Periodontal disease in mothers indicates risk in their children.

INTRODUCTION: It is well established that severe periodontitis clusters in families, but there are no data about the relationship between mothers with chronic periodontitis and their children's periodontal status. OBJECTIVE: To evaluate a risk for periodontal diseases in children of periodontally diseased and healthy mothers. METHODS: Four study groups were included: (I) 20 female patients with untreated generalized severe chronic periodontitis, (II) their children (34), (III) 13 periodontally healthy mothers and (IV) their children (13). Material was collected from years 2004-2006. The clinical examination included registration of visible plaque index, modified gingival index and, bleeding sites on probing. Periodontal microbiological samples were obtained from all study subjects and the isolates were identified according to morphology and biochemical profiles; similar interfamilial pathogens were compared by PCR-technique. RESULTS: The children of diseased mothers more frequently had periodontal diseases, especially gingivitis. In addition, clinical parameters of gingival inflammation were more expressed and oral hygiene was worse in this group of children. VPI and VPI% of the diseased and healthy mothers differed significantly. The most common oral pathogens were P. intermedia/nigrescens and A. actinomycetemcomitans. The children of healthy mothers harboured pathogens less frequently than the children of diseased mothers. The sharing of P. intermedia/nigrescens was more frequent (5 families) than A. actinomycetemcomitans (2 families). CONCLUSION: Maternal indicators, such as periodontitis, hygiene habits, and periodontal microflora are risk factors for childhood periodontal diseases, and might be predictive of future childhood and adolescent periodontitis.

The efficacy of non-surgical and systemic antibiotic treatment on smoking and non-smoking periodontitis patients.

In 28 adult severe periodontitis patients who did not respond to conventional periodontal therapy, full mouth clinical parameters including probing pocket depth, relative attachment level, bleeding on probing and suppuration after probing, visible plaque index and modified gingival index were recorded at the baseline and 14 months after treatment. Based on clinical and bacteriological diagnosis, a combination of systemic amoxicillin 500 mg x 3 and metronidazole 200 mg x 2 was prescribed for 7 days. In combination with non-surgical treatment, systemic antibiotic therapy, significantly improved median values of probing pocket depth, bleeding on probing, suppuration index, visible plaque index and modified gingival index except relative attachment level. Despite the improvement of clinical parameters in general, both bleeding on probing and suppuration index had significantly lower reduction in smokers than in non-smokers.

The microbiological status of patients with periodontitis in southern Estonia after non-surgical periodontal therapy.

Our objective was to investigate the presence of periodontal pathogens in comparison with the total degree of microorganisms after non-surgical periodontal therapy. The study material consisted of microbiological samples from periodontal pockets originating from 140 consecutive patients with chronic generalized severe periodontitis. The subgingival samples from periodontal pockets were obtained by a sterile curette, placed into 2 ml of the VMGA III medium, homogenized and serially diluted in the Brucella broth. 100 microl aliquots from the dilutions were inoculated onto the Brucella and the TSBV agar. The plates were incubated in an anaerobic chamber and under microaerobic conditions. The isolates were identified according to colonial and cellular morphology, the potency disk pattern, and the biochemical profiles. After instrumentation, no periodontal pathogens were isolated in 46 (33%) patients, while 94 patients (67%) were infected with one to five different periodontal pathogens. However, higher degree of the total microflora was positively correlated with number of isolated pathogens, a putative indicator of their presence. Therefore, due to the occurrence of residual microorganisms after non-surgical mechanical treatment, information about the pattern of these pathogens is needed for application of antimicrobial therapy. The level of microbial load in gingival pockets, including both pathogenic and non-pathogenic species, is one of the determinants of presence of residual pathogens after non-surgical periodontal therapy.

Metronidazole concentrations in plasma, saliva and periodontal pockets in patients with periodontitis.

OBJECTIVES: Metronidazole is widely used antibacterial compound in the treatment of some types of periodontal disease. Pharmacokinetics of metronidazole in plasma has been well-described but few data exist about penetration of the drug to the gingival crevice fluid. The aim of the present study was to compare the concentrations of metronidazole in plasma, saliva and gingival crevice fluid in patients with periodontitis after multiple administration. MATERIALS AND METHODS: Eleven patients with severe generalised adult periodontitis participated in the study. Metronidazole, 500 mg, was administered orally two or three times per day for at least 2 days before sample collection. Samples were collected 2 h after last dose. Metronidazole concentrations in all fluids were measured with high-performance liquid chromatography. RESULTS: Mean drug concentrations in plasma, saliva and crevice fluid were 14.33, 15.15 and 12.86 microg/ml, respectively. Difference between plasma and crevice fluid or between plasma and saliva did not reach statistical significance. CONCLUSION: Present study revealed that metronidazole penetrates well into gingival crevice fluid and saliva. Metronidazole concentrations in crevice fluid are about equal to the protein unbound drug concentrations in plasma. Therefore, general pharmacokinetic data of metronidazole can be also applied in the treatment of periodontal disease and in the design of respective treatment regimens.