Histological Evaluation of Internal Dental Resorption: An Analysis of a Cohort of 50 Cases.

Objective: This study aimed to perform a histological evaluation of teeth diagnosed with internal root resorption. Materials and Methods: A descriptive study involved the examination of 50 human teeth extracted due to an unfavorable prognosis for retention in the oral cavity. Teeth were preserved in 10% buffered formalin and subsequently subjected to the decalcification process. Masson-Goldner staining was applied for comprehensive histological assessment. Results: In all the 50 teeth examined, resorption gaps within the dentin tissue were identified, accompanied by the presence of reparative cells in the vicinity of these cavities. Marked structural loss and dentin fragmentation were evident, with regions exhibiting fissures and an absence of dentinal tubules. Conclusions: The histological evaluation of 50 teeth diagnosed with internal dental resorption revealed significant structural alterations, including resorption lacunae, the presence of multinucleated osteoclast-like cells, and reparative connective tissue. These findings highlight the complex and multifaceted nature of internal dental resorption. These histological insights provide a deeper understanding of the pathological processes involved in internal dental resorption and underscore the necessity for early detection and intervention to mitigate tooth loss and preserve dental health.

Artificial Intelligence through Wireless Sensors Applied in Restorative Dentistry: A Systematic Review.

The integration of wireless sensors with artificial intelligence could represent a transformative approach in restorative dentistry, offering a sophisticated means to enhance diagnostic precision, treatment planning, and patient outcomes. This systematic review was conducted to pinpoint and assess the efficacy of wireless sensors in restorative dentistry. The search methodology followed the guidelines outlined by PRISMA and involved the utilization of prominent scientific databases. Following the final phase of evaluating eligibility, the systematic review included six papers. Five experiments were conducted in vitro, while one was a randomized clinical trial. The investigations focused on wireless sensors for cavity diagnosis, toothbrush forces, facial mask applications, and physiological parameter detection from dental implants. All wireless sensors demonstrated efficacy in achieving the objectives established by each study and showed the validity, accuracy, and reproducibility of this device. The investigations examined in this systematic review illustrate the potential of wireless sensors in restorative dentistry, especially in the areas of caries detection, dental implant systems, face masks, and power brushes. These technologies hold promise for enhancing patient outcomes and alleviating the workload of dental practitioners.

Relationship between Intraoperative Bile Culture Outcomes and Subsequent Postoperative Infectious Complications: A Retrospective Cohort Study.

The presence of positive bile culture during intraoperative procedures has been associated with elevated morbidity and mortality rates in hepatobiliopancreatic surgeries, contributing to increased healthcare expenditures. However, the precise impact of bactobilia on the development of postoperative complications remains uncertain due to existing disparities in the published literature. In this retrospective cohort study, we assessed 137 patients who underwent major hepatobiliopancreatic surgery to examine the relationship between intraoperative bile culture outcomes and subsequent postoperative infectious complications. Among patients with bactobilia, a significant 35.1% exhibited systemic or local infectious complications, whereas only 11.1% of those with negative culture results experienced any infectious complications (p = 0.002). Similarly, a notable difference was observed in the incidence of surgical site infections, with 24.3% in the bactobilia group compared to 7.9% in the negative culture group (p = 0.01). A total of 74 monomicrobial cultures with microbiological growth were isolated, predominantly featuring Gram-negative microorganisms, primarily Enterobacteriaceae in 49 cultures. Escherichia coli was identified in 37.8% of positive cultures, while Klebsiella pneumoniae was evident in 21.6%. Gram-positive microorganisms were present in 10 cultures, with Enterococcus emerging as the prevailing species. The logistic regression model identified a positive bile culture as an independent factor significantly associated with infection development (OR: 2.26; 95% confidence interval: 1.23-11; p = 0.02). Considering the limitations of the study, these findings underscore the critical importance of conducting bile cultures during the intraoperative phase to enable vigilant monitoring and prompt management of infectious complications.

Severe Sinus Dysfunction in the Context of Chronic Lithium Intoxication and Poorly Controlled Hypothyroidism.

