Can different stages of leprosy treatment influence the profile of oral health? Oral status in leprosy

BACKGROUND: The aim of study was to evaluate the oral health status, salivary flow and halitosis among individuals diagnosed with leprosy as compared with healthy subjects. MATERIAL AND METHODS: A sample of 160 individuals was allocated into four groups, as follows: (G1) individuals with complete leprosy treatment; (G2) individuals diagnosed with leprosy and under multi-drug therapy; (G3) individuals diagnosed with leprosy not yet under treatment; and (G4) healthy individuals. Then individuals were submitted to periodontal clinical examination (visible plaque index, bleeding index, depth of probing and clinical attachment level); DMFT index (decayed-missing-filled teeth index); evaluation of salivary flow and halitosis using a halimeter equipment (Interscan Corp, Chatsworth, CA, USA). RESULTS: The data were analyzed using Kruskal-Wallis and chi-square tests. The mean DMFT was found to be higher than 6.6, which is considered very high, with no significant difference between groups (P>0.05). As for salivary flow, 76.2% of the subjects presented normal flow rates, while 10% and 13.7% showed low and very low salivary flow rates, respectively, with hyposalivation being mostly observed in Groups 1 and 2. The highest prevalence of noticeable odor was found in healthy individuals (G4), and the most prevalent periodontal diagnosis was gingivitis (63.1%) in Group 3 (individuals with leprosy not yet under multi-drug therapy) followed by periodontitis (25%) in Group 1 (individuals who had completed leprosy treatment). CONCLUSIONS: It was observed that individuals with a history of leprosy present poor oral health similar to that of systemically healthy individuals

Effect of repeated sterilization cycles on the physical properties of scaling instruments: a scanning electron microscopy study.

BACKGROUND: Repeated sterilizations cycles cause undesirable alterations in the material properties of the instruments, such as corrosion, alterations in the hardness of the metal and the loss of the cutting sharpness of the instrument. This research examined the effect of repeated dry heat sterilization and autoclaves cycles on carbon steel (CS) and stainless steel (SS) curettes during the scaling and root planning. MATERIALS AND METHODS: A total of 77 Gracey curettes were used in this study. Of these, 35 were SS and 42 were CS curettes submitted in different process: Dry heat, autoclave, inhibition of corrosion and autoclave, scaling, root planning and dry heat, scaling, root planning, inhibition of corrosion and autoclave. The inhibition of corrosion used on the carbon curettes (prior to sterilization in the autoclave) was sodium nitrite at 2%. The curettes received 10 consecutive cycles of sterilization and after that the cutting edges were examined in the electronic microscope, at 60 and 100 magnification times. RESULTS: The images were evaluated by three independent examiners, who compared the photographs of each group with the control group. CONCLUSION: The surface corrosion products and a deterioration of the edges were observed and the results showed that the SS curettes suffered little alteration with sterilization, scaling, root planning whereas the CS curettes were visibly affected by sterilization in the autoclave, but when the inhibition of corrosion was used prior to the sterilization, the oxidation was considerably reduced.

Clinical, microbial, and immune responses observed in patients with diabetes after treatment for gingivitis: a three-month randomized clinical trial.

BACKGROUND: Although patients with diabetes are frequently affected by periodontitis, only a few investigations have focused on gingivitis in this at-risk population. This randomized placebo-controlled clinical trial compared the response to a gingivitis treatment protocol that combined mechanical procedures and daily use of an essential oil (EO) mouthrinse between patients with and without diabetes. METHODS: The whole-mouth periodontal probing depth (PD), gingival index (GI), and plaque index (PI) were monitored in gingivitis cases among systemically healthy patients (n = 60) or those with diabetes (n = 60) at baseline and 3 months after treatment. Levels of Porphyromonas gingivalis, Tannerella forsythia, Aggregatibacter actinomycetemcomitans, and total bacterial load were determined by a real-time polymerase chain reaction in intrasulci plaque samples. The volume of gingival crevicular fluid (GCF) was quantified, and interleukin-1ß (IL-1ß) levels were determined in GCF samples. After a full-mouth ultrasonic debridement, patients were randomly assigned to an EO or a placebo rinse for 90 days (40 mL/day). The data were analyzed through repeated-measures analysis of variance and multiple comparisons Tukey tests (P <0.05). RESULTS: GI was more severe in the diabetes group. Diabetes impaired GI and reduced GCF volume. PD, bacterial levels, and IL-1ß improved similarly in both systemic conditions. The adjunctive use of EO provided greater reductions of PI, GI, total bacterial load, T. forsythia, A. actinomycetemcomitans, and GCF volume. CONCLUSIONS: Response to gingivitis treatment in patients with diabetes can slightly differ from that in patients without diabetes. Daily use of an EO mouthrinse after ultrasonic debridement benefited patients with and without diabetes.

