Association of rs142548867 (EEFSEC) and periodontitis Grade C in a young Brazilian population.

BACKGROUND: Periodontitis Stage III-IV, Grade C (PerioC) is a severe form of Periodontitis. The individual genetic background has been shown to be an important etiopathogenic factor for the development of this disease in young, systemically healthy, and non-smokers patients. Recently, after exome sequencing of families with a history of the disease, PerioC was associated with three single nucleotide variations (SNVs) - rs142548867 (EEFSEC), rs574301770 (ZNF136), and rs72821893 (KRT25) - which were classified as deleterious or possibly harmful by prediction algorithms. OBJECTIVE: Seeking to validate these findings in a cohort evaluation, this study aims to characterize the allele and genotypic frequency of the SNVs rs142548867, rs574301770, and rs72821893 in the Brazilian population with PerioC and who were periodontally healthy (PH). METHODOLOGY: Thus, epithelial oral cells from 200 PerioC and 196 PH patients were harvested at three distinct centers at the Brazilian Southern region, their DNA were extracted, and the SNVs rs142548867, rs574301770, rs72821893 were genotyped using 5'-nuclease allelic discrimination assay. Differences in allele and genotype frequencies were analyzed using Fisher's Exact Test. Only the SNV rs142548867 (C > T) was associated with PerioC. RESULTS: The CT genotype was detected more frequently in patients with PerioC when compared with PH subjects (6% and 0.5% respectively), being significantly associated with PerioC (odds ratio 11.76, p=0.02). CONCLUSION: rs142548867 represents a potential risk for the occurrence of this disease in the Brazilian population.

Association of rs142548867 (EEFSEC) and periodontitis Grade C in a young Brazilian population

Abstract Periodontitis Stage III-IV, Grade C (PerioC) is a severe form of Periodontitis. The individual genetic background has been shown to be an important etiopathogenic factor for the development of this disease in young, systemically healthy, and non-smokers patients. Recently, after exome sequencing of families with a history of the disease, PerioC was associated with three single nucleotide variations (SNVs) - rs142548867 (EEFSEC), rs574301770 (ZNF136), and rs72821893 (KRT25) - which were classified as deleterious or possibly harmful by prediction algorithms. Objective Seeking to validate these findings in a cohort evaluation, this study aims to characterize the allele and genotypic frequency of the SNVs rs142548867, rs574301770, and rs72821893 in the Brazilian population with PerioC and who were periodontally healthy (PH). Methodology Thus, epithelial oral cells from 200 PerioC and 196 PH patients were harvested at three distinct centers at the Brazilian Southern region, their DNA were extracted, and the SNVs rs142548867, rs574301770, rs72821893 were genotyped using 5′-nuclease allelic discrimination assay. Differences in allele and genotype frequencies were analyzed using Fisher's Exact Test. Only the SNV rs142548867 (C > T) was associated with PerioC. Results The CT genotype was detected more frequently in patients with PerioC when compared with PH subjects (6% and 0.5% respectively), being significantly associated with PerioC (odds ratio 11.76, p=0.02). Conclusion rs142548867 represents a potential risk for the occurrence of this disease in the Brazilian population.

Influence of rs6667202 SNP on Interleukin-10 levels in the gingival fluid of patients with periodontitis grade C

Grade C periodontitis in youngers is characterized by a severe form of periodontitis, and IL10 rs6667202 single nucleotide polymorphism (SNP) has been described as an important feature in this disease etiology. Aim: This study aimed to evaluate, in vivo, the functionality of IL10 rs6667202 SNP on IL-10 gingival fluid levels. Methods: Thirty patients with Perio4C were selected, 15 with the IL10 AA genotype (rs6667202) and 15 with AC/CC genotypes. The gingival fluid was collected from two sites with probing depth ≥ 7 mm and bleeding on probing, and two healthy sites. The IL-10 concentration was determined by Luminex/MAGpix platform. Results: In deep pockets, the IL10 AA genotype presented a lower concentration of IL-10 when compared with AC or CC genotypes (p<0.05). In shallow pockets, no difference between groups was seen (p>0.05). Conclusion: IL10 rs6667202 SNP decreases the production of IL-10 in crevicular fluid, potentially affecting this disease progression

Novel rare frameshift variation in aggressive periodontitis: Exomic and familial-screening analysis.

