Recovery of putative periodontal pathogens from curette sampling at different depths of periodontal lesions: an in vivo cross-sectional clinical study.

OBJECTIVE: The aim of this study was to evaluate the effect of the depth of curette sample collection from periodontal lesions on the recovery of putative periodontal pathogens using real-time polymerase chain reaction (PCR). METHODS: Twenty-two periodontal pockets 6 to 8 mm deep with bleeding on probing at a single-rooted tooth were sampled, yielding 66 separate samples. Curette samples were obtained at three different levels of the periodontal lesion (orifice, shallow--2 mm into the pocket; or base of lesion), and processed using PCR to identify 10 periodontal pathogens. The chi-square procedure was used to determine whether probe depth affected the distribution of bacterial counts observed. A repeated measures analysis of variance tested the hypotheses related to level of probe and microorganism on mean rank of bacterial counts. RESULTS: The effect of probe level on mean bacterial counts depends on the type of microorganism. Likewise, the effect of microorganism type on mean bacterial counts significantly depends on probe level, where sampling from 2 mm into the periodontal pocket was found to yield significantly higher results than sampling from the orifice. Overall mean counts of pathogenic microorganisms were found to differ significantly across the three probe depths. The microorganisms differed in their observed levels over all three probe levels. Further analysis found several significant differences that characterize the nature of the interaction between probe level and microorganism type. CONCLUSION: There is significant difference in the amount of putative periodontal pathogens at varying depths of the pocket when sampled with a periodontal curette.

Implant failure associated with actinomycosis in a medically compromised patient.

Oral actinomycosis is not a common disease, but it can cause massive destruction. This article reports a case of implant failure associated with actinomycosis. A 55-year-old Caucasian male patient had tooth #20 extracted years ago and an implant placed 3 years ago. The #20 implant area developed an abscess about 1½ years after implant placement. Radiographic findings revealed a large radiolucency on the mesial aspect of the #20 implant. The implant was surgically removed and the lesion thoroughly debrided. The patient experienced severe pain when the apical soft tissue was curreted following implant removal. A periapical radiograph revealed that the lesion approached the mental foramen. A short course of antibiotics was prescribed. Histological observation found sulfur granules, which were found to be actinomycotic colonies. Peri-implant actinomycosis was diagnosed. No recurrence had occurred at the 1-year follow-up.

Changes in mRNA expression of adenosine receptors in human chronic periodontitis.

OBJECTIVE: To elucidate the aetiology of periodontitis, this study focused on the adenosine receptor (AR) expression profiles (A1AR, A2AAR, A2BAR and A3AR) in periodontal diseased tissues. METHODS: Adenosine receptor gene expression levels in human gingiva from 15 patients with healthy gingival tissues (control group) and 15 patients who exhibited severe chronic periodontitis (test group) were measured using quantitative reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: The mRNA expression pattern changed in human chronic periodontitis: the A1AR decreased 20%, A2AAR increased 2.5-fold, A2BAR increased 3.7-fold and A3AR decreased 70% as compared with that of healthy gingiva. CONCLUSION: Inflammation of the gingival tissue is associated with (1) an unchanged expression of A1AR, (2) an increased expression of A2AAR and A2BAR, and (3) a decreased expression of A3AR. Logistic regression analysis indicated that the change in the expression patterns can be used to diagnose/predict periodontitis. This finding indicates that the adenosine receptor expression profile is changed in periodontitis with the potential for future clinical application.

Hyperplastic dental follicle - review of literature and report of two cases in one family.

Hyperplastic dental follicle is an extremely rare lesion. The practitioner should be able to differentiate it from a dentigerous cyst. The present article will review related literature and report on two cases in one family. A 12-year-old white female and her 15-year-old brother were referred for exposure of unerupted canines. No systemic diseases or syndromes were present. Intra-oral examinations were unremarkable, except for the absence of all eight canines. Radiographic examinations revealed impacted canines with each unerupted tooth surrounded by a well-demarcated radiolucency, which passed beyond the cementoenamel junction. The teeth were surgically exposed and tissue specimens surrounding the unerupted teeth were analysed histologically. Histology revealed fibrous connective tissue with areas demonstrating some ground substance and multiple odontogenic epithelial rests. Some surfaces were partially lined by reduced enamel epithelium. A diagnosis of hyperplastic dental follicle was made. Sometimes, it is difficult to differentiate hyperplastic dental follicle from odontogenic fibroma, both simple and central forms. A correct diagnosis should be based on clinical, radiographic and histological findings.