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Biomedical subjects

A D Haffajee

Publications and source records attributed to A D Haffajee.

At least 73 records · Page 4Linked to original sources
PubMed1992

Subgingival temperature (I). Relation to baseline clinical parameters.

44 subjects ranging in age from 14-71 years were measured at 6 sites per tooth for gingival redness, plaque accumulation, suppuration, bleeding on probing, pocket depth and attachment level. Subgingival temperatures were measured at the same 6 sites per tooth using a periodontal temperature probe (Periotemp, Abiodent, Danvers, MA). This instrument was also used to measure each subject's sublingual temperature in order to compute the differences between sublingual and subgingival temperature. Relationships were sought between the baseline clinical parameters and the temperature variables in subjects and at sites. The mean and standard deviation of the sublingual temperatures for the 44 subjects was 36.6 +/- 0.4 degrees C (range 35.8-37.6 degrees C). The mean of each subject's mean whole mouth subgingival temperature was 1.9 degrees C lower, 34.8 +/- 0.6 degrees C (range 33.4-36.1 degrees C). The differences of the mean subgingival temperature from sublingual ranged from -0.8 to -3.2 degrees C (average -1.9 +/- 0.5 degrees C). Mean temperature difference for a subject correlated with % of sites with plaque (rs = 0.45), redness (rs = 0.33), bleeding on probing (rs = 0.44), % of sites with attachment level greater than 3 mm (rs = 0.44), mean pocket depth (rs = 0.44) and mean attachment level (rs = 0.39). There were higher mean temperatures at sites exhibiting or not exhibiting plaque (35.0, 34.5 degrees C), redness (34.9, 34.6), bleeding on probing (35.1, 34.7) and suppuration (35.4, 34.8). Sites with pockets less than 4, 4-6 and greater than 6 mm had mean temperatures of 34.6, 35.2, 35.8 degrees C, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Subgingival temperature (II). Relation to future periodontal attachment loss.

The purpose of the present investigation was to determine whether subgingival temperature was a risk indicator of periodontal attachment loss (detected in the following 2 months) in a subject or at a site. 29 subjects were measured at 6 sites per tooth for clinical parameters as well as subgingival temperature using a periodontal temperature probe (Periotemp, ABIO-DENT, Danvers, MA). The same instrument was used to measure sublingual temperature in order to compute differences between subgingival and sublingual temperature. Clinical and temperature parameters were measured at 2-month intervals. A total of 49 subject visits which had both baseline temperature and subsequent attachment level change measurements were available for analysis. Attachment level loss greater than 2.5 mm occurred at 1 or more sites at 16 of 49 subject visits. Elevated mean subgingival temperature was related to subsequent attachment loss particularly in individuals who exhibited more than 1 progressing site. The odds ratios of a subject exhibiting new attachment loss at 1 or more sites or at 2 or more sites were 14.5 and 64.0 if the subject's mean subgingival temperature exceeded 35.5 degrees C. Subjects with high mean subgingival temperatures and widespread periodontal destruction appeared to be at greatest risk for new attachment loss. Discriminant analysis using % of sites with suppuration, redness and attachment level greater than 3 mm and mean site temperature correctly "predicted" disease activity with a sensitivity, specificity and overall agreement of 0.75, 0.76 and 0.82 respectively. Of 7243 sites, 43 (0.59%) and 160 (2.2%) showed attachment loss of either 2.5 mm or more or 2 mm or more respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Subgingival temperature (III). Relation to microbial counts.

