Prevalence and risk indicators for destructive periodontal diseases in 3 urban American minority populations.

BACKGROUND, AIMS: Destructive periodontal diseases have been reported disproportionately more prevalent and severe in African-Americans relative to other American populations. Differences in subgingival microbiota and host immune response have also been reported for African-Americans, implying that risk factors for disease progression may also differ for these populations. Since it is not clear whether these differences are truly genetic or due to confounding variables such as social economic status, we examined a series of clinical, environmental, demographic, and microbiologic features associated with periodontal disease status in a group of 185 urban minority subjects resident within the greater New York metropolitan area. METHODS: The study population consisted of 56 Asian-American, 71 African-American and 58 Hispanic subjects. Clinical data recorded included pocket depth, attachment level, gingival erythema, bleeding upon probing, suppuration, and the presence of supragingival plaque. Environmental and demographic data recorded included smoking history, years resident in the United States, whether the subject reported a private dentist and occupational status. Subgingival plaque was sampled from the mesial aspect of all teeth exclusive of third molars and the levels of 40 subgingival species enumerated using checkerboard DNA-DNA hybridization. RESULTS: The African-American group had more missing teeth, deeper periodontal pocket depth and more attachment loss than the Asian-American or Hispanic groups. However, the African-American group were less likely to report having a private dentist, had a greater proportion of smokers and a greater proportion of unskilled individuals. The profile of subgingival species differed among the three ethnic/racial groups with A. actinomycetemcomitans, N. mucosa, S. noxia and T. socranskii significantly elevated in the Asian-American group and P. micros significantly elevated in the African-American group. When subset by occupational status, numbers of missing teeth, pocket depth, attachment level and prior disease activity were all found increased in the unskilled relative to the professional group. Local factors including the mean % of sites with plaque, marginal gingival erythema, bleeding upon probing and suppuration were also elevated in the unskilled group. The microbial profile differed among the 3 occupational groups with the unskilled group having elevated numbers of species associated with destructive periodontal diseases. CONCLUSIONS: Although greater destructive periodontal disease prevalence and severity were found in the African-American group, these results suggest that environmental and demographic variables, such as occupational status, may have a greater influence on risk indicators associated with disease prevalence and progression in these populations.

An evaluation of resin-ionomers to prevent coronal microleakage in endodontically treated teeth.

While a gutta-percha system is most commonly used by practitioners for canal obturation, there is no agreement on how best to close the chamber of an endodontically treated tooth. Some materials used in restorative dentistry may have endodontic applications. Restorative materials of particular interest to endodontists are those used as subgingival restorations. Their properties include insolubility in oral fluids, adhesiveness, dual-cure capabilities, radiopacity, hardness and fluoride release, low cure shrinkage and a low coefficient of thermal expansion. The purpose of this in vitro study was to test three products that could be used to seal pulp chambers of endodontically treated teeth to prevent bacterial infiltration. A bacteriological assay system was used to determine the efficacy of three commercially available restorative materials to prevent penetration of Streptococcus salivarius from the pulp chambers into the prepared canals. The materials evaluated were: Geristore two-paste system with Tenure Quik with fluoride, Dispersalloy with Tenure Quik with fluoride, and Marathon posterior composite with Tenure Quik with fluoride. During the sixty days of the study, the analysis indicated that the Geristore two-paste system with Tenure Quik with fluoride provided a statistically significant improved seal when compared to the Marathon posterior composite and Dispersalloy amalgam with Tenure Quik with fluoride.

A comparison of MTA, Super-EBA, composite and amalgam as root-end filling materials using a bacterial microleakage model.