Salivary and microbiological parameters of chronic periodontitis subjects with and without type 2 diabetes mellitus: a case-control study / Parâmetros salivares e microbiológicos em indivíduos com periodontite crônica com ou sem diabetes melito tipo 2: estudo caso-controle

Background: Several studies have investigated the differences in salivary parameters and microbial composition between diabetic and non-diabetic patients, however, specific differences are still not clear mainly due to the effects of confounder. Aim: The aim of this case-control study was to evaluate the salivary and microbial parameters of chronic periodontitis subjects with and without type 2 diabetes mellitus. Material and method: This case-control study included 60 chronic periodontitis subjects, 30 diabetics (case group) and 30 non-diabetics (control group), paired according to periodontitis severity, gender and age. Stimulated whole saliva was collected from all volunteers to measure the salivary pH and the salivary flow rate. Bacterial samples were collected with paper points from periodontal sites showing the deepest periodontal pocket depth associated with the highest clinical attachment loss. The frequency of A. actinomycetemcomitans, P. intermedia, P. gingivalis, T. forsythia and C. rectus was evaluated by PCR. Data was statistically analyzed by Student's t, Mann-Whitney and Chi-square (p<0.05). Result: Diabetic subjects showed higher salivary glucose levels and lower stimulated flow rates in comparison to non-diabetic controls. P. gingivalis and T. forsythia were the most frequent pathogens (p<0.05). Bacterial frequency did not differ between case and control groups. Conclusion: Diabetes status influenced salivary glucose levels and flow rate. Within the same severity of chronic periodontitis, diabetic subjects did not show higher frequency of periodontal pathogens in comparison to their paired controls. .

Introdução : Diversos estudos têm investigado as diferenças dos parâmetros salivares e microbianos entre pacientes diabéticos e não diabéticos, contudo, diferenças específicas ainda não estão claras, principalmente devido aos efeitos de variáveis de confusão. Objetivo: O objetivo deste estudo caso-controle foi avaliar os parâmetros salivares e microbianos de indivíduos com doença periodontal crônica com ou sem diagnóstico de diabetes melito tipo 2. Material e método: Este estudo caso-controle incluiu 60 indivíduos com periodontite crônica, 30 diabéticos (casos) e 30 não diabéticos (controles), pareados pela severidade da doença periodontal, gênero e idade. Saliva total estimulada foi coletada de todos os voluntários para mensuração do pH salivar e fluxo salivar. Amostras bacterianas foram coletadas com pontas de papel absorvente dos sítios periodontais com maior profundidade de sondagem e perda de inserção clínica. A frequência de A. actinomycetemcomitans, P. intermedia, P. gingivalis, T. forsythia e C. rectus foi avaliada por PCR. Os dados foram analisados estatisticamente pelo teste t de Student, Mann -Whitney e Qui-quadrado (p < 0,05). Resultado: Diabéticos apresentaram maior nível de glicose salivar e menor fluxo salivar em comparação aos não diabéticos. P. gingivalis e T. forsythia foram os patógenos mais frequentes (p < 0,05). Frequência bacteriana não diferiu entre os casos e controles. Conclusão: A condição diabetes influenciou o fluxo e os níveis de glicose salivar. Dentro da mesma severidade da periodontite crônica, indivíduos diabéticos não mostraram maior frequência de patógenos periodontais em comparação aos seus controles. .

Influence of periodontal status and periodontopathogens on levels of oral human ß-defensin-2 in saliva.