The present investigation examined the relationship of selected bacterial species and subgingival temperature. 35 subjects were measured at 6 sites per tooth for clinical parameters and subgingival temperature. Measurements were repeated for 21 subjects at 2 month intervals providing a total of 66 subjects visits. At each visit, subgingival plaque samples were taken from the mesial aspect of each tooth and anaerobically dispersed, diluted and plated on non-selective media. After anaerobic incubation, colonies were lifted to nylon filters and specific species detected using digoxigenin-labeled whole chromosomal DNA probes. Species enumerated were; A. actinomycetemcomitans serotypes a and b, B. forsythus, B. gingivalis, B. intermedius I and II, C. ochracea, F. nucleatum ss. vincentii, P. micros, S. intermedius, S. sanguis I and II, V. parvula and W. recta. Total viable counts and counts of Capnocytophaga sp. were determined directly from the primary isolation plates. A total of 1581 samples were evaluated. Subject visits with higher mean subgingival temperatures had significantly higher mean %s of B. intermedius I and P. micros, and lower mean %s of Capnocytophaga sp. Sites with higher subgingival temperatures had elevated proportions of B. intermedius I and II, A. actinomycetemcomitans serotype a and B. gingivalis more frequently than sites with lower temperatures, while Capnocytophaga sp. were elevated more often at cooler sites. 43 of the subject visits had follow up attachment level measurements at 2 months. The 1026 microbial samples and the subgingival temperature measurements from these visits were related to longitudinal attachment change.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Longitudinal monitoring of humoral antibody in subjects with destructive periodontal diseases.

Fifty-one subjects (16-61 years old) with evidence of prior destructive periodontal disease were monitored clinically and immunologically at bi-monthly intervals for up to 5 yr. Periodontal disease activity, determined as new attachment loss, was detected in 33 of these subjects. Only 4 of 51 subjects failed to show an elevated serum antibody level to any of the 18 subgingival species tested. The antibody level threshold established for periodontally healthy subjects was exceeded most often in diseased subjects with serum antibody to Actinobacillus sp., P. gingivalis, E. corrodens, C. concisus, F. nucleatum and P. intermedia in that order. In general, most serum antibody levels to subgingival species remained relatively consistent for periods as long as 5 yr. However, major increases and decreases in antibody could be detected to at most one or two species in individual subjects. In addition, prolonged, steady increases and decreases in antibody to specific species could be detected in certain subjects. These findings suggest that major changes occurring in serum antibody may reflect fluctuations in the nature of the infection. Differences were observed in the antibody level to specific species when subjects were divided into subsets on the basis of clinical criteria. These included high levels of antibody to A. actinomycetemcomitans Y4 in LJP and RPP subjects and to A. actinomycetemcomitans 29523 in LJP and GJP subjects.

Adolescent↗
PubMed1992

The bacterial etiology of destructive periodontal disease: current concepts.

The interpretation of diagnostic tests for the detection of subgingival bacterial species is dependent on knowledge of the microbial etiology of destructive periodontal diseases. Specific etiologic agents of these diseases have been sought for over 100 years; however, the complexity of the microbiota, an incomplete understanding of the biology of periodontal diseases, and technical problems have handicapped this search. Nonetheless, a number of possible pathogens have been suggested on the basis of their association with disease, animal pathogenicity, and virulence factors. The immunological response of the host to a species and the relation of successful therapy to the elimination of the species have also been used to support or refute suspected periodontal pathogens. Current data suggest that pathogens are necessary but not sufficient for disease activity to occur. Factors which influence activity include susceptibility of the individual host and the presence of interacting bacterial species which facilitate or impede disease progression. Recent studies have attempted to distinguish virulent and avirulent clonal types of suspected pathogenic species and seek transmission of genetic elements needed for pathogenic species to cause disease. Finally, the local environment of the periodontal pocket may be important in the regulation of expression of virulence factors by pathogenic species. Thus, in order that disease result from a pathogen, 1) it must be a virulent clonal type; 2) it must possess the chromosomal and extra-chromosomal genetic factors to initiate disease; 3) the host must be susceptible to this pathogen; 4) the pathogen must be in numbers sufficient to exceed the threshold for that host; 5) it must be located at the right place; 6) other bacterial species must foster, or at least not inhibit, the process; and 7) the local environment must be one which is conducive to the expression of the species' virulence properties.

Bacteria↗
PubMed1991

Relation of baseline microbial parameters to future periodontal attachment loss.

