Combined effect of zinc ions and cationic antibacterial agents on intraoral volatile sulphur compounds (VSC)

OBJECTIVE: Volatile sulphur compounds (VSC) are major components of oral malodour. As both zinc ions and cationic antibacterial agents inhibit the formation of oral VSC, this study aimed to determine whether these agents combined have synergistic anti-VSC actions. METHODS: Baseline oral VSC measurements of mouth air from 10 volunteers following cysteine rinsing (6mM, pH 7.2) were obtained using gas chromatography (GC). Subjects rinsed for 1 min with 10ml of the test solutions, 0.3% zinc acetate (Zn), 0.025% chlorhexidine (CHX), 0.025% cetyl pyridinium (CPC), and the combinations Zn+CHX and Zn+CPC. Cysteine rinses were repeated at 1h, 2h and 3h and VSC measurements recorded. Three subjects rinsed with the Zn+CHX combination and fasted for 9h, undergoing cysteine rinses and VSC measurements at 3h intervals. 10 microl of the test solutions were also added to 1ml aliquots of human whole saliva (n=8). Following incubation at 37 degrees C for 24h VSC levels in the saliva headspace were measured by GC. Inhibition of VSC formation and the fractional inhibitory index indicating synergy were calculated. RESULTS: Zn+CHX mouthrinse had a synergistic anti-VSC effect, and was effective for at least 9h. Zn+CPC mouthrinse was less effective. Both combinations showed a synergistic inhibiting effect in-vitro. CONCLUSIONS: Synergy between Zn and the antibacterial agents confirms different mechanisms of operation.     

口腔粘膜良性淋巴组织增生症的临床病理和免疫组化分析

目的明确口腔粘膜良性淋巴组织增生症（BLOM）的临床病理特征及其本质。方法收集分析6例BLOM的临床病理资料，并进行文献复习；对该组病例的组织标本进行免疫组化研究。结果发生在唇部和其它口腔解剖部位的口腔粘膜良性淋巴组织增生症的临床表现和诊断各有其特点；B淋巴细胞是淋巴滤泡和浸润炎症细胞的主要细胞万分。结论BLOM分为唇型和非唇型两种临床类型；BLOM是一种B淋巴细胞介导的增殖性局部体液免疫反应疾病。     

Recognition and phagocytosis of multiple periodontopathogenic bacteria by anti-Porphyromonas gingivalis heat-shock protein 60 antisera

The present study has been performed to evaluate Porphyromonas gingivalis heat shock protein (HSP) 60 as a candidate vaccine to protect against multiple putative periodontopathic bacteria. Mouse anti-P. gingivalis HSP antisera demonstrated the elevated IgG antibody titers against the multiple bacteria tested and cross-reacted with heat-induced bacterial proteins of the target bacteria. The antisera also demonstrated a significantly higher opsonophagocytosis function against all the target bacteria than the control sera (P<0.01). We concluded that P. gingivalis HSP 60 could potentially be developed as a vaccine against multiple periodontopathic bacteria.     

Periodontal conditions in patients with juvenile idiopathic arthritis

OBJECTIVE: Our aim was to compare the periodontal conditions in a group of juvenile idiopathic arthritis (JIA) patients with those in a control group of healthy subjects (CTR). MATERIAL AND METHODS: Thirty-two patients with JIA and 24 controls were selected. The measurements used to diagnose periodontal disease included plaque and bleeding scores, probing depths (PDs) and clinical attachment loss (CAL). Laboratory indicators of JIA activity included the erythrocyte sedimentation rate (ESR) and capsule-reactive protein (CRP). The Mann-Whitney test was used to evaluate the data (alpha = 0.05). RESULTS: The mean ages were 15.9 (+/- 2.7) years and 14.7 (+/- 2.3) years for groups JIA and CTR, respectively. The median ESR was 42 mm/h 13 mm/h in the CTR group (p = 0.032) and the median CRP was 1.9 and 0.4 mg/l, respectively (p = 0.001). The prevalence of patients with a proximal attachment loss of 2mm or more in the JIA group was 25% and in controls it was 4.2%. The mean percentages of visible plaque and marginal bleeding were similar in the JIA (54 +/- 22 and 30 +/- 16, respectively) and CTR groups (44 +/- 18 and 29 +/- 11, respectively). The mean percentages of sites with PD > or = 4 mm were significantly higher in the JIA group (3 +/- 4.7) than in the CTR group (0.4 +/- 1.7) (p = 0.012). The mean percentages of sites with proximal CAL > or = 2 mm were 0.7 (+/- 1.4) in the JIA group and 0.001 (+/- 0.2) in the CTR group (p = 0.022). CONCLUSION: Adolescents with JIA present more periodontal attachment loss than healthy controls, in spite of similar plaque and marginal bleeding levels.     

