Periodontal Bacterial Load: A Proposed New Epidemiological Method for Periodontal Disease Assessment

Abstract Aim The purpose of this study was to identify a periodontal clinical measure that correlates with red complex bacteria usually associated with periodontal disease. Methods and Materials Periodontal clinical parameters were recorded in 116 postpartum women at six sites per tooth for all teeth excluding third molars. Two subgingival plaque samples per subject were collected and analyzed for 39 bacterial species using the Checkerboard DNADNA hybridization technique. Periodontal Bacterial Load (PBL) was calculated as the sum of all pocket depth measurements of 4 mm at sites with a Clinical Attachment Level (CAL) of 4 mm. The association of clinical and bacterial scores was analyzed using the Spearman correlation coefficient and the Kruskal-Wallis test. Results The PBL was correlated with microorganisms from the red complex that included Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, individually or grouped (p<0.05). The PBL was not associated with periodontally beneficial species from the yellow, green, purple, and blue complexes (p>0.05). The proportions and mean counts of the red complex were increased according to the quartile groups of distribution of the PBL. Conclusions PBL appears to be a reliable measure of periodontal status in postpartum women. Clinical Significance PBL avoids bias in the assessment of periodontal status in studies of periodontal disease. Citation Vettore MV, Leão ATT, Leal MC, Feres M, Figueiredo LC, Sheiham A. Periodontal Bacterial Load: A Proposed New Epidemiological Method for Periodontal Disease Assessment. J Contemp Dent Pract [Internet]. 2010 Jan; 11(1):049-056. Available from: http://www.thejcdp. com/journal/view/volume11-issue1-vettore.

Download Full-text

Partial recording protocols for periodontal disease assessment in epidemiological surveys

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2007000100005 ◽

2007 ◽

Vol 23 (1) ◽

pp. 33-42 ◽

Cited By ~ 23

Author(s):

Mario Vianna Vettore ◽

Gabriela de Almeida Lamarca ◽

Anna Thereza Thomé Leão ◽

Aubrey Sheiham ◽

Maria do Carmo Leal

Keyword(s):

Periodontal Disease ◽

Disease Model ◽

Periodontal Pocket ◽

Disease Assessment ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Epidemiological Surveys ◽

Periodontal Index ◽

Community Periodontal Index ◽

Attachment Level

The objective of the present study was to compare the reliability of four partial-mouth protocols for assessing shallow, moderate, and deep sites for periodontal pocket depth and clinical attachment levels. Periodontal pocket depth and clinical attachment level measurements were recorded for 156 subjects (age > 30). The four models of partial-mouth protocols compared were: Model I: all sites per tooth in the random half-mouth protocol randomly selecting one maxillary and mandibular quadrant, Model II: buccal sites in a full-mouth protocol, Model III: buccal sites in the random half-mouth protocol randomly selecting one maxillary and mandibular quadrant, Model IV: all sites per tooth using Community Periodontal Index teeth. In comparison with full mouth examination, Model I did not show significant differences for periodontal pocket depth and clinical attachment level parameters. Models II and III were different for some periodontal pocket depth means, and Model IV significantly overestimated all clinical parameters related to periodontal disease. Model I appears to be adequate to substitute for the full-mouth examination to assess the prevalence and severity of chronic periodontal disease in adults.

Download Full-text

The Subgingival Microbiome Relationship to Periodontal Disease in Older Women

Journal of Dental Research ◽

10.1177/0022034519860449 ◽

2019 ◽

Vol 98 (9) ◽

pp. 975-984 ◽

Cited By ~ 7

Author(s):

R.J. Genco ◽

M.J. LaMonte ◽

D.I. McSkimming ◽

M.J. Buck ◽

L. Li ◽

...

