Clinical performance of non-surgical periodontal therapy in a large Chinese population with generalized aggressive periodontitis.

AIM: This study aimed to evaluate clinical performance of non-surgical periodontal treatment (NSPT) and its influential factors in a large Chinese population with generalized aggressive periodontitis (GAgP). MATERIAL AND METHODS: Longitudinal periodontal examination data of 1,004 GAgP patients (numbers of patients with observation periods 6 weeks~, 3 months~, 6 months~, 1 year~, 3 years~ and >5 years were 203, 310, 193, 205, 70 and 23, respectively) were extracted from a hospital-based electronic periodontal charting record system and analysed by multilevel analysis. RESULTS: Mean probing depth (PD) and attachment loss (AL) reductions at patient level were 1.17 mm and 1.07 mm, respectively. Multilevel analysis demonstrated PD reductions after maintenance were mainly influenced by frequency of supportive periodontal treatment (FSPT), gender, adjunctive systemic use of antibiotics, baseline mobility, tooth type and baseline PD and bleeding index reductions were mainly influenced by FSPT, adjunctive systemic use of antibiotics, baseline AL, baseline mobility, tooth type and baseline PD. CONCLUSION: The clinical performance of NSPT on patients with GAgP was proved in the large Chinese population. Outcomes of NSPT were mainly influenced by FSPT, adjunctive systemic use of antibiotics, baseline mobility, tooth type and baseline PD.

[Association between FADS1 rs174537 polymorphism and serum proteins in patients with aggressive periodontitis].

OBJECTIVE: To investigate the potential association between FADS1 rs174537 polymorphism and serum proteins in patients with aggressive periodontitis, which may provide benefits for diagnosis and treatment of aggressive periodontitis. METHODS: A total of 353 patients with aggressive periodontitis (group AgP) and 125 matched controls (group HP) were recruited in the study. Genotyping of FADS1 rs174537 and serum biochemical indexes were tested at the study's start. The relationships between the levels of TP, GLB, ALB, A/G and genotyping were analyzed. RESULTS: (1) The detection rate of allele G in group AgP was higher than that in group HP(68.1% vs. 61.2%, P=0.046,OR=1.35,95% CI 1.00-1.83); the detection rate of genotype GG in group AgP was higher than in group HP(45.5% vs. 34.4%,P=0.029, OR=1.60, 95% CI 1.05-2.44). (2) In group AgP, the patients with GG genotype exhibited significantly lower TP, GLB than the patients with GT+TT genotype [(77.08 ± 7.88) g/L vs. (79.00 ± 4.66) g/L, P=0.007; (28.17 ± 7.63) g/L vs.(29.88 ± 3.49) g/L,P=0.007) and the higher A/G(1.72 ± 0.22 vs.1.67 ± 0.22, P=0.040), but there was no significant difference in ALB between the patients with GG genotype and the patients with GT+TT genotype. In group HP, there were no significant differences in TP, GLB, A/G and ALB between individuals with genotype GT+TT and with genotype GG. (3)Compared with individuals with genotype GT+TT in group HP, the AgP patients with genotype GT+TT exhibited significantly higher TP, GLB [(79.00 ± 4.66) g/L vs. (75.20 ± 4.53) g/L, P<0.01; (29.88 ± 3.49) g/L vs.(26.55 ± 2.94) g/L, P<0.01) and the lower A/G(1.67 ± 0.22 vs. 1.88 ± 0.30, P<0.01), but there was no significant difference in ALB. There were no significant differences in TP, GLB, A/G and ALB the between the AgP patients with genotype GG and the healthy subjects with the same genotype either. CONCLUSION: FADS1 rs174537 polymorphism is associated with aggressive periodontitis. The patients with genotype GG in group AgP had relatively lower TP,GLB and higher A/G. Genotype GG might be a risk indicator for aggressive periodontitis by reducing host defense capability and contributing to inflammatory response in the occurrence and development of aggressive periodontitis.

[Clinical and putative periodontal pathogens' features of different sites with probing depth reduction after non-surgical periodontal treatment of patients with aggressive periodontitis].

