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1.
Chin J Dent Res ; 24(3): 191-198, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34491014

RESUMO

OBJECTIVE: To investigate various factors affecting the clinical outcome of nonsurgical periodontal treatment and evaluate the treatment effects of adjunctive amoxicillin and metronidazole (AMX + MET) in patients with generalised aggressive periodontitis (GAgP). METHODS: Forty-two patients with GAgP were recruited and randomly assigned to three groups: scaling and root planing (SRP) only, AMX + MET after SRP, and AMX + MET during SRP. The patients were assessed every 2 months post-therapy. Periodontal clinical and subgingival microbiological parameters were analysed at baseline and 6 months post-therapy. The impacts of different covariates on pocket probing depth (PD) reduction were evaluated. RESULTS: A multilevel analysis revealed that 58% of the variability in PD reduction was attributed to site-level parameters, 27.3% to patient-level parameters and 18.7% to tooth-level parameters. Greater PD reduction can be expected at initially deeper PD sites and sites with intrabony defects, and in patients with adjunctive use of AMX + MET. Persistent Tannerella forsythia infection and tooth mobility after treatment were negatively associated with PD reduction. CONCLUSION: The clinical outcomes of nonsurgical periodontal treatment were mainly influenced by site-level parameters, and adjunctive use of AMX + MET can lead to better clinical results in patients with GAgP in a short time.


Assuntos
Periodontite Agressiva , Periodontite Agressiva/terapia , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Raspagem Dentária , Humanos , Análise Multinível , Aplainamento Radicular , Resultado do Tratamento
2.
Bull Tokyo Dent Coll ; 62(3): 181-192, 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34393142

RESUMO

Aggressive periodontitis mostly affects young people, causing rapid destruction of periodontal tissue and loss of supporting alveolar bone. The destruction of periodontal tissue induces pathological tooth movement, resulting in various types of malocclusion such as crowding or spacing in the dentition. This report describes orthodontic treatment for malocclusion due to generalized aggressive periodontitis. The patient was a 31-year-old woman who presented with the chief complaint of displacement in the anterior teeth. An oral examination revealed pathological tooth mobility throughout the entire oral cavity due to severe loss of periodontal support. Many gaps in the displaced maxillary anterior teeth and crowding in the mandibular anterior teeth were also observed. The goal of subsequent treatment was to achieve ideal overjet and overbite by aligning the teeth and closing the spaces via non-extraction orthodontic treatment with stripping. The periodontal disease was managed by a periodontist who provided guidance on oral hygiene and periodontal disease control throughout the course of orthodontic treatment. Appropriate occlusion and a good oral environment were achieved. The condition of the periodontal tissue stabilized during and after orthodontic treatment, and favourable occlusal stability was observed at the 2-year follow-up examination.


Assuntos
Periodontite Agressiva , Má Oclusão Classe II de Angle , Má Oclusão , Adolescente , Adulto , Periodontite Agressiva/terapia , Oclusão Dentária , Feminino , Humanos , Má Oclusão/terapia , Técnicas de Movimentação Dentária
3.
Niger J Clin Pract ; 24(7): 965-972, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34290170

RESUMO

Background: IL-13 is the key cytokine in the regulation of inflammatory with an autoimmune disease and has an anti-inflammatory effect. Aims: This study aimed to compare IL-13 (-1112 C/T and -1512 A/C) gene polymorphisms in patients with aggressive periodontitis (AgP), chronic periodontitis (CP), and periodontally healthy group (C) and evaluate the effect of nonsurgical periodontal therapy on gingival crevicular fluid (GCF) IL-13 levels in patients. Materials and Methods: One hundred thirty patients with AgP, 120 patients with CP, and 70 periodontally healthy subjects were included in this study. Clinical parameters were recorded (plaque and gingival index, probing pocket depth, clinical attachment level), and GCF and blood samples were taken at baseline and 6-week. Nonsurgical periodontal therapy was performed in patients with periodontitis. Gene analyses (IL-13 - 1112C/T (rs1800925) and - 1512 A/C (rs1881457) were performed with real-time polymerase chain reaction (PCR) and cytokine levels were determined by an enzyme-linked immunosorbent assay method. Results: AgP and CP patients showed significant improvement in clinical parameters after periodontal therapy (P < 0.05). According to results, genotype distributions and allele frequencies in IL-13 variants - 1112C/T and - 1512 A/C were found similarly in all groups (P > 0.05). In the AgP group, GCF IL-13 cytokine level is statistically significant and increased in 6 weeks; however, in the CP group, there is no statistically significant difference between baseline and 6 week. In the AgP group, baseline GCF IL-13 cytokine level is lower than those of the CP group and C group (P < 0.05). Conclusion: Within the limits of this study, IL-13 -1112 and -1512 gene polymorphisms have not been associated with AgP and CP, and GCF IL-13 cytokine level is increased after treatment in the AgP group.


