Objectives: To describe clinical features, demographic characteristics, and treatment outcome in four prepubertal children with severe periodontitis. This is a case report of prepubertal children that have been referred to the Temple University Kornberg School of Dentistry (TUKSD) for the treatment of severe periodontitis. Methods & Materials: Chart review was performed of available paper and electronic records of patients aged ≤ 10 years that have been treated at the Graduate Periodontology Clinic, TUKSD during the past 5 years. Cases were evaluated for periodontal diseases by means of assessing dental plaque, dental calculus, gingivitis, probing depths and clinical attachment level, and radiographic evidence of bone levels. Cases diagnosed with periodontitis were identified and the patients¡¯ demographics, clinical findings, type of treatment provided, treatment outcome, and medical history were noted. Results: Four children with severe periodontitis were identified. All the subjects had deep probing depths around their primary teeth showing significant bone loss on radiographs and were diagnosed with severe periodontitis. These children were treated with scaling and root planing combined with systemic antibiotics and extraction of hopeless primary teeth. The permanent teeth erupted early and there was no radiographic alveolar bone loss. Three subjects had microbiological testing and showed predominance of certain periodontal pathogens such as Prevotella intermedia and Fusobecterium nucleatum. Following treatment all children were inaccessible for follow-up. Conclusion: Periodontitis in prepubertal children causes early loss of primary teeth and early eruption of permanent teeth. Relevant systemic diseases were not detected in any of the children. Compliance with periodontal maintenance is poor among prepubertal children attending the TUKSD clinics for the treatment of periodontitis. / Oral Biology

Symptomatic apical periodontitis (SAP) is indicative of inflammation of the periodontal ligament. It may or may not be accompanied by radiographic changes and may occur with vital or necrotic pulpal diagnosis. Purpose of this study was to analyze clinical and radiographic presentations of SAP in a retrospective electronic dental chart and digital radiograph review utilizing the endodontic diagnostic template note of predoctoral dental school patients presenting with SAP. The aim was to determine prevalence of periapical radiolucencies (PARLs) in SAP, association of SAP to pulpal diagnosis, and define associated radiographic changes. Most prevalent pulpal diagnosis with SAP was symptomatic irreversible pulpitis (44%). A tooth presenting with SAP was more likely to have an intact lamina dura, but presented with a PARL 38% of the time. When a PARL was present the most common pulpal diagnosis was pulp necrosis however, 24.5% of teeth presented with a vital pulp diagnosis and lesions <2mm.

Introdução: A periodontite é uma doença inflamatória crônica, de alta prevalência na população, que causa perda dentária. A progressão da doença ocorre por meio de surtos, com períodos de remissão e exacerbação. A análise da expressão gênica de lesões ativas na progressão das doenças periodontais pode demonstrar diferenças na resposta do hospedeiro e indicar processos relacionados à atividade destrutiva da doença. Metodologia: Foram selecionados 54 pacientes, sendo 18 com Doença Periodontal Agressiva (DPA), 25 com Doença Periodontal Crônica (DPC) e 11 com ausência de Doença Periodontal (Controle). Medidas clínicas de profundidade de sondagem (PS), nível de inserção relativo (NIR), sangramento à sondagem (SS) e índice de placa (IP) foram obtidas em dois tempos: inicial e após tratamento na reavaliação com dois meses. Nos pacientes com Doença Periodontal (DP), os sítios que apresentaram perda de inserção de um ou mais milímetros foram considerados ativos e os demais, não ativos. O perfil de expressão gênica, de sítios ativos e não ativos, foi obtido pela análise de biópsias gengivais com o Real Time PCR Array. Resultados: Após o tratamento periodontal não cirúrgico, houve melhora significante em todos os parâmetros clínicos (PS, SS, IP; p<0,05) exceto para o NIR (p>0,05). Dos 5112 sítios tratados, aproximadamente 4% apresentam perda de inserção mesmo após o tratamento com ou sem uso de antibiótico. As doenças DPA e DPC demonstraram diferentes perfis de expressão gênica, com sítios ativos apresentando um padrão significantemente up-regulated em relação aos sítios não ativos. Conclusão: A DPA e a DPC são condições clínicas que apresentam diferenças na resposta imune e a atividade destrutiva da lesão periodontal ativa pode ser reconhecida por um padrão inflamatório up-regulated de resposta. Considerando-se as diferenças observadas, abordagens terapêuticas individualizadas e capazes de modular a resposta poderiam potencializar o efeito benéfico da terapia anti-infecciosa e reduzir o número de sítios ativos da DP progressiva. / Aim: Evaluate the gene expression