Keyword(s):

16S Rrna ◽

Periodontal Disease ◽

Older Women ◽

Bacterial Species ◽

Disease Status ◽

Oral Microbiome ◽

Rrna Gene ◽

Minimum Entropy ◽

Pocket Depth ◽

Severe Periodontal Disease

Understanding of the oral microbiome in relation to periodontal disease in older adults is limited. The composition and diversity of the subgingival microflora and their oligotypes in health and levels of periodontal disease were investigated in this study on older postmenopausal women. The 16S rRNA gene was sequenced using the Illumina MiSeq platform in 1,206 women aged 53 to 81 y. Presence and severity of periodontal disease were defined by Centers for Disease Control and Prevention/American Academy of Periodontology criteria. Composition of the microbiome was determined by 16S rRNA amplicon sequencing and the abundance of taxa described by the centered log2-ratio (CLR) transformed operational taxonomic unit (OTU) values. Differences according to periodontal disease status were determined by analysis of variance with Bonferroni correction. Bacteria oligotypes associated with periodontal disease and health were determined by minimum entropy decomposition and their functions estimated in silico using PICRUSt. Prevalence of none/mild, moderate, and severe periodontal disease was 25.1%, 58.3%, and 16.6%, respectively. Alpha diversity of the microbiome differed significantly across the 3 periodontal disease categories. β-Diversity differed between no/mild and severe periodontal disease, although considerable overlap was noted. Of the 267 bacterial species identified at ≥0.02% abundance, 56 (20.9%) differed significantly in abundance according to periodontal disease status. Significant linear correlations for pocket depth and clinical attachment level with bacterial amounts were observed for several taxa. Of the taxa differing in abundance according to periodontal disease status, 53% had multiple oligotypes appearing to differ between none/mild and severe periodontal disease. Among older women, taxonomic differences in subgingival microbiome composition and diversity were observed in relation to clinical periodontal disease measures. Potential differences in bacterial subspecies (oligotypes) and their function were also identified in periodontal disease compared with health.

Download Full-text

Effectiveness of non-surgical treatment to reduce il-18 levels in the gingival crevicular fluid of patients with periodontal disease

Brazilian Dental Journal ◽

10.1590/s0103-64402012000400020 ◽

2012 ◽

Vol 23 (4) ◽

pp. 428-432 ◽

Cited By ~ 6

Author(s):

Bernardo Oliveira de Campos ◽

Ricardo Guimarães Fischer ◽

Anders Gustafsson ◽

Carlos Marcelo da Silva Figueredo

Keyword(s):

Surgical Treatment ◽

Periodontal Disease ◽

Gingival Crevicular Fluid ◽

Gingival Index ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Crevicular Fluid ◽

Attachment Level ◽

Gingival Fluid ◽

Non Surgical Treatment

The aim of this study was to evaluate the effectiveness of the non-surgical periodontal treatment in reducing the gingival crevicular fluid (GCF) levels of IL-18 from inflamed periodontal sites. Fourteen patients with periodontal disease were included, being 9 patients with chronic periodontitis (mean age: 48.8 SD ± 7.4 years) and 5 patients with gingivitis (mean age: 43.6 SD ± 11.8). The patients were divided in the following groups: gingivitis sites from periodontitis patients (sites GP), periodontitis sites from periodontitis patients (sites PP), and gingivitis sites from gingivitis patients (sites GG). Probing pocket depth (PPD), probing attachment level (AL), plaque index (PI) and gingival index (GI) were recorded, and gingival fluid samples were collected. The subjects received non-surgical treatment and were re-evaluated 30 days after treatment (day 30 AT). There was a significant reduction in PI in GG (1.0 ± 0.4 to 0.5 ± 0.2), GP (1.2 ± 0.3 to 0.5 ± 0.3), and in PP (1.3 ± 0.4 to 0.7 ± 0.3) 30 AT. There was also a significant reduction in the GI in GG (1.3 ± 0.3 to 0.7 ± 0.4). PPD reduced significantly in GG (2.4 ± 0.6 to 1.9 ± 0.1), and PP (6.7 ± 1.1 to 5.2 ± 0.9) 30 AT. When all the samples were analyzed together, there was a significant reduction in IL-18 (12.9 ± 7.2 to 10.0 ± 3.1). This study showed that non-surgical treatment was effective in reducing GCF levels of IL-18 from inflamed periodontal sites.

