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.

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.

[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.

[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.

[The accuracy of probing depth measurements of undergraduate students and associated factors analysis].

OBJECTIVE: To investigate the accuracy of probing depth measurements of undergraduate students in department of periodontology and analyze the cause of measurement errors. METHODS: Thirty-eight dental students from Peking Universty School and Hospital of Stomatology who began their periodontal clinical practice for the first time were recruited. According to principle of clinical teaching, after the students recorded the probing depth of 1-2 periodontitis patients using Williams periodontol probe, an experienced teacher checked the probing depth. The measurements of interproximal sites of Ramfjord index teeth (6 14 41 6) were used as the data of this study. According to the probing depth discrepancies between teacher and the students, all the probing sites were divided in three levels: absolutely consistent sites (probing depth measured by teacher and by student was completely consistent), almost consistent sites (the depth discrepancy between teacher and student was 1 mm), inconsistent sites (the depth discrepancies between teacher and student ≥ 2 mm). RESULTS: The accuracy of probing depth measurements of students decreased with the deepening of probing depth, and the accuracy of probing depth measurements in molar teeth was significantly lower than incisor teeth [58.8% (261/444) vs.73.1% (339/464), P < 0.01]. The main factor associated with the accuracy of probing depth measurements in interproximal sites was the probe's inability to get into gingival col, which accounted for 70.7% (87/123) of the total inconsistent sites. CONCLUSIONS: The correct angle of insertion of the probe in interproximal sites should be reinforced during the course of pre-clinical education of periodontal probing. More attention should be paid to check the probing depth of deep pockets and molar teeth during the clinical practice of undergraduate students.

[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.

[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.

[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.

[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.

Treatment of generalised aggressive periodontitis: a 4-year follow-up case report.

Aggressive periodontitis comprises a group of rare, often severe, rapidly progressive forms of periodontitis mostly characterised by an early age of clinical manifestation and a distinctive tendency for cases to aggregate in families. This case report presents a 16-year-old female patient with clinical and radiographic evidence of severe attachment loss, whose mother was also a patient with severe periodontal destruction. The girl was diagnosed with generalised aggressive periodontitis and received full-mouth scaling and root planing, bone graft surgeries and guided tissue regeneration on intrabony defects mesial of the mandibular first molars. Microbiological and immunological tests were performed on five selected sites before and at 2 months after initial therapy. Clinical and radiographic findings reported up to 4 years postoperatively indicated good effects and stability of treatment outcome.

[A preliminary study on the genetic mode of aggressive periodontitis in Chinese Han nationality].

OBJECTIVE: To investigate the potential genetic mode of aggressive periodontitis (AgP) in Chinese Han nationality. METHODS: A total of 233 subjects from 73 nuclear families were recruited. All probands were diagnosed according to the criteria of AgP in 1999 classification of periodontal diseases. Ninety parents, 35 siblings and three grandparents and two offspring were examined based on full-mouth periodontal chartings (including parameter of probing depths, attachment loss, bleeding on probing at six sites per tooth) and full-mouth periapical radiographs. The genetic ratio was calculated and analyzed by the methods of Edwards and simple segregation. RESULTS: The prevalence of AgP in probands' siblings was close to the square root of the prevalence of general population. The segregation ratio was 0.2419, which was close to the theoretical ratio for autosomal recessive inheritance. However, autosomal dominant inheritance could not be rejected in families whose parent(s) suffered from severe chronic periodontitis. CONCLUSIONS: The genetic heterogeneity of AgP existed in Chinese Han nationality. The genetic mode was autosomal recessive inheritance in general, and autosomal dominant inheritance could not be excluded in families whose parent(s) suffered from severe chronical periodontitis. The results imply the genetic heterogeneity of AgP, and further demonstrate that AgP was a multifactorial disease with major genetic component in the disease etiology.

[Short term effect of combined use of amoxicillin and metronidazole at different time of non-surgical periodontal treatment for aggressive periodontitis].

OBJECTIVE: To evaluate the short term clinical results of scaling and root planning (SRP) only, SRP combined with amoxicillin (AMX) and metronidazole (MTZ) after supragingival scaling or after SRP in the treatment of aggressive periodontitis (AgP). METHODS: A total of 45 patients with AgP were randomly divided into SRP group, SRP with AMX + MTZ after supragingival scaling group and AMX + MTZ after SRP group. Subgingival scaling and root planning were performed one week after supragingival scaling and finished within 1 month. AMX and MTZ were given for 7 days immediately after supragingival scaling or the last time of SPR. Clinical examinations including probing depth (PD), attachment level (AL) and bleeding index (BI) were performed at baseline and 8 weeks after non-surgical periodontal treatment by the same examiner. RESULTS: There were more PD reduction and AL gain in both AMX + MTZ after supragingival scaling group and AMX + MTZ after SRP group compared with SRP group [2.5 (1.8, 3.3) mm, 2.3 (1.9, 2.7) mm vs. 1.8 (1.3, 2.1) mm, P < 0.05]; [0.9 (0.5, 1.4) mm, 0.8 (0.4, 1.3) mm vs. 0.4 (0.2, 1.0) mm, P < 0.05]. In sites PD ≥ 7 mm, PD reduction was more in AMX + MTZ after supragingival scaling group than AMX + MTZ after SRP group [4.0 (3.0, 5.0) mm vs. 4.0 (3.0, 4.0) mm, P < 0.05)]. CONCLUSIONS: The combined use of AMX and MTZ during non-surgical periodontal treatment for patients with AgP was effective in short term. In patients with most sites PD ≥ 7 mm, AMX and MTZ could be taken after supragingival scaling, but the long-term clinical effects needs further investigation.

