Comparative periodontal status of human immunodeficiency virus-positive patients and controls in a dedicated human immunodeficiency virus clinic in Nigeria.

BACKGROUND: There are diverse reports on the prevalence and severity of chronic periodontitis in human immunodeficiency virus (HIV) positive persons. Few studies have been carried out in developing countries in Sub-Saharan Africa. This study was aimed at comparing the prevalence and severity of chronic periodontitis of HIV-seropositive patients with that of HIV-seronegative persons using the community periodontal index (CPI). METHODOLOGY: This was a comparative study of the periodontal status of 110 HIV-positive subjects and 110 age and gender-matched HIV-negative controls attending a dedicated HIV Clinic in a Teaching Hospital in Lagos, Nigeria. The CPI and simplified oral hygiene index score were used in the periodontal examination. Highest CPI scores and percentages of CPI sextants assessed the prevalence and severity of chronic periodontitis respectively. Logistic regression was used in adjusting demographic differences in the study population. P ≤ 0.05 was considered as significant. RESULTS: A significant proportion of the HIV-positive patients 61 (55.5%) and the HIV-negative controls 53 (48.7%) had shallow pockets (4-5 mm) (CPI code 3). The prevalence of deep pockets (≥ 6mm) (CPI code 4) was higher among HIV-positive patients 9 (8.2%) than the controls 4 (3.5%) (P = 0.079). HIV-positive patients had a greater percentage of CPI codes 3, 4 and fewer CPI code 0 sextants than controls (P = 0.000). Both groups had comparable oral hygiene status (P = 0.209). Using a logistic regression analysis, HIV-positive status and lower education accounted for the greater severity of chronic periodontitis. CONCLUSION: HIV-seropositive patients had more severe chronic periodontitis than the HIV-seronegative controls, which was independent of lower education.

Self-Reported Medical Conditions and Oral Health Status of Patients seen in a Nigerian Dental Clinic.

OBJECTIVE: To assess the prevalence of self-reported medical conditions among patients attending a dental clinic in Nigeria. SUBJECTS AND METHODS: This was a cross-sectional study conducted at the Oral Diagnosis Clinic of the Lagos University Teaching Hospital. A self-administered questionnaire was used to collect bio-data and history of medical conditions. Oral examination was carried out on all the patients. Teeth present, carious teeth, mobile teeth and the oral hygiene status were recorded. Data entry and analysis was done using SPSS statistical software. RESULTS: The prevalence of self-reported medical conditions in this study was 22.1%. Hypertension was the most prevalent (10.3%), followed by allergies (4.4%), diabetes mellitus (4%) and gastrointestinal disorders (3%). Hypertension (p=0.000) and diabetes (p=0.000) had a statistically significant association with increasing age. The prevalence of medical conditions increased significantly with the increased number of mobile teeth (p=0.033). There was no statistically significant association between the self-reported medical conditions and the number of carious teeth (p=0.619), the oral hygiene status (p=0.765) and the educational level (p=0.712). CONCLUSION: The prevalence of medical conditions among the dental patients was moderate.

Pattern of periodontal treatments performed at the periodontology clinic of the Lagos University Teaching Hospital: 22 months review.