OBJECTIVE: To evaluate the differences of clinical parameters and putative periodontal pathogens in sites of different probing depth (PD) reduction after non-surgical periodontal treatment in patients with aggressive periodontitis (AgP). METHODS: Clinical examinations including plaque index, probing depth (PD), attachment level (AL) and bleeding index (BI), and full-mouth periapical photographs were collected from 20 patients with AgP. All the patients received non-surgical periodontal treatment, including oral hygiene instruction, supra-gingival scaling, subgingival scaling and root planing (SRP) and were followed up for 6 months post-therapy. Gingival crevicular fluids (GCF) were collected at 1 site in each quadrant before and at the end of 6 months post-therapy. Six kinds of putative periodontal pathogens and 6 kinds of short chain fatty acids (SCFAs) were detected in the GCF samples. RESULTS: The baseline clinical parameters of PD, AL and BI, the baseline concentration of succinic acid, acetic acid, propionic acid and butyric acid, and the prevalence of Treponema denticola were significantly higher in sites with PD reduction more than 2 mm sites compared with PD reduction no more than 2 mm sites [(7.7 ± 1.2) mm vs. (5.1 ± 1.8) mm, (6.3 ± 1.9) mm vs. (4.5 ± 2.2) mm, 3.8 ± 0.4 vs. 3.3 ± 0.8, 1.66 mmol/L vs. 1.10 mmol/L, 31.67 mmol/L vs.17.78 mmol/L, 3.31 mmol/L vs.1.95 mmol/L, 84.6% vs. 56.1%, P<0.05]. However, there were no significant differences in the clinical parameters, the 6 kinds of putative periodontal pathogen detection and SCFAs concentration between the 2 groups at the end of 6 months post-treatment. In sites with PD>5 mm at the end of 6 months post-therapy, all were found with red complex bacteria infection. CONCLUSION: The baseline clinical parameters are important factors in predicting PD reduction after non-surgical periodontal treatment in patients with AgP. In sites with deep pockets after non-surgical periodontal treatment, the active control of red complex bacteria is recommended.

[Analysis of serum IgG titers to Aggregatibacter actinomycetemcomitans serotype c in aggressive periodontitis patients].

OBJECTIVE: To analyze the serum IgG titers to Aggregatibacter actinomycetemcomitans(Aa) and associated factors in patients with aggressive periodontitis (AgP). METHODS: Venous blood samples were collected from 62 AgP patients and 45 periodontal healthy controls, unstimulated whole saliva and pooled subgingival plaque samples of AgP patients were also collected for the detection of Aa (PCR method). Serum IgG titers to Aa serotype c were measured by enzyme-linked immunosorbnent assay (ELISA). RESULTS: The detection rates of serum IgG to Aa serotype c in the AgP patients and the healthy controls were both 100%. The AgP patients exhibited significantly higher IgG titers to Aa serotype c than the healthy controls (11.1±1.9 vs. 9.1±1.8, P<0.01). There was no significant difference in serum IgG levels to Aa serotype c and in the prevalence of high-responding patients to Aa serotype c between the incisor-first molar type AgP patients and generalized AgP patients. Serum IgG titers to Aa serotype c in the Aa-positive AgP patients (the patients who were Aa-positive in subgingival plaque or saliva) were significantly higher than those of the Aa-negative patients (11.9±1.3 vs. 10.7±2.1, P<0.05). CONCLUSION: Serotype c was the main serotype of Aa in Chinese patients with AgP. Serum IgG responses in generalized AgP patients were comparable to those in incisor-first molar type AgP patients.

Association of crown-root ratio and tooth survival in Chinese patients with advanced periodontitis: An 11-year retrospective cohort study.