profile under healthy and periodontal disease conditions; identify possible differences in the gene expression profile between chronic and aggressive periodontal diseases; seek evidences of immune regulation differences in active and non active sites during periodontal destruction. Methods: Clinical parameters of probing depth, relative attachment level, bleeding on probing and plaque index were obtained in two stages: initial and two months. The sites that showed attachment loss 1mm were considered active and others non-active. The gene expression profile of active and non-active sites, was obtained by gingival biopsies analysis with Real Time PCR Array. Results: After non-surgical periodontal treatment, significant improvement in all clinical parameters were achieved (P <0.05), except for the relative attachment level (p> 0.05). The disease showed different gene expression profiles with active sites showing a pattern significantly up-regulated compared to non-active sites. Conclusion: Aggressive and Chronic Periodontitis are clinical conditions that showed differences in the immune response profile and that the progressive periodontal lesion can be recognized by an up-regulated inflammatory response. Considering the observed differences, it is possible that individualized therapeutic approaches that modulate the inflammatory response might enhance the efficacy of the anti-infective therapy and reduce active sites number after treatment.

Introdução: A periodontite é uma doença inflamatória crônica, de alta prevalência na população, que causa perda dentária. A progressão da doença ocorre por meio de surtos, com períodos de remissão e exacerbação. A análise da expressão gênica de lesões ativas na progressão das doenças periodontais pode demonstrar diferenças na resposta do hospedeiro e indicar processos relacionados à atividade destrutiva da doença. Metodologia: Foram selecionados 54 pacientes, sendo 18 com Doença Periodontal Agressiva (DPA), 25 com Doença Periodontal Crônica (DPC) e 11 com ausência de Doença Periodontal (Controle). Medidas clínicas de profundidade de sondagem (PS), nível de inserção relativo (NIR), sangramento à sondagem (SS) e índice de placa (IP) foram obtidas em dois tempos: inicial e após tratamento na reavaliação com dois meses. Nos pacientes com Doença Periodontal (DP), os sítios que apresentaram perda de inserção de um ou mais milímetros foram considerados ativos e os demais, não ativos. O perfil de expressão gênica, de sítios ativos e não ativos, foi obtido pela análise de biópsias gengivais com o Real Time PCR Array. Resultados: Após o tratamento periodontal não cirúrgico, houve melhora significante em todos os parâmetros clínicos (PS, SS, IP; p<0,05) exceto para o NIR (p>0,05). Dos 5112 sítios tratados, aproximadamente 4% apresentam perda de inserção mesmo após o tratamento com ou sem uso de antibiótico. As doenças DPA e DPC demonstraram diferentes perfis de expressão gênica, com sítios ativos apresentando um padrão significantemente up-regulated em relação aos sítios não ativos. Conclusão: A DPA e a DPC são condições clínicas que apresentam diferenças na resposta imune e a atividade destrutiva da lesão periodontal ativa pode ser reconhecida por um padrão inflamatório up-regulated de resposta. Considerando-se as diferenças observadas, abordagens terapêuticas individualizadas e capazes de modular a resposta poderiam potencializar o efeito benéfico da terapia anti-infecciosa e reduzir o número de sítios ativos da DP progressiva. / Aim: Evaluate the gene expression profile under healthy and periodontal disease conditions; identify possible differences in the gene expression profile between chronic and aggressive periodontal diseases; seek evidences of immune regulation differences in active and non active sites during periodontal destruction. Methods: Clinical parameters of probing depth, relative attachment level, bleeding on probing and plaque index were obtained in two stages: initial and two months. The sites that showed attachment loss 1mm were considered active and others non-active. The gene expression profile of active and non-active sites, was obtained by gingival biopsies analysis with Real Time PCR Array. Results: After non-surgical periodontal treatment, significant improvement in all clinical parameters were achieved (P <0.05), except for the relative attachment level (p> 0.05). The disease showed different gene expression profiles with active sites showing a pattern significantly up-regulated compared to non-active sites. Conclusion: Aggressive and Chronic Periodontitis are clinical conditions that showed differences in the immune response profile and that the progressive periodontal lesion can be recognized by an up-regulated inflammatory response. Considering the observed differences, it is possible that individualized therapeutic approaches that modulate the inflammatory response might enhance the efficacy of the anti-infective therapy and reduce active sites number after treatment.