BACKGROUND: Expression patterns of human ß-defensin-2 (HBD-2) mRNA or HBD-2 protein concentration and periodontal diseases have been a focus of scientific research. This study compares the salivary levels of HBD-2 protein concentration of healthy patients and patients with gingivitis and chronic periodontitis (CP) and correlates these levels with the presence of periodontopathogens. METHODS: A total of 89 patients were enrolled in this study: 31 periodontally healthy, 27 with gingivitis, and 31 with CP. Plaque and gingival indices, probing depth, and clinical attachment level were measured. The presence of Campylobacter rectus, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Prevotella intermedia was evaluated qualitatively by conventional polymerase chain reaction. HBD-2 quantification in saliva was performed using an immune enzymatic assay. Frequency of periodontopathogens and HBD-2 protein concentration was assessed. Association between HBD-2 protein concentration (≥100 pg/mL) and the simultaneous presence of one to two, three to four, or five to six periodontopathogens was tested. RESULTS: Although periodontally healthy individuals and patients with gingivitis showed similar HBD-2 levels, the CP group displayed an increased level of HBD-2. P. gingivalis, P. intermedia, T. forsythia, and T. denticola were more prevalent in CP; however, their mere presence was not related to the increased levels of HBD-2 (Pearson correlation and multinomial logistic regression model). CONCLUSIONS: Salivary HBD-2 protein concentration was higher in patients with CP compared with healthy individuals or patients with gingivitis. These different protein concentrations were not related to the frequency of periodontopathogens. Clinical inflammatory profile had a higher impact on salivary HBD-2 levels than bacteria.

Avaliação dos hábitos de higiene bucal de pacientes diabéticos / Evaluation of oral hygiene habits of diabetic patients

Pacientes portadores de diabetes desenvolvem diversas complicações, dentre elas alterações bucais como a doença periodontal. A descompensação glicêmica pode agravar o curso de evolução de tais alterações e interferir no plano odontológico. Sendo assim, o objetivo deste trabalho foi avaliar os hábitos de higiene bucal de pacientes diabéticos. Foram aplicados questionários a 25 pacientes diabéticos, sendo 16 (64,0%) do gênero feminino e 9 (16,0%) do gênero masculino. Os resultados demonstraram que 18 pacientes (72,0%) do grupo estudado receberam orientações sobre higiene bucal, no entanto, o retorno semestral ao dentista é realizado por apenas 7 pacientes (28,0%); a maior porcentagem do grupo estudado realiza 3 escavações diárias (48,0%), porém a técnica de escovação mais utilizada é o movimento de vaivém (40,0%) e o uso de fio dental é realizado por 44,0% destes pacientes. A última raspagem periodontal foi realizada nos últimos 6 meses por apenas 6 pacientes (24,0%) e do total da amostra 4 ( 16,0%) nunca realizaram este tipo de tratamento. As alterações de cavidade bucal mais citadas foram xerostomia (64,0%), mau hálito (60,0%), sangramento gengival (40,0%), hálito cetônico (36,0%) e dentes moles (32,0%). Além disso, 16 (64,0%) pacientes referiram utilizar algum tipo de prótese. Diante do exposto sugere-se que pontos importantes relacionados aos cuidados odontológicos como frequência de retorno ao dentista, técnica de escovação correta e frequência de raspagem encontram-se aquém do esperado. Uma vez comprovada à relação entre doença periodontal e diabetes, é de extrema importância que o cirurgião-dentista tenha conhecimento sobre as alterações bucais e sistêmicas deste paciente, e que o paciente diabético busque o atendimento e se conscientize da gravidade destes problemas relacionados à saúde bucal

Patients with diabetes develop several complications, among them oral diseases such the periodontal disease. The glycemic decompensation may aggravate the course of evolution of such changes, interfering with the dental plan. Therefore, the objective of this study was to evaluate the oral hygiene habits of diabetic patients. Questionnaires were administered to 25 diabetic patients, 16 (64%) were female and 9 ( 16%) were male. The results showed that 18 patients (72%) of the study group received guidance for oral hygiene, however, return semiannual to the dentist is carried out by only seven patients (28%) a higher percentage of the study group performs three daily brushings (48%), but the brushing technique most used is the movement of back and forth (40%) and flossing is done by 44% of these patients. The last periodontal scaling was performed in the last six months for only 6 patients (24%) and 4 of the total sample ( 16%) have never done this type of treatment. Changes in the oral cavity most frequently mentioned were dry mouth (64%), halitosis (60 .0%), gingival bleeding (40%), ketone breath (36%) and soft teeth (32%), In addition, 16 (64%) patients reported using some type of prosthesis. Therefore it is suggested that important issues related to dental care and often return to the dentist correct brushing technique and frequency of scaling are less than expected. Once proven the relationship between periodontal disease and diabetes, it is extremely important to the dentist to be aware of oral and systemic changes in this patient and to the diabetic patient to seek care and become aware of the seriousness of these problems related to dental health.