BACKGROUND: A critical evaluation of the pattern of periodontal procedures performed is important in providing useful data to the administrator for proper planning and budgeting for dental health service. OBJECTIVE: To assess the pattern of periodontal treatments performed over a given period of time at the Periodontology clinic of the Lagos University Teaching Hospital, Lagos, Nigeria. METHODS: This was a twenty two months retrospective study of all periodontal procedures performed on patients seen at the periodontology clinic of the Lagos University Teaching Hospital between January 2006 and October 2007. The periodontology treatment record was used to retrieve information which included the patient's age, gender, diagnosis and periodontal procedures given. The procedures were further categorized into surgical and nonsurgical groups. The information obtained was then analyzed using Epi Info 2007 statistical software. RESULTS: A total of 1,938 patients were seen during this period. Females were 1009 (52.1%) and males were 929 (47.9%). (F/M, 1.1:1). A total of 2,110 periodontal treatments were performed. Majority of the patients received non-surgical periodontal therapy which constituted the bulk (96.3%) of the therapies. Scaling and polishing was the most frequently performed non-surgical procedure accounting for 1261 (62.1%) with slightly more males receiving the treatment. Of the surgical treatment modalities, operculectomy accounted for 65.4% and was carried out on more females than males. Regenerative procedures were the least performed surgical treatments. CONCLUSION: This study highlighted that non-surgical periodontal therapy, particularly scaling and polishing was the most frequently utilized periodontal procedure. Operculectomy was the predominant surgical procedure performed. The low percentage of regenerative surgical procedures was however below the desired expectation.

Prevalence of self-reported hypersensitive teeth among a group of Nigerian undergraduate students.

AIMS AND OBJECTIVES: To determine the prevalence of self reported hypersensitive teeth and relate this to the frequency and quantity of consumed carbonated drinks among a group on Nigerian dental and medical undergraduate students and the management of the condition by the students. MATERIALS AND METHODS: Self administered questionnaire was used to collect information on demography, consumption of carbonated drinks, hypersensitivity of teeth and its management from students. Students were chosen using stratified sampling method. Each level of study was taken as a stratum and students were then chosen from each stratum by systematic sampling. RESULTS: A total of 387 questionnaires were returned. Hypersensitivity of teeth was reported by 33.8% while 52.7% of them were bothered about the condition, half (50.0%) of those bothered by the condition had done nothing about it. About a third (29.7%) of the respondents, (16.3% consumed once daily and 13.4% consumed 2/more times daily) consumed carbonated drink at least once a day. A great majority (77.0%, 17.2%) either consumed 1-2 bottles (35cl/bottle) or 1-2(30cl/glass) of carbonated drinks per day respectively. Tooth sensitivity occurred more commonly among students who consumed carbonated drinks most frequently (i.e. 2 or more times a day) but there was no significant statistical association between frequency and quality of carbonated drink consumption and self-reported dentine hypersensitivity. (p>0.05) CONCLUSION: Hypersensitivity of teeth was common among the students studied but request for treatment was poor. There is need for increased public awareness on prevention and management of common dental conditions.

Use of information and communication technology among dental students and registrars at the faculty of dental sciences, University of Lagos.

The aim of this study was to investigate the use of information technology amongst dental students, dental nursing students and resident doctors in training at the faculty of dental Surgery University of Lagos. A structured questionnaire was distributed to 58 clinical dental students in 4 th and 5 th years of training in the 2010/2011 academic year, 36 dental nursing students and 63 resident doctors undergoing specialist training. All participants have access to the computers, 2.5% within the University and 31% at home and internet cafes and about 50% have the basic skills required. A significant difference was observed between the resident doctors and clinical dental students (P = 0.003), between resident doctors and dental nursing students (P = 0.0001) when the use of computer for study was compared. Over 95% of participants have access to internet and about 50% of them use the internet for their studies. A significant difference (P = 0.005) was observed between clinical dental students and dental nursing students that use the internet and word processing. The resident doctors used the computers for multimedia and MedLine search tools more than clinical dental students (P = 0.004) and dental nursing students (0.0006). The findings of the study show that dental students and resident doctors in training have the requisite knowledge to operate the computer for use in their study and personal activities.

Bacteriological and clinical evaluation of twelve cases of post-surgical sepsis of odontogenic tumours at a referral centre.