Thesis (Ph. D.)--Virginia Commonwealth University, 1997. / Prepared for: Dept. of Microbiology and Immunology. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph. D.)--Virginia Commonwealth University, 1997. / Prepared for: Dept. of Microbiology and Immunology. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Orientador: Ana Lia Anbinder / Banca: Maria Aparecida Neves Jardini / Banca: Débora Pallos / Resumo: Os tratamentos mais usados para periodontite são a raspagem e aplainamento radicular, tratamento não cirúrgico, associado ou não ao uso de antimicrobianos. No entanto, novas terapias têm sido testadas com foco na modulação da resposta do hospedeiro. Alguns micro-organismos têm efeitos benéficos na saúde dos seres humanos, pois produzem efeitos antimicrobianos e anti-inflamatórios, os chamados probióticos. O presente trabalho avaliou o efeito antimicrobiano de Lactobacillus reuteri sobre Porphyromonas gingivalis e a influência deste probiótico em sua forma viva, morta (paraprobiótico) e sobrenadante em modelo de invertebrado Galleria mellonella, infectado por P. gingivalis. Posteriormente, foi determinada a viabilidade celular, níveis de óxido nítrico e de interleucina (IL)-1βb, IL-6, IL-17 e fator de necrose tumoral (TNF)- α, através do ensaio de ELISA em osteoblastos infectados por LPS de P. gingivalis in vitro. Os dados foram submetidos ao teste estatístico ANOVA, Kruskal-Wallis ou Log-rank (Mantel-Cox), com nível de significância de 5%.L. reuteri e seu sobrenadante possuem a mesma atividade antimicrobiana. O probiótico viável e o morto apresentaram efeitos iguais na sobrevivência de G. mellonella e L. reuteri vivo foi o único que aumentou densidade hemocitária das lagartas. O probiótico e o paraprobiótico reduziram igualmente os níveis IL-1β, IL-6, TNF-α e IL-17, sendo que o paraprobiótico, diferentemente do lactobacilo vivo, reduziu significantemente as quantidades de IL-... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The most used treatments for periodontitis are scaling and non-surgical root planing, associated or not to the use of antimicrobials. However, new therapies have been tested with a focus on host response modulation. Some microorganisms have beneficial effects on human health because they produce antimicrobial and antiinflammatory effects, called probiotics. The present study evaluated the antimicrobial effect of Lactobacillus reuteri on Porphyromonas gingivalis and the influence of this probiotic in its live, inactivated (paraprobiotic) form and supernatant on Galleria mellonella invertebrate model, after infection by P. gingivalis. Later, the cell viability, nitric oxide levels and interleukin (IL)-1b, IL-6, IL-17 and tumor necrosis factor (TNF)- α, by the Elisa assay, were evaluated in osteoblasts infected with P. gingivalis LPS in vitro. Data were submitted to ANOVA, Kruskal-Wallis or Log-rank (Mantel-Cox) statistical test, with a significance level of 5%. L. reuteri and its supernatant have the same antimicrobial activity. The viable and inactivated probiotic had equal effects in G. mellonella survival and L. reuteri alive was the only one that increased the hemocyte density in the invertebrate model. Probiotics and paraprobiotics also reduced levels of IL-1β, IL-6, TNF-α and IL-17 cytokines, whereas paraprobiotic, unlike living lactobacillus, significantly reduced the amounts of IL-6 and TNF-α, compare to the LPS control group. The highest reductions of the studied cytok... (Complete abstract click electronic access below) / Mestre

Orientador: Márcio Zaffalon Casati / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-22T14:43:32Z (GMT). No. of bitstreams: 1 Taiete_Tiago_M.pdf: 1582293 bytes, checksum: ce2ee2281211fd103a94c527cfce02ab (MD5) Previous issue date: 2013 / Resumo: A periodontite agressiva é caraterizada por apresentar início precoce, rápida progressão e pobre resposta as abordagens terapêuticas quando comparado a periodontite crônica. Entretanto, os mecanismos responsáveis por essas diferenças ainda não são completamente compreendidos. Ferramentas como a genômica, proteômica ou transcriptômica podem esclarecer esses aspectos, gerando importantes informações a respeito da patogênese das doenças periodontais. Portanto, os objetivos do presente estudo