BACKGROUND: Aggressive periodontitis (AgP), currently periodontitis grade C, presents early onset, rapid progression, and a poorly established genetic association. Thus, this study aimed to identify genetic variants associated with AgP via whole exome sequencing (WES) through a familial screening approach. METHODS: WES was performed in two nuclear families, including a proband and a parent affected by AgP and an unaffected parent and sibling. Common variants among affected individuals, excluding those common to healthy people, from each family, composed the data set associated with AgP. In silico analysis evaluated the impact of each variant on protein structure and protein-protein interactions. Moreover, identified deleterious variants were validated in a populational analysis (n = 96). RESULTS: The missense single nucleotide variations (SNVs) rs142548867 in EEFSEC (c.668C>T), rs574301770 in ZNF136 (c.466C>G), and rs72821893 in KRT25 (c.800G>A) and the frameshift indels rs37146475 in GPRC6A (c.2323-2324insT) and c.1366_1372insGGAGCAG in ELN were identified in AgP and have a predicted functional impact on proteins. In silico analysis indicated that the indel in GPRC6A generates a loss of the C-terminal tail of the Gprca protein. Furthermore, this SNV was significantly associated with AgP in a population-based investigation. CONCLUSION: Novel frameshift variation in GPRC6A (c.2323-2324insT) was identified as a potential genetic alteration associated with AgP occurrence.

Local IL-10 level as a predictive factor in generalized aggressive periodontitis treatment response.

Generalized aggressive periodontitis (GAgP) presents a reduced response to non-surgical therapy. However, it is not clear if the initial clinical, microbiological or immunological characteristics are impacting the worse response to treatment. This study aimed to identify the predictive value of clinical, microbiological and immunological patterns on the clinical response to therapy in GAgP patients. Twenty-four GAgP patients were selected, and gingival crevicular fluid (GCF) and subgingival biofilm were collected. Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Tannerella forsythia levels were evaluated by qPCR, and IL-1ß and IL-10 concentration by ELISA. Twelve patients were treated with SRP (scaling and root planning), and twelve with SRP plus 375 mg amoxicillin and 250 mg metronidazole (8/8 hours, 7 days) (SRP + AM). The clinical changes (Probing Pocket Depth [PPD] reduction and Clinical Attachment Level [CAL] gain) 6 months post-treatment were correlated to the initial clinical, inflammatory and microbiological variables using stepwise logistic regression (α = 5%). CAL gain at 6 months was 1.16 ± 0.77 for SRP and 1.74 ± 0.57 mm for SRP + AM (P > .05). PPD reduction was 1.96 ± 0.82 for SRP and 2.45 ± 0.77 mm for SRP + AM (P < .05). In the SRP group, IL-10 showed a predictive value for clinical response. The higher the IL-10 concentration at baseline, the higher the reduction in PPD at 6 months (P = .01, r = .68). However, when antimicrobials were administered, no significant influence was detected (P > .05). It can be concluded that the IL-10 levels in GFC act as a predictor of clinical response to GAgP. Moreover, the intake of antimicrobials appears to overlap the influence of the inflammatory response on clinical response to treatment. Clinical trial registration number: NCT03933501.

Validation of reported GLT6D1 (rs1537415), IL10 (rs6667202), and ANRIL (rs1333048) single nucleotide polymorphisms for aggressive periodontitis in a Brazilian population.

BACKGROUND: Aggressive periodontitis (AgP) is influenced by genetic factors. Recently, the single nucleotide polymorphisms (SNPs) rs1537415 (GLT6D1), rs6667202 (IL10), and rs1333048 (ANRIL) were associated with AgP in different European populations. However, these specific SNPs have not yet been determined in Brazilians. Therefore, this study investigated whether these SNPs previously associated with AgP could be replicated among Brazilians. METHODS: The SNPs rs1537415, rs6667202, and rs1333048 were genotyped using 5'-nuclease allelic discrimination assay in AgP (n = 200), chronic periodontitis (CP, n = 190), and healthy patients (H, n = 196). Differences in allele and genotype frequencies were analyzed using chi-square tests and stepwise logistic regression. RESULTS: The minor C allele of rs6667202 was less frequently detected in AgP patients (23.5%) when compared to non-AgP groups (H = 34.2% and CP = 30.3%; p < 0.01), making the SNP protective against AgP occurrence. Moreover, the final logistic model for AgP diagnosis included gender (p = 0.001) and the SNP rs6667202 (p < 0.001) as significant variables. The SNPs rs1537415 and rs1333048 did not show associations with AgP. CONCLUSION: Only the SNP rs6667202 was associated with AgP in a Brazilian population, being the minor C allele protective against AgP. Moreover, SNPs rs1333048 and rs1537415, previously associated with AgP in other population, was not validated to Brazilian population.

