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Query: UMLS:C0031099 (periodontitis)
 12,489 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Enterococci are potential pathogens in many human body sites. This study determined the subgingival occurrence and the in vitro antimicrobial susceptibility of enterococci in 100 persons with early-onset periodontitis and 545 persons with advanced adult periodontitis. Subgingival microbial samples were collected with paper points, transported in VMGA III and plated onto anaerobic enriched brucella blood agar or selective Enterococcosel agar (BBL Microbiology Systems). Enterococcal speciation was performed using commercial micromethod kit systems. In vitro sensitivity was determined using a commercial kit system and an agar dilution assay. Subgingival enterococci occurred in 1% of early-onset periodontitis patients and in approximately 5% of adult periodontitis patients. Enterococcus faecalis was the only enterococcal species recovered, and all but one isolate belonged to the same biotype. In vitro antimicrobial sensitivity testing revealed subgingival enterococci resistant to therapeutic levels of penicillin G, tetracycline, clindamycin and metronidazole, but relatively sensitive to ciprofloxacin and amoxicillin/potassium clavulanate (Augmentin). Enterococci may populate periodontal pockets as superinfecting organisms and, in heavily infected patients, may contribute to periodontal breakdown.
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PMID:Enterococci in human periodontitis. 140 61

An automated enzyme immunoassay (EIA) to measure prostaglandin E2 (PGE2) in gingival crevicular fluid (GCF) of humans and dogs was developed as an indicator of periodontal disease. GCF is noninvasively collected on Periopaper strips and the PGE2 is extracted by a simple method. Samples containing 10-500 pg/ml PGE2 can be measured. A commercially available kit is used to perform the competitive EIA in microtiter plates. In the EIA, rabbit anti-PGE2 antisera binds to either the PGE2 in the sample or to the acetylcholinesterase-linked PGE2. The assay is automated using the Biomek 1000 workstation, resulting in day-to-day variability of less than 5% CV. Dog models of chronic and ligature-induced periodontitis were used to demonstrate that increased GCF PGE2, as measured by our assay, correlates with increased pocket depth and gingival bleeding scores.
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PMID:Automated enzyme immunoassay to measure prostaglandin E2 in gingival crevicular fluid. 153 3

THIS STUDY SOUGHT TO EVALUATE the ability of gingival crevicular fluid (GCF) elastase to predict attachment and bone loss in human periodontitis. Thirty subjects who were medically healthy and had a history of progressive periodontitis were studied with an automated probe. Five sites in each patient were monitored bi-monthly for a 6-month period for attachment loss. Subtraction radiography was utilized at the beginning and end of the study to monitor bone loss. GCF elastase was measured at 0 month and then bi-monthly by collecting GCF on paper strips impregnated with PMN leukocyte elastase substrate inserted into the gingival crevice for 15 seconds. After 8 minutes of reaction time, the strips were scored relative to fluorescent standards in an ultraviolet view box. Strips were then eluted in methanol and total elastase measured by spectrofluorometry. Total elastase was significantly higher in sites demonstrating progressive attachment loss than in inactive sites (2.81 +/- .29 versus 2.03 +/- .07, P less than 0.0005) and sites demonstrating bone loss (2.32 +/- .17 versus 2.01 +/- .08 P less than 0.05). When considering the joint presence of bone loss and attachment loss of 1.0 mm or greater in the 6-month period following a visual elastase kit score of 2 or greater, the test kit shows a sensitivity and specificity of 82% and 66%, respectively. This study demonstrated that GCF elastase levels are significantly higher in sites demonstrating progressive periodontal attachment and bone loss assessed 6 months later and may serve as a predictor of future bone and attachment loss.
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PMID:Elastase as an indicator of periodontal disease progression. 157 38

The purpose of the present study was to evaluate the diagnostic value of the BANA hydrolysis test using the Perio Scan kit to identify subgingival periodontopathogens (P. gingivalis, T. denticola and B. forsythus) and to determine whether the BANA reaction reflected the presence or absence of clinical signs for periodontitis. 10 patients with periodontitis (AP), 10 healthy subjects (HS) and 10 subjects with treated periodontitis under supportive therapy (MP) participated in the study. Subgingival plaque was sampled and the presence or absence of the above mentioned bacteria assessed with BANA reagent cards (Perio Scan). Additionally, all samples were analyzed for the presence or absence of P. gingivalis and/or T. denticola using an ELISA. The BANA test yielded a high specificity (86.7%) and a high sensitivity (77.0%) for the presence of periodontopathogens when compared with the ELISA results as reference parameter. The diagnostic features of the BANA test result compared to the clinical parameters yielded a high degree of accuracy for overall clinical judgement and for probing depth (PD 5 mm), but to a lesser degree, for bleeding on probing.
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PMID:Use of BANA hydrolysis as a diagnostic test for identifying periodontopathic environments. 179 43