Cardiotoxicity associated with lithium is not a common event; however, it is potentially life-threatening, manifesting electrocardiographically with sinoatrial blocks, high-degree atrioventricular blocks, QT prolongation, and ventricular tachyarrhythmias. This case report presents a patient with severe sinus dysfunction in a clinically severe presentation secondary to cardiogenic shock. The patient sought medical attention for a one-week history of non-anginal chest pain, dizziness without syncope, generalized weakness, and somnolence progressing to bedridden status in the days preceding hospital admission. Laboratory findings revealed elevated blood levels of lithium and thyroid-stimulating hormone (TSH), along with concomitant Acute Kidney Injury Network (AKIN) II acute kidney injury. Subsequently, the patient was admitted to the intensive care unit, where persistent extreme sinus bradycardia of 30 bpm (beats per minute) with sinus pauses without ischemic changes was observed. The patient received supportive treatment, including renal replacement therapy, resulting in complete recovery of hemodynamic status without the need for long-term cardiac conduction devices.

Stroke in a Patient With Antiphospholipid Syndrome.

Antiphospholipid syndrome (APS) is characterized by the occurrence of thrombotic events and/or obstetric complications in the presence of antiphospholipid antibodies. It is considered one of the most common acquired thrombophilias. The presentation of stroke in patients with APS has been described in some studies; however, it is not frequent enough and there is not much information available regarding the indications for pharmacological thrombolysis and the safety of thrombolytic treatment. Likewise, current evidence does not describe contraindications to thrombolytic therapy in cases of this diagnosis, which makes management with fibrinolysis safe in these cases. A clinical case of stroke is presented in which pharmacological thrombolysis is performed with a successful outcome, without complications of angioedema or bleeding. Likewise, concerning the case, the main neurological manifestations associated with APS, especially in its association with stroke, are described.

Efficacy of wireless sensors in assessing occlusal and bite forces: A systematic review.

BACKGROUND: The noteworthy correlation between bite force and masticatory performance emphasizes its significance as a meaningful and objective method for assessing oral function. Furthermore, in the study of bruxism, the measurement of intraoral bite force assumes critical importance. Given the importance of assessing occlusal forces and bite force, this systematic review aims to assess the efficacy of wireless sensors in measuring these forces. METHODS: The search methodology employed in this systematic review adhered to the guidelines outlined by PRISMA. The strategy involved the exploration of various databases, including PubMed/MEDLINE, SCOPUS and SCIELO. An assessment tool was employed to evaluate the bias risk and study quality. RESULTS: This systematic review encompassed six prospective clinical studies involving a total of 89 participants. Wireless sensors for measuring occlusal forces and bite forces were predominantly employed in healthy adults or individuals with bruxism, along with children undergoing orthodontic treatment. All wireless sensors employed in the studies underwent validation and reproducibility assessments, affirming their reliability. The findings indicated that all wireless sensors exhibited efficacy in detecting occlusal forces and bite forces. CONCLUSION: Wireless sensors offer real-time monitoring of occlusal and bite forces, aiding in understanding force distribution and identifying bruxism patterns. Despite limited studies on their application, these sensors contribute to evolving insights. Integration into clinical practice requires careful consideration of factors like calibration and patient compliance. Ongoing research is crucial to address limitations and enhance the efficacy of wireless sensors in measuring occlusal and bite forces and managing bruxism.

Projectile Embolism From a Firearm Injury: A Case Report.

Projectile embolism resulting from firearm injuries is a rare but highly lethal complication when not diagnosed early. This report presents a case of projectile embolism from a firearm injury with an unusual entry site, the cerebral venous circulation, which subsequently migrates to the pulmonary circulation with a fatal outcome. A 24-year-old male patient was admitted to a high-complexity hospital due to a gunshot wound. A plain skull computed tomography (CT) revealed a left laminar subdural hematoma and traumatic subarachnoid hemorrhage with multiple metallic fragments embedded in the skull, some penetrating the galeal sinus, with perilesional bleeding. Contrast-enhanced chest tomography showed non-thrombotic embolism of metallic fragments in the pulmonary artery for the apical segment of the left upper lobe and right intraventricular regions. Transthoracic echocardiography revealed a hyperechoic image of 3 mm in the subvalvular apparatus toward the interventricular septum. Subsequently, the patient experienced neurological deterioration with signs of cerebral edema and parieto-occipital epidural hematomas with metallic fragments and projectiles. Measures to counteract cerebral edema were initiated. Later, the patient developed mydriasis, the absence of brainstem reflexes, and experienced cardiac arrest. This report delineates a case of projectile embolism, highlighting a distinctive aspect characterized by an unusual entry point.

