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.

Radiographic detection and assessment of the periodontal endosseous defects.

AIMS: The aim of the present study was to investigate the potential of conventional radiography in detecting and accurately imaging periodontal endosseous (or osseous) defects when compared to surgical measurements. A further objective of the study was the selection of the most successful radiographic method for the assessment of endosseous defects. METHOD: Surgical measurements, during periodontal flap surgery, and radiographic measurements, from periapical and panoramic radiographs, were obtained from 5,072 proximal surfaces of 100 patients presenting with periodontitis. RESULTS: Statistical evaluation of the surgical and radiographic measurements revealed the following. (1) The ability of the radiographs to detect periodontal osseous defects was relatively low. (2) For periapical radiography, it depended, in descending order, on the depth and buccolingual width of the defect, the number of osseous walls and the jaw location. For panoramic radiography, it depended only on buccolingual width. (3) Osseous defects of small depth and/or small buccolingual width were the most difficult to detect radiographically. (4) Periapical radiography was more successful than panoramic in detecting osseous defects, and more accurate in assessing the defect dimensions (depth, mesiodistal width). (5) The difference in the defect detection ability between the 2 radiographic methods, the accuracy of the radiographic defect dimensions assessment as well as the degree of agreement between periapical and panoramic assessment depended on defect location and dimensions. CONCLUSIONS: Periapical radiography is superior to panoramic in detecting and accurately imaging periodontal osseous destruction.

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.

Radiographic appearance of alveolar osseous defects in relation to their anatomic location.

Radiographs are of limited value in the diagnosis of osseous defects. Anatomic and technical factors affect the radiographic appearance of bone lesions. This study was undertaken in order to determine whether the radiographic appearance of alveolar osseous defects depends on their location, and particularly whether there are any differences in radiographic detection between bone defects located in the maxilla or the mandible, and on the buccal or lingual aspects of the alveolar crest. Experimental bone lesions were created in the alveolar crest of a skull. Standardized periapical radiographs were obtained before and after the defects were made. After processing, pairs of radiographs were randomly mounted. Five dentists acted as observers in order to determine whether or not a change in alveolar bone was detectable at each of the five possible locations. The unpaired t test was applied for the assessment of statistically significant differences with respect to sensitivity, specificity, and positive diagnostic value in the diagnosis of bone lesions depending on their location. The results showed that the anatomic location of a lesion in the alveolar bone affected its radiographic appearance. Moreover, experimental defects were detected more often in the mandible and on the lingual surfaces of the alveolar crest.

Identification of a new endogenous platelet-activating factor-like molecule in gingival crevicular fluid.

Periodontal disease is an inflammatory disease and the major cause of tooth loss in adults. Bacteria and their products are the causative agents of this disease. Endogenous molecules mediate the inflammatory process and play a major role in its amplification and perpetuation as well as in the ensuing tissue destruction. The relationship between platelet-activating factor (PAF) and periodontal disease has not so far been examined thoroughly. We have isolated a phospholipid molecule with PAF-like activity from gingival crevicular fluid. This molecule, purified on HPLC, causes washed platelet aggregation with EC50 value 0.1 microM, based on phosphorus determination. It acts through PAF-receptors and is inactivated by PAF-acetylhydrolase. In addition, this phospholipid presents biological activity towards human platelets. The combination of the results obtained from the chemical and enzymic treatments, the biological assays as well as results from the electrospray analysis, leads to the conclusion that this phospholipid is a hydroxyl-PAF analogue with relative molecular mass 703. This PAF-like molecule may be implicated in periodontal disease.

Selection of the most accurate method of conventional radiography for the assessment of periodontal osseous destruction.

