Características clínicas y microbiológicas de pacientes con periodontitis agresiva generalizada / Clinical and microbiological characteristics of a patients with generalized aggressive periodontitis

RESUMEN: Objetivo: el objetivo de este estudio es describir las características clínicas y microbiológicas de una muestra de pacientes diagnosticados con periodontitis agresiva generalizada (PAgG). Materiales y métodos: En este estudio de corte transversal, 20 sujetos menores de 30 años con PAgG atendidos en las clínicas odontológicas de la Universidad de Antioquia en Medellín Colombia, fueron invitados a participar entre diciembre del 2015 y marzo del 2017, las muestras microbiológicas fueron analizadas usando técnicas de cultivo y tomadas en los seis sitios más profundos de cada paciente (≥ 5mm). Resultados: Prevotella ssp y F. nucleatum fueron detectados en altos porcentajes, Porphyromonas gingivalis (P.g) fue positivo para la mitad de los sujetos estudiados; además de los microorganismos comúnmente estudiados, el 10% de los pacientes fueron positivos para bacilos entéricos gram-negativos. Conclusiones: se observaron grandes proporciones de microorganismos que incluyeron Prevotella spss y F. nucleatum; el 10% de los pacientes fueron positivos para bacilos entéricos gram-negativos.

ABSTRACT: Aim: The aim of this study is to describe the clinical and microbiological characteristics of a sample of patients diagnosed with generalized aggressive periodontitis (PAgG). Materials and methods: In this cross-sectional study, 20 subjects under 30 years of age with PAgG treated at the dental clinics of the University of Antioquia in Medellín, Colombia were invited to participate between December 2015 and March 2017, the microbiological samples analyzed using culture techniques were taken at the six deepest sites of each patient (≥ 5mm). Results: Prevotella ssp and F. nucleatum were detected in high percentages, Porphyromonas gingivalis (P.g) was positive for half of the studied subjects; In addition to the microorganisms commonly studied, 10% of the patients were positive for gram-negative enteric bacilli. Conclusions: large proportions of microorganisms were observed, including Prevotella spss and F. nucleatum; 10% of the patients were positive for gram-negative enteric bacilli.

High occurrence of Fusobacterium nucleatum and Clostridium difficile in the intestinal microbiota of colorectal carcinoma patients

Abstract Colorectal carcinoma is considered the fourth leading cause of cancer deaths worldwide. Several microorganisms have been associated with carcinogenesis, including Enterococcus spp., Helicobacter pylori, enterotoxigenic Bacteroides fragilis, pathogenic E. coli strains and oral Fusobacterium. Here we qualitatively and quantitatively evaluated the presence of oral and intestinal microorganisms in the fecal microbiota of colorectal cancer patients and healthy controls. Seventeen patients (between 49 and 70 years-old) visiting the Cancer Institute of the Sao Paulo State were selected, 7 of whom were diagnosed with colorectal carcinoma. Bacterial detection was performed by qRT-PCR. Although all of the tested bacteria were detected in the majority of the fecal samples, quantitative differences between the Cancer Group and healthy controls were detected only for F. nucleatum and C. difficile. The three tested oral microorganisms were frequently observed, suggesting a need for furthers studies into a potential role for these bacteria during colorectal carcinoma pathogenesis. Despite the small number of patients included in this study, we were able to detect significantly more F. nucleatum and C. difficile in the Cancer Group patients compared to healthy controls, suggesting a possible role of these bacteria in colon carcinogenesis. This finding should be considered when screening for colorectal cancer.

Suscetibilidade antimicrobiana e protocolo de purificação de RNA para análise de expressão gênica de isolados clínicos de Fusobacterium nucleatum / Antimicrobial susceptibility and RNA purification protocol for gene expression analysis of clinical isolates of Fusobacterium nucleatum

