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Biomedical subjects

F H Mikx

Publications and source records attributed to F H Mikx.

At least 19 recordsLinked to original sources

[Routine dental examination as evaluation tool in clinical cariology].

As a result of the caries prevalence of the Dutch population the character of the routine dental examination is changing. Caries screening remains relevant for high caries risk individuals but the interpretation of early caries lesions deserves more attention, especially the assessment of progression of caries lesions in time. Diagnosis of caries by dental practitioners in the Netherlands mainly consists of visual inspection in combination with bitewing radiography and both methods play an important role in the timing of bitewing radiographs and forthcoming recall visits for oral health examination. The content and frequency of the routine dental examination are discussed in relation to the individual risk prediction as relevant aspects of quality of dental care in the Netherlands.

Dental Care↗

The value of salivary bacterial counts as a supplement to past caries experience as caries predictor in children.

This study aimed to determine whether salivary mutans streptococci and lactobacilli counts could add any value to a combination of caries experience variables that was recently presented for the prediction of caries. Sixty-nine children at the age of 7.5 yr participated in this longitudinal study. Microbiological data were obtained at the ages of 7.5, 9.5 and 11.5 yr and caries data at the ages of 7.5. 9.5. 11.5, 13.5 and 15.5 yr. Spearman's correlation coefficients were computed, and forward multiple regression analyses were carried out using bacterial counts and caries experience parameters as explanatory variables and caries increment as a dependent variable. The explained variance (adjusted R2 value) was the measure used to assess the additional value of bacterial counts to the caries predictive potential of the combined parameters of the past caries experience. Correlation coefficients between bacterial counts and 4-yr caries increment were from 0.22 tip to 0.54. In all cases, the simultaneous streptococcus mutans-lactobacilli counts showed a statistically non-significant additional adjusted R2 value of <0.06. The results do not lend support to the concept that these salivary bacterial counts are useful additional caries predictors for the mixed dentition, when a combination of caries experience parameters is used.

Adolescent↗

Proteolysis and utilization of albumin by enrichment cultures of subgingival microbiota.

Subgingival dental plaque consists mainly of microorganisms that derive their energy from amino acid fermentation. Their nutrient requirements are met by the subgingival proteolytic system, which includes proteases from microorganism and inflammatory cells, and substrate proteins from sulcus exudate, including albumin. To determine the selective effect of individual proteins on microbiota, we used albumin as the main substrate for growth. Eight subgingval plaque samples from untreated periodontal pockets of patients with adult periodontitis were inoculated in peptone yeast medium with bovine albumin (9 g/l). After three subculture steps, cell yields of the enrichment cultures at the medium with 0, 1.25, 2.5, 5, 10, and 20 g/l albumin were determined. Proteolytic activity (U/absorbance at 550 nm) of the enrichment cultures and different isolates derived from the cultures was estimated by the degradation of resorufin-labeled casein. It was observed that the yield of the mixed culture was albumin limited, and the proteolytic activities of the cultures in albumin broth were higher than in control (peptone broth). Among the isolates from the enrichment cultures, Peptostreptococcus micros, Prevotella melaninogenica, Prevotella buccae and Prevotella bivia demonstrated proteolysis. The frequent occurrence of Streptococcus gordonii and Streptococcus anginosus in the albumin cultures is explained by their ability to utilize arginine as an energy source for growth. Albumin in the medium was partly degraded by pure cultures but completely consumed in enrichment cultures, indicating synergy of bacterial proteinases. It is concluded that the subgingival microbiota possesses proteolytic activity and may use albumin as a substrate for their growth. Enrichment cultures on albumin may serve as a relatively simple in vitro model to evaluate the effects of proteinase inhibitors.

Bacterial Proteins↗

Environmental effects on the growth and proteolysis of Treponema denticola ATCC 33520.

The effect of pH, redox potential, O2 and H2 on the growth and proteolytic activity of Treponema denticola ATCC 33520 was studied in a chemostat at different growth rates. The peptidase and protease activities were estimated using different amido-methyl coumarin derivatives and azocasein. The maximum growth rate of T. denticola ATCC 33520 was 0.14 h-1. Reduction of the growth rate of T. denticola by 50-60% gave: an increase in cell mass of 150-200%, a higher acetogenesis and a shift of the pH optimum. The protease and phenylalanine peptidase activities seemed to be of greater importance for the growth of T. denticola ATCC 33520 than the rather low arginine and proline peptidase activities. The redox potential (Eh) played a secondary role. At microaerophilic conditions with 1-5% O2, the cultures maintained a redox potential below -311 mV and an optimal acetogenesis. The presence of H2 induced a marked growth stimulation of T. denticola ATCC 33520. It is concluded that the cell mass and proteolytic activity of T. denticola ATCC 33520 are modulated by the growth rate and the pH and to a lesser extend by the redox potential and presence of O2. Stagnation of the exudate-flow influences these factors and will lead to an increase of the spirochetal population and proteolysis in the periodontal pocket.

Culture Media↗

Discrepancy between culture and DNA probe analysis for the detection of periodontal bacteria.

