Cases reported "Periodontal Diseases"

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1/3. Papillon-Lefevre syndrome: serum immunoglobulin g (IgG) subclass antibody response to periodontopathic bacteria. A case report.

    BACKGROUND: Papillon-Lefevre syndrome (PLS) is a rare autosomal recessive disorder which is characterized by palmar-plantar hyperkeratosis and rapid periodontal destruction of both primary and permanent dentitions. In this case report, we present clinical features, and microbiological and immunological findings of 40 month-old Thai male PLS patient. methods: Microbiological examinations consisted of bacterial culture methods utilizing selective media, morphological identification, and biochemical tests. In addition, the specific serum IgG subclass antibody titers reactive with etiologic periodontal bacteria were determined by the dot-blot immunological analysis and enzyme linked immunosorbent assay (ELISA). RESULTS: The examinations revealed that the patient harbored 3 major suspected periodontopathic microorganisms, A. actinomycetemcomitans, P. gingivalis, and P. intermedia. The patient's serum IgG1, IgG2, and IgG3, but not IgG4, titers against A. actinomycetemcomitans were dramatically increased. The predominant IgG subclass was IgG1. In contrast, the IgG titers against other tested bacteria, P. gingivalis, P. intermedia, and F. nucleatum, appeared to be similar to those of a healthy control. CONCLUSIONS: A. actinomycetemcomitans seems to play a pivotal role in the bacteria-host interaction in PLS periodontal pathogenesis. Response of the specific serum IgG subclass antibody titers against the A. actinomycetemcomitans antigen has been demonstrated. This association warrants further investigation.
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2/3. 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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3/3. 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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