Absence of cytomegalovirus in gingivitis and chronic periodontitis in HIV-1 patients in Northern Brazil

Abstract INTRODUCTION The influence of cytomegalovirus (CMV) on the progression of chronic periodontitis in HIV patients is poorly investigated. METHODS ELISA was used for anti-CMV antibody IgG titer measurements and real-time polymerase chain reaction for qualitative and quantitative CMV detection. Data on the CD4 + T lymphocyte count and plasma HIV viral load were obtained from patient records. RESULTS CMV DNA was detected in samples of subgingival biofilm in only three individuals, two of them with chronic periodontitis (4%) and one with gingivitis (3.3%). CONCLUSIONS The prevalence of CMV is very low both in HIV-1 patients with gingivitis and chronic periodontitis.

Lack of associaiion between herpesvirus detectin in saliva and gingivitis in hhiv‑infected children / Ausência de associação entre a detecção de herpesvírus na saliva e gengivite em crianças infectadas pelo HIV

The aims of this study were to compare the detection of human herpesviruses (HHVs) in the saliva of HIV-infected and healthy control children, and to evaluate associations between viral infection and gingivitis and immunodeficiency. Saliva samples were collected from 48 HIV-infected and 48 healthy control children. Clinical and laboratory data were collected during dental visits and from medical records. A trained dentist determined gingival indices and extension of gingivitis. Saliva samples were tested for herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), varicella zoster virus (VZV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) by nested polymerase chain reaction assays. Thirty-five HIV-infected and 16 control children had gingivitis. Seventeen (35.4%) HIV-infected children and 13 (27%) control children were positive for HHVs. CMV was the most commonly detected HHV in both groups (HIV-infected, 25%; control, 12.5%), followed by HSV-1 (6.2% in both groups) and HSV-2 (HIV-infected, 4.2%; control, 8.3%). The presence of HHVs in saliva was not associated with the presence of gingivitis in HIV-1-infected children (p = 0.104) or healthy control children (p = 0.251), or with immunosuppression in HIV-infected individuals (p = 0.447). Gingivitis was correlated with HIV infection (p = 0.0001). These results suggest that asymptomatic salivary detection of HHVs is common in HIV-infected and healthy children, and that it is not associated with gingivitis.

Os objetivos deste estudo foram detectar a presença de herpesvírus humanos (HHVs) na saliva de crianças infectadas pelo HIV, em comparação com controles saudáveis e avaliar a associação entre infecção viral, gengivite e imunodeficiência. Para este fim, foram colhidas amostras de saliva de 48 crianças HIV-positivas e 48 controles saudáveis. O índice gengival e extensão de gengivite foram determinados por um dentista treinado. Informações clínicas e laboratoriais foram obtidas durante a consulta odontológica e dos registros médicos. As amostras de saliva foram testadas para detecção de vírus herpes simplex tipos 1 e 2 (HSV-1 e HSV-2), vírus da varicela-zoster (VVZ), vírus Epistein-Barr (EBV) e citomegalovírus (CMV) através de nested-PCR. Trinta e cinco crianças HIV-positivas e 16 crianças do grupo controle apresentavam gengivite. Dezessete (35,4%) crianças HIV-positivas e 13 (27%) crianças controle testaram positivo para a presença de HHVs. CMV foi o vírus mais comum detectado em ambos os grupos (25% HIV-positivas e 12,5% de controle), seguido por HSV-1 (6,2% de ambos os grupos) e HSV-2 (4,2% HIV-positivas e 8,3% de controle). Não houve associação entre a detecção de HHVs na saliva e a presença de gengivite em ciranças HIV-positivas (p = 0.104) ou crianças saudáveis (p = 0,251), ou com imunossupressão em indivíduos HIV-positivos (p = 0,447). Foi observada uma correlação entre a infecção por HIV e a presença de gengivite (p = 0,0001). Os resultados sugerem que a detecção salivar assintomática de HHVs é comum entre crianças HIV-positivas e crianças saudáveis, e não está associada à gengivite.

Efecto del tratamiento periodontal sobre la microbiota subgingival en pacientes con preeclampsia / Effect of periodontal therapy on the subgingival microbiota in preeclamptic patients

Introducción. Pocos estudios han descrito la microbiota subgingival en mujeres embarazadas con preeclampsia leve. Objetivo. Identificar cambios periodontales y de la microbiota subgingival en mujeres embarazadas con preeclampsia, después del tratamiento periodontal. Materiales y métodos. En un análisis secundario de un ensayo clínico de asignación aleatoria, se estudiaron 57 pacientes con preeclampsia en el Hospital Universitario del Valle de Cali. Se asignaron al azar 31 al grupo de intervención periodontal (detartraje y alisado subgingival ultrasónico y manual) durante su embarazo y otras 26 al grupo control (profilaxis supragingival). Se determinaron los parámetros clínicos periodontales y la microbiota subgingival a la inclusión al estudio y en el posparto. Se evaluaron 8 bacterias periodontopáticas y 2 virus herpes por reacción en cadena de la polimerasa. Se usaron las pruebas de ji al cuadrado, test de McNemar o t de Student, con un nivel de significancia de p≤ Resultados. Los grupos fueron comparables en las variables clínicas y microbiológicas al inicio del estudio. El tratamiento periodontal redujo el promedio de la profundidad de bolsa en el grupo de intervención de 2,44±0,31 a 2,31±0,24 mm (p=0,000) y en el grupo control de 2,58±0,37 a 2,44±0,39 mm (p=0,000),y el índice de sangrado, de 16,4±1,5 a 7,9±0,7 % en el primero (p=0,000), y de 17,1±1,8 a 10±0,9 %, en el segundo (p=0,002). La frecuencia de detección de microorganismos no varió de manera significativa entre los grupos. Conclusión. El raspaje y alisado radicular, así como la profilaxis supragingival, redujeron de manera significativa la profundidad a la sonda y el índice de sangrado gingival. El tratamiento periodontal no fue más efectivo que la profilaxis para reducir los organismos periodontopáticos o los virus herpes.