Assuntos
Periodontite Agressiva , Periodontite Crônica , Periodontite Agressiva/genética , Periodontite Agressiva/terapia , Periodontite Crônica/genética , Periodontite Crônica/terapia , Líquido do Sulco Gengival , Humanos , Interleucina-13/genética , Polimorfismo Genético
4.
Photodiagnosis Photodyn Ther ; 33: 102075, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33157325

RESUMO

AIM: The aim of the present clinical trial was to evaluate the clinical efficacy of photodynamic therapy (PDT) as an adjunct to open flap debridement (OFD) in the treatment of generalized aggressive periodontitis (GAP). MATERIALS AND METHODS: The subjects recruited for the study were divided into two groups: 'control group' received treatment through OFD, whereas the test participants were treated with OFD and adjunctive PDT. The clinical periodontal parameters were plaque index (PI), full mouth probing depth (FMPD) and full mouth relative attachment loss (FMRA). The microbial levels of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg) and Tannarella forsythia (Tf) were analyzed. All parameters were assessed at baseline and 3 months. STATISTICAL ANALYSIS: The observed values for all the parameters were reported in mean and standard deviation (mean ± SD). In order to analyse the mean values and inter-group comparisons, the Mann-Whitney U test was employed. The p-value was set at <0.05 to establish a significant difference among the reported values. RESULTS: A statistically significant improvement for BOP was observed in PDT group in comparison to the control group at 3 months only (p < 0.05). A significant reduction in the microbiological levels for Aa, Pg and Tf in both the study groups was observed. However, no significant differences in microbial levels were observed at any time point when the control and test groups were compared to each other. CONCLUSION: PDT in conjuction with OFD plays a significant role in reducing the microbial load and improving the clinical periodontal parameters in patients with GAP. Moreover, it is regarded as a safe treatment regimen as no side effects have been reported regarding its use in GAP.


Assuntos
Periodontite Agressiva , Periodontite Crônica , Fotoquimioterapia , Aggregatibacter actinomycetemcomitans , Periodontite Agressiva/terapia , Periodontite Crônica/tratamento farmacológico , Desbridamento , Raspagem Dentária , Seguimentos , Humanos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Resultado do Tratamento
5.
J Clin Periodontol ; 48(2): 237-248, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33205510

RESUMO

AIM: To evaluate the local immunoinflammatory profiles in localized aggressive periodontitis patients (LAP) before and after periodontal treatment and maintenance. METHODS: Sixty-six African-Americans with LAP (7-21 years old) were included. After periodontal examination, all patients received periodontal treatment with mechanical debridement plus systemic amoxicillin/metronidazole for 7 days. Gingival crevicular fluid was collected from diseased and healthy sites at baseline and 3, 6, 12, and 24 months following treatment. Levels of 16 inflammatory/bone resorption markers were determined using Milliplex® . Univariate and correlation analyses were performed among all parameters/biomarkers. Discriminant analyses (DA) evaluated profile differences between LAP diseased and healthy sites at each time point as compared to the baseline. RESULTS: Reductions in the clinical parameters (except for visible plaque) were observed at all time points compared to the baseline. Levels of IL-12p70, IL-2, IL-6, MIP-1α, RANKL, and OPG were reduced after treatment, and several cytokines/chemokines were correlated with clinical parameters reductions. DA showed that differences in the immunoinflammatory profiles between LAP diseased and healthy sites decreased after periodontal treatment compared to the baseline. CONCLUSIONS: Periodontal treatment modified the local immunoinflammatory profile of LAP sites in the long term, as suggested by changes in biomarkers from baseline, along with clinical stability of the disease. (Clinicaltrials.gov number, NCT01330719).


Assuntos
Periodontite Agressiva , Adolescente , Adulto , Periodontite Agressiva/terapia , Amoxicilina/uso terapêutico , Quimiocinas , Criança , Citocinas/análise , Líquido do Sulco Gengival/química , Humanos , Adulto Jovem
6.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(7): 475-481, 2020 Jul 09.
Artigo em Chinês | MEDLINE | ID: mdl-32634886