Selection of antimicrobial agents in periodontal therapy

BACKGROUND: The recognition over the past 3 decades of microbial specificity in periodontitis has afforded dental practitioners the ability to prevent and treat the disease with a variety of antimicrobial drugs. These include systemic antibiotics, topical antibiotics and topical antiseptics. RESULTS: Systemic antibiotic therapy can be essential in eliminating pathogenic bacteria that invade gingival tissue and in helping control periodontal pathogens residing in various domains of the mouth from where they may translocate to periodontal sites. Frequently used periodontal combination antibiotic therapies are metronidazole-amoxicillin (250-375 mg of each 3 x daily for 8 days) and metronidazole-ciprofloxacin (500 mg of each 2 x daily for 8 days). Microbiological analysis helps determine the optimal antibiotic therapy and effectiveness of treatment. Topical antibiotics that are commercially available as controlled release devices suffer from several potential problems, including insufficient spectrum of antimicrobial activity in some periodontal polymicrobial infections, risks of producing an antibiotic resistant microbiota, and high acquisition costs. Topical antiseptics of relevance in periodontal treatment include 10% povidone-iodine placed subgingivally by a syringe for 5 min, and 0.1% sodium hypochlorite solution applied subgingivally by patients using an irrigation device. CLINICAL IMPLICATIONS: The present paper recommends periodontal treatment that includes a battery of professionally and patient-administered antimicrobial agents (properly prescribed systemic antibiotics, povidone-iodine and sodium hypochlorite subgingival irrigants, and chlorhexidine mouthrinse). Available chemotherapeutics can provide effective, safe, practical and affordable means of controlling subgingival colonization of periodontal pathogens and various types of periodontal disease.     

Periodontal ligament tissue reactions to trauma and gingival inflammation

Abstract The aims of the present study were to analyze (i) which tissue changes may occur in the zone of co-destruction to better understand why trauma from occlusion may induce additional attachment loss, and (ii) whether changes occur in the periodontal ligament tissue when an inflammatory lesion (ICT) approaches the periodontal ligament space. 16, 1-year-old beagle dogs, were selected and divided into 2 groups, group A and group B, consisting of 6 and 10 dogs, respectively. In group A, on day 0. a bucco-lingual jiggling type movement was induced resulting in increasing tooth mobility at P₃ (test tooth) by the application of an orthodontic elastic which traversed the buccal surface of the crown of the test tooth. The elastic was exchanged either in a buccal or in a lingual position 2x a week during a 3-month period. ₃P served as non-jiggled control tooth. Tooth mobility measurements were recorded on days 0, 30, 60, 90. A plaque control regimen was maintained until the end of the experiment (day 90). On day 90, biopsies including P₃ and ₃P were harvested. The dogs representing group B, were divided into 2 subgroups of 5 each, group BI and group BII. On day 0, a 4-month period of experimental periodontal tissue breakdown was initiated by placing cotton floss ligatures submarginally around the mandibular fourth premolars (₄P₄) in group BI and around the mandibular third premolars (₃P₃) in group BII. All ligatures were exchanged, replaced 1X every month, and on day 120 permanently removed. On the same day, biopsies included ₄P₄ were harvested. Following supragingival debridement ₃P₃ were allowed to accumulate plaque until the end of the study (day 225). On this occasion, biopsies including ₃P₃ were harvested. The results of the histological measurements revealed that in the most coronal portion of the periodontal ligament of teeth exhibiting increasing mobility, there was an increased width, a reduced % tissue volume of collagen, and an increased volume of vascular structures and leukocytes. Furthermore, the number of osteoclasts bordering this portion of the alveolar bone was increased and the number of collagen fibers inserting into the root cementum and into the alveolar bone was reduced. It was also demonstrated that in teeth with normal mobility, the position of the gingival ICT failed to influence the composition of the tissue within the coronal portion of the periodontal ligament.     

