Clinical and microbiologic evaluation, by real-time polymerase chain reaction, of non-surgical treatment of aggressive periodontitis associated with amoxicillin and metronidazole.

BACKGROUND: The aim of the present study is to evaluate the clinical and microbiologic changes resulting from non-surgical periodontal treatment associated with amoxicillin and metronidazole in individuals with aggressive periodontitis. METHODS: Fifteen individuals with aggressive periodontitis received non-surgical periodontal treatment and 45 days after completion of treatment were treated with antibiotics. Clinical data and samples of subgingival plaque were collected at baseline, 45 days after the non-surgical periodontal treatment, and 1 month after the use of antimicrobial agents. After 3 and 6 months, only clinical data were collected. The presence and quantification of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), and Dialister pneumosintes were determined by real-time polymerase chain reaction. RESULTS: All clinical parameters, with the exception of clinical attachment level (CAL), had significantly (P <0.05) improved at the end of the third month after non-surgical therapy associated with antibiotics. There was significant (P <0.05) reduction in the quantities of Td and Tf. After 1 month, there were significant (P <0.05) reductions in the frequencies of Pg and Tf. CONCLUSION: Non-surgical mechanical treatment associated with the use of amoxicillin and metronidazole led to an improvement in all clinical parameters studied, except for CAL, and significantly reduced the amount of subgingival Tf and Td.

Presence of periodontopathic bacteria in coronary arteries from patients with chronic periodontitis.

In this study the presence of periodontopathic pathogens in atheromatous plaques removed from coronary arteries of patients with chronic periodontitis and periodontally healthy subjects by PCR was detected. Our results indicate a significant association between the presence of Porphyromonas gingivalis and atheromas, and the periodontal bacteria in oral biofilm may find a way to reach arteries.

Detection of Epstein-Barr virus and human cytomegalovirus in blood and oral samples: comparison of three sampling methods.

The purpose of this study was to identify and compare the presence of HCMV and EBV-1 in subgingival plaque, unstimulated saliva and peripheral blood of patients with chronic periodontitis. Forty patients diagnosed with chronic periodontitis (mean age, 41.7 years) were recruited. Unstimulated saliva, subgingival plaque and peripheral blood were collected from each patient and the DNA of each sample was isolated. The viruses were detected using the nested PCR technique. The detection frequency of EBV-1 in subgingival plaque, saliva and peripheral blood was 45%, 37.5% and 25%, respectively. HCMV was detected in 82.5% of subgingival plaque samples and peripheral blood and in 75% of salivary samples. The sensitivity for detecting EBV-1 in saliva and peripheral blood when EBV-1 was detected in subgingival plaque samples was low (22% and 27.7%, respectively) and the sensitivity for detecting HCMV in saliva and peripheral blood when compared to subgingival plaque was high (81.8% and 87.8%, respectively). There is a high agreement among the three sampling methods in detection of HCMV, but the detection of EBV-1 would require a combination of saliva and subgingival plaque sampling to avoid false negative results.

Evaluation of subgingival bacterial plaque changes and effects on periodontal tissues in patients with renal transplants under immunosuppressive therapy.

OBJECTIVE: The purpose of this study was to identify the presence of periodontal microrganisms in 35 renal transplant patients before the transplant procedure. STUDY DESIGN: At each time point, clinical parameters were recorded and subgingival plaque samples were collected from 4 different sites at days 30 and 90 after surgery. Samples were plated onto selective and nonselective media to determine total colony counts and the presence of putative periodontal pathogens. After transplant surgery, patients received immunosuppressive therapy. RESULTS: Statistical analysis of the microbiologic data showed significant changes between time points. An increase in total counts of microrganisms was observed on day 90 after surgery. As a side effect of cyclosporine, 14 patients developed gingival overgrowth. Beta-hemolytic Streptococcus was more frequently detected in patients who did not present gingival overgrowth 90 days after surgery. CONCLUSION: Quantitative and qualitative changes of the subgingival microflora can occur 90 days after transplant surgery, while patients are still under immunosupressive drugs.

Análise da diversidade da microbiota periodontopatogênica e sua influência sobre o tratamento periodontal / Analysis of the diversity of periodontopathic microbiota and its influence on periodontal treatment

O tratamento periodontal convencional através de raspagem e controle da higiene bucal assim como a complementação cirúrgica nem sempre são eficientes para o controle da doença periodontal. Dentre as principais bactérias associadas as periodontites, Actinobacillus actinomycetencomitans e Porphyromonas gingivalis, são considerados os verdadeiros patógenos periodontais. A virulência destas bactérias já é bem conhecida, além de sua diversidade genética. Porém, muitos outros microorganismos do sulco gengival possuem fatores de virulência semelhantes; o que torna possível que outras espécies bacterianas contribuam na etiologia da doença. O propósito deste trabalho é revisar a Literatura referente à diversidade genética de A. actinomycetemcomitans e P. gingivalis e as possíveis influências no tratamento periodontal.

Antibióticos de liberação local e controlada em periodontia: minociclina e doxiciclina / Local antibiotics in periodontal diseases

Os antibióticos locais parecem estar se tornando uma alternativa nos casos em que a raspagem e alisamento radicular não conseguem bons resultados, principalmente em sítios isolados. Deste modo, o paciente não é exposto a ação de antibióticos de forma sistêmica. Entretanto, estamos ainda distantes de agentes que possam, de maneira prática, rápida e econômica substituir o tratamento convencional

Gene expression of extracellular matrix proteoglycans in human cyclosporin-induced gingival overgrowth.

BACKGROUND: Gingival overgrowth is one of the side effects associated with the systemic use of cyclosporin A (CsA). In vitro studies on the extracellular matrix of gingival tissues have demonstrated an altered composition, particularly an accumulation of proteoglycans and collagen. We investigated the gene expression of extracellular matrix proteoglycans in CsA-induced gingival tissue alterations. METHODS: mRNA expression of the proteoglycans perlecan, decorin, biglycan, and versican was analyzed by reverse transcription polymerase chain reaction (RT-PCR) in gingival samples obtained from 12 individuals, six with CsA-induced gingival overgrowth (CsA group) and six with a normal gingiva (control group). The RT-PCR products were subjected to 1% agarose gel electrophoresis containing ethidium bromide and analyzed qualitatively and semiquantitatively by densitometry. Density values were normalized by determining the expression of the housekeeping gene beta-actin in the same sample. Groups were compared by the Student's t test. RESULTS: Perlecan expression showed a marked increase (54%) in the CsA group compared to the control group (P < 0.01), while no significant differences were observed for the other proteoglycans. CONCLUSION: CsA-induced gingival overgrowth seems to be associated with increased expression of perlecan, a typical basement membrane proteoglycan, but not decorin, biglycan, or versican.