Introduction. Few studies have described subgingival microbiota in pregnant women with mild preeclampsia. Objective. Clinical periodontal and subgingival microbiota changes were identified in pregnant women with mild preeclampsia after periodontal treatment. Materials and methods. In a secondary analysis of a randomized clinical trial, 57 preeclamptic women were studied at Hospital Universitario del Valle in Cali, Colombia. Thirty one women were randomized to the periodontal intervention group (subgingival scaling and planing ultrasonic and manual) during pregnancy and 26 to the control group (supragingival prophylaxis). Periodontal clinical parameters and subgingival microbiota were characterized at the time of acceptance into the study and again at postpartum. Eight periodontopathic bacteria and 2 herpesviruses were assessed by polymerase chain reaction. Chi-square, McNemar or Student´s t tests were used, with a significance level of p≤0.05. Results. Both groups were comparable in the clinical and microbiological variables at baseline. Periodontal treatment reduced the average pocket depth in the intervention group from 2.4±0.3 to 2.3±0.2 mm (p<0.001) and in control group 2.6±0.4 to 2.44±0.4 mm, (p<0.001) and bleeding index 16.4±1.5% to 7.9±0.7% in the intervention group(p<0.001) and 17.1±1.8% to 10±0.9% in the control group (p=0.002). The frequency of detection of microorganisms did not differ significantly between groups. Conclusion. Scaling/root planning and supragingival prophylaxis significantly reduced the probing depth and gingival bleeding index. Periodontal treatment was not more effective than prophylaxis in reducing periodontopathic organisms or herpesvirus.

Primary herpetic gingivostomatitis in an adult patient using an orthodontic appliance / Gingivoestomatitis herpética primaria en un paciente adulto utilizando un aparato ortodóntico

The present article describes a clinical case of an adult patient using an orthodontic appliance, who returned to the dental office after the placement of orthodontic mini-implants, complaining of aphthas. By means of clinical and case history evaluation the diagnosis of primary herpetic gingivostomatitis was reached. The treatment was prescription of an antiviral agent associated with a chlorhexidine-based oral mouthwash. One week after their onset, there was complete regression of the lesions.

El presente artículo describe un caso clínico de un paciente adulto utilizando un aparato de ortodoncia, que regresó a la consulta dental después de la colocación de mini-implantes ortodónticos, quejándose de aftas. Por medio de la evaluación clínica y de historia del caso, el diagnóstico de gingivoestomatitis herpética primaria fue realizado. El tratamiento fue la prescripción de un agente antiviral asociados con un enjuague bucal con clorhexidina. Una semana después de su inicio, se produjo regresión completa de las lesiones.

EBV-1 and HCMV in aggressive periodontitis in Brazilian patients

The purpose of the present investigation was to compare the presence of Epstein-Barr virus type 1 (EBV-1) and of Human Cytomegalovirus (HCMV) in crevicular fluid samples from deep and shallow periodontal pocket sites of Brazilian patients with aggressive periodontitis. A total of 30 systemically healthy patients with aggressive periodontitis participated in the study. Paper points were inserted into 2 gingivitis sites (< 3 mm) and into 2 periodontitis sites (> 5 mm) in each patient. PCR assay was used to identify genomic copies of HCMV and EBV-1. Twenty-three patients (77 percent) were positive for EBV-1, while only 2 patients (6 percent) were positive for HCMV. The McNemar test revealed a positive association between EBV-1 and periodontal lesions (p = 0.043). Thirty-four (57 percent) out of 60 periodontitis sites were positive for EBV-1, whereas 18 (30 percent) gingivitis sites were positive (p = 0.01). Only two sites (6.7 percent) were positive for HCMV. No positive association was found between HCMV and periodontitis or gingivitis (p = 0.479). The elevated occurrence of EBV-1 DNA in periodontal pockets of patients with aggressive periodontitis supports a possible periodontopathic role of this virus.

O objetivo do presente estudo foi comparar a presença do vírus Epstein-Barr tipo 1 (EBV-1) e do Citomegalovírus Humano (HCMV) em amostras de fluido crevicular de bolsas periodontais rasas e profundas de pacientes brasileiros com periodontite agressiva. Trinta pacientes sistemicamente saudáveis com periodontite agressiva participaram deste estudo. Cones de papel foram inseridos em 2 sítios de gengivite (< 3 mm) e em 2 sítios de periodontite (> 5 mm) de cada paciente. Reações de PCR foram usadas para identificar cópias de DNA genômico de HCMV e EBV-1. Em 23 pacientes (77 por cento), os testes foram positivos para EBV-1, enquanto apenas 2 pacientes (6 por cento) foram positivos para HCMV. O teste de McNemar apontou associação positiva entre EBV-1 e lesões periodontais (p = 0,043). Trinta e quatro (57 por cento) dos 60 sítios de periodontites foram positivos para o EBV-1, enquanto 18 (30 por cento) dos sítios de gengivites foram positivos (p = 0,01). Apenas 2 sítios (6,7 por cento) foram positivos para o HCMV. Não foi encontrada associação positiva entre HCMV e periodontite ou gengivite (p = 0,479). A alta ocorrência de DNA de EBV-1 em bolsas periodontais de pacientes com periodontite agressiva corrobora a possível função periodontopática deste vírus.