Presença de Aggregatibacter actinomycetemcomitans em associação a Porphyromonas gingivalis e Prevotella intermedia em pacientes periodontais / Presence of Aggregatibacter actinomycetemcomitans in association with Porphyromonas gingivalis and Prevotella intermedia in periodontal patients

Introdução: O conhecimento das inter-relações bacterianas e sua associação com a condição clínica periodontal podem auxiliar o manejo terapêutico. Objetivos: Avaliar a distribuição de Aggregatibacter actinomycetemcomitans em relação a duas espécies bacterianas membros dos complexos Vermelho e Laranja, e analisar a relação entre a combinação de cepas leucotóxicas de A.actinomycetemcomitans, Porphyromonas gingivalis e Prevotella intermedia com a manifestação clínica da doença. Material e método: Incluíram-se 50 indivíduos (38,38 ± 10,15 anos), de ambos os gêneros, com periodontite crônica (n = 25) ou agressiva (n = 25). De cada indivíduo, amostras subgengivais foram coletadas de quatro dentes em quadrantes diferentes, com profundidade de sondagem (PS) maior ou igual a 6 mm e nível clínico de inserção (NCI) maior ou igual a 4 mm. Os parâmetros avaliados foram: clínicos - PS, NCI, Índice de Placa (IP-0/1) e Índice Gengival (IG-0/1) - e microbiológicos, com detecção de A. actinomycetemcomitans (cepas de máxima e mínima leucotoxicidades), P. gingivalis e P. intermedia por reação em cadeia da polimerase. Os dados foram estatisticamente analisados usando-se testes t-Student e Qui-quadrado (p <0,05). Resultado: Apresentaram P. gingivalis 90% dos indivíduos, P. intermedia, 82%, e A. actinomycetemcomitans, 28%. A. actinomycetemcomitans foi mais frequente em indivíduos jovens ou com periodontite agressiva. Apenas IG apresentou maiores frequências médias (p = 0,019) quando da presença simultânea de cepas A. actinomycetemcomitans de máxima leucotoxicidade, P. gingivalis e P. intermedia. Conclusão: Indivíduos com periodontite agressiva exibiram maiores frequências de A. actinomycetemcomitans. A presença de P. gingivalis e/ou P. intermedia não potencializou a patogenicidade das cepas de A. actinomycetemcomitans de máxima leucotoxicidade, pois tal combinação foi somente acompanhada de maior inflamação.

Introduction: Knowledge of bacterial interrelationships and its association with clinical periodontal condition may help the therapeutic management. Objective: To evaluate the distribution of Aggregatibacter actinomycetemcomitans in relation to 2 bacterial species members of Red and Orange Complexes; also to exam the relationship between the combined presence of A. actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia with clinical pattern of disease. Material and method: 50 (mean age 38.38 ± 10.15) subjects both gender were enrolled in the study, with chronic (n = 25) or aggressive (n = 25) periodontitis. For each subject subgingival samples were collected from 4 teeth in different quadrants showing probing depth (PD) is greater than or equal to 6 mm and clinical attachment level (CAL) is greater than or equal to 4 mm. The parameters evaluated were: clinical - PD, CAL, Plaque Index (PI-0/1) and Gingival Index (GI-0/1); microbiological - detection of A. actinomycetemcomitans (highly and minimally leukotoxic strains), P. gingivalis and P. intermedia by polymerase chain reaction. Data were statistically analyzed using Student t and Chi-square tests (p <0.05). Result: 90% of the subjects harbored P. gingivalis, 82% P. intermedia and 28% A. actinomycetemcomitans. A. actinomycetemcomitans was most frequent in young or aggressive periodontitis subjects. Only GI showed higher mean frequency (p = 0.019) in the combined presence of highly leukotoxic A. actinomycetemcomitans strains,P. gingivalis and P. intermedia. Conclusion: Subjects with aggressive periodontitis exhibited higher frequency of A. actinomycetemcomitans. The presence of P. gingivalis and/or P. intermedia did not improve the pathogenicity of highly leukotoxic A. actinomycetemcomitans strains due to the fact that this combination was only followed by increased inflammation.