冠心病和牙周病相互关系的临床观察

目的：通过临床问卷调查及体检，初步探讨牙周病与冠心病间的相互关系。方法：选取齐鲁医院内科患者150例作为观察对象，冠心病组76例，对照组74例，两组均进行相同的病史、血液及牙周病检查。比较两组牙周患病率及牙周健康状况（牙龈出血、牙齿松动、牙齿缺失、牙龈萎缩）的差异。结果：冠心病组牙周病患病率（53．01％）高于对照组（33．35％），统计学检验两组差异有显著性（P〈0．01）。结论：牙周病与冠心病之间可能存在一定的相关性。     

Periodontal repair in dogs: evaluation of a bioresorbable calcium phosphate cement (Ceredex) as a carrier for rhBMP-2

BACKGROUND: Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been shown to induce clinically relevant bone formation for orthopedic, craniofacial, and oral indications. It appears critical, in particular for onlay indications, that the associated carrier technology exhibits structural integrity to offset compressive forces in support of rhBMP-2-induced bone formation. The objective of this study was to evaluate a calcium phosphate (CP) cement, Ceredex, as a candidate carrier for rhBMP-2 in a defect model with limited osteogenic potential. MATERIALS: Bilateral, critical size, 6-mm, supra-alveolar, periodontal defects were created in six, adult, male, Hound Labrador mongrels. Three animals received rhBMP-2/Ceredex (rhBMP-2 at 0.20 and 0.40 mg/ml) in contralateral defect sites (implant volume/defect approximately 1 ml). One defect site in each of the three remaining animals received Ceredex without rhBMP-2 (control). The animals were euthanized at 12 weeks postsurgery for histologic and histometric analysis. RESULTS: Mean induced bone height exceeded 80% of the defect height for supra-alveolar periodontal defects receiving rhBMP-2/Ceredex without major differences between rhBMP-2 concentrations compared with approximately 40% for the control. The newly formed bone, a mixture of lamellar and woven bone in fibrovascular tissue, circumscribed relatively large portions of the residual Ceredex biomaterial. Inflammatory lesions were associated with limited bone formation in some sites. From a periodontal perspective, sites receiving rhBMP-2/Ceredex exhibited increased cementum formation compared with control, but without a functionally oriented periodontal ligament, and increased ankylosis and root resorption. Control sites exhibited early wound failure and exposure, loss of the Ceredex biomaterial, and limited bone formation. CONCLUSIONS: The Ceredex CP cement appears a potentially promising carrier technology for rhBMP-2 onlay indications. However, a slow resorption rate may prevent its wider use. This study does not support use of the rhBMP-2/Ceredex combination for periodontal indications.     

牙周病与肺部感染的关系

牙周病不仅破坏局部牙齿支持组织，亦可影响许多全身性疾病。近年来，牙周病与肺感染的关系逐渐引起人们的重视。本文就牙周病与肺炎(尤其是重症卧床老年人的院内获得性肺炎)及慢性阻塞性肺病(COPD)之间的潜在联系作一综述。     

Cysteine protease inhibitory activity and levels of salivary cystatins in whole saliva of periodontally diseased patients

The 3 human salivary cystatins S, SA and SN are multifunctional proteins that possess a cysteine protease inhibitory property, but their ability to act as such is very different (SN > SA > S). One form, S, also appears to possess antibacterial properties towards the bacterium Porphyromonas gingivalis, often associated with periodontal diseases. In this study we measured the total cystatin inhibitory activity and the levels of each salivary cystatin in the whole saliva of 8 periodontally diseased patients and 2 groups of control subjects (n = 6 and n = 10). The total cystatin inhibitory activity and the total salivary cystatin concentration in the periodontally diseased patients were found to be lower than the controls (p < or = 0.005). The concentration of S was depleted to levels that would not allow it to be an effective antibacterial agent, and the concentration of SA, although depleted in some cases, was still present at sufficient levels to allow it to act as an effective physiological inhibitor of cathepsin L. The concentration of cystatin SN was also depleted in the periodontally diseased patients, but was still present in sufficient quantities to act as an effective physiological cysteine protease inhibitor of cathepsins H and L. In comparison, the concentration of all 3 salivary cystatins in the control subjects were sufficient to enable these proteins to be both effective physiological cysteine protease inhibitors and antibacterial agents.