Download Full-text

Relative quantification of Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia and Aggregatibacter actinomycetemcomitans high-risk bacterial species in Romanian patients evaluated for periodontal disease

10.1101/184770 ◽

2017 ◽

Author(s):

Cosac Ion Constantin ◽

Ionica Consuel ◽

Ratiu Attila Cristian ◽

Savu Lorand

Keyword(s):

Periodontal Disease ◽

Porphyromonas Gingivalis ◽

Gingival Crevicular Fluid ◽

Bacterial Species ◽

Bacterial Load ◽

Clinical Signs ◽

Aggregatibacter Actinomycetemcomitans ◽

Treponema Denticola ◽

Tannerella Forsythia ◽

Complex Species

AbstractThree bacterial species pertaining to the red complex (Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia) and Aggregatibacter actinomycetemcomitans were investigated in relation to the incidence and severity of periodontal disease. A total of 259 patients were included in this study, 179 being diagnosed with periodontal disease. The gingival crevicular fluid samples were obtained from periodontal pockets and the presence and levels of target bacteria were assessed following DNA extraction and real-time quantitative PCR. Our results account for significant positive associations between the number of bacterial species from the red complex coexisting within a patient and several clinical signs (gingival bleeding, inflammation and bone deterioration). A similar positive association was found between bacterial load of the red complex species and the clinical Case Type diagnostic of the periodontal disease, as well as the probing depth with the most evident results for T. denticola. In conclusion, our study, a first for the Romanian population, confirms previous results found elsewhere and finds a possible regional pathogenic specificity for T. denticola as a major factor for periodontitis severity.

Download Full-text

Salivary Matrix Metalloproteinase-8 (MMP-8) in Relation to Periodontal Health Status Among a Group of Hypertensive Patients

Journal of Baghdad College of Dentistry ◽

10.26477/jbcd.v30i3.2531 ◽

2018 ◽

Vol 30 (3) ◽

pp. 48-53

Author(s):

Iman Z AlMudaris ◽

Nadia A AlRawi

Keyword(s):

Periodontal Disease ◽

Plaque Index ◽

Control Group ◽

Study Group ◽

Periodontal Health ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Probing Pocket Depth ◽

Significant Difference ◽

Attachment Level

Background: Hypertension is probably the most important public health problem around the world. People with periodontal disease may be at greater risk of hypertension. The inflammatory effects of periodontal disease help to promote endothelial dysfunction in arteries which may lead to changes in blood pressure. Salivary MMP-8 has been associated with both periodontal disease and prevalent hypertension. Aim of study: This study was conducted to measure salivary matrix metalloproteinase - 8, in relation to periodontal health condition among a group of patients with hypertension in comparison with control group. Materials and methods: Ninety subjects, aged 45-50 years old were included in this study, seeking treatment for chest pain in Ibn-AlBaytar center for cardiac surgical treatments in Baghdad, Iraq. The subjects were divided into study group (45 patient) who were diagnosed to be a hypertensive patient, and a control group (45 subject), with no hypertension. Plaque status was evaluated according to the Silness and Loe, probing pocket depth and clinical attachment level. Unstimulated saliva was collected from all subjects to analyses MMP-8. Result: A high mean value of plaque index, clinical attachment level and probing pocket depth for the study group than the control group with statistically no significant difference. In addition to that, a significant positive correlation between the plaque index and the clinical attachment level among both groups. Salivary MMP-8 level showed a higher level in the study group than in the control group, with statistically significant difference between groups, and a significant positive correlation was detected between salivary MMP-8 with plaque index, among study group, Conclusions: Higher percentage of periodontal diseases was found among patients with blood hypertension. In addition, high level of salivary MMP-8 is potentially associated with periodontal status of the study group.