INTRODUCTION: Periodontitis is a chronic multifactorial inflammatory disease which eventually lead to tooth loss (TL). Therefore, a retrospective study was conducted to evaluate the status of tooth survival within 11 years after non-surgical periodontal treatment (NSPT) and to analyze the risk factors especially crown-root ratio (CRR) that affected TL in Chinese with advanced periodontitis. METHODS: 3481 teeth of 131 subjects who underwent NSPT were examined retrospectively within a mean follow-up period of 11.6 years. The association of risk factors including clinical and radiographic parameters with TL was assessed using univariate and multivariate Cox regression analyses. Smooth curve fitting and segmented regression model were conducted to show the nonlinear relationship and the threshold effect between CRR and the risk of TL. RESULTS: 347 teeth were lost in 97 patients in this study. Male, diabetes mellitus, heavy-smoker, molar, probing depth (PD), attachment loss (AL), bleeding on probing (BOP), tooth mobility, and radiographic bone loss were significantly associated with tooth loss (P<0.05). A nonlinear relationship between CRR and the risk of TL was found, with different turning point values between molars and non-molars (1.9 vs. 2.76). CONCLUSIONS: The findings based on practice-based clinical and radiographic data do suggest a nonlinear relationship between CRR and the survival of teeth, and provide evidence to help clinicians to determine the prognosis of teeth for patients with advanced periodontitis. CLINICAL SIGNIFICANCE: Based on clinical and radiographic data, this study provides an individualized basis for clinicians to judge the dental prognosis of patients with advanced periodontitis according to the different tooth sites.

[Relationship between volatile fatty acids and Porphyromonas gingivalis and Treponema denticola in gingival crevicular fluids of patients with aggressive periodontitis].

OBJECTIVE: Short chain fatty acids (SCFAs), such as succinic acid, acetic acid, propionic acid, butyric acid, etc. are metabolic product of putative periodontal pathogens, which play significant roles in periodontitis. The aim of this study was to analyze the relationship between Porphyromonas gingivalis (P. gingivalis), Treponema denticola (T. denticola), and the concentration of SCFAs in gingival crevicular fluid (GCF) of patients with aggressive periodontitis (AgP). METHODS: GCF was sampled from 4 sites per individual in 20 patients with AgP and 14 healthy controls. Concentrations of SCFAs, including succinic acid, acetic acid, propionic acid, butyric acid, and isovaleric acid in the supernant of GCF were analyzed by high performance capillary electrophoresis (HPCE), P. gingivalis and T. denticola in the deposit of the same GCF were detected by PCR with their electrophoretic band quantified. RESULTS: The concentrations of succinic acid, acetic acid, propionic acid, butyric acid, and isovaleric acid, the prevalence and PCR band quantity of P. gingivalis and T. denticola in GCF were all significantly higher in patients with AgP than that of healthy controls. In patients with AgP, butyric acid concentration was significantly higher in P. gingivalis positive sites than negative sites [2.87 (0.99, 4.36) mmol/L vs. 0.33 (0.00, 1.44) mmol/L, P<0.05], the concentrations of succinic acid, acetic acid, propionic acid, butyric acid, and isovaleric acid were positively correlated with PCR band quantity of P. gingivalis (r value was 0.334, 0.548, 0.411, 0.493, 0.273, respectively, P<0.05); the concentrations of SCFAs were significantly higher in T. denticola positive sites than negative sites: succinic acid, 1.67 (1.15, 2.11) mmol/L vs. 0.80 (0.48, 1.06) mmol/L; acetic acid, 31.95 (23.77, 43.13) mmol/L vs.12.51 (7.57, 15.69) mmol/L; propionic acid, 11.86 (6.55, 14.98) mmol/L vs. 2.82 (1.71, 7.03) mmol/L; butyric acid, 3.45 (2.41, 4.78) mmol/L vs. 0.54 (0.00, 1.56) mmol/L; isovaleric acid, 2.23 (1.05, 3.85) mmol/L vs. 0.62 (0.00, 2.33) mmol/L. The concentrations of succinic acid, acetic acid, propionic acid, butyric acid were positively correlated with PCR band quantity of T. denticola (r value was 0.443, 0.702, 0.625, 0.557, respectively, P<0.05). CONCLUSION: SCFAs concentrations reflect the quantity of P. gingivalis and T. denticola in patients with AgP, and may be an indicator to the disease progression in patients with AgP.

[Predictive model for post-treatment tooth loss of patients with aggressive periodontitis].