The relationship between the level of subgingival species at baseline and subsequent attachment loss in a subject was examined. 38 subjects (14-71 years) with prior evidence of periodontal destruction were monitored 2x for pocket depth and attachment level at 6 sites per tooth at baseline and 2 months. A subject was considered to exhibit new attachment loss if 1 or more sites increased 3 mm or more in attachment level in 2 months. Subgingival plaque samples were taken at the baseline visit from the mesial aspect of each tooth (28 sites) using Gracey curettes. Samples were dispersed, diluted and plated on Trypticase soy agar supplemented with 5% sheep blood. After 7 days of anaerobic incubation, the colonies were lifted onto nylon filters, lysed and the DNA fixed to the filters. Digoxygenin-labeled DNA probes were used to enumerate 14 subgingival species. 17 of 38 subjects (44.7%) exhibited new attachment loss in 2 months. The % of the total viable count of each species was averaged for each subject. The species enumerated and the mean % of the total cultivable microbiota averaged across the active and inactive subjects were as follows; B gingivalis 2.3, 1.2; W. recta 1.3, 0.6; B. intermedius I 2.5, 2.0; B. forsythus 1.5, 1.2; A. actinomycetemcomitans serotype a 1.1, 0.8; F. nucleatum ss vincentii 1.1, 1.0; S. intermedius 2.0, 1.9; P. micros 1.5, 1.5; B. intermedius II 1.6, 1.7; A. actinomycetemcomitans serotype b 0.4, 0.6; S. sanguis I 1.8, 2.1; S. sanguis II 2.7, 3.0; V. parvula 3.9, 4.2; C. ochracea 0.9, 1.8.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Relation of counts of microbial species to clinical status at the sampled site.

The purpose of the present investigation was to relate clinical characteristics at a site to the frequency of detection, absolute counts and proportions of 14 subgingival species. Subgingival plaque samples were removed by curette from the mesial surface of 2299 teeth in 3 healthy and 87 subjects with periodontal attachment loss. Samples were dispersed, diluted and plated on Trypticase soy agar supplemented with 5% sheep blood. After 7 days of anaerobic incubation, colonies were lifted onto nylon filters, lysed and the DNA fixed to the filters. Digoxygenin-labeled DNA probes were used to identify colonies of each test species. Measurements of pocket depth, attachment level, recession, redness, bleeding on probing and suppuration were made at each sampled site. Total viable counts at sites ranged from 10(3) to greater than 10(8) and were strongly related to pocket depth. Mean total counts at sites less than 3 mm averaged 4.6 x 10(6), while mean counts at sites greater than 7 mm averaged 2.0 x 10(7). Species enumerated and % of sites colonized were as follows; V. parvula 44; S. sanguis II 36; B. intermedius I 33; C. ochracea 31; B. intermedius II 30; S. sanguis I 29; B. gingivalis 27; S. intermedius 25; P. micros 24; W. recta 23; F. nucleatum ss vincentii 18; B. forsythus 15; A. actinomycetemcomitans serotype a 10; A. actinomycetemcomitans serotype b 8. Counts of B. intermedius II were higher at sites which exhibited gingival redness while B. intermedius I was higher at sites which bled on probing. A. actinomycetemcomitans serotype b was more frequent and at higher mean % at sites without recession. The opposite was true for S. sanguis II. B. gingivalis was somewhat more prevalent and at higher levels at suppurating sites. B. gingivalis, B. intermedius I and II and B. forsythus were found more frequently and at higher levels at sites with deeper pockets, while V. parvula was less prevalent at sites with pocket depths less than 4 mm. B. gingivalis, B. intermedius I and A. actinomycetemcomitans serotype b increased with increasing pocket depth in both localized and widespread disease subjects, but mean counts were higher in the localized disease subjects at any pocket depth. Only W. recta was found at higher levels at deep sites in widespread disease subjects when compared with similar sites in localized disease subjects. No suspected pathogens were detected in 38% of shallow sites, 31% of intermediate sites and 22% of deep sites, 2/3 of deep pockets, but less than 1/2 of shallow pockets harbored at least 2 of the suspected pathogens.