AIM: The aim of this study was to compare traditional and newly developed root-end filling materials for resistance to bacterial microleakage. METHODOLOGY: Sixty extracted single-rooted teeth were randomly divided into five groups for root-end filling with mineral trioxide aggregate, Super-EBA, TPH composite resin with ProBond dentine bonding agent, Dispersalloy amalgam with and without ProBond, and positive and negative control groups. Root canals were instrumented using the step-back technique and simulated root-end resections performed. Root-end filling materials were placed in 3 mm ultrasonic retropreparations. Nail varnish was applied to all external root surfaces to the level of the resected root ends to prevent lateral microleakage. Samples were sterilized in an ethylene oxide sterilizer for 12 h. Using a newly designed model system, the apical 3-4 mm of the roots were immersed in BHI culture medium with phenol red indicator within culture chambers. The coronal access of each specimen was inoculated every 48 h with a suspension of Streptococcus salivarius. Culture media were observed every 24 h for colour change indicating bacterial contamination. Media demonstrating colour change were plated for S. salivarius. Samples were observed for 12 weeks. RESULTS: At 4 weeks 10% of specimens from each experimental group had evidence of leakage. At 8 weeks 20% of specimens filled with amalgam without dentine bonding agent, Super-EBA and MTA had evidence of leakage. At 12 weeks minor differences between materials were noted. CONCLUSIONS: Under the conditions of the study, despite some variations, there were no statistically significant differences in rate of microleakage among the five groups tested at either 4, 8 or 12 weeks.

Respiratory pathogen colonization of the dental plaque of institutionalized elders.

Although it has been established that aspiration of pharyngeal bacteria is the major route of infection in the development of nosocomial pneumonia, colonization of the pharyngeal mucosa by respiratory pathogens has been shown to be a transient phenomenon. It has been suggested that the dental plaque may constitute an additional, possibly more stable, reservoir of respiratory pathogens. The purpose of this study was to assess the prevalence of oral colonization by potential respiratory pathogens in a group of elderly (mean age = 75.9 yrs) chronic-care-facility residents (n = 28) and a group of age-, gender-, and race-matched outpatient control subjects (n = 30), with specific attention to plaque present on tooth, denture, and oral mucosal surfaces. Plaque scores on teeth and dentures were significantly higher in the chronic-care-facility (CCF) subjects than in the dental outpatient control (DOC) subjects (PII 2.3 vs. 1.2 and denture plaque 1.4 vs. 0.3). While no subjects in the DOC group were found to be colonized with respiratory pathogens (> 1.0% of the cultivable aerobic flora), 14.3% (4/28) of the CCF subjects were found to be colonized. Oral colonization with respiratory pathogens in CCF subjects was associated with the presence of chronic obstructive pulmonary disease (COPD) and higher plaque scores. These results suggest that deficient dental plaque control and the presence of COPD may be related to respiratory pathogen colonization of dental plaque in chronic-care-facility residents.

Antimicrobial activity of cavity disinfectants.

The purpose of this study was to determine the antimicrobial activity of four commercially available cavity disinfectants and one prescription mouthwash as they came into contact with bacteria commonly found in the oral cavity. Streptococcus mutans, salivarius, and Actinomyces viscosus were used in the study. Zones of microbial inhibition were measured in millimeters after 48 hours. The results of this study indicate that all of the antimicrobial agents demonstrated activity against the bacteria tested. Consepsis Solution produced the largest zones of inhibition against all three of the bacteria used.

Antimicrobial activity produced by six dentifrices.

The antimicrobial activity of six commercially available dentifrices and positive and negative controls as they come into contact with Streptococcus mutans, S. sanguis, and Actinomyces viscosus commonly found in the oral cavity. Sterile discs treated with the dentifrices were placed on agar plates with the controls. Zones of microbial inhibition were measured in millimeters after 48 hours. All of the test dentifrices demonstrated antimicrobial activity against the bacteria.

A comparison of antimicrobial activity of etchants used for a total etch technique.

The purpose of this study was to determine the antimicrobial activity of eight commercially available etchant materials and positive and negative controls as they came into contact with bacteria commonly found within the oral cavity. The following bacteria were used in this study: Streptococcus mutans, Streptococcus salivarius, and Actinobacillis actinomycetocomitants. The study was conducted in two parts: Part I--Etchants and controls placed within wells in agar plates; Part II--Enamel-dentin disks saturated with the etchants for 20 seconds and placed on the agar plates with the controls. Zones of microbial inhibition were measured in millimeters after 48 hours. The results of the study indicate that all of the etchants demonstrated antimicrobial activity against the bacteria tested.

A comparison of the apical seals achieved using retrograde amalgam fillings and the Nd:YAG laser.