Hipersensibilidade dentinária: revisão da literatura / Dentine hypersensitivity: literature review

Este estudo teve como proposta, baseado numa revisão literária, discutir aspectos importantes sobre hipersensibilidade dentinária cervical, sua etiologia multifatorial, teorias de mecanismo de dor, diagnóstico diferencial, bem como a variedade de tratamentos disponíveis para alívio da dor. A hipersensibilidade dentinária é uma resposta exacerbada a um estímulo sensorial, que normalmente em um dente sadio não causaria dor. É uma patologia que afeta indivíduos de ambos os sexos em grande parte da população, e vários grupos dentais, causando desconforto bucal e gerando inconvenientes na vida do indivíduo. Sua etiologia é multifatorial e existem várias teorias que procuram explicar o mecanismo da dor, sendo atualmente a mais aceita a teoria hidrodinâmica. Para que se possam eleger medidas terapêuticas adequadas é necessário um diagnóstico diferencial com outros tipos de lesões que podem causar respostas dolorosas semelhantes.

The present study has as its proposal, based on a review of literature, to discuss important aspects of cervical dentinehypersensitivity, its multi-factorial etiology, theories about the mechanism of pain, differential diagnosis, as well as the variety of available treatments for pain relief. Dentine hypersensitivity is an exacerbated response to a sensorial stimulus that would not be cause for pain on a healthy tooth. It is a pathology affecting both sexes in a great amount of the population,and in several tooth groups, causing mouth discomfort and generating inconveniences to one´s living. Its etiology is a multi-factorial one, and there are a number of theories that try to explain the pain mechanism, the best accepted one being the hydrodynamics theory, nowadays. In order to electadequate therapeutic measures, a differential diagnosis is needed, from other types of lesions that can cause similar pain responses.

Avaliação clínica e radiográfica de indivíduos diagnosticados com periodontite crônica e tratados com minociclina subgengival / Clinical and radiographic evaluation in chronic periodontitis subjects treated with subgingival minocycline

Objetivo deste estudo longitudinal foi avaliar, por meio de mensurações de profundidade de sondagem (PS) e medidas lineares em radiografias digitalizadas, os resultados dos procedimentos de raspagem e aplainamento radicular (RAR) associados à minociclina subgengival. Participaram deste estudo 29 indivíduos de 26 a 69 anos de idade (47,0 ± 9,71) diagnosticados com periodontite crônica. Foram selecionados 58 dentes/sítios contra-laterais com bolsas ≥ 6 mm de profundidade, os quais aleatoriamente receberam RAR + minociclina subgengival (teste) ou RAR + placebo (controle). Previamente e 6 meses após a realização da terapia periodontal, PS e radiografias periapicais com posicionadores, foram realizadas, digitalizadas e analisadas por medidas lineares entre pontos: a) junção cemento esmalte à crista óssea, b) junção cemento-esmalte ao fundo do defeito e c) (crista óssea ao fundo do defeito). Análise estatística foi realizada pelo Teste t pareado e não pareado no momento inicial, aos 3 e 6 meses, para os grupos teste e controle. Com relação a PS observou-se redução significativa (p<0,05) comparando-se pré e pós-terapia nos grupos teste e controle, todavia, entre os grupos não foi observada diferença estatística (p>0,05). Comportamento semelhante foi observado na análise radiográfica. Concluiu-se que procedimentos exclusivos de RAR foram tão efetivos quanto RAR + minociclina subgengival

The aim of this longitudinal study was to evaluate, through probing depth (PD) and digitized radiographic parameters, the results of scaling and root planning (SRP) associated with subgingival minocycline. Twenty- nine subjectsaged 26 to 69 (47,00 ± 9,71) years old were enrolled in this study, diagnosed with chronic periodontitis. There were selected 58 tooth/sites, homologous with PD > 6mm, which randomly received SRP plus subgingival minocycline (test) or SRP plus placebo (control). At baseline and at 6 months after the periodontal therapy, PD and periapicals radiographs were evaluated. The images were digitized and analyzed by linear measurements between points: a) junction cemento-enamelto the bony crest, b) junction cemento-enamel to the bottom of the defect and c) bony crest to the bottom of the defect). Statistical analysis was performed by paired and non-pairedT test (p < 0.05). Regarding the PD, significant reductions were observed (p<0.05) from baseline to six months in the test and control groups. However, in each time-point there was no difference between test and control groups (p>0.05). Similar findings were observed with the radiographic analysis. It was concluded that exclusive procedures of SRP were so effective as SRP plus subgingival minocycline.