Aggregatibacter actinomycetemcomitans↗
PubMed1991

Levels of interleukin 1 beta in tissue from sites of active periodontal disease.

Interleukin 1 beta is a potent bone resorptive cytokine which also mediates soft tissue destruction through the stimulation of prostaglandin production, and the induction of collagenase and other proteases. This constellation of activities suggests a role for IL-1 beta in the pathogenesis of human periodontitis. Levels of IL-1 beta were therefore determined in tissue obtained from (1) diseased, active (2) diseased, inactive and (3) healthy sites from 12 patients with destructive adult periodontitis. Disease activity was defined as attachment loss of greater than or equal to 2.5 mm, as determined by sequential probing and the tolerance method. IL-1 beta was extracted from homogenates of tissue biopsies taken at surgery, and levels were quantified by ELISA. IL-1 beta was found to be present in most patient tissue samples, with levels ranging from 0-82 ng/ml. Disease active sites had higher IL-1 beta levels (p less than 0.05) than inactive and healthy sites. Diseased inactive sites were divided into 2 groups, those losing small amounts of attachment (0.5-2.0 mm, worsening sites) and those which showed no change or attachment gain (stable sites). Stable diseased sites had IL-1 beta levels which were comparable to those found in healthy sites, and which were significantly different from active sites (p less than 0.02). Worsening sites had IL-1 beta levels intermediate between the levels in stable and active sites. Detection of disease activity occurred more frequently at sites with IL-1 beta levels greater than 25 ng/ml (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Clinical risk indicators for periodontal attachment loss.

The purpose of the present investigation was to evaluate the association of baseline clinical parameters of periodontal disease with disease progression in the following year. 271 randomly selected subjects from Ushiku Japan were monitored for overt gingivitis and plaque accumulation at 4 sites per tooth and probing pocket depth, probing attachment level and bleeding on probing at 6 sites per tooth for all teeth at baseline and 1 year. A subject was considered to exhibit additional attachment loss if one or more sites increased 3 mm or more in a probing attachment level measurement in one year. The clinical variables included age, sex, number of missing teeth, mean pocket depth and attachment level. In addition, the % of sites which exhibited overt gingivitis, visible plaque, pocket depths, attachment levels or gingival recession over certain mm thresholds or bled on probing were determined. Chi 2 analysis was used to seek significant associations between the baseline clinical variables and subsequent attachment loss in a subject. Only 74 of the 271 subjects (27.3%) exhibited additional attachment loss of 3 mm or more at 1 or more sites after 1 year. Older subjects had a greater risk of disease progression than younger subjects. There were no significant differences in % of individuals exhibiting additional attachment loss when divided on the basis of sex, number of missing teeth or % of sites with overt gingivitis. However, the greater the % of sites with visible plaque or which bled on probing, the greater was the likelihood of subsequent attachment loss. Increasing mean levels of pocket depth or attachment level or increasing %s of sites exhibiting prior attachment loss were strongly related to the proportion of individuals with subsequent attachment loss. Gingival recession exhibited similar but weaker relationships. Log-linear analysis suggested that the association between bleeding on probing, age, or plaque levels with additional attachment loss may be explained by the association of these variables with baseline attachment loss. The analyses were repeated with a positive subject defined as having only 1 active site or 2 or more active sites. 37 subjects fit the 1st criterion and the remaining 37 the 2nd criterion. The associations observed were almost identical to those found when subjects were considered positive on the basis of 1 or more changing sites. Discriminant analysis was used to classify subjects as active or inactive using up to 11 predictor variables.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1989

Relationship of clinical parameters to attachment loss in subsets of subjects with destructive periodontal diseases.