The purpose of this in vitro study was to compare the apical seals achieved using retrograde amalgam fillings or the Nd:YAG laser. Freshly extracted teeth were randomly separated into groups that would have their apices treated either with a Nd:YAG laser or retrograde amalgam. After instrumentation and obturation, bacterial reservoirs were prepared in the coronal portion of canals. Teeth to receive retrofillings had their apices prepared and amalgams placed. Teeth to be lasered had no apical preparations. Teeth and culture media were then sterilized by irradiation. Streptococcus salivarius was deposited in the opened bacterial reservoirs. At intervals, culture media with an indicator in culture chambers was observed for color change. Specimens that demonstrated color change were cultured for S. salivarius. Under the conditions of this in vitro study, no statistically significant difference was found in bacterial leakage between the laser-treated group and the retrograde amalgam group.

Effectiveness of a professional formula disinfectant for irreversible hydrocolloid.

In this study, the effectiveness of Professional Lysol (PL) disinfectant in both its spray and solution forms was evaluated as a surface disinfectant for irreversible hydrocolloid (IH) impressions. Sixteen impressions of a typodont were made with IH, immersed in a microbial broth, and then rinsed in running tap water. The impressions were then treated as follows: four were immersed in PL for 2.5 minutes; four were sprayed by PL and stored for 10 minutes; four were immersed in 2% glutaraldehyde for 10 minutes; four were untreated. Pretest plates showed an average of 421 colonies per plate (c/p). The glutaraldehyde group showed 0.00 c/p. The PL spray group showed 1.75 c/p. The PL immersion group showed 19.00 c/p and showed evidence of surface deterioration in the IH. The untreated group showed 426.25 c/p.

An in vivo comparison of antimicrobial activities of four commercial mouthwashes.

The purpose of this in vivo double-blind study was to determine and compare the antimicrobial effectiveness of four commercial over-the-counter mouthwashes and a water control. Two of the products tested contained alcohol (Listerine and Scope) and two products were alcohol-free (Rembrandt Mouth Refreshing Rincs and Clear Choice). The antimicrobial efficacy of the products was determined against aerobic, microaerophilic, and anaerobic bacteria in saliva. Thirty human subjects participated in the study. At each experimental session for a given subject, a pretest saliva sample was taken. This sample was divided and used to grow three bacteria cultures under the different incubation environments. After giving the pretest sample, the subject rinsed with one of the commercial mouthwashes or the water control for 30 seconds, then waited one hour at which time a posttest saliva sample was collected. Again, the sample was divided and used to culture the different type of bacteria. Following a 48-hour incubation period, the numbers of microbial colonies on each plate were counted and compared. The results indicated that all of the mouthwashes tested performed significantly better than the water control. Both of the non-alcohol-containing products showed efficacy in inhibiting aerobic, microaerophilic, and anaerobic bacteria. Rembrandt Mouth Refreshing Rinse and Listerine inhibited all three types of bacteria, and were not significantly different from each other in efficacy. The Rembrandt mouth wash inhibited all three types of bacteria more effectively than Clear Choice mouthwash, and inhibited two of the three types of bacteria more effectively than Scope mouthwash.

Vital bleaching agents and oral antiseptic: effect on anaerobic bacteria.

This in vitro study compared the antimicrobial effect of several at-home bleaching agents and an oral antiseptic against anaerobic bacteria that are commonly found in the oral cavity. Zones of inhibition produced by Rembrandt Lighten Bleaching Gel, Opalescence, and Peroxyl were measured and compared. All the materials produced zones of inhibition with the five bacteria used in the study.

A note on epidemics in heterogeneous populations.

Recent analysis has shown the importance of heterogeneity for understanding the course of epidemics. However, the results generally rely on computer models or the assumption that the population consists of internally homogeneous subgroups. This note presents some analytic results for the more general case, in which any distribution can characterize population heterogeneity in susceptibility under proportionate mixing. At any moment, epidemics in such a situation resemble classic epidemics, with rate of spread governed by the average susceptibility of those not yet infected. But, over time, this average susceptibility falls at a rate proportional to the dispersion of susceptibility among those not yet infected. The author concludes by noting some implications of heterogeneity for understanding epidemics.