Efficacy of microchips and 3D sensors for orthodontic force measurement: A systematic review of in vitro studies.

OBJECTIVE: To evaluate the efficacy of microchips and 3D microsensors in the measurement of orthodontic forces. METHODS: Through September 2023, comprehensive searches were conducted on PubMed/MEDLINE, SCOPUS and SCIELO without restrictions. RESULTS: After removing duplicate entries and applying the eligibility criteria, 23 studies were included for analysis. All the studies were conducted in vitro, and slightly more than half of them were centred on evaluating orthodontic forces exerted by aligners. Eight utilized microchips as measurement tools, while the remaining studies made use of 3D microsensors for their assessments. In the context of fixed appliances, key findings included a high level of agreement in 3-dimensional orthodontic force detection between simulation results and actual applied forces. Incorporating critical force-moment combinations during smart bracket calibration reduced measurement errors for most components. Translational tooth movement revealed a moment-to-force ratio, aligning with the bracket's centre of resistance. The primary findings in relation to aligners revealed several significant factors affecting the forces exerted by them. Notably, the foil thickness and staging were found to have a considerable impact on these forces, with optimal force transmission occurring at a layer height of 150 µm. Furthermore, the type of material used in 3D-printing aligners influenced the force levels, with attachments proving effective in generating extrusive forces. Deliberate adjustments in aligner thickness were observed to alter the forces and moments generated. CONCLUSIONS: Microchips and 3D sensors provide precise and quantitative measurements of orthodontic forces in in vitro studies, enabling accurate monitoring and control of tooth movement.

A finite element study comparing Advansync® and Twin Block in mandibular anterior repositioning.

OBJECTIVE: This study aims to utilize the finite element method (FEM) to compare the dentoalveolar and mandibular effects associated with anterior mandibular repositioning using AdvanSync® (ADV) and Twin Block (TB). METHODS: A patient with Class II skeletal malocclusion and mandibular retrognathism was selected. A TB appliance was subsequently applied. Computed Tomography (CT) scans were acquired at the beginning of treatment (T1) and 8 months later (T2). Concurrently, a numerical TB model was validated through FEM simulations, which were compared with the T2 results. The ADV appliance was virtually simulated to evaluate stress and deformation on the condyle, symphysis, first lower molar and lower central incisors. RESULTS: Both simulations demonstrated significant mandibular advancement. However, ADV led to less incisor proclination and more molar intrusion compared to TB. ADV exhibited increased stress in the lower molar area, while TB had higher stress in the lower incisor region. Stress and deformations in the condyle and mandibular symphysis were similar in both simulations, with the highest stress observed at the condylar neck and the lowest at the upper pole of the condylar head. CONCLUSIONS: Both appliances achieved similar levels of mandibular advancement, with greater proclination of the lower central incisors and more widespread distribution of stress and molar intrusion when using ADV compared to TB.

The Potential Clinical Applications of a Microfluidic Lab-on-a-Chip for the Identification and Antibiotic Susceptibility Testing of Enterococcus faecalis-Associated Endodontic Infections: A Systematic Review.

This systematic review evaluated the potential clinical use of microfluidic lab-on-a-chip (LOC) technology in the identification and antibiotic susceptibility testing of E. faecalis in endodontic infections. The search methodology employed in this review adhered to the PRISMA guidelines. Multiple scientific databases, including PubMed/MEDLINE, SCOPUS, and SCIELO, were utilized, along with exploration of grey literature sources. Up to September 2023, these resources were searched using specific keywords and MeSH terms. An initial comprehensive search yielded 202 articles. Ultimately, this systematic review incorporated 12 studies. Out of these, seven aimed to identify E. faecalis, while the remaining five evaluated its susceptibility to different antibiotics. All studies observed that the newly developed microfluidic chip significantly reduces detection time compared to traditional methods. This enhanced speed is accompanied by a high degree of accuracy, efficiency, and sensitivity. Most research findings indicated that the entire process took anywhere from less than an hour to five hours. It is important to note that this approach bypasses the need for minimum inhibitory concentration measurements, as it does not rely on traditional methodologies. Microfluidic devices enable the rapid identification and accurate antimicrobial susceptibility testing of E. faecalis, which are crucial for timely diagnosis and treatment in endodontic infections.