RESUMO

Objective: To explore the effect of systemic use of amoxicillin and metronidazole during mechanical therapy on the clinical parameters of the first molars and periodontal microorganisms in subgingival plaque and saliva in patients with generalized aggressive periodontitis (GAgP). Methods: A total of 23 GAgP patients were recruited from Peking University School and Hospital of Stomatology from January 2006 to December 2009 and then randomly divided into two groups according to random number table: 12 patients received scaling and root planning (SRP) only and 11 patients received SRP combined with systemic administration of antibiotics (amoxicillin and metronidazole for a week after supragingival scaling). Clinical examination of periodontal parameters and collection of saliva and pooled subgingival plaque samples from mesial-buccal sites of 4 first molars were performed before initial therapy and 2, 4 and 6 months respectively after mechanical therapy, and saliva samples were also collected 2 weeks after therapy. Eight different periodontal microorganisms were detected in these samples by PCR. In addition, semiquantitative analysis of red complex microorganisms [Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td)] was performed. Results: Both therapies led to significant decrease of the plaque index (PLI), probing depth (PD) and bleeding index (BI) from mesial-buccal sites of first molars. Meanwhile the PD of antibiotics group [(4.21±1.50), (4.00±1.54), (3.84±1.89) mm of 2, 4 and 6 months respectively after therapy] was significantly lower than the SRP group [(5.29±1.27), (5.30±1.34), (4.98±1.36) mm of 2, 4 and 6 months respectively after therapy] at 3 different time points after mechanical therapy (P<0.05). In the antibiotics group, the quantities of Pg, Tf and Td in subgingival plaque samples (the median quantity decreased to 0.0 ng at 2, 4 and 6 months after therapy) and saliva samples (the median quantity of Tf and Td decreased to 0.0 ng at 2, 4 and 6 months after therapy (P<0.05), and the median quantity of Pg decreased to 16.3, 59.6 and 22.4 ng at 2, 4 and 6 months respectively after therapy) significantly decreased at 3 different time points after mechanical therapy compared with before therapy (P<0.05). While in the SRP group, there were no significant changes in the quantities of Tf and Td in saliva at 2, 4 and 6 months after mechanical therapy (P>0.05) , and the quantities of Tf and Td in subgingival plaque significantly decreased only at 2 months after therapy (P<0.05). Conclusions: SRP combined with systemic administration of amoxicillin and metronidazole could achieve greater improvement in PD of first molars and better control of the amounts of red complex microorganisms in the saliva and subgingival plaque of GAgP patients over a 6-month period.


Assuntos
Periodontite Agressiva/terapia , Placa Dentária , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Raspagem Dentária , Humanos , Metronidazol/uso terapêutico , Saliva
7.
J Clin Periodontol ; 47(8): 980-990, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32557763

RESUMO

AIMS: The primary aim of this investigation was to analyse the periodontal microbiome in patients with aggressive periodontitis (AgP) following treatment. METHODS: Sixty-six AgP patients were recalled on average 7 years after completion of active periodontal treatment and had subgingival plaque samples collected and processed for 16S rRNA gene sequencing analyses. RESULTS: Of 66 participants, 52 showed persistent periodontal disease, while 13 participants were considered as "successfully treated AgP" (no probing pocket depths >4 mm) and 1 was fully edentulous. Genera associated with persistent generalized disease included Actinomyces, Alloprevotella, Capnocytophaga, Filifactor, Fretibacterium, Fusobacterium, Leptotrichia, Mogibacterium, Saccharibacteria [G-1], Selenomonas and Treponema. "Successfully treated" patients harboured higher proportions of Haemophilus, Rothia, and Lautropia and of Corynebacterium, Streptococcus and Peptidiphaga genera. Overall, patients with persistent generalized AgP (GAgP) revealed higher alpha diversity compared to persistent localized AgP (LAgP) and stable patients (p < .001). Beta diversity analyses revealed significant differences only between stable and persistent GAgP groups (p = .004). CONCLUSION: Patients with persistent AgP showed a more dysbiotic subgingival biofilm than those who have been successfully treated. It remains to be established whether such differences were predisposing to disease activity or were a result of a dysbiotic change associated with disease recurrence in the presence of sub-standard supportive periodontal therapy or other patient-related factors.


Assuntos
Periodontite Agressiva , Placa Dentária , Microbiota , Periodontite Agressiva/terapia , Bactérias/genética , Humanos , RNA Ribossômico 16S/genética
8.
J Periodontol ; 91(11): 1495-1502, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32246842

