A rapid diagnosis of anaerobic infection in the oro-maxillary region by gas-liquid chromatography

The relationship between volatile fatty acids (VFAs) in pus and infecting bacterial species was examined in order to establish a rapid identification system for anaerobic microorganisms in purulent inflammation in the oro-maxillary region. VFAs were detected by the direct injection of pus into gas-liquid chromatography (GLC). Bacterial examination was carried out by anaerobic culture using blood agar plates. The bacterial identification was carried out mainly according to the VPI manual. Analysis of the direct VFA patterns of each sample resulted in 5 groups. The following bacterial species were the main isolates in each group: Streptococcus intermedius in Group A, Peptostreptococcus micros in Group B, Fusobacterium nucleatum in Group C, Bacteroides gingivalis in Group D, and Peptostreptococcus anaerobius in Group E. The profile of VFAs produced in the PYG culture medium of the above isolated bacteria was compared with the direct VFA patterns. Agreement ratios between direct and PYG VFA patterns were as follows: Group A, 47.1%; Groups B and C, 45.0%; Group D, 87.5%; and Group E, 62.9%. The acetic acid concentration was more than 14 x 10(-4) meq/ml in Group B, the butyric acid concentration was more than 7 x 10(-4) meq/ml in Group C, and the iso-caproic acid concentration was more than 14 x 10(-4) meq/ml in Group E. In these cases, it was found that the agreement ratios between the direct and PYG FVA pattern were high. In Group D, irrespective of the concentration of iso-valeric acid detected, the agreement ratio was very high. The antibiotic susceptibility of the isolates was studied. Efficiency rates of ABPC, PIPC, CCL, CEZ, CMZ, SBT/CPZ, JM, CLDM, MINO and GM were relatively low and resistant rates were high for the gram-negative rods.     

Chemiluminescence of neutrophils from patients with Beh?et's disease and its correlation with an increased proportion of uncommon serotypes of Streptococcus sanguis in the oral flora

Zymosan-induced chemiluminescence was investigated in whole blood and in neutrophils: in both, the peak count was frequently elevated in Beh?et's disease, and was significantly higher than in healthy controls; similarly the peak time was shorter. There were more uncommon serotypes of Streptococcus sanguis in the oral flora of patients with Beh?et's disease. Common serotypes were present in the flora of healthy controls, but not in patients with the disease. The percentage of Strep. sanguis in the oral flora was significantly correlated with the level of chemiluminescence response. Thus infection with uncommon serotypes of Strep. sanguis may play a role in the aetiology of Beh?et's disease.     

Fluoride in saliva and plaque following use of fluoride-containing mouthwashes

The sensitivity of methodology for measuring the concentration of fluorine species in saliva and in plaque has been tested. Human subjects mouth-rinsed daily with aqueous solutions of NaF and Na2FPO3. Samples of unstimulated whole saliva and of plaque were collected twice weekly at least 18 hr after treatment application. Oral fluoride concentrations rose from placebo values for approximately two weeks before attaining equilibrium and returned to baseline when daily mouthrinsing was stopped. Mean elevated oral fluoride concentrations increased significantly with increasing applied NaF concentration in the range 0-1000 ppm F (0-0.053 mol/L). There appeared to be a linear relationship between saliva and plaque fluoride. The ability of fluoride treatments to sustain elevated oral fluoride levels between daily applications may be of major importance in caries control.     

Blue-black macule on the maxillary palate

A cellular blue nevus located on the palate of a 72-year-old female is reported. This intraoral finding is uncommon and should be distinguished from clinical entities it closely resembles. Practitioners should be aware that a pigmented palatal lesion in fact may be a malignant melanoma. Surgical excision with microscopic examination is the only means by which an accurate diagnosis can be made.     

The effect on the composition of subgingival plaque of a simplified oral hygiene system including pulsating jet subgingival irrigation

The aim of this study was to investigate the effect on subgingival plaque of a simplified oral hygiene regime consisting of instruction in Bass brushing without stress on interdental cleaning, scaling and root planing, in combination with subgingival pulsated jet irrigation with dilute solutions of chlorhexidine, metronidazole or placebos. Twenty-five patients, 14 women and 11 men, each with periodontal pockets ≥ 4 mm, participated in a randomized, double-blind, placebo-controlled study. The patients were assigned to 4 groups: 2 test groups (0.02% chlorhexidine and 0.05% metronidazole) and 2 placebo groups (0.01% quinine sulphate and 0.09% sodium chloride). Subgingival plaque samples were obtained from at least 4 sites in each subject on days 0 (prior to scaling and root planing), 7, 28, 56 and 84. Subgingival irrigation was terminated on d 28. Darkfield microscopy was used to assess the effects of treatment on the subgingival microflora by observing 4 morphologic groups: cocci, motile organisms, spirochetes and others (i.e. non-motile rods and filaments). All the groups showed marked beneficial changes at the end of the 28-d irrigation period, with increases in cocci and decreases in motile forms and spirochetes to less than baseline values. These beneficial effects were maintained for at least 8 weeks after irrigation was stopped. Metronidazole was more effective in reducing motile forms, but the reduction was not significant at d 84. It was concluded that pulsating monojet subgingival irrigation as part of a simplified oral hygiene program, with or without an active antimicrobial agent at low concentration, is effective in reducing the motile and spirochete portions of the subgingival microflora. These effects might be enhanced and prolonged if suitable antimicrobial solutions of higher concentration were used.