Remolinos mesentéricos en la angiotomografía de paciente con hernia de Petersen y aparente trombosis mesentérica / Mesenteric swirl on angiotomography of a patient with Petersen's hernia and apparent mesenteric thrombosis

RESUMEN Introducción: Las imágenes diagnósticas son fundamentales para diagnosticar la trombosis de la vena mesentérica y la hernia de Petersen. Objetivo: Describir el tratamiento de una paciente que en angiotomografía presentó aparente trombosis de la vena mesentérica y hernia de Petersen. Caso clínico: Una paciente consultó por dolor abdominal tipo cólico, de predominio en epigastrio, irradiado a región dorsal. Por el cuadro clínico sugestivo de emergencia vascular se solicitó inmediatamente angiotomografía de vasos del tórax y abdomen. Las imágenes revelaron permeabilidad de la arteria mesentérica superior en su origen y en tercio proximal, se aprecia un giro de vasos (signo de remolino) a aproximadamente 7 cm de su origen, con aparente oclusión completa, por trombosis. En el mismo sitio donde se evidenció el giro de vasos, se apreció aparente inicio de trombosis de la vena mesentérica superior. Se realizó procedimiento quirúrgico en el cual se encontró espacio de Petersen y herniación de todo el intestino delgado a través de dicho espacio. La laparotomía evidenció que la paciente no cursó con trombosis, sino que era un efecto dado por la imagen y el hallazgo que se veía era secundario a la hernia de Petersen. Conclusiones: La presencia del signo de remolino en una angiotomografía es muy importante pero no definitiva en el diagnóstico de la hernia de Petersen.

ABSTRACT Introduction: Diagnostic images are essential for the diagnosis of mesenteric vein thrombosis and Petersen's hernia. Objective: To describe the treatment of a patient who presented apparent thrombosis of the mesenteric vein and Petersen's hernia on angiotomography. Clinical case: A patient consulted for colicky abdominal pain predominantly in the epigastrium, radiating to the dorsal region. Due to the clinical picture suggestive of vascular emergency, an angiotomography of the vessels of the thorax and abdomen was immediately requested. The images revealed patency of the superior mesenteric artery at its origin and in the proximal third, appreciating a vessel turn (swirl sign) approximately 7 cm from its origin with apparent complete occlusion due to thrombosis. In the same place where the twisting of the vessels was evident, the initiation of apparent thrombosis of the superior mesenteric vein was appreciated. A surgical procedure was performed in which Petersen's space and herniation of the entire small intestine through this space were found. The laparotomy showed that the patient did not have thrombosis at any time, but that it was an effect given by the image and the finding that was seen was secondary to Petersen's hernia. Conclusions: The presence of the swirl sign on an angiotomography is very important but not definitive in the diagnosis of Petersen's hernia.

Porphyromonas gingivalis and aggregatibacter actinomycetemcomitans IgG subclass antibody levels as immunological risk indicators of chronic periodontitis: a multilevel approach / Niveles de anticuerpos subclase IgG de porphyromonas gingivalis y aggregatibacter actinomycetemcomitans como indicadores de riesgo inmunológico de periodontitis crónica: un enfoque multinivel

Antibody levels to some periodontal pathogens are associated with enhanced levels of inflammatory markers. The purpose of the current study was to examine the relative contribution of serum immunoglobulin G (IgG) subclass antibody level factors and local factors on the probing pocket depth in chronic periodontitis. Serum samples were taken from 444 patients diagnosed with moderate and severe periodontitis and 223 control subjects. The IgG subclass antibody titers to Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa) and Tanerella forsythia (Tf) using indirect immunoassay (ELISA) were determined. The relative contribution of patient, tooth and site-associated parameters on the probing pocket depth were evaluated with a hierarchical multilevel model. The results indicated that periodontitis patients had detectable levels of IgG1 and IgG2. High IgG1 and IgG2 antibody levels against Aa occurred in 132 and 142 periodontitis patients, respectively. High IgG1 and IgG2 antibody levels against Pg occurred in 141 and 138, periodontitis patients, respectively, and High IgG1 and IgG2 antibody levels against Tf occurred in 121 and 136 periodontitis patients, respectively. The majority of the variance was attributed to the site level (48 percent). The multilevel analysis associated deeper probing depth with subject factors (serum IgG1 and IgG2 antibody to Pg and Aa), tooth factors (tooth type), and site factors (mesial-distal location and bleeding on probing). Elevated serum IgG1 and IgG2 antibody to Pg and Aa (subject factors) reflects destructive periodontal disease status.

