemia, a condition with alterations in blood lipids levels. However, more than acting as disease modifiers, these conditions commonly occur as comorbidities, possibly synergically affecting periodontal tissues. The aim of the current study is to identify whether DM2 and dyslipidemia are related to the occurrence and severity of chronic periodontitis. Methods: A total of 254 individuals participated: 56 were patients with DM2, 67 had dyslipidemia, 74 had DM2 and dyslipidemia, and 57 were systemically healthy individuals. The clinical examination included a full‐mouth evaluation of periodontal probing depth, plaque score, bleeding on probing, and clinical attachment level (CAL). Blood samples were taken to assess fasting plasma glucose, low‐density lipoprotein, high‐density lipoprotein, and triglyceride levels. These parameters, as well as other medical conditions (i.e., smoking habits and body mass index), were considered in multiple regression analyses for data analyses (α = 5%). Results: Dyslipidemia was not related to periodontal disease (P >0.05). At the same time, DM2, age, and smoking showed a statistical and positive association, an increase in percentage of sites with CAL ≥3 and ≥5 mm. Regarding the percentage of sites presenting severe destruction (CAL ≥7 mm), only DM2 remained a significant risk factor (P <0.05). Conclusions: It could be concluded that dyslipidemia did not influence periodontal conditions in participants with normal health or those with DM2. However, age, smoking habits, and especially DM2 were significantly associated with loss of CAL.     

Extent and severity of chronic periodontitis in chronic kidney disease patients

Brito F, Almeida S, Figueredo CMS, Bregman R, Suassuna JHR, Fischer RG. Extent and severity of chronic periodontitis in chronic kidney disease patients. J Periodont Res 2012; 47: 426–430. © 2011 John Wiley & Sons A/S Background and Objectve: Chronic inflammatory diseases have been investigated as a possible source of inflammation in chronic kidney disease patients; however, there is a shortage of information about the prevalence of periodontitis in such individuals. Therefore, the aim of this cross‐sectional study was to determine the extent and severity of periodontitis in chronic kidney disease patients undergoing the following three different treatment modalities: predialysis; continuous ambulatory peritoneal dialysis (CAPD); and hemodialysis (HD); and to compare the findings with those from systemically healthy individuals. Material and Methods: Forty CAPD patients (mean age 52 ± 12 years), 40 HD patients (mean age 50 ± 10 years), 51 predialysis patients (mean age 54 ± 11 years) and 67 healthy individuals (mean age 50 ± 7 years) were examined. The periodontal examination included probing pocket depth, clinical attachment loss, bleeding on probing and presence of plaque. Patients with at least four sites with clinical attachment loss ≥ 6 mm were considered to have severe chronic periodontitis, and those with at least 30% of sites with clinical attachment loss ≥ 4 mm were considered to have generalized chronic periodontitis. Results: Predialysis and HD patients had significantly more sites with clinical attachment loss ≥ 6 mm than healthy individuals. The CAPD patients had similar periodontal condition to healthy subjects. There were significantly more cases of severe chronic periodontitis in predialysis and HD patients. Conclusion: Predialysis and HD are associated with a higher prevalence of severe periodontitis compared with healthy individuals and CAPD patients.     

Subgingival human cytomegalovirus correlates with increased clinical periodontal parameters and bacterial coinfection in periodontitis

BACKGROUND: Viruses from the Herpesviridae family may be implicated in the pathogenesis of periodontal disease. The aim of this investigation was to compare the subgingival frequency of human cytomegalovirus (HCMV) in subjects affected by periodontitis to periodontally healthy subjects and to assess the correlation of HCMV with periodontal clinical parameters and periodontopathic bacteria. METHODS: Thirty subjects with periodontitis (20 with chronic periodontitis and 10 with aggressive periodontitis) were included in the study. A group of 22 periodontally healthy individuals served as controls. Clinical periodontal parameters of probing depth (PD) and clinical attachment level (CAL) were recorded using a computerized periodontal probe. Subgingival plaque samples were processed for viral identification by nested polymerase chain reaction and bacterial identification by culture. Clinical periodontal parameters, frequency of detection of HCMV, and microbial composition were compared between the groups using the two-tailed Student t, chi(2), and Mann-Whitney tests. Logistic and linear regression analyses were performed to measure the association between virus-bacterial coinfection and clinical parameters (P < or =0.05). RESULTS: HCMV detection was more prevalent (P < or =0.05) in periodontally diseased subjects compared to healthy ones. Furthermore, in all groups, PD and CAL were increased in HCMV-positive sites. In the periodontitis groups, higher frequencies and levels of specific periodontopathic bacteria were detected in HCMV-positive sites. CONCLUSIONS: HCMV detection in periodontal pockets was associated with higher levels of periodontopathic bacteria and increased PD and CAL at sampled sites. HCMV/bacteria coinfection may be an important factor in periodontal destruction.     