foram: i) Apresentar uma revisão de literatura focada na aplicação da genômica, transcriptômica, proteômica e metabolômica no estudo das doenças periodontais. ii) Avaliar as diferenças no perfil de expressão gênica da mucosa mastigatória, sem a influência do biofilme subgengival, em indivíduos com histórico de periodontite agressiva e crônica, comparando-os entre si e também com o perfil de expressão de indivíduos sem histórico de periodontite visando à identificação de possíveis alterações constitutivas na expressão de genes que podem estar relacionadas com as diferenças entre as duas formas de periodontite. Para o primeiro objetivo, foi realizada uma revisão dos artigos que empregaram as tecnologias ômicas no estudo das doenças periodontais. Os estudos presentes na literatura indicaram que essas tecnologias podem levar a um melhor entendimento dos eventos moleculares envolvidos na patogênese das doenças periodontais. Para o segundo objetivo, foram obtidas amostras teciduais da mucosa mastigatória de 4 pacientes com histórico de periodontite crônica, 4 com periodontite agressiva generalizada e 4 indivíduos sem histórico de periodontite. As amostras foram manipuladas para a extração de RNA total, síntese de cDNA de fita dupla e a hibridização por microarranjo de DNA, avaliando a expressão de 45033 genes. Os programas R e Bioconductor foram empregados para realizar a análise de RMA (Robust-Multi-Array), calcular o valor de expressão (fold-change) e o valor de p para comparações múltiplas através do método de Benjamini-Hochberg. O enriquecimento dos dados, através de ontologia gênica e análise de via, foi realizado com o programa de bioinformática DAVID (Database for Annotation, Visualization and Integrated Discovery). Três comparações foram realizadas: comparação 1 (periodontite agressiva x indivíduos sem histórico de periodontite); comparação 2 (periodontite crônica x indivíduos sem histórico de periodontite); e comparação 3 (periodontite crônica x periodontite agressiva). A comparação entre os grupos identificou: 192 genes e 50 grupos diferencialmente expressos na comparação 1, 43 genes e 27 grupos na comparação 2 e 168 genes e 75 grupos na comparação 3. Genes com funções no sistema imune, entre os quais receptores de linfócitos natural killer, foram mais expressos em periodontite agressiva; em contraste, genes envolvidos na proliferação e diferenciação de queratinócitos, assim como genes com função em processos neurais foram menos expressos. Já os indivíduos com periodontite crônica se caracterizaram por um aumento na expressão de genes com função na resposta a estímulos externos, e uma diminuição na expressão dos genes relacionados ao sistema imune. Dentro dos limites desse estudo, pode-se concluir que existem diferenças nos perfis de expressão gênica da mucosa mastigatória de indivíduos com histórico de periodontite agressiva e crônica, quando comparadas entre si e com indivíduos sem histórico de periodontite, que podem estar associadas às diferenças em suas patogêneses / Abstract: Aggressive periodontitis is characterized by early onset, rapid progression and poor response to treatment compared to chronic periodontitis. However, mechanisms responsible for these differences are not fully understood. Tools such as genomics, proteomics and transcriptomics can clarify these aspects, producing important information about the pathogenesis of periodontal diseases. Therefore, the aims of this study were: i) Provide a literature review focused on the application of genomics, transcriptomics, proteomics, and metabolomics in the study of periodontal diseases. ii) Evaluate the gene expression profile of tissue from masticatory mucosa, without the influence of biofilm, in patients with a history of generalized aggressive and chronic periodontitis, and also with gene expression profile of individuals without periodontitis, with the aim to identify possible constitutive alterations in gene expression, which may be related to the differences between both forms of periodontitis. For the first objective, it was performed a review of articles that employed omics technologies in the study of periodontal diseases. The studies in the literature indicated that these technologies can lead to a better understanding of molecular