Cases reported "Dental Plaque"

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1/7. Microbiological features of Papillon-Lefevre syndrome periodontitis.

    Papillon-Lefevre syndrome patients exhibit hyperkeratosis palmo-plantaris and severe periodontitis. The syndrome is an autosomal recessive trait, but the mechanism of periodontal destruction is not known. This report presents the clinical and microbiological features of an 11-year old girl with Papillon-Lefevre syndrome. Clinical examination included conventional periodontal measurements and radiographic analysis. In samples from 3 deep periodontal lesions, the occurrence of major suspected periodontopathic bacteria was determined by selective and non-selective culture and polymerase chain reaction (PCR) identification, and the presence of cytomegalovirus and Epstein-Barr type 1 virus by a nested-PCR detection method. 10 of 22 available teeth demonstrated severe periodontal breakdown. Major cultivable bacteria included actinobacillus actinomycetemcomitans (3.4% of total isolates), prevotella nigrescens (16.4%), fusobacterium nucleatum (14.3%) and peptostreptococcus micros (10.6%). A. actinomycetemcomitans, P. nigrescens, porphyromonas gingivalis and eikenella corrodens were identified by PCR analysis. The patient's non-affected parents and older brother revealed several periodontal pathogens but not A. actinomycetemcomitans. The viral examination demonstrated cytomegalovirus and Epstein-Barr type 1 virus in the subgingival sample of the Papillon-Lefevre syndrome patient. The father and brother yielded subgingival cytomegalovirus but not Epstein-Barr type 1 virus. We hypothesize that human herpesviruses in concert with A. actinomycetemcomitans play important roles in the development of Papillon-Lefevre syndrome periodontitis.
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2/7. Comparing periodontal disease in identical twins: a case report.

    Previous investigators have shown that numerous environmental and genetic variables may contribute to the pathogenesis of periodontal disease. This case report presents clinical and laboratory findings of a set of Caucasian female identical twins. One patient presented clinically with mild gingivitis and no clinical or radiographic signs of periodontitis. The other exhibited gingivitis with localized, moderate-to-severe periodontitis. Neither patient reported a history of systemic conditions that might influence their periodontal health, and neither presented other known risk factors, such as tobacco use. The only apparent variable was related to their oral hygiene. The periodontally involved patient exhibited higher plaque scores than her twin in all clinical visits. Subgingival plaque cultures revealed the presence of porphyromonas gingivalis and bacteroides forsythus only in the diseased twin. Both patients had low colony counts of prevotella intermedia and eikenella corrodens, but only the healthy twin harbored small quantities of fusobacterium nucleatum. This case report offers an opportunity to assess etiology of periodontitis in two genetically identical patients whose only obvious difference was their oral hygiene.
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3/7. Features of severe periodontal disease in a teenager with chediak-higashi syndrome.

    BACKGROUND: chediak-higashi syndrome (C-HS) is a rare congenital disease characterized by defective neutrophil function with abnormal lysosomal inclusions, neutropenia, and reduced chemotaxis. The complete syndrome includes oculocutaneous albinism with photophobia, neurologic features, recurrent infections, and enterocolitis. methods: A 14-year-old male C-HS patient was referred to us because of serious periodontal destruction with acute inflamed gingiva and ulcers. Clinical and biological investigations were performed, leading to the diagnosis of C-HS. RESULTS: Laboratory findings included neutropenia and hypergammaglobulinemia. Peripheral blood smears showed giant granules in neutrophils, eosinophils, and granulocytes. bone marrow smears showed giant inclusions in leukocyte precursor cells. These granules and inclusions were characteristic of chediak-higashi syndrome. Oral radiographic status showed extensive loss of alveolar bone leading, in most cases, to tooth exfoliation. bacteria often associated with periodontitis were detected in subgingival plaque samples, including fusobacterium nucleatum, campylobacter rectus, prevotella melaninogenica, peptostreptococcus anaerobius, and clostridium sp. Biopsies of periodontal tissues for light and electronic microscopic examinations revealed massive bacterial invasion of the epithelial tissue, epithelial cells, and connective tissue. Ultrastructural observations of periodontal polymorphonuclear leukocytes showed defective granulation, with abnormal granules not discharging their lysosomal content against engulfed bacteria. Viable dividing bacteria were found in the cytoplasm. CONCLUSIONS: In this case, early-onset periodontitis seems to be the expression of C-HS granulocyte deficiency. Periodontal treatment of these patients is often unsuccessful. This case report illustrates the importance of the dentist in initiating clinical and biological investigations in such early aggressive periodontitis in young patients.
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4/7. Periodontal therapy in siblings with Papillon-Lefevre syndrome and tinea capitis: a report of two cases.