Fusobacterium nucleatum é uma espécie bacteriana Gram-negativa, anaeróbia estrita e uma das espécies frequentemente encontradas nas infecções primárias do sistema de canais radiculares. Esta espécie tem grande importância na formação de biofilmes por ser uma ponte de união entre espécies que não são capazes de interagir. Os micro-organismos constituintes de biofilmes trocam material genético, aumentando a tolerancia dos mesmos e é quase impossível um isolado clínico ter os genes totalmente iguais à cepa padrão de coleções de cultura como da ATCC (American Type Culture Colection). O presente estudo investigou a espécie bacteriana anaeróbia Fusobacterium nucleatum isolada de canais radiculares, comparando-a com sua cepa de referência. Foi feito a comparação da suscetibilidade microbiana in vitro por meio de cultura microbiológica pelo método do E-test, com as cepas em crescimento planctônico e em biofilme. Também foi definido um protocolo de Purificação de RNA para esta espécie em ambas as condições de crescimento. As cepas clínicas de F. nucelatum foram isoladas por meio da cultura microbiológica de 23 pacientes que apresentavam dentes com infecção primária e periodontite apical visível em radiografia. Foi feito isolamento e identificação da espécie por série bioquímica com testes comerciais (Sistema Api, Bio-Meriéux, França) e PCR convencional, sendo no total 4 isolados clínicos investigados. Foi verificada a suscetibilidade antimicrobiana dos seguintes antibióticos: Amoxicilina, Amoxicilina + ácido clavulânico, Ampicilina, Azitromicina, Clindamicina, Eritromicina e Metronidazol. O protocolo para purificação de RNA foi feito com microesferas de zircônia, dispositivo bead beater, kit comercial RNeasy (Qiagen) e transcrição para DNA complementar (cDNA). A qualidade da purificação foi testada quanto a sua capacidade de amplificação pela reação em cadeia da polimerase em tempo real (qPCR) utilizando primer para o gene 16s RNA específico para F. nucelatum...

Fusobacterium nucleatum is a Gram-negative bacterial species, strict anaerobic and one of the species often found in primary infection of the root canal system. This species has great importance in biofilm formation to be a union bridge between species which are not able to act alone. The constituent microorganisms of the biofilm exchange each tother genetic material, increasing the strength of them. It is almost impossible for a clinical isolate have genes totally equal to a standard strain, such as strains of culture collections like ATCC (American Type Culture Collection). The present study investigated anaerobic bacterial species Fusobacterium nucleatum isolated from root canals, comparing them to the ATCC strain. The microbial in vitro susceptibility of biofilm and planktonic growth of the strains was compared by means of microbiological culture and the E-test method, with the antibiotics Amoxicillin, Amoxicillin + clavulanic acid, Ampicillin, Azithromycin, Clindamycin, Eritromycin and Metronidazole.. Also, a RNA Purification protocol for the strains under the same growth conditions was defined. Clinical isolates were obtained by microbiological samples of patients with teeth with pulp necrosis and apical periodontitis visible on radiographs. The species isolation and identification were performed using commercial biochemical tests (Sistema Api, Bio-Meriéux, France) and conventional PCR, obtaining four clinical isolates. The protocol for RNA purification was done with zirconia beads, bead beater device and commercial kit RNeasy (Qiagen) and transcribed into complementary DNA (cDNA). The quality of purification was tested for its ability of amplification by real time polymerase chain reaction (qPCR) using primer for the gene 16s RNA specific for F. nucleatum. All tested trains were 100% susceptible to amoxicillin + clavulanic acid, ampicillin, azithromycin, clindamycin and metronidazole. Both types of bacterial growth showed resistance to...

Association between periodontal condition and subgingival microbiota in women during pregnancy: a longitudinal study

Objectivo In this study, the gingival conditions and the quantitative detection for Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis and Prevotella intermedia in pregnant women were determined. Material and Methods Quantitative determinations of periodontal bacteria by using a SyBr green system in women during pregnancy were performed. Women at the 2nd and 3rd trimesters of pregnancy and non-pregnant women were included in this study. A. actinomycetemcomitans was observed in high numbers in women at the 2nd and 3rd trimesters of pregnancy with a significant difference (p<0.05). F. nucleatum and P. intermedia were also observed in high levels. Results and Conclusion Our results show that pregnant women are more susceptible to gingivitis, and the presence of A. actinomycetemcomitans in subgingival biofilm might be taken into account for the treatment of periodontal disease. .