OBJECTIVE: To determine the bacterial aetiology of sepsis occurring following surgery of odontogenic tumours and assess the effect of prompt and proper antibiotic usage. DESIGN: A prospective study. SETTING: A tertiary referral centre in Lagos, Nigeria. SUBJECTS: Twelve patients with odontogenic tumours that developed sepsis postoperatively. Eight of the patients were referred from private hospitals, the remaining were in-patients who sought for alternative medical attention following interruption of health care services at the referral centre. INTERVENTION: Adequate review of patient's medical history, bacteriological investigations and antibiotic therapy. MAIN OUTCOME MEASURES: Bacteriological and clinical cure following antibiotic therapy based on susceptibility test results. RESULTS: Two categories of patients were identified; those who completed the course of antibiotics prescribed post-surgery and patients who failed to conform to antibiotic prescription. Sepsis developed in the non-compliance group much earlier than in the group that complied (p<0.001). Infections were polybacterial with aerobes accounting for 77.4% (alpha-haemolytic streptococci 29.0%, Streptococcus pyogenes 16.1%, Staphylococcus aureus 16.1%, diphtheroids 9.7%, Klebsiella pneumoniae 6.5%) and anaerobes 22.6% (Porphyromonas gingivalis 9.7%, Peptostreptococcus spp. 6.5%, Prevotella melaninogenica 3.2%, Clostridium perfringens 3.2%). Mixed aerobic and anaerobic aetiology occurred more in osteosarcoma and fibrosarcoma. Clostridium perfringens was isolated from a case of osteosarcoma with necrotic tissues. The anaerobic bacteria were 100% sensitive to metronidazole, ciprofloxacin and augmentin, 65-85% sensitivity to ampicloxacillin, amoxicillin and erythromycin. Over 92% of the streptococci were sensitive to the beta-Lactams contrast low susceptibility with S. aureus and K. pneumoniae. CONCLUSION: Interruption of healthcare service was the sole factor identified in the development of sepsis as the patients could not be monitored to ensure compliance to prescription.

Pattern of tooth mobility and missing teeth types among juvenile periodontitis patients in Lagos University Teaching Hospital Dental Centre.

UNLABELLED: The objective of this study was to determine the degree of tooth mobility and missing teeth according to tooth type of juvenile periodontitis patients attending the Lagos University Teaching Hospital Dental Centre from January 2004 to March 2004. METHODOLOGY: Eighteen juvenile periodontitis patients were identified with an age range of 18 years to 36 years. There were 9 males and 9 females. RESULT: In this study, the most common tooth mobility exhibited was grade 2 (46%), followed by grade 3 (37%) and grade 1 (17%). The most mobile tooth type were the upper incisors (23%) when considering all degrees of tooth mobility. The least mobile teeth were the lower cuspid/bicuspins (7.5%). Within the jaws, the most commonly missing tooth type were the upper incisors (28%), more females exhibited grade 2 tooth mobility than males, while more males exhibited grade 3 tooth mobility. CONCLUSION: Mild or moderately mobile teeth particularly of 1st molars and incisors should be considered a risk factor for aggressive periodontitis and should require further periodontal examination at routine dental visits particularly amongst adolescents and young adults. Regular prophylactic scaling and polishing with frequent recalls should result in early diagnosis and in preventing the rapid progression of this condition.

Periodontal Status of Adolescents in Surulere; Lagos State; Nigeria

Objective : The objective of this study was to assess the periodontal status; treatment needs and dental visit practice of adolescents in Lagos; Nigeria. Methods : 600 subjects were selected by stratified random sampling from 6 schools; 3 secondary and 3 primary schools in Surulere Local Government Area of Lagos state; Nigeria. About one hundred subjects in each age category of 11 to 16 years were selected. A questionnaire was designed seeking biographic data such as age; sex; occupation of parent; and dental visit attendance and a section for recording periodontal clinical examination using the Community Periodontal Index of Treatment Needs (CPITN) was included. The periodontal status; treatment needs and dental visit practices of adolescents were determined. Results: Only 3 were found to be healthy periodontally. 83 of the subjects presented predominately with the worst condition recorded; code 2 (i.e. calculus); which is a reversible condition. A mean of 0.6 healthy sextants; 2.3 bleeding sextants and 3.1 calculus-accumulated sextants was calculated. A statistical difference in periodontal status was noted with age; the younger adolescents (11-13 years) presenting predominately with bleeding sextants when compared to the older adolescents (14-16 years) who presented more calculus-accumulated sextants. Nearly all subjects required periodontal treatment. 83 needed professional prophylaxis (TN2). Conclusion: There is a need for a school oral health education programme within the LGA with a focus on periodontal disease prevention and provision of oral prophylaxis by dental surgeons; therapists and volunteer dental students

