Profile of subgingival microbiota in children with primary dentition.

Eruption of primary teeth has a great influence on the oral environment by providing suitable niches for bacterial colonization. The aim of the study was to investigate the composition of the subgingival microbiota of primary incisors, canines and molars in 40 systemically healthy children aged 4-5 yr, chosen randomly. Subgingival plaque samples were taken from the mesiobuccal sites of primary incisors (61, 81), canines (53, 73) and molars (64, 84). The samples were cultured for bacterial isolation anaerobically and in 10% CO2 plus air using selective and non-selective media. Forty-one different microbial species were isolated. Gemella morbillorum and Peptostreptococcus magnus were statistically significantly more frequently detected in incisors while P. micros, Streptococcus intermedius, Bacteroides forsythus, Fusobacterium nucleatum, Prevotella loeschei, P. melaninogenica and Selenomonas sputigena were more frequently detected in molars. The bacterial species S. constellatus, G. morbillorum and P. magnus were isolated in greater numbers in incisors and P. micros, S. intermedius, Campylobacter concisus, Bacteroides egertheii, B. forsythus, P. oralis and S. sputigena were isolated in greater numbers in molars, respectively. Cluster analysis revealed 4 clusters in which 6-7 bacterial species were elevated above mean levels. Cluster I was predominated by S. constellatus, S. mitis, S. sanguis, G. morbillorum, P. melaninogenica and P. oralis; cluster II was predominated by S. sanguis, Actinomyces naeslundii, Capnocytophaga gingivalis, C. ochracea and P. intermedia; cluster III was predominated by S. mitis, C. ochracea, F. nucleatum, P. loeschei, P. melaninogenica and P. oralis; and finally cluster IV was predominated by S. sanguis, C. gingivalis, Veillonella parvula, Campylobacter gracilis, F. nucleatum and P. intermedia. The bacterial species S. constellatus, P. micros, Pseudoramibacter alactolyticus, Eikenella corrodens and F. nucleatum were associated with non-bleeding sites while S. intermedius, C. concisus, P. intermedia and P. loescheii were found more frequently in bleeding sites.

Profile of subgingival microbiota in children with mixed dentition.

A diversity of microbial species has been detected in children's oral flora at an early age. To investigate the composition of the subgingival microbiota of different groups of teeth in children with mixed dentition, 40 systemically healthy children, aged 7-8 years, randomly chosen, were examined. Subgingival plaque samples were taken from the mesiobuccal sites of 21, 41, 16 and 36 permanent teeth and 53, 73, 64 and 84 deciduous teeth. The samples were cultured for bacterial isolation anaerobically and in 10% CO2 plus air using selective and nonselective media. Forty-five different microbial species were isolated from both permanent and deciduous teeth. Streptococcus sanguis (79-70%), Streptococcus mitis (66-65%), Prevotella melaninogenica (51-57%), Eikenella corrodens (51-52%), Capnocytophaga gingivalis (46-34%), Capnocytophaga ochracea (45-45%), Actinomyces naeslundii (39-60%) and Prevotella intermedia (42-35%) were among the most frequently detected species in permanent and deciduous teeth respectively. Several suspected periodontal pathogens, such as Porphyromonas gingivalis, Prevotella loescheii, Campylobacter gracilis, Bacteroides forsythus, Campylobacter concisus, Peptostreptococcus micros and Selenomonas sputigena, albeit less frequently detected, were present in the microbiota of these children. The bacterial species Streptococcus constellatus, Peptostreptococcus micros, Pseudoramibacter alactolyticus, E. corrodens and Fusobacterium nucleatum were associated with non-bleeding permanent and deciduous teeth whereas Streptococcus intermedius, C. concisus, P. intermedia and P. loescheii were associated with bleeding.

The clinical and microbiological effects of systemic ornidazole in sites with and without subgingival debridement in early-onset periodontitis patients.