Occurrence of Aggregatibacter actinomycetemcomitans in Brazilian Indians from Umutina Reservation, Mato Grosso, Brazil.

UNLABELLED: Aggregatibacter actinomycetemcomitans is associated with periodontal disease, especially localized aggressive periodontitis, produces a potent leukotoxin and its distribution is influenced by ethnic characteristics of the population. OBJECTIVE: Using culture and polymerase chain reaction (PCR) techniques, this study evaluated the occurrence of this microorganism and the distribution of leukotoxic strains isolated from Indians belonging to the Umutima Reservation, Mato Grosso, Brazil. MATERIAL AND METHODS: Forty-eight native Brazilians with gingivitis and 38 with chronic periodontitis, belonging to Umutina, Paresi, Bororo, Bakairi, Kayabi, Irantxe, Nambikwara and Terena ethnicities, were studied. Subgingival, supragingival and saliva samples of each patient were collected and transferred to VMGA III medium and to ultra pure Milli Q water. Bacteria were grown on TSBV agar and incubated in anaerobiosis (90% N2 + 10% CO2) at 37 degrees C for 72 h. The presence of the ltx promoter was determined by PCR, and a 530 bp deletion in the promoter was evaluated by using specific primers. RESULTS: A. actinomycetemcomitans was isolated from 8.33% of saliva, supragingival and subgingival samples from patients with gingivitis and from 18.42% of saliva and supragingival biofilm, and 26.32% subgingival biofilm from patients with chronic periodontitis. By PCR, the bacterial DNA was detected in 8.33% of saliva, supragingival and subgingival biofilms from patients with gingivitis and from 23.68% of saliva, 28.95% supragingival biofilm and 34.21% subgingival biofilm from patients with periodontitis. All strains were grouped as non-JP2 clones based on the absence of deletion in the leukotoxin promoter. Differences among the microbial and clinical parameters in patients were analyzed by using the Mann-Whitney, Chi-square or Fisher's exact tests. CONCLUSIONS: The present results suggest that A. actinomycetemcomitans can be related to the attachment loss in this population, but the presence of minimally leukotoxic strains, as well as its role in the pathogenesis of the periodontitis in these native Brazilians need to be further investigated.

Occurrence of Aggregatibacter actinomycetemcomitans in Brazilian indians from Umutina Reservation, Mato Grosso, Brazil

Aggregatibacter actinomycetemcomitans is associated with periodontal disease, especially localized aggressive periodontitis, produces a potent leukotoxin and its distribution is influenced by ethnic characteristics of the population. Objective: Using culture and polymerase chain reaction (PCR) techniques, this study evaluated the occurrence of this microorganism and the distribution of leukotoxic strains isolated from Indians belonging to the Umutima Reservation, Mato Grosso, Brazil. MATERIAL AND METHODS: Forty-eight native Brazilians with gingivitis and 38 with chronic periodontitis, belonging to Umutina, Paresi, Bororo, Bakairi, Kayabi, Irantxe, Nambikwara and Terena ethnicities, were studied. Subgingival, supragingival and saliva samples of each patient were collected and transferred to VMGA III medium and to ultra pure Milli Q water. Bacteria were grown on TSBV agar and incubated in anaerobiosis (90 percent N2 + 10 percent CO2) at 37ºC for 72 h. The presence of the ltx promoter was determined by PCR, and a 530 bp deletion in the promoter was evaluated by using specific primers. RESULTS: A. actinomycetemcomitans was isolated from 8.33 percent of saliva, supragingival and subgingival samples from patients with gingivitis and from 18.42 percent of saliva and supragingival biofilm, and 26.32 percent subgingival biofilm from patients with chronic periodontitis. By PCR, the bacterial DNA was detected in 8.33 percent of saliva, supragingival and subgingival biofilms from patients with gingivitis and from 23.68 percent of saliva, 28.95 percent supragingival biofilm and 34.21 percent subgingival biofilm from patients with periodontitis. All strains were grouped as non-JP2 clones based on the absence of deletion in the leukotoxin promoter. Differences among the microbial and clinical parameters in patients were analyzed by using the Mann-Whitney, Chi-square or Fisher's exact tests. CONCLUSIONS: The present results suggest that A. actinomycetemcomitans ...