[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.

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

OBJECTIVE: To evaluate the subgingival prevalence of human cytomegalovirus (HCMV), Epstein-Barr virus-1 (EBV-1) in chronic periodontitis (CP) patients before and after treatment and to analyze the relationship between the prevalent variance and periodontal clinical parameters. METHODS: Gingival crevicular fluids of 13 CP patients were collected at baseline, 2 weeks, 2 months and 4 months after periodontal mechanical treatment. HCMV and EBV-1 were detected using nested polymerase chain reaction (n-PCR). RESULTS: The plaque index (PLI), probing depth (PD) and bleeding index (BI) of CP patients at 2 months, 4 months after periodontal mechanical treatment were evidently lower than before treatment, P < 0.01. These parameters at 4 months after treatment were higher than at 2 months, the differences were significant, P < 0.05. The prevalence of HCMV and EBV in CP patients was 42% (33/78), 14% (11/78). EBV and HCMV were mostly coexistent in the same site [9 sites HCMV(+) in 11 EBV positive sites]. The sites of HCMV(+) and EBV(+) were almost deep pockets. Thirteen of 14 sites with deep pockets were HCMV(+), 9 sites were deep pockets in 11 sites EBV(+). The prevalence of HCMV and EBV (8% and 0 respectively) at 2 weeks was the lowest in all four time points. The prevalence of HCMV and EBV at 2 weeks, 2 months and 4 months following treatment was significantly lower than baseline (P < 0.01), but the prevalence of HCMV (15%) at 2 months after treatment was higher than at 2 weeks (8%), the difference was not significant (P = 0.133). CONCLUSIONS: Herpesviruses may play a role in the development of CP. The changes of the prevalence of herpesviruses before the changes of clinical parameters could be detected after periodontal mechanical treatment. The patients should be re-evaluated and re-treated within 2 months after treatment.

[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.

[Analysis of alveolar bone loss and related factors in patients with aggressive periodontitis].

OBJECTIVE: To evaluate the alveolar bone loss status and the related factors in aggressive periodontitis (AgP) patients. METHODS: A total of 108 untreated AgP patients were included. The patients averaged 27.7 years of age with 45 males and 63 females. Twenty males were current smokers and the smoking status was evaluated by cigarette/day and packyears. The educational condition of the patients was recorded. The proximal probing depth (PD) of each tooth in all patients was measured and assessed (shallow: PD = 3, 4 mm, moderate: PD = 5, 6 mm, deep: PD ≥ 7 mm). The alveolar bone loss was assessed on a full set of periapical radiographs. The number of teeth with bone loss was scored in three categories (light bone loss, moderate bone loss and severe bone loss) for each patient. Based on the number of teeth (≥ 8 teeth) with severe alveolar bone loss and of the teeth lost, the patients (n = 108) were divided into severe AgP group (n = 61), and light-moderate group (n = 47). RESULTS: There were significantly positive correlations between shallow pocket and light bone loss (r = 0.518, P = 0.000) or deep pocket and severe bone loss (r = 0.366, P = 0.000) in proximal sites. The number of teeth with light bone loss, moderate bone loss and severe bone loss was not significantly different between male (7.1 ± 6.2, 12.5 ± 4.7 and 5.1 ± 0.6) and female group (8.7 ± 6.3, 12.9 ± 4.8, 4.2 ± 0.5, P values were 0.707, 0.671 and 0.413 respectively). There were more teeth with moderate bone loss and severe bone loss in the elderly than in the young (13.6 ± 4.2 vs 11.0 ± 5.5, 5.2 ± 3.7 vs 3.6 ± 3.5, P < 0.01). The difference of teeth number with light bone loss, moderate bone loss and severe bone was not found between higher education and non-higher education groups (P values were 0.314, 0.862 and 0.407). Smoking status had a significant positive correlation with the number of the teeth with severe bone loss(r = 0.575, P = 0.032). CONCLUSIONS: The bone loss status is related to the pocket depth. Smoking and age are risk factors for alvelar bone loss in AgP patients.

Combined association of CCR2-V64I and MCP-1-2518A/G polymorphisms with generalised aggressive periodontitis in Chinese.

OBJECTIVE: to examine the possible association of CCR2-V64I and MCP-1-2518A/G polymorphisms with generalised aggressive periodontitis (GAgP) in the Chinese population. METHODS: one hundred and twenty-four GAgP patients and 94 healthy subjects were included in the study. A peripheral blood sample was obtained from each subject and genomic DNA was isolated. Gene polymorphisms of CCR2-V64I and MCP-1-2518A/G were analysed by standard polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. RESULTS: a possible combined effect of CCR2-V64I and MCP-1-2518A/G was observed in the female GAgP patients, as the odds ratio for VV genotype (CCR2) and G+ genotype ( MCP-1) was 0.2 (P = 0.023). Individuals carrying VV genotype and G+ genotype were at reduced risk for GAgP. A possible combined effect of genotype and smoking was observed in the male GAgP patients, as the odds ratio for VV genotype (CCR2) and smoking, or G+ genotype (MCP-1) and smoking were 7.4 (P = 0.022) and 4.9 (P = 0.030), respectively. CONCLUSION: the combined association of CCR2-V64I and MCP-1-2518A/G polymorphisms may play an important role in determining GAgP susceptibility in Chinese females. A possible combined effect of genotype and smoking on GAgP susceptibility was suggested in males.