BACKGROUND: The purpose of this study was to evaluate the clinical and microbiological effects of systemic ornidazole (ORN) in sites with or without subgingival debridement in early-onset periodontitis (EOP) patients. METHODS: Two pooled bacterial samples consisting of 4 sites each (scaled and non-scaled sites) were obtained from 30 individuals exhibiting EOP. All patients received oral hygiene instruction (OHI), supragingival scaling and ORN. Subgingival scaling and root planing (SRP) was carried out only in scaled sites. Bacterial samples were taken at baseline (BL) and 1 week and 2, 6, and 12 months after systemic ornidazole administration (500 mg/bid for 7 days). One more sample was taken at scaled sites, one week after SRP. RESULTS: One week following SRP (scaled sites) Gram-negative facultative and anaerobic rods were significantly reduced while Gram-positive facultative cocci were significantly increased. After ORN administration, P. gingivalis, P. denticola, P. intermedia, B. forsythus, C. rectus, and S. sputigena were no longer detectable in either scaled or non-scaled sites. A statistically significant long-term (2, 6, and 12 months) reduction of P. gingivalis, P. intermedia, P. loescheii, B. forsythus, and C. rectus and a pronounced increase of S. milleri, S. oralis, and S. sanguis counts in both scaled and non-scaled sites were detected in comparison to baseline. A sustained reduction of bleeding tendency and of probing depth was also observed in both scaled and non-scaled sites. CONCLUSIONS: ORN combined with SRP effects beneficial shifts in the bacterial population associated with substantial clinical improvement, thereby indicating that ORN is effective adjunct in the treatment of EOP deep periodontal pockets where anaerobic bacteria are predominant.

Subgingival microflora associated with nifedipine-induced gingival overgrowth.

The purpose of this study was to examine the composition of subgingival plaque of 140 periodontal lesions in 35 patients with cardiovascular disorders who were administered nifedipine and manifested nifedipine-induced gingival overgrowth (GO). Age was inversely associated with the GO. Plaque index and bleeding index showed a significant association with GO, while nifedipine dosage and duration of nifedipine therapy were not found to be significant predictors of GO. The gingival inflammation as expressed in the logistic regression model by the interaction term color x tone was found to be significantly associated with the GO. Statistically significant differences between the groups of comparable probing depth and different degrees of GO were detected for Propionibacterium acnes, Capnocytophaga gingivalis, Capnocytophaga ochracea, Capnocytophaga sputigena, Bacteroides gracilis, Fusobacterium mortiferum, Fusobacterium nucleatum, Fusobacterium varium and Selenomonas sputigena in deep and enlarged lesions. Significantly more frequently isolated were the bacterial species Eubacterium alactolyticum, Campylobacter concisus, C. gingivalis, C. ochracea, C. sputigena, F. mortiferum, F. nucleatum, and F. varium from the more enlarged lesions (GO >3).

Periodontal microflora of HIV infected patients with periodontitis.

The aim of this study was to determine the microbial profile of periodontal lesions in HIV seropositive patients and to compare it with rapidly progressing periodontal lesions in systemically healthy patients. The subgingival microflora of 20 CDC II, 20 CDC III, 20 CDC IV/V and 20 systemically healthy patients with rapidly progressing periodontitis was examined. Four sites with greatest probing depth in each patient were selected for microbiological sampling. The samples were cultured aerobically and anaerobically for bacterial isolation using selective and non-selective media. Isolates were characterized to species level by conventional biochemical tests and various identification kits. The microflora of periodontitis lesions within the three stages of the HIV infection was similar to that of progressing periodontitis in systemically healthy adults including Campylobacter rectus, Capnocytophaga spp., Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Selenomonas spp. and Peptostreptococcus micros. However, HIV seropositive periodontitis lesions harboured a range of exogenous pathogens rarely associated with common types of periodontitis including Staphylococcus aureus, Enterobacter cloaca, Pseudomonas aeruginosa, Candida albicans, Enterococcus faecalis, Enterococcus avium, Clostridium difficile, Aspergillus fumigatus, Klebsiella pneumoniae and Mycoplasma incognitum. The lack of immune effector and regulatory cells in HIV infected patients could in fact explain the increase of some opportunistic pathogens and the characteristic and rapidly progressing nature of the periodontal disease in these patients.

A clinical survey of periodontal conditions in Greece.