OBJECTIVE: To establish a predictive model for long-term tooth loss of patients with aggressive periodontitis (AgP) after periodontal treatment. METHODS: Patients diagnosed as AgP in Department of Periodontology, Peking University School and Hospital of Stomatology, who were re-evaluated 3 to 11 years after periodontal treatment were enrolled (n=85). Logistic regression was performed to select background, periodontal and radiographic factors which were related to long-term post-treatment tooth loss. A predictive model was built and analyzed by receiver operator characteristic (ROC) curve. RESULTS: After periodontal treatment, 55 teeth from 22 patients lost further. High prevalence of baseline bone loss, root abnormality, and residual severe bleeding sites, as well as poor compliance to maintenance were detected as risk factors in the predictive model. ROC analysis found the sensitivity and specificity of the model could reach up to 80% simultaneously. CONCLUSION: Predictive model for post-treatment tooth loss of patients with AgP is an important adjunct in clinical practice.

[Clinical evaluation of periodontal intrabony defects treated with a reconstituted bovine porous bone mineral containing bone morphogenetic proteins].

OBJECTIVE: To compare the outcomes of bovine porous bone mineral (BPBM) containing bone morphogenetic proteins (BMP) and BPBM alone in periodontal intra-bony defects. METHODS: In the study, 22 intrabony defects of 9 patients with periodontitis were recruited. All the patients had at least one pair of intrabony defects of ≥3 mm. The split-mouth and single blind methods were used. The defects were randomly assigned to BPBM containing BMP (test) or BPBM alone (control). After debridement, the intrabony defects were treated by bone graft. Assessments at baseline and after 6 months included plaque index, attachment level, probing pocket depth, bleeding indexes on probing and gingival recession. The early wound-healing, adverse effects and patients' perceptions were also recorded. RESULTS: The gain in clinical attachment was (3.0±1.2) mm in the test group and (3.2±1.1) mm in the control group. The pocket reduction was (3.4±1.5) mm in the test group and (2.8±1.0) mm in the control group. The reduction of bleeding index was 1.9±1.3 in the test group and 2.3±0.8 in the control group. There was no statistical difference between the test group and control group (P>0.05). CONCLUSION: Both treatment modalities led to similar significant clinical improvements.

[A short-term clinical evaluation of periodontal treatment with an Er:YAG laser for patients with chronic periodontitis: a split-mouth controlled study].

OBJECTIVE: To compare the short-term clinical effects following non-surgical periodontal treatment with Er:YAG laser or with combination of ultrasonic subgingival scaling and root planing with hand instrument (SRP) for patients with chronic periodontitis. METHODS: In the study, 17 patients with chronic periodontitis were randomly treated in a split-mouth design with Er:YAG laser (test group) or a combination of ultrasonic subgingival scaling and root planing with hand instrument (control group). The degree of discomfort experienced during the treatment was graded by the patient using visual analogue scale (VAS) immediately after the completion of test and control treatment procedures. The following clinical parameters were recorded by a calibrated and blinded examiner: plaque index (PLI), bleeding index (BI), probing depth (PD) and attachment loss (AL). RESULTS: The mean VAS score of Er:YAG laser treatment [3 (2, 4.5)] was significantly lower than that of control treatment [5 (4, 6), P=0.013]. Both the groups showed significant reduction of PLI, PD, AL and BI values 2 months and 4 months after treatment. For sites with PD≥4 mm at baseline, the sites treated with Er:YAG laser demonstrated mean PD change from (5.6±1.1) mm to (3.6±1.1) mm and to (3.4±1.0) mm at the end of 2 months and 4 months respectively and demonstrated mean AL change from (5.1±1.5) mm to (3.9±1.6) mm and to (3.8±1.7) mm at the end of 2 months and 4 months respectively, meanwhile the BI value showed significant decrease, P=0.000; the sites treated with conventional SRP demonstrated mean PD change from (5.6±1.1) mm to (3.8±1.1) mm and (3.5± 1.0) mm at the end of 2 months and 4 months respectively and demonstrated mean AL change from (4.8±1.6) mm to (3.8±1.6) mm and (3.6±1.8) mm at the end of 2 months and 4 months respectively, and the BI value also showed significant improvement. No statistical difference for all clinical parameters were found between the two treatment groups. CONCLUSION: The present results indicate that non-surgical periodontal therapy with Er:YAG laser is safe and effective, and Er:YAG laser therapy could be used for patients who was sensitive to pain.

Multilevel Analysis of Non-surgical Periodontal Treatment of Patients with Generalised Aggressive Periodontitis.

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.