Download Full-text

The Influence of Smoking and Non-Insulin-Dependent Diabetes Mellitus on Periodontal Disease

Journal of International Medical Research ◽

10.1177/147323000203000203 ◽

2002 ◽

Vol 30 (2) ◽

pp. 116-125 ◽

Cited By ~ 14

Author(s):

R Orbak ◽

A Tezel ◽

V Çanakçi ◽

T Demir

Keyword(s):

Diabetes Mellitus ◽

Periodontal Disease ◽

Systemic Disease ◽

Insulin Dependent Diabetes Mellitus ◽

Insulin Dependent Diabetes ◽

Dependent Diabetes Mellitus ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Insulin Dependent ◽

Attachment Level

The periodontal health of smokers and non-smokers with non-insulin-dependent diabetes mellitus (NIDDM) and non-smokers with periodontitis who were not suffering from a systemic disease was assessed. The investigation was carried out on 60 adult subjects. Levels of blood glucose, glycosylated haemoglobin and immunoglobulins G, A and M were determined, together with the plaque index, gingival index, probing pocket depths and clinical attachment level. Periodontitis was more severe in smokers and non-smokers with NIDDM than non-smokers without NIDDM, and the periodontal condition (clinical attachment level, probing pocket depth and gingival bleeding) was better in non-smokers with NIDDM than smokers with NIDDM. The results suggest that diabetes and smoking are high-risk factors for periodontal disease.

Download Full-text

Putative periodontal bacteria in clinically healthy and diseased sites of periodontitis patients

Brazilian Journal of Oral Sciences ◽

10.20396/bjos.v18i0.8657248 ◽

2019 ◽

Vol 18 ◽

pp. e191417

Author(s):

Carlos Eduardo Barros ◽

Vivian Siqueira ◽

Dennis Carvalho ◽

Antonio Canabarro

Keyword(s):

Dna Hybridization ◽

Healthy Subjects ◽

Bacterial Species ◽

Treponema Denticola ◽

Hybridization Technique ◽

Pocket Depth ◽

Microbial Profile ◽

Probing Pocket Depth ◽

Periodontal Bacteria ◽

Microbial Analysis

Aim: The aim of this study was to compare the microbial profile of subgingival sites in Periodontitis (Pd) patients and healthy ones. Methods: Eighteen patients with Pd and 18 gender-matched healthy controls were selected. Subgingival samples were collected from three types of sites: 1) healthy site of healthy subjects (probing pocket depth (PPD) ≤ 3mm, CG), 2) healthy site of Pd patients (PPD ≤ 3mm, PG-C) and 3) diseased site (PPD > 3mm) of the same Pd patients (PG-T). All sites were subjected to microbial analysis for the detection of 40 bacterial species by the "Checkerboard DNA-DNA hybridization" technique. Results: It was observed a great diversity of bacteria in all patients evaluated. The sites from the Pd groups (PG-T and PG-C) showed a higher overall count of the studied bacteria than those of the CG group, especially from Green, Orange, and Red complexes. Also, PG-T showed a higher prevalence of Red complex bacteria than CG. Individual pathogens, such as Porphyromonas gingivalis, Treponema denticola and Treponema socranskii were detected in higher levels and/or prevalence in Pd than in control patients. However, it was not observed any difference between PG-T and PG-C. Conclusion: Pd patients showed higher prevalence and counts of some putative periodontal bacteria, especially from the red complex, than control ones, regardless of the severity of their sites.