The present study used full-mouth clinical assessments of plaque, calculus, bleeding on probing, probing pocket depth and probing attachment level to evaluate the periodontal conditions in a rural (A) and an urban (B) sample of 25-64 year old Greek adults, comprising 190 and 373 subjects, respectively. 13% of the subjects in sample (A) and 8% in sample (B) were edentulous, while mean values of teeth present in the four age cohorts ranged between 19.8-12.6 and 23.3-18.3, respectively. A poor level of oral hygiene was recorded in both samples with high plaque, calculus and bleeding scores. Deep pocketing was more pronounced in the rural than in the urban sample; between 1.7 and 8.0% of all sites probed showed a PPD of > or = 6 mm and between 20 and 51.2% of the subjects in each age cohort had at least one deep pocket. Corresponding figures for the urban sample was 0.6-4.7% and 15.1-49.2%. However, the prevalence of severe attachment loss was of comparable magnitude in both samples; between 2.8-25.7% of the sites in sample (A) and 2.8-20.6% in sample (B) displayed a PAL of > or = 6 mm, while 32.5-72.1% and 31.8-73.8% of the subjects, respectively, had at least one severely affected site. It was further found that the distribution of advanced disease in the samples was skewed; 14.4% of the subjects in sample (A) and 9.5% in sample (B) accounted for 75% of all deep pockets, while 21.8 and 19.4% of the subjects, respectively, accounted for 75% of all sites with PAL of > or = 6 mm. Multiple regression revealed that male sex and high plaque and bleeding scores had a significant, positive influence to the amount of attachment loss on a subject level.

Alveolar bone loss on neolithic man remains on 38 skulls of Khirokitia's (Cyprus) inhabitants.

38 skulls, belonging to inhabitants of various age groups of the Neolithic settlement of Khirokitia in Cyprus (5800-3000 BC) were studied and the alveolar bone loss was evaluated in areas where teeth still existed. It was found that the alveolar bone loss increased with age. The differences deriving from the comparison of skulls belonging to older people (the mean life-span of the inhabitants was 35.2 years), with skulls belonging to younger people suggest that our findings are not due to postmortem weathering of bones through the centuries but represent a real fact. The results of this study indicate that periodontal disease has accompanied human beings since prehistoric time without being affected by civilization.

A radiographic survey of periodontal conditions in Greece.

The present study used radiographic assessments to evaluate the pattern of destructive periodontal disease ina rural and an urban sample of 25-64 year old Greek adults. The rural sample (A) comprised 190 subjects and the urban sample (B) 400 subjects. 13% of the subjects in sample A and 8% in sample B were edentulous. Full-mouth intraoral radiographs were obtained from the 503 dentate subjects and were examined with respect to (i) number and type of teeth present, and (ii) alveolar bone level (ABL), i.e., the distance between the cementoenamel junction and the alveolar bone crest at the approximal tooth surfaces. The results revealed that alveolar bone loss was ubiquitous in both samples. Pronounced bone loss, however, (i.e., a subject mean ABL of > or = 6 mm) affected 18% (sample A) and 8% (sample B) of the individuals. Although an ABL of > or = 6 mm was scored at 7.2 sites/subject in sample A and at 4.5 sites/subject in sample B, more than 10 such sites were found in 23% (A) and 11% (B) of the examined subjects. 25% of the subjects in the rural sample (A) and 12% in the urban sample (B) accounted for 75% of the total number of tooth sites with pronounced bone loss. Multiple regression revealed that age and number of remaining teeth were the parameters most strongly correlated with the amount of bone loss on both the individual subject and the tooth site level. The present findings (i) demonstrated a high prevalence and severity of destructive periodontal disease in these 2 samples. and (ii) confirmed the skewed distribution of advanced disease in the population.

Comparative estimation of periodontal conditions by means of different index systems.

The aim of the present study was to compare epidemiological data of periodontal disease obtained from a sample of adults by means of different, commonly employed, partial and full-mouth index systems, in order to explore the amount of discrepancy attributed to the methodology per se. 169 dentate subjects, aged 25-64 years, were subjected to a clinical examination, including circumferential probing assessments of pocket depth (PPD) and attachment level (PAL) at all teeth present. The individual mean % of tooth sites with PPD of > or = 6 mm and the % of subjects exhibiting at least one such deep pocket were calculated based on (i) full-mouth data, (ii) data derived from the buccal and mesial surfaces from 1 randomly selected upper and 1 lower quadrant, (iii) probing assessments at the 6 "Ramfjord teeth", (iv) the full-mouth community periodontal index for treatment needs (CPITN), and (v) the partial CPITN based on 10 index teeth. The PAL data were analyzed by means of 3 versions of the extent and severity index, 1 generated by full-mouth assessments and 2 by partial assessments based on 28 and 10 tooth sites, respectively. In the entire sample, the individual mean % of sites with PPD of > or = 6 mm generated by the different systems ranged between 5.0 and 4.2 sites/subject. By full-mouth CPITN scorings, an average of 1.0 score-4 sextants/subject was recorded, while the partial CPITN generated a corresponding value of 0.8 score-4 sextants/subject.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical evaluation of the effect of tetracycline root preparation on guided tissue regeneration in the treatment of Class II furcation defects.