Actividad antibacteriana in vitro del extracto etanólico de propóleo de Oxapampa-Perú, sobre cepas de Porphyromonas gingivalis y Fusobacterium nucleatum / In vitro antibacterial activity of ethanolic extract of propolis Oxapampa-Peru, on strains of Porphyromonas gingivalis and Fusobacterium nucleatum

En la presente investigación se buscó comparar la actividad antibacteriana in vitro del extracto etanólico de propóleo de Oxapampa, Perú, en concentraciones al 1%, 5% y 10% con gluconato de clorhexidina al 0,2% sobre cepas de Porphyromonas gingivalis ATCC 33277 y Fusobacterium nucleatum ATCC 25586. La actividad antibacteriana se determinó usando el método de difusión en el agar. Los halos de inhibición se midieron con un calibrador y fueron anotados en una ficha de registro. Los datos fueron analizados con la prueba t de student para muestras independientes y la prueba de U de Mann Whitney. Los resultados mostraron que no había diferencia estadísticamente significativa entre los promedios de los halos de inhibición del extracto etanólico de propóleo al 10% y gluconato de clorhexidina al 0,2% (p=0,63) sobre la cepa de Fusobacterium nucleatum. No hubo diferencia estadísticamente significativa entre los promedios de los halos de inhibición del extracto etanólico de propóleo al 5% y gluconato de clorhexidina al 0,2%(p=0,81) sobre la cepa de Porphyromonas gingivalis. Mientras que el extracto etanólico de propóleo al 10% presentó mayor actividad antibacteriana que el gluconato de clorhexidina al 0,2% (p=0,02) sobre la cepa de Porphyromonas gingivalis. En conclusión, el extracto etanólico de propóleo al 10% es el que presenta mejor efectividad antibacteriana sobre ambas cepas periodontopatógenas cuando se le compara con la gluconato de clorhexidina al 0,2%. El propóleo podría usarse a futuro como posible alternativa para el tratamiento de la enfermedad periodontal, se necesitan para ello más estudios con otras metodologías para confirmar esta posibilidad.

The aim of this study was to compare the antibacterial activity of propolis ethanolic extract of Oxapampa, Peru, in concentrations of 1%, 5% y 10% against 0.2% clorhexidine over strains of Porphyromonas gingivalis ATCC 33277 and Fusobacterium nucleatum ATCC 25586. The antibacterial activity was evaluated using the agar diffusion method. The inhibition haloes were measured using a calibrator and written out in a data collecting paper. The data were analyzed with the t student test and U Mann Whitney test. The results showed that there was not statistically significant difference between the averages of inhibition haloes of 10% propolis ethanolic extract compares to 0.2% clorhexidine for Fusobacterium nucleatum strains (p=0.63). There was not statistically significant difference between the average of inhibition halo of 5% propolis ethanolic extract compared to 0.2% clorhexidine (p=0.81) for Porphyromonas gingivalis strains. While 10% propolis ethanolic extract showed more antibacterial activitythan 0.2% clorhexidine for Porphyromonas gingivalis strains (p=0.02). In conclusion, 10% propolis ethanolic extract showed the best antibacterial activity over both periodontopathogenic strains when compared to 0.2% clorhexidine. The propolis could be used as a therapeutic alternative to treat the periodontal disease in the population. Further studies are needed to confirm these results.

Detection of odoriferous subgingival and tongue microbiota in diabetic and nondiabetic patients with oral malodor using polymerase chain reaction.

Background: Halitosis has been correlated with the concentration of volatile sulfur compounds (VSCs) produced in the oral cavity by metabolic activity of bacteria colonizing the periodontal pockets and the dorsum of the tongue. It has been assumed that there is a relationship between periodontal disease and diabetes mellitus. Objectives: The aim of the study was to assess the malodor using the organoleptic method and tanita device; to quantify odoriferous microorganisms of subgingival plaque and tongue coating, such as P. gingivalis (Pg), T. forsythia (Tf), and F. nucleatum (Fn) using polymerase chain reaction (PCR) in nondiabetic and diabetic chronic periodontitis patients. Patients and Methods: Thirty chronic periodontitis patients (with and without diabetes) with 5-7 mm pocket depth, radiographic evidence of bone loss, and presence of oral malodor participated in this study. Subjective assessment of mouth air was done organoleptically and by using a portable sulfide monitor. Tongue coating was also assessed. Results: The scores of plaque index, gingival index, gingival bleeding index, VSC levels, and tongue coating between the nondiabetic and diabetic patients were not significant (P>0.5). In nondiabetic patients, Fn was found to be significantly (P<0.5) more in tongue samples, whereas Pg and Tf have not shown significant values (P>0.5). In diabetic patients, Fn and Tf have shown significant (P<0.5) an increase in subgingival and tongue samples, respectively, whereas Pg has not shown significant difference between subgingival and tongue samples. Interpretation and Conclusion: The results confirm that there is no difference in clinical parameters between nondiabetic and diabetic periodontitis patients, but the odoriferous microbial profiles in tongue samples of diabetic patients were found to be high. However, there is a weak positive correlation between VSC levels, clinical parameters, and odoriferous microbial profiles.