events involved in the pathogenesis of periodontal diseases. For the second objective, masticatory mucosa tissue samples were obtained from 4 patients with a history of chronic periodontitis, 4 with generalized aggressive periodontitis, and 4 from subjects without history of periodontitis. Tissue samples were processed for total RNA extraction, double-strand cDNA synthesis for subsequent hybridization reaction on microarrays, which assessed the expression of 45033 genes. R and Bioconductor softwares used to perform the RMA analysis (Robust Multi-Array), calculate the value of expression (fold-change) and the p-value for multiple comparisons through Benjamini-Hochberg method. Enrichment analysis, through gene ontology (GO) and pathway analysis, was performed with DAVID (Database for Annotation, Visualization and Integrated Discovery). Three comparisons were performed: comparison 1 (aggressive periodontitis x healthy subjects); comparison 2 (chronic periodontitis x healthy subjects); and comparison 3 (chronic periodontitis x aggressive periodontitis). Comparisons analysis found 192 genes and 50 groups differentially expressed in comparison 1, 43 genes and 27 groups in comparison 2, and 168 genes and 75 groups in comparison 3. Genes with function in the immune system, including natural killer cells receptors, were higher expressed in aggressive periodontitis; in contrast, genes involved in proliferation and differentiation of keratinocytes, as well as genes with function in neural process were lower expressed. Chronic periodontitis subjects were characterized by increased expression of genes related to response to external stimuli, and a decrease in the expression of genes related to the immune system. Within the limits of this study, it can be concluded that there are differences in the gene expression profile of masticatory mucosa of patients with a history of chonic and aggressive periodontitis, when compared among them and with healthy group, which may be associated with differences in their pathogenesis / Mestrado / Periodontia / Mestre em Clínica Odontológica

Objetivo: Determinar la asociación entre la periodontitis y el sedentarismo en adultos de los Estados Unidos entre los años 2013-2014. Materiales y métodos: Estudio analítico, observacional, transversal y retrospectivo, se utilizó la información de 3333 adultos de 30 a 78 años, de la encuesta Nacional de Examen de Salud y Nutrición NHANES 2013-2014 de los Estados Unidos. Se evaluó la periodontitis como presencia y ausencia y el sedentarismo se compuso de horas en la televisión, horas en la computadora y horas de actividad sedentaria. Asimismo, como variables intervinientes se tuvo género, edad, nivel educativo, ingreso, condiciones médicas, medidas de prevención, diabetes, discapacidad, visita al dentista, consulta odontológica, salud bucal, nutrición, consumo de tabaco, seguro de salud. Se obtuvieron estadísticas descriptivas de las variables mencionadas. Se analizó la comparación de la periodontitis con las covariables mediante las pruebas Chi Cuadrado y T-student. Asimismo, se realizó un análisis multivariado mediante la regresión de Poisson con varianza robusta, donde se calcularon las razones de prevalencia. Además se incluyeron los intervalos de confianza (IC 95%). Resultados: Se encontró una asociación entre la variable periodontitis y el sedentarismo, en la dimensión horas en la computadora (RP=1.57 I.C. = 1.23 -2.02, RP: 1.56, 95% IC 1.24-1.96) y horas en la televisión (RP=1.62 I.C. = 1.27 -2.06, RP: 1.58, 95% IC 1.27-1.98). Se encontró que aquellos adultos de 30 a 78 años de edad, que pasan menos de 2 horas en la computadora (RP=1.57 I.C. = 1.23 -2.02), más de 2 horas; pero menos de 4 horas (RP=1.56 I.C. = 1.24 -1.96), tienen mayores probabilidades de presentar periodontitis. Asimismo, las personas que pasan menos de 2 horas en la televisión (RP=1.62 I.C. = 1.27 -2.06) y más de 2 horas; pero menos de 4 horas (RP=1.58 I.C. = 1.27 -1.98), también tienen probabilidades de presentar periodontitis. Conclusiones: Existe asociación entre la periodontitis y el sedentarismo en la dimensión horas en la computadora y horas en la televisión. / Objective: To determine the association between periodontitis and sedentary lifestyle in adults in the