Evaluation of peri-implant marginal tissues around tissue-level and bone-level implants in patients with a history of chronic periodontitis.

OBJECTIVE: To evaluate clinical and radiographic characteristics in peri-implant marginal tissues in patients with a history of chronic periodontitis, rehabilitated using tissue-level or bone-level implants. MATERIAL AND METHODS: Using a split-mouth design, 20 patients with a history of chronic periodontitis were selected and received two different implants, tissue-level group (n = 20) and the bone-level group (n = 20). Peri-implant probing depth, relative peri-implant mucosal margin position, relative peri-implant clinical attachment level, peri-implant plaque index and peri-implant bleeding on probing were evaluated at prosthesis installation, 1, 3, 6, 12 and 24 months after implant loading. Radiographic marginal bone level was evaluated at implant insertion, prosthesis installation, 6 and 24 months after implant loading. RESULTS: The mean difference of peri-implant marginal bone resorption from implant installation to 24 months in function was 0.75 ± 1.12 mm for the tissue-level group and 0.70 ± 0.72 mm for the bone-level group. No statistically significant difference was found between groups at all assessment periods for clinical and radiographic peri-implant evaluation. CONCLUSION: Under a rigid supportive therapy, both approaches performed likewise regarding clinical and radiographic parameters for rehabilitation of patients with a history of chronic periodontitis.

Transcriptome of healthy gingival tissue from edentulous sites in patients with a history of generalized aggressive periodontitis.

BACKGROUND: This study evaluates the transcriptome of healthy gingival tissue from edentulous sites in patients with a history of generalized aggressive periodontitis (GAgP), chronic periodontitis (CP), and in patients with no history of periodontitis (H), using microarray and quantitative reverse transcription polymerase chain reaction (qRT-PCR) analysis. METHODS: Healthy gingival tissue from edentulous sites was taken from patients from the GAgP (n = 12), CP (n = 12), and H (n = 12) groups. Initially, total RNA from four tissue samples per group was used in transcriptomic microarray analysis. Differential gene expression (fold-change), gene ontology (GO; biologic process), and pathway analyses were performed. Genes that were differentially expressed and showing a significant role on altered pathways were validated by qRT-PCR analysis on 12 samples per group. RESULTS: In total, 270 probe sets and 50 GO groups were differentially expressed (upregulated or downregulated) between GAgP and H. Natural killer cell receptors and other genes related to the immune system were upregulated in GAgP, whereas genes with functions in neural processes and in proliferation/differentiation of keratinocytes were underexpressed. There were 220 probe sets and 75 GO groups that were differentially expressed when comparing CP and GAgP. CP was characterized by increased expression of genes related to responses to external stimuli and an underexpression of immune system-related genes. qRT-PCR analysis confirmed microarray results, that killer cell immunoglobulin (Ig)-like receptor, two Ig domains and long cytoplasmic tail 4; interleukin-6; and selectin E were more highly expressed in patients from the GAgP group compared with the CP and H groups. CONCLUSION: This study demonstrates differences in the transcriptome of healthy gingival tissue from edentulous sites in patients with GAgP compared with patients from H or CP groups.

Clarithromycin as an Adjunct to One-Stage Full-Mouth Ultrasonic Periodontal Debridement in Generalized Aggressive Periodontitis: A Randomized Controlled Clinical Trial.