RESUMO

BACKGROUND: Hypoxia-inducible angiogenic pathway involving hypoxia inducible factor-1 alpha (HIF-1α), vascular endothelial growth factor (VEGF) and tumor necrosis factor-alpha (TNF-α) may regulate several biological processes related to inflammation. The present study aimed to assess the effect of non-surgical periodontal treatment on gingival crevicular fluid (GCF) HIF-1α, VEGF, and TNF-α levels in generalized aggressive periodontitis (G-AgP). METHODS: Twenty G-AgP patients and 20 periodontally healthy individuals were included. G-AgP patients received scaling and root planning (SRP), per quadrant at a 1-week-interval, performed with ultrasonic and periodontal hand instruments. GCF samples were collected and clinical periodontal parameters including probing depth, clinical attachment level, gingival index and plaque index were recorded at baseline, 1 and 3 months after treatment. Biomarker levels in GCF were analyzed by ELISA. RESULTS: At baseline all clinical parameters and GCF HIF-1α, VEGF, and TNF-α levels were significantly higher in G-AgP patients compared to healthy control (P < 0.05). All clinical parameters improved over the 3-month-period in G-AgP patients (P < 0.05). GCF HIF-1α levels in G-AgP reduced at 1 and 3 months post-treatment, however, this did not reach to statistical significance (P > 0.05). GCF VEGF and TNF-α levels remained unchanged throughout the study period (P > 0.05). CONCLUSIONS: Within the limitations of the present study, although HIF-1α seems to possess a potential diagnostic value for G-AgP, it might not be a proper predictor of clinically favorable treatment outcome. SRP plus different adjunctive therapies could provide better information about the prognostic role of hypoxia-inducible angiogenic pathway in G-AgP.


Assuntos
Periodontite Agressiva , Fator de Necrose Tumoral alfa , Periodontite Agressiva/terapia , Raspagem Dentária , Líquido do Sulco Gengival/química , Humanos , Hipóxia , Fator de Necrose Tumoral alfa/análise , Fator A de Crescimento do Endotélio Vascular
9.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(2): 86-92, 2020 Feb 09.
Artigo em Chinês | MEDLINE | ID: mdl-32074668

RESUMO

Objective: To investigate the influential factors related to the long-term effect of periodontal-orthodontic treatment in patients with aggressive periodontitis (AgP). Methods: A retrospective analysis was conducted in 25 AgP patients, who have received periodontal-orthodontic treatment in Peking University School and Hospital of Stomatology. Changes in the ratio of the residual alveolar bone height (RBH) was measured at three time points: baseline (T0), post orthodontic treatment (T1), and the last re-visit 3 years after orthodontic treatment (T2). Root abnormity was evaluated by observing periapical radiographs, and its relationship with alveolar bone loss after orthodontic treatment was analyzed. A multi-level analysis on factors related to the clinical outcome (alveolar bone height change) was performed. Results: Totally 693 teeth of 25 patients at T0 and T1 and 368 teeth of 14 patients at T2 were investigated. During the periodontal-orthodontic treatment, the RBH was mainly influenced by root abnormity (estimation value -2.392), tooth position (estimation value for upper teeth vs. lower teeth 3.139, and anterior teeth vs. posterior teeth -3.469) and the baseline RBH at T0 (estimation value -0.391) (P<0.05). Teeth with root abnormity, teeth in mandibular and anterior area, and teeth with higher RBH showed less change in T1-T0 RBH values. In the long-term follow-up, RBH was mainly influenced by tooth position (estimation value for upper teeth vs. lower teeth 3.735, and anterior teeth vs. posterior teeth -5.318), the baseline RBH and probing depth (PD) at T0. Teeth in mandibular and anterior area, teeth with higher RBH (estimation value -0.498) and PD (estimation value -1.594) (P<0.05) showed less change in T0-T2 RBH values. Conclusions: During orthodontic treatment, teeth with abnormal root, lower teeth, anterior teeth, and teeth with high RBH were unfavorable factors for bone gain. In the long-term observation, lower teeth, anterior teeth, teeth with high RBH and PD at first visit were unfavorable factors for bone gain.


Assuntos
Periodontite Agressiva/terapia , Má Oclusão/terapia , Dente/patologia , Perda do Osso Alveolar , Humanos , Ortodontia Corretiva , Estudos Retrospectivos
10.
Clin Oral Investig ; 24(4): 1369-1378, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32060656