Los niveles de anticuerpos en algunos patógenos periodontales están asociados con mayores niveles de marcadores inflamatorios. El propósito de este estudio fue examinar la contribución relativa de inmunoglobulina sérica G (IgG) factores de nivel de anticuerpos de subclase y factores locales en la profundidad del sondaje en periodontitis crónica. Se tomaron muestras de suero de 444 pacientes con diagnóstico de periodontitis moderada y grave y de 223 sujetos de control. Se determinaron los títulos de anticuerpos IgG subclase a Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa) y Tanerella forsythia (Tf) mediante inmunoensayo indirecto (ELISA). La contribución relativa de los pacientes, los dientes, y el sitio asociado a los parámetros en la profundidad de sondaje fueron evaluados con un modelo multinivel jerárquico. Los resultados indicaron que los pacientes con periodontitis tenían niveles detectables de IgG1 e IgG2. Altos niveles de anticuerpos IgG1 e IgG2 contra Aa fueron observados en 132 y 142 pacientes con periodontitis, respectivamente. Niveles altos de anticuerpos IgG1 e IgG2 contra Pg fueron detectados en 141 y 138 en pacientes con periodontitis respectivamente, y niveles altos de anticuerpos IgG1 e IgG2 contra Tf se produjeron en 121 y 136 pacientes con periodontitis, respectivamente. La mayor parte de la varianza se atribuyó a nivel de sitio (48 por ciento). El análisis multinivel asociados a profundidad de sondaje con factores relacionados a los sujetos, anticuerpos (suero IgG1 e IgG2 Aa y Pg), factores de los dientes (tipo) y los factores del sitio (localización mesial - distal y sangrado al sondaje). Anticuerpos elevados de suero IgG1 e IgG2 Aa y Pg (factores de los sujetos) reflejan el estado de la enfermedad periodontal destructiva.

Etiology and pattern of maxillofacial fractures in Medellín, Colombia: a retrospective analysis of 2680 patients / Patrón etiológico de fracturas maxilofaciales en Medellín, Colombia: un análisis retrospectivo de 2680 pacientes

Maxillofacial injuries can cause significant long-term functional, esthetic, and psychological complication. Besides, these injuries may pose a substantial economic consequence for the patients as the treatment may involve a complex procedure. The purpose of the current retrospective study was to investigate the pattern of maxillofacial fractures in Medellín, Colombia over a 13-year period (1998-2010). A retrospective study of 2680 subjects with 4893 maxillofacial fractures admitted at the Oral and Maxillofacial Surgery Department of the San Vicente de Paul University Hospital in Medellín, Colombia, is presented. The patients were evaluated by age, gender, etiology, type of injury, treatment modalities and hospitalization time. The Chi-Square test was used to compare the counts of categorical response between two independent variables. The study population consisted of 2193 males and 487 females with a mean age of 26.5 (SD: 13.5) years. The age group 21-30 years accounted for the largest subgroup in both sexes. The most common cause of the fractures was traffic related followed by interpersonal violence. There were mainly mandibular, maxilla alveolar process and zygomatic bone fractures in both males and females, accounting for approximately 92 percent of all fractures. The main fracture site of the mandible was the mandibular condyle. The results of the present study reveal that road traffic accidents remain among the main reasons of maxillofacial fractures. Measures on prevention of road traffic crashes and policies that strengthen social investment should be strongly emphasized in order to reduce the occurrence of these injuries.