BACKGROUND: The aim of the present study is to evaluate the periodontal clinical and microbiologic responses and possible adverse effects of clarithromycin (CLM) combined with periodontal mechanical therapy in the treatment of patients with generalized aggressive periodontitis. METHODS: Forty patients were selected and randomly assigned into one of two groups: 1) CLM (n = 20): one-stage full-mouth ultrasonic debridement (FMUD) associated with CLM (500 mg, every 12 hours for 3 days); and 2) placebo (n = 20): FMUD associated with placebo pills. Clinical and microbiologic parameters were evaluated at baseline and 3 and 6 months postoperatively. RESULTS: Both treatments presented statistically significant clinical and microbiologic improvements. However, the CLM group presented lower means of probing depth for pockets ≥7 mm at 6 months (4.0 ± 1.7 mm) compared with the placebo group (4.7 ± 1.3 mm) (P = 0.04). In addition, the CLM group also presented greater reduction of Porphyromonas gingivalis (Pg) DNA counts at 6 months (P = 0.0001). CONCLUSION: Results from this study suggest both treatments are effective; however, adjunct use of CLM to FMUD leads to better reduction of deep pockets and Pg at 6 months compared with FMUD alone.

Effect of Resveratrol on periodontal pathogens during experimental periodontitis in rats.

The objective of this study was to investigate the antibacterial effect of resveratrol against putative periodontal pathogens during the progression of experimental periodontitis in rats. Periodontitis was induced in rats in one of the first molars chosen to receive a ligature. Animals were assigned to one of two groups: daily administration of the placebo solution (control group, n = 12) or 10 mg/Kg of resveratrol (RESV group, n = 12). The therapies were administered systemically for 30 days, for 19 days before periodontitis induction and then for another 11 days. Then, the presence and concentrations of Porphyromonas gingivalis, Tannerella forsythia and Aggregatibacter actinomycetemcomitans in the cotton ligatures collected from the first molars were evaluated using real-time PCR. Inter-group comparisons of the microbiological outcomes revealed that no differences were detected for P. gingivalis, T. forsythia and A. actinomycetemcomitans levels (p > 0.05). Continuous use of resveratrol did not promote additional benefits in microbiological outcomes during experimental periodontitis in rats.

Transmissão intrafamiliar de patógenos periodontais / Intrafamilial transmission of periodontal pathogens: a literature review

Objetivo: revisar quais seriam os diferentes fatores envolvidos na transmissão de periodontopatógenos entre membros de uma mesma família e quais as suas consequências. Material e métodos: uma revisão da literatura foi realizada na base de dados PubMed, utilizando os termos "vertical transmission", "periodontal pathogens", "oral colonization", e "periodontitis". Resultados: após a leitura do título e resumo, 30 artigos foram incluídos nesta revisão. A transmissão de patógenos periodontais entre indivíduos de uma mesma família está relacionada à passagem via salivar e ao compartilhamento alimentar e de higiene, aos cuidados dos filhos pelos pais ou cuidadores, e ao contato íntimo entre cônjuges. Estudos que avaliaram a transmissão do Aggregatibacter actinomycetemcomitans entre indivíduos de uma mesma família mostraram a ocorrência da transmissão vertical, embora também ocorra transmissão horizontal. Entretanto, resultados semelhantes não puderam ser observados para o Porphyromonas gingivalis. Enquanto alguns relatos indicam a ocorrência de transmissão horizontal desta bactéria, diversos outros estudos indicam características bacterianas que reduzem sua ocorrência. Conclusão: a colonização oral por microrganismos patogênicos está relacionada à transmissão vertical e horizontal de patógenos, embora a persistência dos microrganismos pareça estar relacionada a fatores individuais do hospedeiro e características dos patógenos. Além disso, atividades preventivas e terapêuticas devem ser realizadas de forma a alterar o processo de transmissão, colonização e o maior risco do desenvolvimento de problemas periodontais.

Objective: to review the different factors involved in the transmission of periodontopathogens between members of the same family and their consequences. Material and methods: an electronic literature review was conducted at the PubMed using the keywords "vertical transmission", "periodontal pathogens", "oral colonization", and "periodontitis". Results: after reading of title and abstract, 30 articles were included. The transmission of periodontal pathogens among individuals of the same family is related to the passage through salivary and food and hygiene sharing, the care of the children by parents or caregivers, and the intimate contact between individuals. Studies evaluating the transmission of Aggregatibacter actinomycetemcomitans among individuals from the same family showed the occurrence of vertical transmission and horizontal transmission. However, similar results could not be observed for Porphyromonas gingivalis. While some reports indicate the occurrence of horizontal transmission, several other studies indicate bacterial characteristics that reduce its occurrence. Conclusion: oral colonization by pathogenic microorganisms is related to its vertical and horizontal transmission, although the persistence of the microorganisms seems to be related to individual host factors and pathogen characteristics. In addition, preventive and therapeutic activities must be performed in a way that will alter the transmission, colonization and the greater risk of developing periodontal problems.