[Effect of periodontal mechanical treatment on periodontal pathogenic bacteria in gingival crevicular fluid of chronic periodontitis patients].

OBJECTIVE: To evaluate the subgingival prevalent rates of 6 periodontal pathogenic bacteria in gingival crevicular fluids of CP patients before and after treatment, to analyze the relationship between the prevalent variance and periodontal clinical parameters, and to provide a microbiologic method of evaluating curative effect and estimating the prognosis. METHODS: Gingival crevicular fluids of 13 CP patients were collected at baseline, 2 weeks, 2 months and 4 months after periodontal mechanical treatment. Also, gingival crevicular fluids were collected from 11 healthy subjects. Six periodontal pathogenic bacteria including Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis(Pg), Tannerella forsythensis (Tf), Prevotella intermedia (Pi), Fusobacterium nucleatum(Fn), Prevotella nigrescens (Pn) were detected by 16S rRNA based PCR. RESULTS: The PLI, PD, BI of the CP patients 2 months and 4 months after periodontal mechanical treatment were evidently less than those before treatment. These 4 months after treatment were a little more than those 2 months after. The six bacteria were more frequently detected in the CP patients at baseline than in healthy controls. The prevalent rates of Tf (42.1%, 73.7%, 70.2%), Pg (47.4%, 68.4%, 77.2%), Aa (15.8%, 22.8%, 7.0%), Pn (38.6%, 57.9%, 64.9%), Pi(15.8%, 38.6%, 42.1%) 2 weeks, 2 months and 4 months following treatment were significantly lower than those at baseline (Tf 96.5%, Pg 93.0%, Aa 36.8%, Pn 86.0%, Pi 84.2%), but the prevalent rates of all the detected bacteria 2 months after treatment were higher than those at 2 weeks after. CONCLUSION: Tf, Pg, Aa, Pn and Pi may cooperate in the development of CP. The changes of periodontal pathogenic bacteria could be detected before the changes of clinical parameters and the patients should be re-evaluated and re-treated regularly within 2 months after treatment.

[Clinical significance of the change in serum IgG titers respond to Aggregatibacter actinomycetemcomitans in chronic periodontitis patients].

OBJECTIVE: To characterize serum antibody response to Aggregatibacter actinomycetemcomitans (Aa) serotype c in chronic periodontitis (CP) patients, and to observe the correlation of IgG titer with clinical parameters. METHODS: Venous blood samples were collected from 30 CP patients and 45 periodontal healthy controls, and unstimulated whole saliva and pooled subgingival plaque samples of CP patients were also collected for detection of Aa (PCR method). Serum IgG titers to Aa were measured by Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS: The detection rates of serum IgG to Aa serotype c in CP patients and healthy controls were both 100%. CP patients exhibited significantly higher IgG titers to Aa serotype c than healthy controls [(10.9+/-1.9) vs (9.1+/-1.8), P=0.000], and the prevalence of high-responding patients in CP group was also significantly higher than that of healthy controls (23.3% vs 0%, P=0.003). Serum IgG titers to Aa serotype c in Aa-positive CP patients (Aa-positive in subgingival plaque or saliva, n=7) were significantly higher than those of Aa-negative patients [(12.6+/-1.6) vs (10.4+/-1.7), P=0.005)]. Serum IgG titers to Aa in CP patients tended to be positively related to mean probing depth of whole mouth (r=0.344, P=0.068). CONCLUSION: Serotype c was the main serotype of Aa in CP patients. Serum IgG antibody to Aa serotype c did not seem to have a protective effect against periodontal infection.

[Correlation study on polymorphisms of vitamin D receptor gene in patients with periodontitis].

OBJECTIVE: To investigate the relationship between vitamin D receptor (VDR) gene polymorphisms and periodontitis. METHODS: Ninety patients with aggressive periodontitis(AgP), 34 patients with chronic periodontitis and 91 healthy controls were recruited in this study. VDR gene was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) with Taq I restriction endonuclease. RESULTS: The detection frequency of Tt genotype was higher in the aggressive periodontitis patients than in the healthy controls (16.7% vs 7.7%, P>0.05). The difference between the female aggressive periodontitis patients and healthy controls (20.8% vs 4.2%, P<0.05) was statistically significant, but no difference was found between the male patients and controls (10.8% vs 11.6%, P>0.05). There was a strong association between aggressive periodontitis and Tt genotype in females (AgP patients vs healthy controls, OR=6.02). The detection frequency of Taq I ER-alpha genotypes was not statistically different between the chronic periodontitis patients and healthy controls. CONCLUSION: In female Han Chinese population, the Tt VDR genotype may be associated with aggressive periodontitis.