The occurrence of subgingival staphylococci was determined in 506 individuals with advanced adult periodontitis, 108 with early-onset periodontitis, 13 with localized juvenile periodontitis, 18 with gingivitis, and 13 with 20 failing osseointegrated titanium dental implants. Subgingival samples were collected with paper points and transported in VMGA III. The bacterial samples were plated on Staphylococcus 110 medium which was incubated in 10% CO2, and on enriched brucella blood agar, which was incubated anaerobically. Staphylococcal isolates from 94 adult periodontitis subjects were speciated using the API STAPH Trac micromethod kit system and the Bacto Staph latex agglutination test for coagulase activity. Staphylococcus epidermidis comprised 45.8% and Staphylococcus aureus 22.3% of total staphylococcal isolates. At 1 microgram/ml, in vitro resistance by staphylococci was found to tetracycline (14.4% of isolates), penicillin (4.9%), erythromycin (12.1%), and metronidazole (31.9%). Subgingival staphylococci were isolated from approximately 50% of gingivitis and periodontitis patients. No statistically significant differences were found between these patient groups in the prevalence or mean proportions of staphylococci recovered. "Periimplantitis" lesions exhibited significantly higher proportions of staphylococci (15.1%) than gingivitis (0.06%) or periodontitis (1.2%) lesions. Staphylococci may play a role in some failing osseointegrated dental implants.
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PMID:Staphylococci in human periodontal diseases. 208 42

The occurrence by age and sex of subgingival enteric rods and pseudomonads, yeasts, and staphylococci was studied in 3075 "refractory" periodontitis patients referred for microbiological analysis. Each subject contributed a pooled subgingival sample obtained from 3 deep periodontal pockets with paper points. Selective and nonselective media and commercial identification kit systems were used for microbial isolation and speciation. Females constituted about 60% of the study subjects, and almost one-third of all patients were in their forties. Females (47.3%) showed a higher prevalence of the study organisms than males (43.9%). Older females (15.9%) and males (15.3%) revealed significantly higher prevalences of enteric rods and pseudomonads than younger individuals (10.9%), and older infected females yielded significantly higher viable counts than younger infected females. The sexes demonstrated a similar prevalence of staphylococci (about 28%), but younger infected females and males showed significantly higher viable counts than older infected individuals. No sex or age relationships were found for yeasts (about 14% of individuals infected). The high level of subgingival enteric rods and pseudomonads in some individuals may be important in the pathogenesis of geriatric and other forms of periodontitis and may have therapeutic implications.
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PMID:Age and sex relationships of superinfecting microorganisms in periodontitis patients. 209 7

Microbiologic assessments are often included in longitudinal studies to elucidate the significance of the association of certain Gram-negative bacteria and the development of periodontal diseases. In such studies, the reliability of methods is crucial. There are several methods to identify putative pathogens, and some of them are commercially available. The purpose of the present study was to compare the reproducibility of four different methods for detecting Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia in order to evaluate their usefulness in epidemiologic studies. The test panel consisted of 10 young subjects and 10 adult periodontitis patients. Subgingival plaque was sampled from sites showing bone loss and "healthy" control sites. The four different methods for detecting the target bacteria were 1) cultivation, 2) Evalusite (a chair-side kit based on ELISA), 3) OmniGene, Inc, based on DNA probes, and 4) indirect immunofluorescence (IIF). The test procedure was repeated after a 1-wk interval and was performed by one examiner. Sites reported to be positive for a microorganism by any of the four methods at one or both examinations were considered to be positive for that organism and included in the analysis. The reproducibility of the four methods was low. The IIF and the cultivation methods showed somewhat higher reproducibility than did the commercial systems. A second test was done for Evalusite, three paper points for sampling being used instead of one as described in the manual. The reproducibility of the second test was improved, indicating that the detection level of the system may influence the reliability.
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PMID:Microbiologic tests in epidemiologic studies: are they reproducible? 787 59

We designed and performed a multicenter clinical trial to determine the relationship between measurements of the level of the enzyme aspartate aminotransferase (AST) in gingival crevicular fluid (GCF) to other measures used to detect periodontal disease and monitor outcome of treatment, including pocket depth and gingival inflammation. 32 periodontitis patients were enrolled at the University of Washington, Seattle, 30 at the University of Florida, Gainesville, and 34 at the University of Illinois, Chicago. 10 periodontally normal control subjects were enrolled at each location. 8 diseased and 4 healthy sites were designated for study in each patient and 8 healthy sites designated in each control subject. Measures of disease included pocket depth, severity of gingival inflammation, and GCF volume. AST levels were measured using the PerioGard test kit. Clinical measurements were made and GCF samples harvested and tested 2x before and 2x after therapy consisting of scaling and root planing under local anesthetic. Specific design and other issues are discussed, including selection of patients and control subjects, sample size, selection of experimental test sites, methods for assessment of diseased and therapeutic improvement, harvesting of GCF and selection of appropriate biostatistical methods for data analysis. Demographics of the patient populations at the 3 locations are reported. As expected, therapy induced only negligible changes in the measures of disease at healthy sites in control subjects, and relatively minor improvement in healthy sites in patients. In contrast, statistically significant improvement relative to pretreatment baseline status in all 3 measures of disease was observed for diseased sites at all 3 study locations with all p-values less than 0.0002. The magnitude of improvement was comparable to that reported previously by others. The % of PerioGard-positive sites decreased significantly between the screening baseline and both post-treatment visits for patients at all 3 locations, with p values of 0.0001 to <0.0008.
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PMID:A multicenter clinical trial of PerioGard in distinguishing between diseased and healthy periodontal sites. (I). Study design, methodology and therapeutic outcome. 868 27