Regeneração óssea guiada no tratamento de peri-implantite: dois anos de acompanhamento clínico / Guided bone regeneration in the treatment of peri-implantitis: 2 years of clinical follow-up

A peri-implantite é caracterizada pelo processo inflamatório ao redor de um implante, que inclui inflamação do tecido mole e perda progressiva de suporte ósseo. O foco do seu tratamento está no controle da infecção bacteriana, através da eliminação do biofilme da superfície do implante e, quando possível, na regeneração do osso perdido. Contudo, atualmente não existe evidência suficiente na literatura para indicar qual abordagem terapêutica é superior no tratamento da peri-implantite a longo prazo. Dessa forma, o objetivo do presente relato de caso clínico foi reportar os resultados a longo prazo do tratamento de um caso de peri-implantite, com a combinação de acesso cirúrgico para descontaminação da superfície do implante, uso adjunto de solução de tetraciclina (50 mg/ml) e procedimento de regeneração óssea guiada, utilizando enxerto xenógeno e membrana reabsorvível de colágeno. Aos dois anos de acompanhamento pós-operatório, observou-se uma melhora clínica significativa, com redução da profundidade de sondagem, ganho de inserção clínica e preenchimento ósseo radiográfico do defeito peri-implantar. Pôde-se observar que o acesso cirúrgico associado à regeneração óssea guiada é uma alternativa viável para o tratamento de lesões de peri-implantite.

Peri-implantitis is an inflammatory process around an implant, which includes soft tissue inflammation and progressive bone loss. Treatment aims to control the bacterial infection through elimination of the established biofilm from the implant surface, and if possible, the regeneration of the lost bone. However, currently there is not sufficient evidence in the literature supporting which therapeutic approach is most suitable for the treatment of peri-implantits at long-term follow-up. Thus, the aim of this case demonstrate was to report the results of a peri-implantitis treatment at long-term follow-up, with the combination of surgical access for decontamination of the implant surface, with adjunctive use of tetracycline solution (50 mg/ml) and guided bone regeneration procedure using xenogeneic graft and resorbable collagen membrane. A significant clinical improvement was observed at 2 years of follow-up, with reduced probing depth, clinical attachment gain and radiographic bone fill in the peri-implant defect. It can be concluded that the surgical access associated with guided bone regeneration is a viable option for the treatment of peri-implant lesions

Amoxicillin/metronidazole associated with nonsurgical therapy did not promote additional benefits in immunologic parameters in generalized aggressive periodontitis: A randomized controlled clinical trial.

OBJECTIVE: This randomized, blinded, placebo-controlled clinical trial compared the levels of interferon γ (IFN-γ), prostaglandin E2 (PGE2), and interleukin 6 (IL-6) in the gingival crevicular fluid (GCF) from generalized aggressive periodontitis (GAgP) patients treated with nonsurgical therapy associated or not with amoxicillin/metronidazole adjunctive. METHOD AND MATERIALS: Thirty-nine GAgP patients were followed during 6 months. The patients were randomly allocated to one of the groups: experimental (scaling and root planing plus 375 mg amoxicillin and 250 mg metronidazole for 7 days) and control (scaling and root planing + placebo). Probing pocket depth (PPD), relative clinical attachment level (rCAL), gingival margin position (GMP), and IL-6, IFN-γ, and PGE2 levels in GCF were evaluated at baseline, and at 3 and 6 months after treatment. RESULTS: Both therapies promoted PPD reductions, rCAL gains, and recession in GMP at the end of the study, with the experimental group presenting an additional PPD reduction in fullmouth analysis and deep pockets at the 3- and 6-month follow-ups (P < .05). During the period of the study, only the experimental group promoted a reduction in PGE2 levels in deep pockets at 3 and 6 months, while IFN-γ and IL-6 levels remained unchanged. However, the differences in the immunologic parameters were not statistically significant among the groups. CONCLUSION: It can be concluded that amoxicillin/ metronidazole associated with nonsurgical therapy promotes an additional PPD reduction in the treatment of GAgP; however, this therapy did not promote additional benefits in the evaluated immunologic parameters.