[Association of SNPs in N-formylpeptide receptor gene with susceptibility of aggressive periodontitis].

OBJECTIVE: To explore the association of the single nucleotide polymorphisms (SNPs) in N-formylpeptide receptor (FPR) gene with the susceptibility of aggressive periodontitis (AgP). METHODS: A total of 94 AgP patients and 73 healthy controls were entered into the study. Peripheral blood sample was obtained from each subject by venepuncture. Genomic DNA was isolated from each sample. The target fragment of FPR gene was amplified by PCR. The SNPs in FPR gene were detected by denature high performance liquid chromatography (DHPLC) combined with DNA sequencing. RESULTS: There were two non-synonymous SNPs in the 370 bp FPR gene fragment: 289C/A and 301G/C. The 289C/A was a novel SNP. No variation in nucleotides 329 and 378 was detected. There were no statistically significant differences in distributions of the genotypes and alleles for FPR289 and FPR301 between AgP patients and healthy controls. Using multivariate logistic regression (adjusted for age and gender), it was showed that the adjusted ORs of AgP for the C(+) genotype and allele C of FPR301 combined with smoking were 5.74 and 5.20 respectively. CONCLUSION: The presence of the C(+) genotype/allele C of FPR301 together with smoking conferred a higher risk for AgP. The result suggests that the SNPs in FPR gene may not be associated with the susceptibility of AgP in Chinese.

[Detection of 3 anaerobic microorganisms in saliva and subgingival plaque of patients with periodontitis].

OBJECTIVE: To investigate the prevalence of 3 anaerobic microorganisms including Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf) and Treponema denticola (Td) in saliva and pooled subgingival plaque of different types of periodontitis and compare the detections of three microorganisms between saliva and pooled subgingival plaque sample from the same patient, and analyze the relationship between prevalence of these pathogens in saliva and periodontal parameters. METHODS: Non-stimulated saliva samples and pooled subgingival plaque samples were collected from 50 patients with aggressive periodontitis (AgP), 48 patients with chronic periodontitis (CP) and 25 subjects with no periodontitis, and three microorganisms including Pg, Tf and Td were detected in these samples by PCR method. RESULTS: Prevalence of three microorganisms in pooled subgingival plaque and saliva samples of AgP patients and CP patients were significantly higher than subjects with no periodontitis (P<0.01). The prevalence of Pg in Subgingival plaque and saliva was as follows: AgP, 100% vs 100%; CP, 93.8% vs 93.8%; Subjects with no periodontitis, 32% vs 48%. The prevalence of Tf in Subgingival plaque and saliva was as follows: AgP, 96% vs 88%; CP, 97.9% vs 89.6%; Subjects with no periodontitis, 32% vs 24%. The prevalence of Td in Subgingival plaque and saliva was as follows: AgP, 94% vs 86%; CP, 89.6% vs 70.8%; Subjects with no periodontitis, 12% vs 16%. The agreement between saliva and pooled subgingival plaque samples of these three microorganisms from the same patient was high. The presence of three microorganisms in saliva was all associated with bleeding index of gingiva, and odds ratio of Pg was 13.5 (P<0.01). CONCLUSION: Pg, Tf and Td were widely distributed in saliva and subgingival plaque of patients with AgP and CP. Presence of Pg, Tf and Td in saliva was related to periodontal parameters of gingiva, and saliva could be used as a promising sample for oral detection of these 3 microorganisms.

[Serum anti-Pg IgG antibody titers in patients with aggressive periodontitis].