The purpose of this clinical trial was to evaluate the effect of tetracycline root preparation on guided tissue regeneration in the treatment of Class II furcation defects. Nine pairs of defects with horizontal clinical attachment level value > or = 5 mm comprised the study group. Measurements were made to determine presence of plaque, gingival condition, probing depth, and vertical and horizontal clinical attachment level. Defects from each pair were randomly assigned for treatment with an expanded polytetrafluoroethylene membrane (e-PTFE) and tetracycline root conditioning (100 mg/ml) or the membrane alone. The membranes were removed 4 to 6 weeks postsurgery. Patients were then seen monthly for the duration of the study. Six months postsurgery, all clinical measurements were repeated. Following either treatment, improvement was observed in all clinical parameters, particularly in horizontal clinical attachment level. However, there was not a statistically significant difference in the improvement observed between sites treated with guided tissue regeneration in conjunction with tetracycline as compared to membrane placement alone. Further studies are needed to fully evaluate tetracycline root preparation in conjunction with regenerative therapy.

Pattern of tooth loss in a selected population in Greece.

The pattern of tooth loss with age for individual teeth was examined in a selected population. The survey covered patients attending the Dental School of Athens University. Tooth loss increased steadily with age and was higher for the periodontitis than the gingivitis group. Mortality of individual teeth was analyzed for each type of tooth within the maxillary pair and within the mandibular pair and no statistical significance was found. The statistically highly significant differences in loss rates within most groups of four teeth were clearly attributable to differences between the maxilla and mandible. For the permanent second molars differences in loss were close to the significance level while for the first molars the difference was statistically highly significant. A statistically significant difference was found between losses of the four second premolars while highly significantly differences were noticed between first premolars. Mortality for canines was low, but differences in losses were highly statistically significant. The two mandibular incisors had the lowest rates of loss in our sample, difference in loss between maxillary and mandibular incisors was statistically highly significant. Central incisors had a similar pattern of loss to that of lateral incisors but differences in loss rates were not statistically significant.

Hepatitis B virus infection in dentists and dental students in Greece.

The prevalence of hepatitis B virus (HBV) markers in 416 dental students, 115 dentists, and 329 members of the general population was studied in Athens. Markers were present in 36 students (8.7%), 34 dentists (29.6%), and 74 controls (22.5%). Four students (1.0%), 3 dentists (2.6%), and 6 controls (1.8%) were carriers of hepatitis B surface antigen (HBsAg). The prevalence of HBV infections increased with age significantly faster in the dental profession than in the general population, showing an increased risk. Of 22 dentists in practice for more than 20 years, 12 (54.5%) had HBV markers and 4 (18.2%) reported a clinical hepatitis infection. These data show that members of the dental profession should also be included in the national hepatitis B vaccination program.

Microbiological findings of infected root canals and adjacent periodontal pockets in teeth with advanced periodontitis.

The purpose of the present study was to examine the flora from the root canals and periodontal pockets of teeth with advanced periodontal disease in order to compare the predominant cultivable microflora from the canals with those found in the adjacent periodontal pockets. Three samples were collected from each of sixteen patients, one from the root canal and two from the adjacent periodontal pocket in two different sites. Criteria for inclusion in the survey were pocket depth of greater than or equal to 7 mm, intact clinical crowns, and lack of periapical lesions. The study has demonstrated that the microorganisms present in the root canals of caries-free teeth with advanced periodontitis generally resembled those found in the adjacent periodontal pockets. The similarity in the recovery of organisms in the current study suggests that the pocket could be the source of the root canal infections. Further investigation is needed to clarify whether such factors as duration of periodontitis and age of the patient play a role in pulpal pathosis and whether the presence of specific bacterial species is also a factor in the etiology and pathogenesis of pulp disease.