The effects of topical ketorolac tromethamine mouthrinse (0.1%) on gingival crevicular fluid (GCF) prostaglandin E2 (PGE2) concentrations were investigated in a 6-week, randomized, double-blind, placebo-controlled, parallel group, single center study of 42 patients with moderately advanced chronic adult periodontitis. Following screening, GCF was sampled from 6 sites per subject with filter paper strips and PGE2 levels measured using an enzyme immunoassay kit. Only those subjects with mouth median GCF PGE2 concentrations >30 ng/ml entered the rinsing phase. Eligible subjects were allocated placebo rinse in the first 2-week period (days 0 through 14), either ketorolac rinse (test group, n = 21) or placebo rinse (control group, n = 21) in the second 2-week period (days 14 through 28), and placebo rinse in the third 2-week period (days 28 through 42). Full mouth median GCF PGE2 concentrations were calculated for each subject at days 0, 14, 28, and 42, and group means were compared. From day 0 to day 14, no significant changes in GCF PGE2 concentrations were detected in either study group (P > 0.05). Utilizing mean GCF PGE2 concentrations at days 0 and 14 as covariates, no significant differences were observed in adjusted mean PGE2 levels at days 28 and 42 between the study groups (ANCOVA, P > 0.05). A statistically significant increase in GCF PGE2 levels was noted at days 28 and 42 in the placebo group (P < 0.01), but not in the ketorolac group (P > 0.05), when compared to baseline, however. GCF PGE2 levels were further studied in a subset of volunteers (n = 11) during a 12-hour period following first rinsing with mouthrinse (active or placebo) at day 14. GCF was sampled 0, 2, 4, 6, 8, and 12 hours post-rinsing. Mean PGE2 levels were higher in the placebo subgroup than in the ketorolac subgroup, and increased gradually over the 12-hour period in both subgroups. These data indicate that 1) 14 days of rinsing with 0.1% ketorolac mouthrinse controlled the elevation of GCF PGE2 observed in the placebo group but did not actually reduce GCF PGE2 concentrations and 2) changes in GCF PGE2 levels were not detectable in the 12-hour period following first rinsing with ketorolac.
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PMID:Effects of ketorolac tromethamine mouthrinse (0.1%) on crevicular fluid prostaglandin E2 concentrations in untreated chronic periodontitis. 970 55

The present study was performed to assess and compare the clinical healing and the microbiological findings following local application of metronidazole or tetracycline to augment subgingival scaling in previously untreated adult periodontitis sites. Eighteen patients with moderate to severe adult periodontitis at single-rooted teeth were selected. In each patient, 3 interproximal sites having comparable root anatomy, probing depth > or =5 mm and bleeding on probing were randomly assigned to 1 of 3 treatment groups: 1) two sessions of subgingival scaling and root planing; 2) similar to 1, with each treatment supplemented with a 25% metronidazole sustained release gel; 3) similar to 1 with each treatment supplemented with a 3% tetracycline ointment. The treatments were performed by 1 operator and the clinical variables probing depth, attachment level, and bleeding on probing were evaluated at baseline, 3 months and 6 months by a second blinded examiner. The microbiological findings were evaluated using a commercial test kit. The average probing depth reduction for the 3 groups at 6 months was 1.5 mm and the average gain of clinical attachment was 0.8 mm. There were no significant differences between the effects following topical application of the metronidazole gel or the tetracycline ointment. Scaling and root planing alone appeared as effective as the drug augmented regimens, although there was a weak but non-significant tendency for better results in sites treated with the antibiotic drugs. Actinobacillus actinomycetemcomitans was generally not detected; Prevotella intermedia was not significantly reduced, while Porphyromonas gingivalis was significantly reduced in all treatment groups. It was concluded that the augmentative effect of the metronidazole gel and the tetracycline ointment was comparable but small compared to scaling and root planing alone. The clinical importance of such small augmentation effects should be further evaluated.
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PMID:Effects of topical metronidazole and tetracycline in treatment of adult periodontitis. 970 61


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