Bacterial contamination in reversible hydrocolloid conditioning units.

Four hydrocolloid conditioning units were randomly tested for bacterial contamination. All were contaminated beyond the United States Army's acceptable limit of potability. The predominant bacteria were identified. A discussion of clinical significance and proposals for aseptic technique are presented.

Social support, life stress, and subsequent medical care utilization.

Four-hundred thirty-seven adults 40 years old or older were monitored for medical care utilization in a health maintenance organization over a 5-year period. Rates of utilization were related, in specific ways, to initially obtained indicators of life stress and social support and to interactions between life stress, social support, and age. Use of both standard and step-down hierarchical multiple-regression procedures permitted a distinction between immediate and delayed effects. Implications are drawn regarding the buffering hypothesis for the mitigating effects of social support on the likelihood of health breakdown.

Regulation of the bacterial cell wall: analysis of a mutant of Bacillus subtilis defective in biosynthesis of teichoic acid.

Bacillus subtilis 168ts-200B is a temperature-sensitive mutant of B. subtilis 168 which grows as rods at 30 C but as irregular spheres at 45 C. Growth at the nonpermissive temperature resulted in a deficiency of teichoic acid in the cell wall. A decrease in teichoic acid synthesis coupled with the rapid turnover of this polymer led to a progressive loss until less than 20% of the level found in wild-type rods remained in spheres. Extracts of cells grown at 45 C contained amounts of the enzymes involved in the biosynthesis and glucosylation of teichoic acids that were equal to or greater than those found in normal rods. Cell walls of the spheres were deficient also in the endogenous autolytic enzyme (N-acyl muramyl-l-alanine amidase). Genetic analysis of the mutant by PBS1-mediated transduction and deoxyribonucleic acid-mediated transformation demonstrated that the lesion responsible for these effects (tag-1) is tightly linked to the genes which regulate the glucosylation of teichoic acid in the mid-portion of the chromosome of B. subtilis.

Ultrastructure of a temperature-sensitive rod- mutant of Bacillus subtilis.

Mutant 168ts-200B, resulting from nitrosoguanidine treatment of Bacillus subtilis 168 (trp(-) C2), exhibits a rod-to-sphere morphogenetic interconversion when the incubation temperature is 30 or 45 C, respectively. Ultrathin sections of rods grown at 30 C, after glutaraldehyde-osmium uranium-lead fixation and staining, show trilaminar cell walls with a well-developed underlying periplasm as in wild-type cells. However, the outer wall layer is irregular, and abnormal protrusions of wall material occur at the cross-walls. In contrast, cells growing at 45 C become rounded and are intersected randomly by irregular cross-walls which fail to split normally, resulting in large spherical masses. In these, the outer and inner wall layers and periplasm are lost, and the wall consists only of irregularly thickened and loosely organized middle layer. Wall ultrastructure is reversible in either direction as cell shape changes during temperature shifts. Mesosomes are rare and atypical at either temperature. It thus appears that cell wall ultrastructure is altered by the conditional (temperature-sensitive) mutation, and that loss of normal wall and submural organization is correlated with changes in cell size and shape as well as with inability to complete cell division. Preliminary studies after transformation of the mutant locus to another strain and growth at 45 C showed an increase in mucopeptide, loss of wall teichoic acid, failure of phage adsorption, and identical ultrastructural changes. The site of expression of the basic defect-be it in wall, submural region, or membrane-is undetermined.

Initial characterization of a temperature-sensitive rod--mutant of Bacillus subtilis.

The general biological properties of a temperature-sensitive morphological mutant of Bacillus subtilis (168ts-200B) are described. At the restrictive temperature (45 C), cells grow as spheres which divide irregularly to form grapelike clusters. At the permissive temperature (30 C), the mutant grows as typical B. subtilis rods in short chains. A log-phase culture of rods (30 C) may be converted to spheres by transfer to 45 C. Reversion of spheres to rods occurs when the alternate temperature shift is made. Growth curves, deoxyribonucleic acid replication kinetics, and the morphology of mutant 168ts-200B are described.