Comparative study of oral hygiene status of HbSS subjects and controls.

There is paucity of information on the oral health status of individuals with the HbSS gene in Nigeria. This study was carried out to determine the state of their oral hygiene, compare this with unaffected people and create awareness of importance of oral health care in the patients and their parents. Three hundred and thirty-six subjects, aged 1-45 years and comprising 185 HbSS and 151 controls took part in this study. They were seen in three hospitals in Lagos-General Hospital Lagos, Massey Street Children Hospital and Lagos University Teaching Hospital. They were examined using the Simplified Oral Hygiene Index, (OHIS). Mean OHI-S scores for HbSS subjects and controls were 1.24+/-0.95 and 0.66+/-0.58 respectively (P< 05). There was no significant difference in OHI-S score across the socio-economic classes of both groups (P> 05). Females in both groups had cleaner mouths than males. It is concluded that the controls had cleaner mouths than those with HbSS. Socio-economic class did not influence their oral hygiene. It is recommended that preventive oral health care should be included in the management of HbSS patients.

Awareness of periodontal diseases amongst Nigerian diabetics.

This prospective study sample consisted of 261 Nigerians made up of 155 diabetics seen at the medical outpatient clinic of Lagos University Teaching Hospital, Lagos and general hospital, Ikeja, Lagos, Nigeria and 106 health controls randomly selected. The subjects were required to complete a questionnaire containing the biographic data and occupation, and assessment of their knowledge, attitude and practice towards periodontal health and utilisation of appropriate professional care. They were then examined and assessed using the CPITN code. Their ages ranged from 5 to 65 years. Close to three-quarters of the subjects (73.5% for diabetics and 74.5% for controls) were 45 years or older. Furthermore, 6% of the low skilled diabetics new about periodontal disease while only 27.2% of those in the medium and highly skilled group had some knowledge of periodontal disease. This relationship was found to be statistically significant (X2 = 12-22 ; df = 2, p < 0.05). Similarly, statistically significant relationship was demonstrated between diabetics and controls with regards to knowledge about the demonstrated between diabetic and controls with regards to knowledge about the cause/s of periodontal disease and awareness of gum bleeding. 73.6% of the controls had never been to the dentist before unlike 62.1% of diabetics. All subjects in either group who claimed not to bleed scored at least the minimum on the CPITN code. While 52.3% of diabetics and 22.5% of control had a CPITN score of 2,54% of those in the control group and 30% of diabetics recorded a score of 3 on the CPITN code. In conclusion, the level of awareness of periodontal disease is quite low amongst both groups, hence there is a need to promote periodontal health awareness in the general populace as well as clinics.

Prevalent bacterial species and novel phylotypes in advanced noma lesions.