RESUMO

OBJECTIVES: To analyse evidence regarding the efficacy of periodontal regenerative procedures in intrabony defects in patients treated for aggressive periodontitis (AgP). MATERIAL AND METHODS: A systematic search of the literature for randomised controlled clinical trials including patients treated for aggressive periodontitis that compared a group treated with regenerative therapy with another group treated with surgical debridement alone was conducted by two independent reviewers. RESULTS: Six studies were included in the meta-analysis of clinical and/or radiographic parameters at 6 and 12 months. Probing pocket depth was smaller at 6 months in patients treated with regenerative therapies compared with those treated with regular debridement (1.00 mm, p < 0.001, 95% CI (0.67, 1.34)). At 12 months this difference was more marked (0.41 mm, p = 0.12, 95% CI (- 0.10, 0.91)). The distance between the cemento-enamel junction and the alveolar crest at both 6 (1.36 mm, p < 0.001, 95% CI (1.03, 1.68)) and 12 months (0.90 mm, p = 0.01, 95% CI (0.24, 1.56)) was smaller in the group treated with regeneration. CONCLUSIONS: The use of biomaterials for regenerative therapy in AgP may be more effective than surgical debridement. Better outcomes were observed in terms of probing pocket depth and distance between the cemento-enamel junction and the alveolar crest at 6 months. Regeneration should be considered as a therapy to prevent tooth loss, although more studies with larger sample size and longer follow-up are needed. CLINICAL RELEVANCE: Periodontal regeneration is effective in the treatment of intrabony defects in patients with AgP, as it leads to better outcomes in clinical and radiographic parameters.


Assuntos
Periodontite Agressiva/terapia , Regeneração Tecidual Guiada Periodontal , Processo Alveolar , Humanos , Desbridamento Periodontal , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
11.
J Clin Periodontol ; 47(2): 223-232, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31782533

RESUMO

AIM: To assess tooth loss in patients with aggressive periodontitis (AgP) 10-35 years after active periodontal therapy (APT) in a private practice and to detect possible factors influencing tooth loss. MATERIAL AND METHODS: In 100 patients with AgP, tooth loss was recorded over a median follow-up period of 25.5 years after APT, retrospectively. Patient- and tooth-level factors were assessed with a Cox frailty regression model. RESULTS: Of 2,380 teeth, 227 were lost during a median follow-up time of 25.5 years (2.3 ± 3.6 teeth/patient, range 0-17 teeth), resulting in a mean tooth loss rate of 0.09 teeth/patient/year. At patient-level, statistically significant factors for tooth loss were smoking (p = .039) and the baseline diagnosis generalized AgP (p < .001). Influencing factors at tooth-level were location in the maxilla (p = .003), baseline bone loss (p < .001), molars (p < .001) and premolars (p < .001) as well as abutment teeth (p = .009). CONCLUSION: Tooth loss occurred rarely in patients with AgP treated in a private practice over a long-time period. Annual tooth loss rates are comparable with those described in university settings. Smoking, generalized form of AgP, location/type of tooth, baseline bone loss and abutment status could be detected as factors impacting upon tooth loss.


Assuntos
Periodontite Agressiva/complicações , Periodontite Agressiva/terapia , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/epidemiologia , Perda de Dente/epidemiologia , Perda de Dente/etiologia , Seguimentos , Humanos , Prática Privada , Estudos Retrospectivos , Resultado do Tratamento
12.
Chin J Dent Res ; 23(4): 273-279, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33491359

RESUMO

Objective: To investigate the influence of CYP1A1 rs1048943 on short- and long-term outcomes of nonsurgical periodontal therapy (NSPT) for generalised aggressive periodon- titis (GAgP). Methods: The CYP1A1 rs1048943 polymorphisms of 224 GAgP patients were genotyped by time-of-flight mass spectrometry. A total of 125 patients received NSPT and subsequent followup for 3 months. Of the 125 patients, 81 were followed for at least 3 years. Clinical periodontal parameters were collected at baseline and at the follow-up visits. Negative binomial regression was used to analyse the association between the number of teeth lost during the 3-year observation period and CYP1A1 rs1048943 genotypes. Results: The mean probing depth (PD) and percentage of sites with Bleeding Index (BI) ≥ 3 were all significantly greater in CYP1A1 rs1048943 G allele carriers than non-carriers at 3 months and 3 years after treatment (P < 0.05). In the PD ≥ 7 mm subgroup, the mean PD was significantly higher in G allele carriers than non-carriers at the 3-year follow-up (P < 0.05). The other clinical parameters did not show a similar trend (P > 0.05). Furthermore, the changes of percentage of sites with BI ≥ 3 were significantly smaller in G allele carriers than non-carriers at 3 months and 3 years after treatment (P < 0.05). GAgP patients with the GG genotype had lost more over the 3-year follow-up period compared with patients with the AA genotype (P < 0.05). Conclusion: These data indicated that the CYP1A1 rs1048943 AG/GG genotypes may influence the short- and long-term outcomes of NSPT in GAgP patients.