Detection of Tannerella forsythensis (Bacteroides forsythus) and porphyromonas gingivalis by polymerase chain reaction in subjects with different periodontal status

BACKGROUND: The aim of this study was to determine the prevalence of Tannerella forsythensis (formerly Bacteroides forsythus) and Porphyromonas gingivalis in subgingival plaque samples by using polymerase chain reaction (PCR), and to assess the relationship of these bacteria with different categories of periodontal disease and health. METHODS: Subjects were distributed into 3 groups according to their periodontal diagnosis: group 1, periodontally healthy (N = 10); group 2, periodontitis with probing depth < or = 5 mm (N = 10); group 3, periodontitis with probing depth > 5 mm (N = 10). The subjects in groups 2 and 3 had healthy and diseased periodontal sites. Subgingival plaque samples were obtained using paper points inserted into periodontal pockets (diseased sites) and into healthy gingival sulci (healthy sites) of the same subject. RESULTS: The distribution of bacteria differed in healthy and diseased sites. T. forsythensis (B. forsythus) was not detected in any sample from healthy sites in any group but was detected in 70% and 100% of diseased sites in groups 2 and 3, respectively. P. gingivalis was detected in only one sample from a healthy site (group 2), and in the diseased sites, its prevalence was 40% (group 2) and 90% (group 3). In addition, T. forsythensis (B. forsythus) and P. gingivalis were both detected in 30% and 90% of the diseased sites in groups 2 and 3, respectively. CONCLUSION: These results indicate a possible association between periodontal disease and the presence of T. forsythensis (B. forsythus) and/or P. gingivalis.     

Periodontal status and cytoplasmic enzyme activities in gingival crevicular fluid of type 2 diabetic and/or obese patients with chronic periodontitis

Type 2 diabetes mellitus and obesity are the most common nutritional disorders in developed and developing countries. Increased prevalence of periodontal disease is a well-known complication of type 2 diabetes mellitus (DM). As obesity is generally the first step toward type 2 diabetes mellitus, it is possible to find exacerbated periodontal disease in obese patients, also. The purpose of this cross-sectional study was to investigate the periodontal status and aspartate aminotransferase and lactate dehydrogenase enzyme activities in gingival crevicular fluid (GCF) of type 2 diabetic and/or obese chronic periodontitis patients. A total of 39 chronic periodontitis patients participated in the study. The study population was divided into four groups according to body mass index and type 2 DM status: 1) type 2 DM obese patients, n = 8; 2) type 2 DM patients, n = 12; 3) obese patients, n = 8; 4) systemically healthy control group, n = 11. Enzyme activities in gingival crevicular fluid and periodontal status were evaluated. No significant differences in age, gingival index, plaque index, aspartate aminotransferase and lactate dehydrogenase enzyme activities were observed, but probing depths were significantly higher in the DM groups than in the control group. Obesity did not seem to be a significant factor in any parameters evaluated. The present study showed increased probing depth values for the diabetic groups but failed to show any significant relation between obesity and enzyme activity or periodontal status. However, the slightly increased probing depth values in the obese groups might be a clue to an impaired immune response and predisposition to periodontitis in that patient group.     

Description of the subgingival microbiota of periodontally untreated Mexican subjects: chronic periodontitis and periodontal health

BACKGROUND: Recent studies have suggested that changes in the prevalence and/or proportion of distinct microorganisms characterize the subgingival microbial profiles of populations around the world. At present, no information is available on the subgingival microbiota of Mexican subjects. The purpose of the present study was to determine the microbial composition of subgingival plaque in Mexican subjects with untreated chronic periodontitis. METHODS: A total of 44 chronic periodontitis and 20 periodontally healthy subjects (who were currently non-smokers) were selected. Clinical measurements including plaque accumulation, gingival erythema, bleeding on probing, suppuration, probing depth, and attachment level were recorded at six sites of every tooth. Up to 28 subgingival plaque samples were obtained from each subject and individually analyzed to determine the levels, proportion, and prevalence of 40 microbial species using the checkerboard DNA-DNA hybridization technique. RESULTS: Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythensis were the only species that presented higher mean levels in periodontitis subjects. The proportions of P. gingivalis (P<0.001), T. forsythensis (P<0.01), and red complex species (P. gingivalis, T. forsythensis, and T. denticola; P<0.001) as a group were also significantly higher in periodontitis subjects. Periodontally healthy subjects harbored a significantly larger proportion of Actinomyces species (P<0.05). No significant differences were detected in the percentage of carriers of any of the species tested. CONCLUSIONS: Our results revealed that the subgingival microbiota of untreated chronic periodontitis Mexican subjects was characterized by increases in the level, prevalence, and proportion of classic periodontal pathogens. However, the prevalence and proportion of specific microbial species varied significantly from the results of other reports on subjects from different geographical locations.     

Association of cortisol and dehydroepiandrosterone sulphate levels in serum with periodontal status in older Japanese adults

Background and Aim: The associations between periodontitis and stress‐related steroid hormone levels released by the hypothalamic–pituitary–adrenal axis are poorly understood. In this study, we examined the association between levels of the stress‐related steroid hormones cortisol and dehydroepiandrosterone‐sulphate (DHEAS) and periodontitis in elderly subjects. Methods: A total of 467 subjects participated in this study. Serum cortisol and DHEAS levels were determined, and a medical questionnaire regarding medical conditions and lifestyle was administered. In addition, clinical examinations including probing depth (PD), bleeding on probing (BOP), and clinical attachment loss (CAL) were conducted. Results: The subjects were divided into tertiles on the basis of periodontitis severity. When the analysis was stratified by smoking status, we found that cortisol levels were significantly higher in those with severe CAL among subjects who had never smoked. Furthermore, multiple regression analysis showed that a higher level of cortisol was significantly associated with greater numbers of sites with severe CAL only in those who had never smoked, while a somewhat weaker association was also observed regarding cortisol/DHEAS ratio. In contrast, the level of DHEAS in serum was not associated with periodontitis. Conclusion: There were significant associations between serum cortisol level, including cortisol/DHEAS ratio, and periodontitis severity in elderly subjects who had never smoked.