The purpose of this study was to determine the bacterial diversity in advanced noma lesions using culture-independent molecular methods. 16S ribosomal DNA bacterial genes from DNA isolated from advanced noma lesions of four Nigerian children were PCR amplified with universally conserved primers and spirochetal selective primers and cloned into Escherichia coli. Partial 16S rRNA sequences of approximately 500 bases from 212 cloned inserts were used initially to determine species identity or closest relatives by comparison with sequences of known species or phylotypes. Nearly complete sequences of approximately 1,500 bases were obtained for most of the potentially novel species. A total of 67 bacterial species or phylotypes were detected, 25 of which have not yet been grown in vitro. Nineteen of the species or phylotypes, including Propionibacterium acnes, Staphylococcus spp., and the opportunistic pathogens Stenotrophomonas maltophilia and Ochrobactrum anthropi were detected in more than one subject. Other known species that were detected included Achromobacter spp., Afipia spp., Brevundimonas diminuta, Capnocytophaga spp., Cardiobacterium sp., Eikenella corrodens, Fusobacterium spp., Gemella haemoylsans, and Neisseria spp. Phylotypes that were unique to noma infections included those in the genera Eubacterium, Flavobacterium, Kocuria, Microbacterium, and Porphyromonas and the related Streptococcus salivarius and genera Sphingomonas and TREPONEMA: Since advanced noma lesions are infections open to the environment, it was not surprising to detect species not commonly associated with the oral cavity, e.g., from soil. Several species previously implicated as putative pathogens of noma, such as spirochetes and Fusobacterium spp., were detected in at least one subject. However, due to the limited number of available noma subjects, it was not possible at this time to associate specific species with the disease.

Alveolar bone regeneration pattern following surgical and non-surgical treatment in juvenile periodontitis.

One hundred and fifty six interproximal sites, with periodontal pockets deeper than 5mm and showing loss of bone on standard dental periapical radiographs, were treated by subgingival instrumentation and open periodontal flap debridement in 12 patients properly motivated and given thorough oral hygiene instructions. The indices of gingival condition, plaque, calculus, oral hygiene and degree of mobility with loss of attachment were measured at baseline, 1,3 and 6 months after treatment. Standardized reproducible radiographs of the interproximal sites were taken before and 6 months after treatment. Alveolar bone levels pre and post treatment were measured with a grid in square millimetres using a view box (Watson and sons, London) and the Dunning and Leach gingival bone count index for both treatment procedures. Radiographic analysis showed statistically and clinically significant increases in bone fill of both the superficial and deep bone defects for the surgical technique (p < 0.05). This study has shown that surgical procedure resulted in a better bone regeneration than subgingival instrumentation.

Lactobacilli in human dental caries and saliva.

Samples (98 plaque and 72 saliva) from 93 patients with dental caries were investigated for Lactobacillus species which comprised 65 (62.5%) of 104 isolates. Yeasts (20.1%), Streptococcus spp. (8.7%), Staphylococcus spp. (2.9%) and a few unidentified species (5.8%), were also found. The Lactobacillus isolates were L. brevis (24.6%) L. fermentum (18.5%) L. casei (16.9%), L. delbrueckii (15.4%), L. plantarum (9.23%), L. acidophilus (7.69%), L. jensenii (4.62%), L. salivarius (1.54%) and L. gasseri (1.54%). The most common species was L. brevis (24.6%). The strains tested for beta-lactamase production showed 75.4% positive. All the Lactobacillus strains were tested for bacteriocin production against Escherichia coli, Salmonella spp., Shigella dysenteriae, S. sonnei, Klebsiella spp. and Campylobacter sp. All the lactobacilli except L. jensenii produced bacteriocin against at least one of the indicator organisms. The involvement of Lactobacillus in dental caries was established, although its role and mechanism is not well understood. The ability of Lactobacillus spp. to protect their host against certain diseases by inhibiting the growth of potential pathogens was evident.

Noma (cancrum oris): questions and answers.

Noma (cancrum oris) is an infectious disease which destroys the oro-facial tissues and other neighboring structures in its fulminating course. It affects predominantly children aged 2-16 years in sub-Saharan Africa where the estimated frequency in some communities may vary from one to seven cases per 1000 children. The key risk factors are poverty, malnutrition, poor oral hygiene, deplorable environmental sanitation, close residential proximity to livestock, and infectious diseases, particularly measles. Malnutrition acts synergistically with endemic infections in promoting an immunodeficient state, and noma results from the interaction of general and local factors with a weakened immune system as the common denominator. Acute necrotizing gingivitis (ANG) is considered the antecedent lesion. Current studies suggest that evolution of ANG to noma requires infection by a consortium of microorganisms with Fusobacterium necrophorum and Prevotella intermedia as the suspected key players. Without appropriate treatment, mortality rate is 70-90%. Survivors suffer the two-fold affliction of oro-facial disfigurement and functional impairment. Reconstructive surgery of the resulting deformity is time-consuming and financially prohibitive for the victims who are poor.