Assuntos
Periodontite Agressiva , Citocromo P-450 CYP1A1 , Periodontite Agressiva/genética , Periodontite Agressiva/terapia , Humanos
13.
Clin Adv Periodontics ; 9(1): 9-14, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-31490033

RESUMO

INTRODUCTION: Localized aggressive periodontal disease is an uncommon finding observed in adolescents and children. Studies have been conducted to elucidate the etiology, contributing factors, and genetic roles in the phenomena. In particular, twin studies have shown genetic makeup to be a substantial risk factor for periodontitis. This case is, to the best of the authors' knowledge, the first to be presented in literature of a same dwelling, set of monozygotic twins, displaying similar presentation of localized aggressive periodontitis, however with different microbial profiles. CASE PRESENTATION: A set of 17-year-old black male monozygotic twins were referred for a full-mouth periodontal evaluation and any necessary periodontal treatment on July 7, 2007. A full-mouth radiographic series, periodontal charting, and intraoral photographs were performed on each individual. A family history was obtained through the biological mother, which yielded no known history of early tooth loss or treatment of severe periodontal disease. The father was not involved in the rearing of the children and his periodontal history was unavailable. An initial and surgical treatment plan was developed. Microbial analysis of subgingival plaque samples was collected on the affected sites. Initial treatment with scaling and root planing, subgingival irrigation, with administration of systemic antibiotics, and oral hygiene instruction, were rendered on both individuals. CONCLUSION: Within limitations of this report, it is demonstrated that different microbial pattern exists on aggressive periodontitis even in genetically identical individuals with the same environmental exposure.


Assuntos
Periodontite Agressiva , Adolescente , Periodontite Agressiva/diagnóstico , Periodontite Agressiva/genética , Periodontite Agressiva/terapia , Criança , Índice de Placa Dentária , Humanos , Masculino , Bolsa Periodontal , Aplainamento Radicular , Gêmeos Monozigóticos
14.
Clin Adv Periodontics ; 9(4): 185-191, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31496127

RESUMO

INTRODUCTION: This case series illustrates the use of the new classification system of periodontal diseases and conditions. This case series highlights how the assessment of the rate of progression of periodontal disease, that is, grading, allows for the identification of individual patients, who are more likely to require active periodontal treatment intervention to prevent onset of disease, need long-term disease control, or referral to a periodontist. CASE PRESENTATION: A 17-year-old female presents with slight gingival inflammation. However, exploration into indirect evidence of disease progression, that is, family history of periodontal disease, leads to the discovery of advanced disease in the mother. The patient was diagnosed with generalized Stage I Grade C periodontitis. The patient was managed with initial periodontal therapy, consisting of scaling and root planing with systemic antibiotic therapy. Special consideration was taken to mitigate the potential for rapid disease progression because of indirect evidence of familial history of aggressive periodontitis and indicated the need for early intervention. The case resulted in remission of the progression of periodontal disease. CONCLUSIONS: Applying the staging and grading system leads to an understanding of the need for periodontal referral and early periodontal treatment intervention. Wide adoption of staging and grading could increase early referral leading to early periodontal treatment intervention, decreased tooth loss, and have a potential effect on overall health improvement and wellness.


Assuntos
Periodontite Agressiva , Gengivite , Aplainamento Radicular , Perda de Dente , Adolescente , Periodontite Agressiva/classificação , Periodontite Agressiva/diagnóstico , Periodontite Agressiva/terapia , Antibacterianos/uso terapêutico , Progressão da Doença , Feminino , Gengivite/complicações , Gengivite/diagnóstico , Humanos
15.
Scand J Immunol ; 90(6): e12816, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31448837

RESUMO

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.


Assuntos
Periodontite Agressiva/diagnóstico , Periodontite Agressiva/metabolismo , Interleucina-10/metabolismo , Adulto , Periodontite Agressiva/etiologia , Periodontite Agressiva/terapia , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Biofilmes , Biomarcadores , Feminino , Líquido do Sulco Gengival/metabolismo , Líquido do Sulco Gengival/microbiologia , Humanos , Masculino , Prognóstico , Aplainamento Radicular/métodos , Resultado do Tratamento , Adulto Jovem
16.
Oral Dis ; 25(3): 839-847, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30614174

RESUMO

OBJECTIVE: Extrinsic and intrinsic pathways of apoptosis are involved in generalized aggressive periodontitis (GAgP). The aim of this study was to evaluate 6-month clinical outcomes relative to apoptosis of one-stage full-mouth disinfection (OSFMD) and systemic antibiotics (SA) in the treatment of GAgP. METHODS: Twenty-six patients with GAgP were included in this prospective follow-up intervention study. Gingival crevicular fluid (GCF) was collected from patients at baseline and 3 and 6 months after periodontal therapy, which consisted of OSFMD and SA (amoxicillin and metronidazole, 500 mg each for 7 days). The levels of p53, caspase-3, TNF-α, TRAIL, IL-1ß, and IL-10 in GCF were measured via ELISA. RESULTS: Periodontal parameters were improved at 3 and 6 months compared to baseline (p < 0.05). p53 was decreased up to 6 months (p < 0.05). TRAIL, TNF-α, and IL-10 were similar at baseline and 3 and 6 months. Caspase-3 and IL-1ß were decreased at 3 months (p < 0.05), but similar at 6 months compared to baseline (p > 0.05). CONCLUSION: Although OSFMD plus SA improves clinical periodontal parameters up to 6 months, this treatment protocol differentially regulates the apoptosis markers caspase-3 at 3 months and p53 at 6 months without influencing TRAIL in GCF.