OBJECTIVE: To measure the anti-Pg (porphyromonas gingivalis, Pg) IgG antibody titers in serum in patients with aggressive periodontitis (AgP); to study the association of IgG titers with periodontal status (alveolar bone loss); to analyze the age, gender or smoking status on IgG levels in patients with aggressive periodontitis. METHODS: (1) Ninety-one AgP subjects with an average age of 27.6 years (females 56, males 35, and 14 male-smokers) were collected. Thirty-five healthy subjects with an average age of 29.4 years (males 10 and females 25) were also collected as control group. (2) Questionnaire, clinical evaluations and assessments of alveolar bone loss were made. (3) Patients were categorized into two groups: severe AgP group (58 subjects, with >14 teeth of moderate-severe alveolar bone loss); light-moderate group (33 subjects). (4) To collect serum sample of patients and determine the anti-Pg IgG antibody titers in serum using ELISA. RESULTS: (1) The mean IgG antibody titers to Pg in AgP group (8.55 +/-3.24) were significantly higher than that in control group (4.78+/-2.58, P=0.0004). (2) No significant difference [(8.38+/-3.73) and (8.67+/-2.90), respectively] of mean anti-Pg IgG titers was found between male and female. (3) The mean of anti-Pg IgG titers (9.26+/-2.58) in elder group (aged>25) was significantly higher than that in younger patients (6.96+/-3.98, P=0.0014). (4) Smokers had significantly lower anti-Pg IgG titers (7.33+/- 3.72) than non-smokers (8.78+/-3.12, P=0.016). (5) Anti-Pg IgG titers in severe AgP group was significantly higher than that in light-moderate AgP group. (6)The results of multi-factor regression analysis showed that smoking, age and status of alveolar bone loss were the factors affecting anti-Pg IgG titers. CONCLUSION: The titers of IgG antibody to Pg in serum were related to age, smoking and periodontal status in AgP patients.

[Correlation analysis between plasma levels of 25-hydroxy vitamin D3 and osteocalcin in patients with aggressive periodontitis].

OBJECTIVE: To explore the relationship between plasmatic 25-hydroxy vitamin D3 (25OHD3) level and plasmatic osteocalcin level in patients with aggressive periodontitis (AgP). METHODS: Thirty four AgP patients and 29 healthy controls were included in this study. 25OHD3 and osteocalcin levels in plasma were measured using commercially available radioimmunoassay kits. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured using a standard hospital analytical technique. RESULTS: Plasmatic 25OHD3 level was significantly higher in AgP patients than that in healthy controls (8.65 microg/L vs 3.10 microg/L; P<0.01). Osteocalcin level was also significantly higher in AgP patients than that in healthy subjects (1.0 microg/L vs 0.8 microg/L; P=0.028). AST level was significantly lower in AgP patients than that in healthy controls(20.0 U/L vs 23.0 U/L). No correlations between the plasmatic levels of 25OHD3 and osteocalcin were detected in AgP patients or in healthy controls (r=0.271, P=0.12; r=-0.356, P=0.58). CONCLUSION: Plasmatic 25OHD3 and osteocalcin concentrations were not correlated but might be influenced by AgP.

[Relationship between herpesviruses and periodontal pathogenic bacteria in subgingival plaque].

OBJECTIVE: To evaluate the prevalence rates of human cytomegalovirus(HCMV) and Epstein-Barr virus-1(EBV-1) in subgingival plaque and analyze the relationship between herpesviruses, periodontal pathogenic bacteria and periodontal clinical parameters in Chinese patients with aggressive periodontitis(AgP). METHODS: A total of one hundred and twenty subgingival plaque samples were collected from 89 AgP patients and 31 healthy subjects. HCMV and EBV-1 were detected using nested polymerase chain reaction(PCR).Contemporaneously, 8 periodontal pathogenic bacteria including Actinobacillus actinomycetemcomitans(Aa), Porphyromonas gingivalis(Pg), Tannerella forsythensis(Tf), Prevotella intermedia(Pi), Campylobacter rectus(Cr),Fusobacterium nucleatum(Fn), Treponema denticola(Td), Prevotella nigrescens(Pn) were detected by 16S rRNA based PCR. RESULTS: HCMV was more frequently detected in AgP patients (43.8%) than in healthy controls (12.9%, P<0.01). The prevalence rates of HCMV and EBV-1 in AgP patients with 6-8 kinds of bacteria detected were 54.4% and 17.4%, respectively, significantly higher than those with 3-5 kinds of bacteria detected (P<0.05). CONCLUSION: The prevalence rates of HCMV and EBV was higher in AgP patients than in healthy controls. Herpesviruses and periodontal pathogenic bacteria may cooperate synergistically in the development of AgP, which could be considered as a pathogenetic consortium in future investigation of periodontaltitis.