Living conditions of children at risk for noma: Nigerian experience.

The study reported in this paper was carried out in the Northwestern and Southwestern regions of Nigeria, between October 1996 and April 1998. The study examined the possible contributory role of living conditions in the development of acute necrotizing gingivitis (ANG) or noma from oral lesions. Questionnaire data obtained from 42 fresh noma cases seen in the Northwest and four fresh cases seen in the Southwest were examined. In addition 46 cases of advanced ANG from the Southwest were included. The main focus was to compare some of the environmental living conditions of cases with advanced ANG and those with noma in these regions. All the noma and ANG cases were seen in children aged 2-12 years. The level of good oral hygiene practices and general environmental living conditions were significantly higher in the Southwest than in the Northwest. Data also showed that living in close proximity with livestock was significantly higher in the Northwest than in the Southwest (P < 0.05). The environmental living conditions of children in the Northwest were further compounded by poor sanitary faecal disposal practices as well as minimal access to potable water. The overall data indicated that living in substandard accommodations, exposure to debilitating childhood diseases, living in close proximity to livestock, poor oral hygiene, limited access to potable water and poor sanitary disposal of human and animal faecal waste could have put the children in the Northwest at higher risk for noma than the children in the Southwest. These could have been responsible for the higher prevalence of noma in the Northwest than in the Southwest.

Comparison of the periodontal treatment needs of normal and handicapped children in Lagos.

The periodontal treatment needs of normal children and those who have mental and multiple handicaps are compared. There were 7.8% handicapped children who did not require any periodontal treatment compared with 1.5% of normal children. Similarly, a higher proportion of normal children (78.6%) compared with 59.4% of handicapped children needed professional oral prophylaxis and oral hygiene education. It was also found from the study that there was a greater need for professional oral prophylaxis in normal children and handicapped children living in institutions than in handicapped children staying with their parents at home. It was concluded that both normal and handicapped children require supervised oral hygiene measures till effective oral hygiene habit is established.

Alveolar bone patterns in sickle cell anemia and non-sickle cell anemia adolescent Nigerians: a comparative study.

The association between sickle cell anemia (SCA) and gnathopathy of the permanent incisors forms the basis of this study. The alveolar bone patterns of adolescent Nigerians were observed in a comparative study of 50 SCA subjects and 50 controls from the same environment. Periapical radiographs of the lower incisor and upper molar regions were taken. Alveolar bone levels were measured as a percent of the root lengths to account, in part, for angulation, error. These readings were then compared between the two groups. No significant difference was observed in the radiographic bone level measurements when the two groups were compared. These results clearly show that in this population of adolescents, sickle cell anemia is not associated with a difference in alveolar bone levels.

Perception of gingival bleeding by Nigerians.

Two hundred and seventy-five (275) subjects were seen to assess their perception of gingival bleeding and relate it to their periodontal status, sex, and age. Only about a quarter of the subjects claimed to bleed from the gingivae during routine oral prophylaxis. Unfortunately, about the same number admitted to having gum disease, whereas during clinical oral examination it was discovered that all these subjects had gingival bleeding. Also this study showed that more of the subjects who claimed to bleed from the gums thought it was normal compared to those who claimed not to bleed from the gums. The conclusion from the study is that there is poor perception of gingival bleeding and little relevance is placed on its presence in the mouth. There is poor awareness of it as a sign of the presence of pathology of the tooth supporting structures (periodontium), which may be due to local or systemic body disorders. The medical community must, therefore, recognize this fact and educate their patients and the public at large.