Assuntos
Periodontite Agressiva/terapia , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Metronidazol/uso terapêutico , Adulto , Anti-Infecciosos Locais/uso terapêutico , Apoptose , Caspase 3/metabolismo , Clorexidina/uso terapêutico , Terapia Combinada , Desinfecção , Feminino , Seguimentos , Líquido do Sulco Gengival/metabolismo , Humanos , Interleucina-10/metabolismo , Interleucina-1beta/metabolismo , Masculino , Aplainamento Radicular , Ligante Indutor de Apoptose Relacionado a TNF/metabolismo , Fatores de Tempo , Resultado do Tratamento , Fator de Necrose Tumoral alfa/metabolismo , Proteína Supressora de Tumor p53/metabolismo , Adulto Jovem
17.
Cytokine ; 116: 27-37, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30684915

RESUMO

BACKGROUND: The local and systemic immunological profiles of important inflammatory mediators in the localized (LAgP) and generalized (GAgP) forms of aggressive periodontitis are still unknown, as well as the effect of periodontal therapy on these parameters. The aim of this prospective study was to evaluate clinical and immune responses of patients with AgP undergoing nonsurgical treatment. MATERIAL AND METHODS: Eighteen patients with GAgP, 10 with LAgP and 10 healthy participants were included in this study. AgP participants were submitted to scaling and root planing plus systemic antibiotics (amoxicillin and metronidazole). At baseline and 1-year follow-up were measured clinical parameters, such as probing depth [PD] and clinical attachment loss [CAL], and the levels of 10 immunological mediators (GM-CSF, M-CSF, MCP-1, ICAM-1, CXCL8, IL-1ß, TNF-α, IL-17, IL-4, and IL-10) in the gingival crevicular fluid (GCF) of selected sites [AgP forms: PD ≥ 6 mm or the deepest, bleeding on probing (BoP) and bone loss measured by periapical radiography; healthy individuals: PD ≤ 3 mm, no BoP, no bone loss] and serum. RESULTS: After periodontal treatment both forms of AgP presented a significant reduction of PD and CAL, an increase of GM-CSF, ICAM-1, MCP-1, TNF-α, IL-17, IL-4, and IL-10 in the GCF, as well as of GM-CSF and IL-4 in the serum, and a reduction in the serum concentration of IL-1ß. Serum levels of M-CSF, ICAM-1, and MCP-1 remained significantly below those found in healthy individuals in both forms of AgP even after therapy. An increase in the systemic or local levels of MCP-1, ICAM-1 and the anti-inflammatory profile (IL-4, IL-10) was correlated with an improvement in clinical parameters of LAgP patients. Also, a local reduction of IL-1ß levels in both forms of AgP was correlated with an increase in the clinical attachment gain. CONCLUSION: Nonsurgical periodontal therapy was successful in improving clinical parameters and modulating the immune response in both forms of AgP. However, this therapeutic approach does not seem to affect the deficient level of important serum mediators involved in mechanisms of cell transmigration.


Assuntos
Periodontite Agressiva/diagnóstico , Periodontite Agressiva/patologia , Citocinas/análise , Líquido do Sulco Gengival/química , Periodontite Agressiva/imunologia , Periodontite Agressiva/terapia , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Movimento Celular/fisiologia , Humanos , Metronidazol/uso terapêutico , Estudos Prospectivos , Aplainamento Radicular
18.
Clin Oral Investig ; 23(7): 3005-3020, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30374832