23 subjects were followed prior to treatment for 5 to 12 months in an attempt to relate attachment loss during this period to attachment level, probing depth, gingival redness and bleeding on probing. The subjects were divided into 3 groups based on amount and distribution of prior attachment loss: minor periodontitis, predominantly molar periodontitis and generalized periodontitis. The % of sites that exhibited attachment loss during the study period in the minor periodontitis, predominantly molar periodontitis and generalized periodontitis groups, were 1.3, 8.1 and 5.4, respectively. Subjects with minor periodontitis and predominantly molar periodontitis exhibited attachment loss more frequently in molar sites, proximal sites and sites with attachment level greater than or equal to 4 mm. In subjects with generalized periodontitis, attachment loss was related to tooth surface and attachment level, but not to tooth type. The relationship between the clinical parameters and attachment loss was improved compared with previous studies by using more homogeneous subject groups, more sensitive methods of analyzing attachment change and multivariate data analysis. However, the clinical parameters could not be used as diagnostic tests to predict attachment loss at individual sites.

Adult↗
PubMed1988

Clinical, microbiological and immunological features of subjects with refractory periodontal diseases.

27 subjects with active destructive periodontal diseases were treated by modified Widman flap surgery and systemic tetracycline and divided into 4 groups based on pre- and post-therapy hazard rates (% of sites losing greater than 3 mm of attachment in 1 year). Pre- and post-therapy hazard rates were respectively: group I (3 subjects) less than 4 and less than 4; group II (8 subjects) greater than 4 and less than 4; group III (3 subjects) less than 4 and greater than 4; group IV (refractory group of 13 subjects) greater than 4 and greater than 4. Baseline mean pocket depths and attachment loss of groups I and II subjects were less than groups III and IV subjects and exhibited less suppuration. 6 group IV subjects lost a total of 38 teeth after therapy, in contrast to no tooth loss in subjects in the other 3 groups. Redness, bleeding on probing, plaque levels and age did not differ among groups. Subjects in the 4 groups differed in the subgingival species to which they showed elevated serum antibody responses. Group IV subjects showed elevated responses to a select range of gram-negative species, including A. actinomycetemcomitans strains Y4 or ATCC 29523, F. nucleatum and B. intermedius. No subject in any of the other groups exhibited an elevated response to B. intermedius. The mean % of each species in all sampled sites, both before and after therapy, was computed for each subject. Subjects in groups III and IV (high post-therapy hazard rates) exhibited elevated mean levels of B. forsythus, F. nucleatum, S. intermedius, E. corrodens, and B. gingivalis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Clinical, microbiological and immunological features of subjects with destructive periodontal diseases.

76 subjects with prior evidence of destructive periodontal diseases were monitored clinically and immunologically every 2 months for up to 5 years. Clinical parameters measured included bleeding on probing, gingival redness, plaque accumulation, suppuration, pocket depth and attachment level. Blood samples were taken by venipuncture and serum antibody levels to a series of 18 subgingival species determined. 33 of these subjects showed evidence of active disease during the monitoring period, based on changes in attachment level measurements assessed using the tolerance method of analysis. Mean attachment loss in these 33 subjects varied from 1.4 mm to 9.0 (median value 3.4 mm) and subjects whose mean attachment level was above the median showed a higher % of pockets greater than 3 mm and more suppuration. Severity of gingival inflammation related poorly to mean attachment loss. Subgingival plaque samples were taken from the active site(s) and from control sites of equal pocket depth and attachment loss in the same active disease subjects, prior to therapy, for predominant cultivable microbiota studies. 50 randomly selected isolates were identified from each sample. Predominant cultivable species in 170 pretreatment active and inactive sites combined (8500 isolates) were enumerated. The most frequently detected species were F. nucleatum (112 sites) and S. intermedius (106 sites), although the predominant species in the samples from each subject differed. The distribution of putative pathogens differed among subjects. For example, A. actinomycetemcomitans was found in 21 samples in 11 subjects and B. forsythus was found in 18 samples from 10 individuals. Antibody response patterns to the 18 subgingival species also varied among subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Effect of modified Widman flap surgery and systemic tetracycline on the subgingival microbiota of periodontal lesions.