    OBJECTIVE: Report of clinical and microbiological periodontal findings before and 6 months after treatment of two siblings with Papillon-Lefevre syndrome (PLS) and tinea capitis. methods: Two brothers, RG 3 years and NG 5 years of age, were referred for treatment due to premature mobility of their deciduous teeth. Probing depths (PPD), attachment levels (PAL-V), and furcation involvements were examined clinically. Panoramic radiographs were taken. Subgingival plaque samples within the deepest pocket of each tooth were taken and analysed by real-time polymerase chain reaction (PCR) for actinobacillus actinomycetemcomitans (AA), porphyromonas gingivalis, Tannerella forsythensis, treponema denticola, fusobacterium nucleatum, and prevotella intermedia. One-stage full-mouth scaling and extraction of hopeless teeth were performed under general anaesthesia, followed by systemic amoxicillin and metronidazole for 7 days. Clinical and microbiological analyses were performed 6 months after treatment. RESULTS: Before treatment, both siblings had exhibited PPD of up to 13 mm, Class III furcation defects at four teeth, and marginal suppuration. AA was detected in both patients and at all teeth at levels ranging from 3.0 x 10(2) to 5.1 x 10(6). Both patients exhibited palmar and plantar hyperkeratosis. Seven teeth were extracted from RG, and nine from NG. Six months after treatment, PPD had been reduced to patients can be treated successfully. Suppression of AA to below detection level seems to be of high significance.
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5/7. A family study of a mother and daughter with increased susceptibility to early-onset periodontitis: microbiological, immunological, host defensive, and genetic analyses.

    Microbiological, immunological, host-defensive, and genetic analyses were performed on a mother and daughter, both of whom had early-onset periodontitis (rapidly progressive periodontitis in the mother; localized juvenile periodontitis in the daughter). Microscopic examination revealed a greatly elevated percentage of rod-form bacteria in both subjects. Fusobacterium sp. and porphyromonas gingivalis (formerly bacteroides gingivalis) were the predominant microorganisms cultured. The humoral immune responses to F. nucleatum, P. gingivalis, and actinobacillus actinomycetemcomitans were much higher in both subjects than those to any other periodontal bacteria examined. Functional and phenotypic analysis of the peripheral lymphocytes showed no significant abnormalities. However, investigation of neutrophil function showed that the mother had depressed neutrophil chemotaxis and superoxide production. The daughter had depression not only of chemotaxis and superoxide production, but also of neutrophil phagocytosis. Serological typing of hla antigens revealed the same Class II HLA profile in both subjects. It was concluded that both subjects very probably had an identical condition and that these patients provided a unique model for improving our understanding of the host factors involved in periodontal disease.
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6/7. Clinical, microbiological and immunological features associated with the treatment of active periodontosis lesions.

    Clinical, microbiological and immunological factors were examined using data from a subject with periodontosis. The subject was monitored at bimonthly intervals for 26 months at 6 sites per tooth for redness, plaque, suppuration, bleeding on probing, pocket depth, and attachment level. Using attachment level measurements and the tolerance method of analysis, sites with active disease and control (inactive) sites of equal pocket depth were selected. Subgingival plaque samples were taken from these sites for predominant cultivable and dark field evaluation before, and 5 and 13 months after treatment by Widman flap surgery and systemic tetracycline. 50 isolates from each of 5 sites monitored before and after treatment were characterized and, if possible, identified. Active sites showed between 2 and 6 mm of attachment loss prior to therapy and "gained" between 2 and 9 mm of attachment after therapy. The control sites "gained" 0 to 1 mm of attachment after therapy. Bleeding on probing was significantly reduced after treatment, whereas plaque accumulation increased significantly in the sampled sites. Similar changes were seen in the remaining sites. The proportions of actinobacillus actinomycetemcomitans and selenomonas sputigena were elevated in active sites, while proportions of bacteroides intermedius were elevated in control sites. 5 months after treatment, proportions of A. actinomycetemcomitans, S. sputigena and eikenella corrodens were significantly decreased in the previously active sites and proportions of B. intermedius and E. corrodens were significantly decreased in the control sites. 13 months after therapy, the proportions of fusobacterium nucleatum and capnocytophaga species had increased. Multiple linear regression analysis was used to examine models which could "predict" the outcome, attachment level change in the previous monitoring period. The proportions of A. actinomycetemcomitans and S. sputigena, which were associated with destruction, coupled with the proportions of streptococcus sanguis II and Campylobacter concisus which were associated with "gain" could predict prior attachment level change with an r2 of 0.93. Humoral antibody response to A. actinomycetemcomitans and C. sputigena significantly increased in a period in which multiple actively breaking down sites were detected. Antibody responses to 20 other species tested did not significantly change during the course of monitoring. Crevicular fluid and tissue levels of antibody to A. actinomycetemcomitans were elevated in 5 of 6 active destructive lesions prior to therapy.(ABSTRACT TRUNCATED AT 400 WORDS)
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7/7. Microbiological findings in prepubertal periodontitis. A case report.

    Generalized pre-pubertal periodontitis (GPP) is a rare entity that usually affects children with severe systemic diseases. We report the case of a 7-year-old male patient diagnosed with GPP, with no apparent systemic condition, who lost all his primary teeth to periodontal disease. Before extractions, while he was still in mixed dentition the subgingival plaque was collected and analyzed using dna probes to 40 different microorganisms. Putative periodontopathogens such as prevotella intermedia, selenomonas noxia, fusobacterium nucleatum, and actinobacillus actinomycetemcomitans could be identified throughout the mouth. More intriguing was the colonization of the sulcus of some secondary teeth by potentially harmful microorganisms found in pockets of diseased adjacent primary teeth.
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