RESUMO

OBJECTIVES: The main objectives of this study were (1) to evaluate bone/graft density alterations by digital subtraction radiography; (2) to determine factors associated with favorable clinical and radiographic outcomes, and (3) to report on patient morbidity after guided tissue regeneration (GTR) in aggressive periodontitis (AgP) patients. MATERIALS AND METHODS: Adapting a split-mouth design, 30 comparative intrabony defects in 15 patients were randomly treated with xenogenic graft plus modified perforated membranes (MPM, tests) or xenogenic graft plus standard collagen membranes (CM, controls). The time period of observation was 12 months. RESULTS: There were significant improvements in clinical and radiographic parameters within each group, without intergroup differences. However, higher PPD reduction for three-wall defects was noted in MPM sites (5.22 versus 3.62 mm; p = 0.033). Moreover, a significant gain in bone/graft density of 4.9% from 6 to 12 months post-operatively was observed in test sites. Multivariate analysis demonstrated that morphology of intrabony defects was a predictor of CAL gain (p = 0.06), while independent prognostic variables effecting changes in bone/graft density were radiographic defect depth (p = 0.025) and radiographic angle (p = 0.033). The majority of patients reported some discomfort, pain, and edema with mild intensity without any significant differences between treatment modalities. CONCLUSIONS: This study demonstrated enhanced bone/graft density gain after GTR with MPM, which may indicate greater area of new bone formation. Independent variables effecting treatment outcomes were intrabony defect morphology, radiographic defect depth, and radiographic angle. CLINICAL RELEVANCE: This study supports the regenerative treatment of intrabony defects in AgP patients and identifies some variables with prognostic value.


Assuntos
Periodontite Agressiva , Perda do Osso Alveolar , Regeneração Tecidual Guiada Periodontal , Radiografia , Periodontite Agressiva/diagnóstico por imagem , Periodontite Agressiva/terapia , Seguimentos , Humanos , Membranas Artificiais , Perda da Inserção Periodontal , Prognóstico , Radiografia/métodos , Técnica de Subtração , Resultado do Tratamento
19.
Quintessence Int ; 50(2): 104-113, 2019 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-30574612

RESUMO

It is challenging for clinicians to carry out successful periodontal therapy and maintain a full dentition in young patients with generalized bone loss of 90%. Due to advanced attachment loss and the young age of patients, fixed or removable prosthetic treatment options are compromised. Implant therapy would be complex and expensive. The presented case shows the successful conservative periodontal therapy of advanced generalized aggressive periodontitis in a 29-year-old female. A conservative approach was applied and maintained all teeth with patient satisfaction both functionally and esthetically. This case was followed over 5 years.


Assuntos
Periodontite Agressiva/terapia , Adulto , Periodontite Agressiva/diagnóstico por imagem , Antibacterianos/uso terapêutico , Terapia Combinada , Dispositivos para o Cuidado Bucal Domiciliar , Profilaxia Dentária , Raspagem Dentária , Feminino , Humanos , Índice Periodontal , Radiografia Panorâmica , Aplainamento Radicular , Resultado do Tratamento
20.
Oral Dis ; 25(2): 569-579, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30506613

RESUMO

OBJECTIVE: To evaluate the effect of the periodontal treatment on Aggregatibacter actinomycetemcomitans JP2 clone, and the IgG serum levels against its outer membrane protein (Omp29) and A. actinomycetemcomitans serotypes in aggressive periodontitis (AgP). SUBJECTS AND METHODS: Seventeen patients with generalized (GAgP), 10 with localized (LAgP), and 10 healthy controls were included. AgP participants were submitted to periodontal treatment-scaling and root planing plus antibiotics (SRP+A). Periodontal parameters, for example, probing depth (PD) and clinical attachment loss (CAL), were evaluated at baseline and at 1-year. Serum IgG against Omp29 and serotypes a, b, and c were determined by ELISA. The levels of A. actinomycetemcomitans JP2 clone were determined in subgingival biofilm samples by qPCR. RESULTS: Periodontal treatment resulted in significant reductions of PD, CAL, and IgG levels against Omp29, serotypes b, and c. After therapy, IgG levels against A. actinomycetemcomitans serotypes, as well as the levels of the JP2 clone in AgP, became similar to controls. The reduction in JP2 clone count was correlated with a reduction of PD and IgG response against Omp29. CONCLUSION: Scaling and root planing plus antibiotics decreased IgG levels response against Omp29 and A. actinomycetemcomitans serotypes involved in the disease (b and c), while the serum response increased against tne commensal serotype (a), similar to what occurs in periodontally healthy individuals.


Assuntos
Aggregatibacter actinomycetemcomitans/crescimento & desenvolvimento , Aggregatibacter actinomycetemcomitans/imunologia , Periodontite Agressiva/microbiologia , Periodontite Agressiva/terapia , Proteínas da Membrana Bacteriana Externa/imunologia , Imunoglobulina G/sangue , Adolescente , Adulto , Periodontite Agressiva/sangue , Periodontite Agressiva/complicações , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Contagem de Colônia Microbiana , Feminino , Humanos , Masculino , Metronidazol/uso terapêutico , Perda da Inserção Periodontal/microbiologia , Índice Periodontal , Estudos Prospectivos , Aplainamento Radicular , Sorogrupo , Adulto Jovem
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