A Case of Liver Abscess Caused by Fusobacterium nucleatum in a Patient with Recurrent Periodontal Diseases / 대한소화기학회지

Fusobacteria are anaerobic gram-negative, non-spore forming bacilli found in normal flora of the oral cavity, urogenital tract, and gastrointestinal tract. Fusobacterium nucleatum has been seldom reported as a cause of liver abscess, particularly in immunocompetent hosts. A 55-year-old man with frequent periodontal disease visited our hospital with intermittent fever and headache for 2 months. Abdominal CT scan revealed an 8.2x6 cm mass in the right hepatic lobe with central low density. Abscess culture revealed F. nucleatum as the causative organism. Percutaneous abscess drainage and intravenous administration of antibiotics for 4 weeks improved symptoms and decreased the abscess size. We report a rare case of liver abscess due to F. nucleatum in an immunocompetent man with periodontal disease.

Co-detección de patógenos periodontales en pacientes chilenos con periodontitis crónica / Co-detection of periodontal pathogens in Chilean patients with chronic periodontitis

Las enfermedades periodontales asociadas a la placa dental son un importante problema de salud pública. La etiología de estas patologías es de origen multifactorial e involucra factores del hospedero, medio ambiente y de carácter infeccioso asociados a bacterias embebidas en la placa dental. Las principales bacterias asociadas a la periodontitis crónica son Porphyromonas gingivalis, Treponema denticola y Tannerella forsythia, mientras que Aggregatibacter actinomycetemcomitans se ha asociado principalmente a la periodontitis agresiva. Otro microorganismo clave en el desarrollo de la enfermedad es Fusobacterium nucleatum, el cual tiene la capacidad de co-agregarse con los patógenos periodontales y así facilitar su colonización. Para demostrar la prevalencia de estas bacterias, la co-detección y la asociación entre pacientes chilenos fumadores y no fumadores, se analizaron 67 muestras mediante PCR convencional. Los resultados mostraron que un 90 por ciento de las muestras fueron positivas para F. nucleatum, siendo la bacteria más detectada. Al analizar la co-detección entre las distintas bacterias se observa que F nucleatum está presente en más de un 80 por ciento de los casos cuando se detecta cualquiera de las cuatro bacterias restantes, mientas que A. actinomycetemcomitans se detecta en no más de un 20 por ciento al amplificar cualquiera de las bacterias restantes. Por otra parte, los resultados por género indican que existen diferencias significativas en la detección de T. forsythia, F. nucleatum y A. actinomycetemcomitans. Al considerar el factor de tabaquismo se observó que ninguna de las muestras de pacientes fumadores resultó ser positiva para A. actinomycetemcomitans.

Periodontal disease associated with dental plaque is a major public health problem. The etiology of these disorders is multifactorial involved seeing host factors, environmental factors and infectious nature associated with the presence of bacteria belonging to the plaque. The main bacteria associated with chronic periodontitis are Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia, while Aggregatibacter actinomycetemcomitans is mainly associated with aggressive periodontitis. Another key organism in the development of the disease is Fusobacterium nucleatum, which has the ability to co-aggregate with other periodontal pathogen. To demonstrate the prevalence of these bacteria and the association between Chilean smokers and nonsmokers patients, 67 samples were analyzed by conventional PCR. The results showed that 90 percent of the samples were positive for F nucleatum being the most commonly detected bacteria. By analyzing the co-detection between different bacteria shows that F nucleatum is present in more than 80 percent of cases when it detects any of the four remaining bacteria, which lie A. actinomycetemcomitans was detected in no more than 20 percent by amplifying any remaining bacteria. Moreover the results by gender indicate that significant differences exist in the detection of T forsythia, F. nucleatum and A. actinomycetemcomitans. In considering the factor of smoking was observed that none of the samples from smokers was found to be positive for A. actinomycetemcomitans.

The detection of eight putative periodontal pathogens in adult and rapidly progressive periodontitis patients: an institutional study.