Full-mouth ultrasonic debridement associated with povidone iodine rinsing in GAgP treatment: a randomised clinical trial.

OBJECTIVE: This study evaluated the clinical, immunological and microbiological results of full-mouth ultrasonic debridement (FMUD) with 10 % povidone iodine (PVPI) as the cooling liquid in the treatment of generalised aggressive periodontitis (GAgP). MATERIAL AND METHODS: Twenty-eight patients presenting GAgP were randomly assigned to one of the following groups for evaluation: FMUD + SS (n = 14)--single session of FMUD with 0.9 % saline solution as cooling agent and FMUD + PVPI (n = 14)--single session of FMUD with PVPI solution as cooling agent. Probing depth (PD), relative clinical attachment level (RCAL), relative position of gingival margin, plaque index (FMPI) and bleeding score (FMBS), immunological (interleukin-10 and interleukin-1ß concentrations in gingival crevicular fluid) and microbiological (Aa and Pg amounts) parameters were evaluated at baseline, first, third and sixth months after treatment. RESULTS: The two groups presented reduction of FMPI and FMBS and had statistically significant PD reductions, RCAL gains and gingival recession (p < 0.05). Both therapies reduced Pg levels in deep and in moderate pockets (p < 0.05). FMUD + PVPI reduced Aa levels in deep pockets. However, no inter-group differences in clinical, immunological and microbiological parameters were observed (p > 0.05). CONCLUSIONS: It could be concluded that 10 % PVPI used as an irrigant solution in FMUD decreased Aa levels in deep pockets but had no additional benefits when compared with saline solution irrigation in terms of clinical, microbiological and immunological results. CLINICAL RELEVANCE: The FMUD is a valid option for the treatment of GAgP, but the use of 10 % PVPI did not improve the results of the periodontal therapy.

Effect of Resveratrol on periodontal pathogens during experimental periodontitis in rats

Abstract The objective of this study was to investigate the antibacterial effect of resveratrol against putative periodontal pathogens during the progression of experimental periodontitis in rats. Periodontitis was induced in rats in one of the first molars chosen to receive a ligature. Animals were assigned to one of two groups: daily administration of the placebo solution (control group, n = 12) or 10 mg/Kg of resveratrol (RESV group, n = 12). The therapies were administered systemically for 30 days, for 19 days before periodontitis induction and then for another 11 days. Then, the presence and concentrations of Porphyromonas gingivalis, Tannerella forsythia and Aggregatibacter actinomycetemcomitans in the cotton ligatures collected from the first molars were evaluated using real-time PCR. Inter-group comparisons of the microbiological outcomes revealed that no differences were detected for P. gingivalis, T. forsythia and A. actinomycetemcomitans levels (p > 0.05). Continuous use of resveratrol did not promote additional benefits in microbiological outcomes during experimental periodontitis in rats.

Periodontal clinical and microbiological characteristics in healthy versus generalized aggressive periodontitis families.

AIM: Generalized aggressive periodontitis (GAP) is a severe and multifactorial disease in which a familial aggregation and a specific microbiological profile have been suggested. Thus, this case-control study evaluated the clinical and subgingival microbial profile of GAP subjects and their families compared to healthy families. METHODS: Fifteen families with parents presenting periodontal health and 15 with parents with a history of GAP were selected. Each family should have at least one child between 6 and 12 years old. Plaque index (PI), gingival index (GI), and periodontal probing depth (PPD), as well as Porphyromonas gingivalis, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans (Aa) amounts (by qPCR), were assessed from all subjects. RESULTS: Children of GAP families showed a higher PI, GI, and PPD when compared to children of healthy families (p ≤ 0.05). A higher frequency of detection and amounts of Aa was observed in GAP children compared to children of healthy families (p ≤ 0.05). Moreover, a significant association between Aa amounts and gingival bleeding was observed in children (p ≤ 0.05, r = 0.37). CONCLUSION: Children from GAP families have worst clinical conditions, i.e. higher levels of PI, GI, and PPD, a more pathogenic microbiological profile, and the amount of Aa are associated with a higher marginal inflammation.