Las lesiones maxilofaciales pueden causar complicaciones funcionales, estéticas y psicológicas significativas a largo plazo. Además, pueden representar una consecuencia económica sustancial para los pacientes, y su tratamiento puede implicar un procedimiento complejo. El propósito de este estudio retrospectivo fue investigar el patrón de las fracturas maxilofaciales en Medellín, Colombia en un período de 13 años (1998-2010). Se estudiaron 2.680 pacientes con 4.893 fracturas maxilofaciales, quienes ingresaron al Departamento de Cirugía Oral y Maxilofacial del Hospital Universitario San Vicente de Paúl en Medellín, Colombia. Los pacientes fueron evaluados clasificados según edad, sexo, etiología de la fractura, tipo de lesión, tratamiento y tiempo de hospitalización. Se utilizó la prueba de chi-cuadrado para comparar los conteos de respuestas categóricas entre dos variables independientes. La muestra se conformó por 2.193 hombres y 487 mujeres, con una edad promedio de 26,5 años (DE 13,5). El grupo entre 21-30 años fue el más numeroso. La causa más común de fracturas fue el accidente de tránsito, seguido por la violencia interpersonal. En ambos sexos se observaron, principalmente, fracturas de la mandibula, proceso alveolar maxilar y hueso cigomático; aproximadamente el 92 por ciento de todas las fracturas. En la mandíbula, el sitio principal de fractura fue el cóndilo mandibular. Los resultados revelan que los accidentes de tránsito aun son la principal causa de fractura maxilofacial. Se debe enfatizar en medidas de prevención de los accidentes de tránsito, junto a políticas que fortalezcan la inversión social con el fin de reducir la aparición de estas lesiones.

Positive correlations between presence of Gram negative enteric rods and Porphyromonas gingivalis in subgingival plaque

La asociación entre bacilos entéricos Gram-negativos y Porphyromonas gingivalis en las enfermedades periodontales ha recibido poca atención en la literatura. Así, el objetivo de este estudio fue investigar la asociación entre bacilos entéricos Gram-negativos, Porphyromonas gingivalis y los parámetros clínicos de la periodontitis. Se evaluó la prevalencia de bacilos entéricos Gram-negativos y P. gingivalis en pacientes con periodontitis crónica. Se utilizaron pruebas de Chi-cuadrado y Mann-Whitney para determinar las diferencias en las variables clínicas frente a la presencia o ausencia de ambos microorganismos. Se empleó el coeficiente de correlación de Spearman para determinar las correlaciones de ambos organismos y los datos clínicos obtenidos. Se detectaron bacilos entéricos Gram-negativos y P. gingivalis en 20 (26,3 por ciento) y 51 (67,1 por ciento) sujetos, respectivamente. Un total de 17 (22,4 por ciento) individuos presentó los dos microorganismos estudiados. Se observó una correlación poisitiva significativa entre bacilos entéricos y la presencia de P. gingivalis (r=0,531m O<0,0001). Se encontró una correlación positiva estadísticamente significativa de los dos microorganismos estudiados con la profundidad de sondaje (PS), pérdida de inserción clínica y sangrado al sondaje (P<0,0001). El promedio de la profundidad de sondaje (mm), de los sitios incluidos en la muestra fue significativamente superior en pacientes con presencia de P. gingivalis y bacilos entéricos Gram-negativos. La presente investigación sugiere que la presencia de bacilos entéricos Gram negativos y P. gingivalis se relaciona con condiciones periodontales adversas. Estos resultados podrían tener un impacto en el tratamiento periodontal y se deben tener en cuenta en la terapia mecánica y antimicrobiana de la periodontitis en diferentes poblaciones.

High resistance against clindamycin, metronidazole and amoxicillin in Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans isolates of periodontal disease

Objectives: To test the antimicrobial sensitivity of two periodontal pathogens to a panel of five orally administrable antibiotics in periodontal disease.Study design: A total of 69 isolates of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis were processed using culture and biochemical tests. Selected colonies of A. actinomycetem comitans and P. gingivalis were used to evaluate the antibacterial activity of clindamycin, metronidazole, amoxicillin, moxifloxacinand amoxicillin/clavulanic acid. Results: Susceptibility testing revealed a sensitivity of 100% of A. actinomycetemcomitans and P. gingivalis tomoxifloxacin and amoxicillin/clavulanic acid but moderate susceptibilities were found for the rest of antibioticsagents evaluated. Conclusions: The widespread use of antibiotics is reflected in the level of resistance of A. actinomycetemcomitans andP. gingivalis in patients with periodontal infections. This suggests that antibiotic susceptibility testing is necessary to determine efficacy of antimicrobial agents. Clinical studies with antibiotics should take these differences into account (AU)

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