PURPOSE: Periodontal disease is a commonly prevalent problem faced alike by both the developed and third world countries but showing wide variations in prevalence and severity across different geographical areas. The purpose was to identify Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Ekinella corrodens (Ec), Campylobacter rectus (Cr), Bacteroides forsythus (Bf), Treponema denticola (Td) and Fusobacterium nucleatum (Fn) in Indian adult periodontitis and rapidly progressive periodontitis patients. MATERIALS AND METHODS: Paper points were used to collect the sample from 28 sites in both adult periodontitis and rapidly progressive periodontitis (8 healthy/20 diseased sites) patients and DNA analysis done. The categorical data was analysed by Fishers exact test and difference in the clinical parameters was tested by Mann-Whitney test. RESULTS: In healthy sites of adult and rapidly progressive periodontitis patients, Aa, Ec, Bf and Aa, Pg, Pi, Td, Fn were detected respectively. However, when diseased and healthy sites were compared in both adult periodontitis and rapidly progressive periodontitis patients respectively, only Pg( P =0.004), Cr( P =0.04), Fn( P =0.014) and Pg( P =0.002), Cr( P =0.02), Fn( P =0.008) were statistically significant. CONCLUSION: The prevalence of the microorganisms correlate with the clinical parameters like probing depth and bleeding on probing as seen in the Japanese and Western periodontitis patients' population.

Virulence of oral "Fusobacterium nucleatum" from humans and non-human primates in mice

The lethal action in Balb/c mice of 80 oral "Fusobacterium nucleatum" recovered from patients with adult periodontitis, healthy subjects of "Cebus apella" monkeys was studied. Mice were inoculated intraperitoneally with each bacterial inoculum of 5,0E+8 CFU/ml. All the clinical isolates induced weight and coordinated movements loss. Pathological alterations in liver, CNS, heart, and kidney with inflammatory reactions of vascular congestion were observed. Of all the tested "F. nucleatum" isolates, 61.2(per cent) from periodontal patients, 57.1(per cent) from healthy subjects and 60(per cent) from monkeys, were capable of killing the mice in 48h. The clinical isolates were significantly more pathogenic than "F. nucleatum" ATCC 10953 or ATCC 25586. "B. fragilis" ATCC 23745 showed lethality against control mice. Our results suggest that LPS could be involved in lethal action against mice and it may play an important role in producing tissue damage or death of mice.

Bacteriocin-like activity of oral Fusobacterium nucleatum isolated from human and non-human primates

"Fusobacterium nucleatum" is indigenous of the human oral cavity and has been involved in different infectious processes. The production of bacteriocin-like substances may be important in regulation of bacterial microbiota in oral cavity. The ability to produce bacteriocin-like substances by 80 oral "F. nucleatum" isolates obtained from periodontal patients, healthy individuals and "Cebus apella" monkeys, was examinated. 17.5(per cent) of all tested isolates showed auto-antagonism and 78.8(per cent) iso- or hetero-antagonism. No isolate from monkey was capable to produce auto-inhibition. In this study, the antagonistic substances production was variable in all tested isolates. Most of the "F. nucleatum" showed antagonistic activity against tested reference strains. These data suggest a possible participation of these substances on the oral microbial ecology in humans and animals. However, the role of bacteriocins in regulating dental plaque microbiota "in vivo" is discussed

Amplificación de genes bacterianos con reacción de polimerasa en cadena (PCR) para la detección de invasión microbiana de la cavidad amniotica (IMCA) y predicción de parto prematuro / Amplification of bacterial genes with polimerase chain reaction (PCR) for the detection of microbial invasion of amniotic cavity and prediction of premature labor

Se realizaron PCR y cultivos en líquido amniótico (LA) obtenido por amniocenteáis en 50 embarazadas con trabajo de parto prematuro sin rotura de membranas, y en 13 pacientes con embarazo de término, sin trabajo de parto, en quienes se realizó amniocentesis para evaluar madurez pulmonar fetal antes de la interrupción electiva de la gestación. Las pacientes fueron controladas hasta la resolución del embarazo. Se determinó el valor diagnóstico de los exámenes para predecir parto prematuro y complicaciones neonatales. PCR fue positivo en 23 casos, siendo E coli el germen más frecuentemente detectado (13). El cultivo fue positivo en 6 casos, coincidiendo el germen con PCR en 4 de ellos. La evolución a parto prematuro fue diferente entre los grupos PCR + y PCR-. PCR demostró sensibilidad mayor que los cultivos (40 vs 13 por ciento), y especificidad menor (45 vs 90 por ciento) para predecir parto prematuro menor a 37 semanas. La sensibilidad y especificidad para predecir parto prematuro menor a 34 semanas resultó aún mayor (64 y 59 por ciento, respectivamente). Ninguna de las 13 pacientes de término, candidatas a operación cesárea electiva, resultó positiva para PCR o cultivo