United States between the years 2013-2014. Materials and Methods: Analytical, observational, cross-sectional, retrospective, retrospective study, data from 3333 adults aged 30 to 78 years, from the 2013-2014 NHANES National Health and Nutrition Examination Survey of the United States were used. Periodontitis was assessed as presence and absence and sedentary lifestyle was composed of hours on TV, hours on the computer, and hours of sedentary activity. Likewise, intervening variables were gender, age, educational level, income, medical conditions, preventive measures, diabetes, disability, dental visit, dental consultation, oral health, nutrition, tobacco use, health insurance. Descriptive statistics were obtained for the variables mentioned. Comparison of periodontitis with the covariates was analyzed using Chi-square and T-student tests. Likewise, a multivariate analysis was performed using Poisson regression with robust variance, where prevalence ratios were calculated. Confidence intervals (95% CI) were also included. Results: An association was found between the variable periodontitis and sedentary lifestyle, in the dimension hours on the computer (PR=1.57 C.I. = 1.23 -2.02, PR: 1.56, 95% CI 1.24-1.96) and hours on television (PR=1.62 C.I. = 1.27 -2.06, PR: 1.58, 95% CI 1.27-1.98). It was found that those adults 30 to 78 years of age, who spend less than 2 hours on the computer (PR=1.57 C.I. = 1.23 -2.02), more than 2 hours; but less than 4 hours (PR=1.56 C.I. = 1.24 -1.96), are more likely to present periodontitis. Likewise, people who spend less than 2 hours on television (PR=1.62 C.I. = 1.27 -2.06) and more than 2 hours; but less than 4 hours (PR=1.58 C.I. = 1.27 -1.98), are also likely to present periodontitis. Conclusions: There is an association between periodontitis and sedentary lifestyle in the dimension of hours on the computer and hours on the television. / Tesis

Objectives: Microbial infection and the host response to the infection play a significant role in the etiology of periodontal diseases. Previous studies reported a relatively high prevalence of periodontitis among adolescents in Morocco. The importance of the composition of subgingival plaque and the presence and proportion of Aggregatibacter actinomycetemcomitans to the total plaque bacteria in the pathogenesis of periodontitis is not well understood. The purpose of this study is to compare the relative abundance of A. actinomycetemcomitans in subgingival dental plaque from young Moroccans with aggressive periodontitis, chronic periodontitis, and those without periodontitis, and to construct a multivariable model to investigate the effect of demographic attributes of age, gender and relative ratio of A. actinomycetemcomitans in dental plaque with periodontal disease status. Methods: Sample population includes 984 subjects, aging from 12-20 years old, who were surveyed and examined for periodontal disease status. 82 subjects were selected consisting of 26% aggressive periodontitis, 12% chronic periodontitis, and 62% without periodontitis. Subgingival plaque was collected from these 82 subjects. Whole DNA was extracted and purified, and real-time PCR was used employing a primer for eubacteria, and specific primer for A. actinomycetemcomitans. PCR assays confirmed the amplification and quantification of DNA of total bacterial and A. actinomycetemcomitans. Results: 73% of the subjects harbored A. actinomycetemcomitans: 63% in aggressive periodontitis, 90% in chronic periodontitis, and 73% in controls. The percentage A. actinomycetemcomitans to total bacterial load increased with age, was similar among males and females, and was somewhat higher in persons with periodontitis than the controls. Using a logistic regression analysis that included age, gender and A. actinomycetemcomitans ratio showed that only age is significantly correlated with the diagnosis of periodontitis in this population. Conclusions: A. actinomycetemcomitans is prevalent among this young Moroccan group and is somewhat more prevalent in subjects with periodontitis than the controls. However, the presence and ratio of this species to the total bacteria in subgingival plaque explained only a small proportion of the variance in periodontitis in this group. / Oral Biology