Human Herpesviridae in acute necrotizing ulcerative gingivitis in children in Nigeria.

Herpesviruses have been implicated in the pathogenesis of human periodontitis. The present study investigated whether herpesviruses are present in the lesions of acute necrotizing ulcerative gingivitis. Sixty-two Nigerian children, aged 3-14 years, were studied. Twenty-two children had acute necrotizing ulcerative gingivitis and were also malnourished, 20 exhibited no acute necrotizing ulcerative gingivitis but were malnourished and 20 were free of acute necrotizing ulcerative gingivitis and in a good nutritional state. Polymerase chain reaction methods were used to determine the presence of human cytomegalovirus (HCMV), Epstein-Barr virus type 1 and type 2 (EBV-1, EBV-2), herpes simplex virus (HSV), human herpes virus 6 (HHV-6), human papilloma virus and human immunodeficiency virus type 1 in crevicular fluid specimens collected by paper points. Of the 22 acute necrotizing ulcerative gingivitis patients, 15 (68%) revealed viral infection and 8 (36%) viral coinfection. Thirteen (59%) acute necrotizing ulcerative gingivitis patients demonstrated HCMV, 6 (27%) EBV-1, 5 (23%) HSV and 1 (5%) HHV-6. Only 2 (10%) subjects from each group not affected by acute necrotizing ulcerative gingivitis showed viral presence, and no control subject revealed viral coinfection. These findings suggest that HCMV and possibly other herpesviruses contribute to the onset and/or progression of acute necrotizing ulcerative gingivitis in malnourished Nigerian children.

PIP: Recent laboratory studies have implicated herpesviruses in the pathogenesis of human periodontitis. This present study examines whether herpesviruses are present in the lesions of acute necrotizing ulcerative gingivitis. A total of 62 Nigerian children, aged 3-14 years were studied: 22 had acute necrotizing ulcerative gingivitis and were also malnourished, 20 showed no acute necrotizing ulcerative gingivitis but were malnourished, and 20 were free of acute necrotizing ulcerative gingivitis and in a good nutritional state. A polymerase chain reaction assay was used to determine the presence of human cytomegalovirus (HCMV), Epstein-Barr virus type 1 and type 2 (EBV-1, EBV-2), herpes simplex virus (HSV), human herpes virus 6 (HHV-6), human papilloma virus, and HIV-1 in crevicular fluid samples obtained by paper points. Of the 22 patients with acute necrotizing ulcerative gingivitis, 15 (68%) showed viral infection and 8 (36%) showed a viral coinfection. In addition, 13 (59%) of these patients demonstrated HCMV, 6 (27%) EBV-1, 5 (23%) HSV, and 1 (5%) HHV-6. Only 2 (10%) subjects from each group not affected by acute necrotizing ulcerative gingivitis revealed viral presence, and none of the control group demonstrated viral coinfection. The findings suggest that HCMV and possibly other herpesviruses contribute to the onset and/or progression of acute necrotizing ulcerative gingivitis in malnourished children in Nigeria.

Periodontal disease in homozygous HBSS adolescent Nigerians.

The association between sickle cell anaemia (SCA) and periodontal disease was assessed in a prospective comparative study over 6 months using 50 adolescents known SCA patients and 50 adolescent non-SCA subjects. Their ages ranged from 11 to 19 years (mean = 15.25 years). The partial mouth recording system was used to determine the gingival index, plaque index, and probing depths of 6 sampled teeth in the mouth. There was no significant difference between the mean plaque and gingival indices of SCA and the control, but the mean probing depth of the SCA subjects was significantly higher than that of the control, notably amongst the females. However, this was of no clinical significance. The periodontal status of the males in the SCA group was similar to that of their female counterpart whereas the males in the control group have poorer status than the females in the same group. These results suggest that SCA does not lead to increased severity in periodontal disease in adolescent Nigerians.