Prevalência de microrganismos na placa subgengival da dentiçäo decídua / Prevalence of microorganisms in the subgingival plaque of the deciduous dentition

O conhecimento da composiçäo microbiana do sulco gengival de crianças com dentiçäo decídua, sabidamente resistentes à doença periodontal, é importante näo só porque pode definir a microbiota essencialmente näo patogênica para iniciar a doença, como também o momento da colonizaçäo inicial de microrganismos periodontopáticos. Utilizando a técnica do "slot-immunoblot", amostras de placa subgengival de 59 crianças sadias, com idades entre 3 e 6 anos, foram pesquisadas quanto a presença, distribuiçäo e intensidade de colonizaçäo de dez bactérias: A. viscosus, S. sanguis, S. mutans, P. gingivalis, P. intermedia, A. actinomycetemcomitans (A.a.), F. nucleatum, S. sputigena, T. denticola e T. vincentii. O A. viscosus foi detectado em 100 por cento das crianças; o S. sanguis em 72,9 por cento; o S. mutans em 22,0 por cento; a P. intermedia em 23,7 por cento; o A.a. em 52,5 por cento; o F. nucleatum em 57,6 por cento, a S.sputigena em 17,0 por cento e o T. vincentii em 27,1 por cento. A P. gingivalis e o T. denticola näo foram detectados. A distribuiçäo dos microrganismos näo foi homogênea, ocorrendo a colonizaçäo em 1, 2, 3 ou 4 sítios...

Pesquisa de bactérias bucais em amostras de placa subgengival de indivíduos com periodonto normal e de portadores de periodontite através da técnica do "Slot Immunoblot" / Oral bacterias investigation in subgingival plaque perform of patients with normal periodontium and owners of periodontitis across \"Slot Immunoblot\" assay

Alguns microrganismos säo considerados patógenos periodontais potenciais por sua capacidade de implantar-se no sulco gengival, produzir substâncias tóxicas, invadir o tecido periodontal e possuir mecanismos que lhes permitam resistir aos fatores de defesa do hospedeiro. Alguns desses microrganismos säo o Actinobacillus actinomycetemcomitans (A.a), Porphyromonas gingivalis (P.g.). Prevotella intermedia (P.i), Bacteroides forsythus (B.f.), Selenomonas sputigena (S.s.), Fusobacterium nucleatum (F.n.), Treponema denticola (T.d.), Treponema vincentii (T.v.). Também foram testados o Streptococcus mutans (S.m.) e o Actinomyces viscosus (A.v.) como representantes de microrganismos Gram posistivos, encontrados na microbiota bucal. Usando a técnica do "Slot Immunoblot" (SIB), amostras de placa gengival de 10 indivíduos normais e 27 portadores de periodontite do adulto foram examinados quanto à presença dessas bactérias. No grupo normal a prevalência de indivíduos com pelo menos um sítio positivo a uma bactéria variou de 50 a 100 por cento e a porcentagem de sítios positivos foi de 80 por cento para o T.d., 60 por cento para o A.v., 47,5 por cento para o B.f., 45 por cento para a P.i. e o T.v., 40 por cento para a P.g., 32,5 por cento para o F.n. e S.s., 30 por cento para o S.m. e 27,5 por cento para o A.a. Todos os pacientes apresentaram pelo menos um sítio positivo a pelo menos uma bactéria, exceto para o S.m., com 62,9 por cento de positividade. A porcentagem de sítios positivos nesse grupo foi de 100 por cento para o A.v., 99 por cento para o T.d. e o T.v., 96,2 por cento para o F.n., 93,5 por cento para a P.g., 91,6 por cento para a P.i. e S.s., 87,9 por cento para o B.f., 81,4 por cento para o A.a. e 46,2 por cento para o S.m. Dos 400 testes realizados com as amostras do grupo normal para as dez bactérias, 176 (44 por cento) foram positivos a pelo menos uma bactéria, com somente quatro sítios dos 40 analisados negativos a todas as bactérias. Dos 1080 testes realizados para o grupo de pacientes, 958 (88,7 por cento) foram positivos, näo havendo nenhum sítio negativo para todas as bactérias e 41 sítios foram positivos para todas elas. A comparaçäo dos escores médios obtidos revelou diferença estatisticamente significante entre os grupos para todas as bactérias exceto para o S.m. Näo houve correlaçäo entre profundidade de sondagem média dos quatro sítios amostrados e os escores médios para os mesmos sítios, exceto para o T.v. e S.s...