Association analysis between interleukin-1 family polymorphisms and generalized aggressive periodontitis in a Chinese population.

BACKGROUND: It has been suggested that aggressive periodontitis (AgP) has a genetic basis, but this theory has not been confirmed. The intent of this investigation was to study whether specific interleukin (IL)-1 genotypes and/or alleles could be used to predict susceptibility to generalized AgP (GAgP) in Chinese. METHODS: The GAgP group consisted of 122 patients, and the control group included 95 healthy subjects. Single nucleotide polymorphisms at IL-1A (+4845) and IL-1B (-511, +3954) were analyzed by standard polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. The polymorphism of a variable number tandem repeat (VNTR) in intron 2 of IL-1RN was detected by PCR amplification and fragment size analysis. RESULTS: There was no significant association of IL-1 polymorphisms with GAgP in the unstratified subjects. However, when cases were stratified by gender, the frequencies of A2+ genotype and allele 2 at IL-1A +4845 were significantly increased in male patients compared to male controls (genotype: odds ratio [OR] 5.58, 95% confidence interval [CI]: 1.09 to 28.68, P = 0.039; allele: OR 4.97, 95% CI: 1.01 to 24.50, P = 0.049; adjusted for age and smoking status). The frequency of IL-1B -511 A1/A2 heterozygote was significantly increased in male GAgP group compared to male controls (adjusted OR 3.16, 95% CI: 1.01 to 9.89, P = 0.048). In females, no significant differences were found between patients and controls in corresponding analyses at all polymorphic loci. A possible combined effect of IL-1B -511 polymorphism and smoking on the elevated risk to GAgP was observed. The OR of GAgP for combined A2+ genotype and smoking was 12.45 (95% CI: 1.43 to 108.06, P = 0.022), and for combined allele 2 and smoking was 18.25 (95% CI: 2.32 to 143.86, P = 0.006). CONCLUSIONS: The polymorphisms of IL-1A +4845 and IL-1B -511 may play an important role in determining GAgP susceptibility in Chinese males. Furthermore, a possible combined effect of the polymorphism of IL-1B -511 and smoking on GAgP susceptibility was suggested.

[Alveolar bone loss in nuclear families of aggressive periodontitis and the heredity of root shape].

OBJECTIVE: To evaluate the status of residual alveolar bone in aggressive periodontitis (AgP) nuclear families and to investigate the influence of teeth with root abnormity on residual alveolar bone and the heredity of root abnormity, the premolar cone-root and proportion of crown and root. METHODS: Nineteen AgP probands (9 males and 10 females) at average age of 24.5 and 38 parents at average age 51.0 were included. A full set of periapical radiographs of all the subjects were taken. The residual alveolar bone of each tooth was measured by the ratio (shown as percentage) of the distance between apical and the alveolar bone crest to the whole root length. The abnormity of roots was detected on a full set of periapical radiographs. All the roots and crowns of teeth were measured. The relationship between the residual bone and the ratio was studied. The heredity grade of the premolar cone-root, proportion of crown and root, and root abnormity were computed. RESULTS: The average residual alveolar bone of probands was less than that of their parents.In 11 families, the father's residual alveolar bone was less than that of the mother's. The average residual alveolar bone of the teeth with root abnormity was less than that of normal teeth. The average residual alveolar bone of the teeth with abnormity of roots and the normal teeth were (67.5 ± 22.2)% and (73.1 ± 18.7)% respectively, with statistical significance (P < 0.001). The heredity grade of the premolar cone-root was 40.1%, the heredity grade of proportion of crown and root was 46.8%, the heredity grade of root abnormity was 30.3%. CONCLUSIONS: The residual alveolar bone of the teeth with root abnormity was less than that of normal teeth in nuclear families. The heritability of the root abnormity, the cone-root and proportion of crown and root in our sample was 0.3-0.5, which means that genetic factors accounted for about one third to half of the efficiency for AgP.