Salivary carriage of periodontal pathogens in generalized aggressive periodontitis families.

BACKGROUND: Generalized aggressive periodontitis (GAP) is a multifactorial disease that shows a specific microbial profile and a familial aggregation. AIM: This study evaluated the salivary microbial profile of families with a history of GAP and compared them with healthy families. DESIGN: Fifteen families with parents presenting periodontal health and 15 with parents with a history of GAP were selected. Each family had a child aged 6-12 years. Stimulated saliva was collected from all subjects, and Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), and Aggregatibacter actinomycetemcomitans (Aa) amounts were determined. RESULTS: Children of GAP families showed higher detection of Aa (90%) than children of healthy families (45%) (P < 0.05). Parents with GAP showed a Pg salivary concentration statistically higher than that of healthy parents (P < 0.05).Children of GAP families, however, exhibited similar Pg concentration than healthy children (P > 0.05). Tf amounts did not differ either in parents or in children (P > 0.05) The infection risk calculation indicates that children who have one parent who is positive for Aa have 16.3 times (95% CI 3.1-87.2) more risk of being infected with Aa (P < 0.05) than children from an Aa-negative family. CONCLUSION: It may be concluded that children of parents with aggressive periodontitis have higher levels and higher risk of Aa infection.

Emdogain no tratamento de defeito infraósseo em paciente com periodontite agressiva generalizada / Emdogain in the treatment of intrabony defect in a patient with generalized aggressive periodontitis

Periodontite agressiva é uma doença rara, de rápida progressão, que pode resultar na perda dentária. O foco do tratamento está no controle da progressão da doença, na prevenção de sua recorrência e, quando possível, na regeneração dos tecidos perdidos. A terapia periodontal não cirúrgica pode trazer melhora clínica modesta em pacientes com periodontite agressiva generalizada. A abordagem regenerativa, como a utilização de proteínas derivadas da matriz do esmalte (Emdogain), embora pouco documentada na literatura, pode então trazer benefícios clínicos adicionais no tratamento de defeitos infraósseos nestes pacientes. Dessa forma, o objetivo do presente trabalho foi relatar o tratamento de defeito infraósseo em paciente com periodontite agressiva generalizada através de uma abordagem regenerativa com a utilização de Emdogain. Aos nove meses de acompanhamento pós-operatório observou-se significativa melhora clínica, com redução da profundidade de sondagem e ganho de inserção clínica. Pôde-se observar que a associação do Emdogain à terapia cirúrgica pode ser uma alternativa viável para o tratamento de defeitos infraósseos em pacientes com periodontite agressiva generalizada.

Mutacins of Streptococcus mutans

The colonization and accumulation of Streptococcus mutans are influenced by various factors in the oral cavity, such as nutrition and hygiene conditions of the host, salivary components, cleaning power and salivary flow and characteristics related with microbial virulence factors. Among these virulence factors, the ability to synthesize glucan of adhesion, glucan-binding proteins, lactic acid and bacteriocins could modify the infection process and pathogenesis of this species in the dental biofilm. This review will describe the role of mutacins in transmission, colonization, and/or establishment of S. mutans, the major etiological agent of human dental caries. In addition, we will describe the method for detecting the production of these inhibitory substances in vitro (mutacin typing), classification and diversity of mutacins and the regulatory mechanisms related to its synthesis.

Mutacins of Streptococcus mutans.

The colonization and accumulation of Streptococcus mutans are influenced by various factors in the oral cavity, such as nutrition and hygiene conditions of the host, salivary components, cleaning power and salivary flow and characteristics related with microbial virulence factors. Among these virulence factors, the ability to synthesize glucan of adhesion, glucan-binding proteins, lactic acid and bacteriocins could modify the infection process and pathogenesis of this species in the dental biofilm. This review will describe the role of mutacins in transmission, colonization, and/or establishment of S. mutans, the major etiological agent of human dental caries. In addition, we will describe the method for detecting the production of these inhibitory substances in vitro (mutacin typing), classification and diversity of mutacins and the regulatory mechanisms related to its synthesis.