Download Full-text

Application of Lactoferrin andα1-Antitrypsin in Gingival Retention Fluid to Diagnosis of Periodontal Disease

Disease Markers ◽

10.1155/2018/4308291 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Ryosuke Koshi ◽

Kazuhiko Kotani ◽

Mariko Ohtsu ◽

Naoto Yoshinuma ◽

Naoyuki Sugano

Keyword(s):

Clinical Practice ◽

Periodontal Disease ◽

Area Under The Curve ◽

Pocket Depth ◽

Bleeding On Probing ◽

Periodontal Status ◽

Positive Correlation ◽

Probing Pocket Depth ◽

The Relationship

Objectives.Periodontal disease is prevalent and has an inflammation associated with not only oral but also systemic pathologies. The diagnosis by biomarkers is required for clinical practice on periodontal disease. The lactoferrin andα1-antitrypsin were both inflammation-related molecules. The present study investigated the relationship between the periodontal status and the two biomarkers in gingival retention fluid (GRF).Patients and Methods. In 63 subjects with periodontitis, the GRF was sampled from maxillary anterior gingiva using a microbrush for 30 seconds. The lactoferrin andα1-antitrypsin levels in GRF were measured by an enzyme-link solvent immunoassay. Periodontal status was evaluated by probing pocket depth (PD) and bleeding on probing (BOP).Results. There was a higher level of these biomarkers in saliva (median (ng/mL), lactoferrin: 3611.9,α1-antitrypsin: 4573.3) than in GRF (lactoferrin: 61.0,α1-antitrypsin: 54.7). There was a mild-to-moderate but significantly positive correlation in lactoferrin orα1-antitrypsin between GRF and saliva. There was a positively mild-to-moderate accuracy (area under the curve: 0.60–0.81) of lactoferrin orα1-antitrypsin in GRF or in saliva to distinguish the severity of periodontal status. The cutoff level (ng/mL) of lactoferrin in GRF for detecting ≥30% of PD ≥ 4 mm (moderate periodontitis) was 68.6 and for detecting ≥20% of BOP (clinically active periodontitis) was 61.2. The cutoff level (ng/mL) ofα1-antitrypsin in GRF for detecting ≥30% of PD ≥ 4 mm was 54.5 and for detecting ≥20% of BOP was 35.3.Conclusions.The data can promote an application of the measurements of lactoferrin andα1-antitrypsin in GRF to clinical practice on periodontal disease.

Download Full-text

Ozone Gel in Chronic Periodontal Disease: A Randomized Clinical Trial on the Anti-Inflammatory Effects of Ozone Application

Biology ◽

10.3390/biology10070625 ◽

2021 ◽

Vol 10 (7) ◽

pp. 625

Author(s):

Marco Colombo ◽

Simone Gallo ◽

Alessandro Garofoli ◽

Claudio Poggio ◽

Carla Renata Arciola ◽

...

Keyword(s):

Periodontal Disease ◽

Antimicrobial Properties ◽

Experimental Treatment ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Beneficial Effects ◽

Probing Pocket Depth ◽

Chronic Periodontal Disease ◽

Attachment Level ◽

Chlorhexidine Gel

The search for new topical treatments able to display not only antimicrobial properties but also a multiplicity of other beneficial effects while expressing safe cytocompatibility toward host tissues is being progressively developed. Antiseptics represent an aid to the gold standard nonsurgical treatment Scaling-and-Root-Planing (SRP) for periodontal disease. This split-mouth study aims to assess the efficacy of the ozonized gel GeliO3 (Bioemmei Srl, Vicenza, Italy) plus SRP (experimental treatment), with respect to SRP + chlorhexidine gel. Ten participants were treated with SRP + chlorhexidine gel (control sites) and with SRP + ozone gel (trial sites). After 1 (T1) and 3 months (T2) from baseline (T0), patients were revisited. At each time-point, the following indexes were assessed: probing pocket depth (PPD), clinical attachment level (CAL), gingival index (GI), plaque index (PI), and bleeding on probing (BoP). It has been assessed that the use of the ozonized gel in addition to SRP did not show significant differences if compared to conventional SRP + chlorhexidine. Chlorhexidine was found to be more effective than ozone in reducing CAL and GI at T2. Ozone deserves consideration for its wide applicability in several clinical fields. In this connection, we also glance at the latest research on ozone therapy.

Download Full-text