33 subjects with evidence of active destructive periodontal disease were treated by modified Widman flap surgery and systemic tetracycline (1 g/day for 21 days). Subgingival plaque samples were taken from 41 sites in 12 of these subjects before and 6 months after therapy for predominant cultivable microbiota studies. Mean pocket depth and attachment levels in the 41 sampled sites were 7.1 +/- 2.9 mm and 7.7 +/- 3.2 mm prior to therapy and 4.8 +/- 2.3 mm and 6.2 +/- 3.4 mm after therapy. B. melaninogenicus and V. parvula were more frequently detected in samples taken after therapy, while S. intermedius, S. morbillorum, S. uberis and W. recta were less frequently detected after therapy. A. actinomycetemcomitans were detected in 7 sites pretherapy and 1 site post therapy. The frequency of detection of B. gingivalis and B. intermedius was virtually unchanged. The mean levels of the Actinomyces sp., A. actinomycetemcomitans, B. gingivalis, B. intermedius, S. morbillorum, S. uberis and W. recta were decreased after therapy, while the mean levels of B. melaninogenicus, S. mitis, S. sanguis II and V. parvula were increased after therapy. V. parvula showed the greatest increase to 8.2% of the microbiota. In the second phase of the study, subgingival plaque samples from 94 sites in the 33 treated subjects were analyzed by predominant cultivable techniques. As a result of therapy, 24 sites exhibited attachment loss greater than 2 mm, 23 sites exhibited "gain" greater than 2 mm and the remaining 47 sites were considered to be unchanging.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

The predominant cultivable microbiota of active and inactive lesions of destructive periodontal diseases.

Subgingival plaque samples were taken from active and inactive lesions in 33 subjects exhibiting active destructive periodontal diseases. Active diseased sites were those which showed a significant loss of attachment within a 2-month interval as computed by the "tolerance method". The predominant cultivable species from 100 active sites were compared with those found in 150 inactive sites of comparable pocket depth and attachment level loss. Among the 33 subjects, W. recta, B. intermedius, F. nucleatum, B. gingivalis and B. forsythus were elevated more often in active sites; whereas, S. mitis, C. ochracea, S. sanguis II, V. parvula and an unnamed Actinomyces sp. were elevated in inactive sites. The likelihood of a site being active was increased if B. forsythus, B. gingivalis, P. micros, A. actinomycetemcomitans, W. recta, or B. intermedius were detected in that site, and decreased if S. sanguis II, the Actinomyces sp., or C. ochracea were detected.

Actinomyces↗
PubMed1988

Relationship of subgingival microbial complexes to clinical features at the sampled sites.

Subgingival plaque samples from 100 active destructive periodontal lesions and 150 inactive subgingival sites in 33 subjects were analyzed by predominant cultivable microbiota techniques. 50 isolates were characterized from each sample and where possible, the isolate was placed in 1 of 134 microbial species or groups. The sites were clustered on the basis of the proportions of all of the species detected in each sample using a minimum similarity matching coefficient and an average unweighted linkage sort. 10 clusters containing 166 sites were formed which exhibited greater than 35% minimum similarities. All clusters were made up of sites from multiple subjects and were formed on the basis of different combinations of micro-organisms. Certain complexes of micro-organisms appeared to relate to the severity of periodontal destruction and the activity of the sampled site. The combination of F. nucleatum, B. forsyth and W. recta (cluster VII) or B. gingivalis, B. intermedius and S. intermedius (cluster VIII) distinguished clusters made up of sites which on average had the most attachment loss and the deepest pockets. These clusters contained the highest proportions of active sites and sites which lost greater than 3 mm of attachment after therapy. Clusters dominated by V. parvula (cluster III), the Actinomyces sp. (cluster X) or the combination of S. sanguis II, S. mitis, V. parvula and S. intermedius (cluster II) were made up of sites which exhibited less active disease and responded more favorably to therapy. Sites in other clusters exhibited moderate levels of prior destructive disease and disease activity status closer to the mean values for all 250 sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