The purpose of the present study was to compare the radiographic measurements of periodontal osseous destruction with the surgical measurements, which represent the true value of osseous destruction, and to select the most successful method of conventional radiography in detecting and accurately assessing periodontal osseous destruction. A total of 5072 proximal surfaces in 2536 teeth of 100 patients with periodontitis were evaluated surgically during periodontal flap surgery and radiographically by using periapical and panoramic radiography. Comparative evaluation of the measurements obtained by these 3 different methods of osseous destruction assessment revealed the following. (1) The radiographic detection ability of small osseous destruction (1-4 mm) was very low for both methods of assessment and became even lower for the initial osseous destruction (1 or 2 mm). (2) Periapical radiography was more successful than panoramic in the detection of osseous destruction, especially of the small destruction (4.7x). (3) Panoramic radiography underestimated the osseous destruction, whereas periapical radiography was relatively accurate in the osseous destruction assessment. (4) Periapical radiography was more accurate in the osseous destruction assessment than panoramic, regardless of the location of the dental surfaces (jaw, tooth group, mesial or distal) and the degree of osseous destruction. (5) The deviation of the radiographic measurements of osseous destruction from the surgical measurements, as well as the difference between the two radiographic methods, depended on the jaw location, the tooth group and the degree of osseous destruction. (6) The radiographic assessment of osseous destruction underestimated the osseous destruction in initial periodontitis, it was relatively accurate in moderate periodontitis, but overestimated it in severe periodontitis. The radiographic measurements of osseous destruction deviated least from the surgical measurements in the group of moderate periodontitis and most in that of severe osseous destruction. (7) The 2 radiographic methods agreed most in the assessment of osseous destruction in the severe periodontitis group and least in the initial periodontitis group. (8) The indirect Schei method was less successful in detecting the small osseous destruction and less accurate in assessing the osseous destruction than the direct millimetric method of radiographic evaluation. (9) The osseous destruction as assessed from periapical radiographs by the Schei method was not significantly different from that assessed by the radiopaque Fixot-Everett grid. The results of the present study suggest that periapical radiography is more successful in detecting periodontal osseous destruction and more accurate in assessing it than panoramic radiography.

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.

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 and microbiological effects of fixed orthodontic appliances.

The purpose of this clinical and microbiological study was to evaluate longitudinally the changes occurring in the subgingival microbiota in children following the placement of orthodontic bands in the absence of a prophylactic oral hygiene program. A total of 12 children in the age between 10 and 15 years were selected for the study. The experimental group (E) consisted of 6 subjects scheduled for orthodontic treatment including the placement of fixed appliances. They were seen 1 week before and just prior to the placement of orthodontic bands. The control group (C) involved 6 children in the maintenance phase of orthodontic therapy in which removable retainers were used. All subjects were examined at 3-5 week intervals for a period of 4 months. At each examination, microbiological subgingival plaque samples were collected by means of sterile paper points. Plaque and gingival index scores as well as pocket probing depth at the site of sampling were determined. The microbiological samples were processed using continuous anaerobic culturing techniques and were plated on non-selective and selective media. Differential counts and biochemical characterization of isolates were performed according to the methods described by Kornman and Loesche. Following tooth-banding, an increase in pocket probing depth was observed, while the P1I and GI scores remained unaffected. A statistically significant increase from baseline values (p less than 0.05) was found for the %s of black-pigmented bacteroides, the B. intermedius and A. odontolyticus species, concomitantly with a decrease of the anaerobe/facultative bacteria ratio in the experimental, but not the control sites.(ABSTRACT TRUNCATED AT 250 WORDS)

[Current concepts of the effect of contraceptives on the oral cavity and especially on the periodontal tissues]. / Eugchrones apopseis gia ten epidrase ton antisyllgeptikon ste stomatike koiloteta kai kyrion stous periodontikous istous.

PIP: The effect of oral contraceptives (OCs) in oral and periodontal status has been reviewed. The way by which OCs influence periodontal tissues is that they alter the inflammatory response of the gingiva to local irritants; i.e. dental plaque. After longterm use of contraceptives, the important clinical symptom seems to be gingival inflammation which ranges from an increase in gingival exudate only, to the appearance of pregnancy-like tumor. It is important to note that as it has been proven from experimental studies, only progesterone and not the estrogens is responsible for vascular changes which had as a result edema, redness, and tenderness. Among the undesirable effects associated with the use of OCs which have been observed, are an increased occurrence of localized osteitis, dry sockets, salivary changes, and alterations of the bony trabecular pattern of the mandible, the clinical significance of which are yet undetermined. (author's)^ieng