The purpose of this study was to compare a commercially available DNA probe technique with conventional cultural techniques for the detection of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia in subgingival plaque samples. Samples from 20 patients with moderate to severe periodontitis were evaluated at baseline and during a 15 months period of periodontal treatment. Paperpoints from 4 periodontal pockets per patient were forwarded to Omnigene for DNA probe analysis, and simultaneously inserted paperpoints from the same pockets were analyzed by standard culture techniques. In addition, mixed bacterial samples were constructed harbouring known proportions of 25 strains of A. actinomycetemcomitans, P. gingivalis and P. intermedia each. A relatively low concordance was found between both methods. At baseline a higher detection frequency was found for A. actinomycetemcomitans and P. gingivalis for the DNA probe technique; for P. intermedia the detection frequency by culture was higher. For A. actinomycetemcomitans, 21% of the culture positive samples was positive with the DNA probe. Testing the constructed bacterial samples with the DNA probe method resulted in about 16% false positive results for the 3 species tested. Furthermore, 40% of P. gingivalis strains were not detected by the DNA probe. The present data suggest that at least part of the discrepancies found between the DNA probe technique used and cultural methods are caused by false positive and false negative DNA probe results. Therefore, the value of this DNA probe method for the detection of periodontal pathogens is questionable.

Adult↗

Cariogenicity depends more on diet than the prevailing mutans streptococcal species.

This review aims to compare the occurrence and distribution of mutans streptococci in Africa, Europe, and North America and in addition will try to offer explanations for existing relationships among salivary mutans streptococci counts, dietary patterns, and dental caries. The literature reveals that salivary mutans streptococci counts in child populations of the three continents are comparable. The distribution of mutans streptococci species, with a predominance of S. mutans followed by S. sobrinus, and the virtual absence of other mutans streptococci species are also comparable. Although it is widely believed that diet has an important effect on mutans streptococci counts, this review provides evidence that this does not hold true when variations in dietary patterns are moderate, as they normally are in real-life situations. Since the diets of the child populations in the three continents vary moderately, a strong dietary-induced effect on salivary mutans streptococci counts cannot be expected. The observed analogous salivary mutans streptococci counts in these child populations are thus 'not surprising' but are in accordance with the conceptual expectation. The differences in caries experience in children of the three continents cannot be explained by the prevailing mutans streptococci species but instead should be attributed to differences in the cariogenicity of the various diets. The fact that the cariogenicity of the diet determines the development of dental caries while hardly affecting the mutans streptococci counts explains the limited value of the latter as an indicator of dental caries. The reviewed literature shows that mutans streptococci are ubiquitous in children aged 7 years and older in Africa, Europe, and North America. Mutans streptococci should therefore be considered as belonging to the indigenous microflora of the human mouth.

Adolescent↗

[Antibiotic use in periodontics. Results from a research study].

The sensitivity of the subgingival plaque for amoxicillin, doxycycline, ofloxacin and clindamycin was estimated by agar diffusion disks and Etest in 22 periodontal patients. The sensitivity of the subgingival plaque varied per patient. Resistance of the subgingival plaque for amoxicillin was observed in 50% of the patients and was significantly related to the use of antibiotics in the previous 6 months. The resistance to clindamycin was 68% and to doxycycline 82%. The resistance of the subgingival plaque to these antibiotics could not be related to the previous use. A decision-tree was constructed including a step wise use of a microscopical spirochete test and an antibiotic sensitivity test of the subgingival microflora for the above mentioned antibiotics. The clinical implications of the observed long lasting antibiotic resistance and the practical use of a decision-tree including a spirochete test and antibiotic sensitivity tests need further investigation.

Amoxicillin↗

Microscopic spirochete counts in untreated subjects with and without periodontal tissue destruction.

The purpose of the study was to determine microscopically the %s of spirochetes at sites without periodontal destruction in subjects with destructive periodontal diseases (cases) and in subjects free of it (controls), who had not received professional prophylaxis. From a sample of 164 individuals aged between 30-44 years living in rural and urban areas of Tanzania, cases and controls were selected. Cases (n = 25) were selected who exhibited at least 3 teeth with pocket depth of > 5 mm. The controls (n = 28) had no pockets deeper than 3 mm. From each subject, 1 subgingival plaque sample was taken at the mid point of the lingual surface of 1 of the upper premolars which showed bleeding on probing but no calculus and no pockets. In addition, one subgingival sample was obtained from a pocket. Pockets contained the highest %s of spirochetes, which confirms earlier findings. A significant difference in % of spirochetes between cases and controls was found at non-destructive sites, indicating a host effect on the subgingival microflora. However, the spirochete counts at non-destructive sites did not provide a reliable measure to identify subjects with destructive periodontal disease.

Adult↗

[Prescription of antibiotics for the prevention of bacterial endocarditis by dentists in the Netherlands].

In 1993 a representative sample of dental practitioners in the Netherlands was questioned on the use of antibiotics for the prevention of endocarditis in the previous year. Most of the responding dentists (67%) reported prescription of antibiotics for patients at risk. Some of them prescribed an antibiotic regimen that differed from the guidelines drawn up by the Dutch Heart Foundation. In 1992 only 47% of the responding dentists prescribed antibiotics for the prevention of endocarditis entirely according to these guidelines.

Anti-Bacterial Agents↗

[Prescription of antibiotics for periodontitis patients by dental practitioners in the Netherlands].

In 1993 a representative sample of dentists in the Netherlands was questioned on the use of antibiotics in the treatment of periodontitis. It was found dat 50% of the general practitioners had a positive attitude, 15% a negative one and 35% had an indifferent attitude towards the use of antibiotics in periodontal treatment. Almost 40% of them indicated the prescription of antibiotics for periodontal reasons in the previous year. Most of the dentists (71%) prescribed a combination of metronidazole and amoxicillin. The average prescription frequency in 1992 was 18 times. The prescription frequency and the choice of a combination of metronidazole and a broad spectrum penicillin in the treatment of periodontitis is discussed, emphasizing the importance of the traditional mechanical therapy, the disturbance of the colonization resistance by means of antibiotics and the worldwide concern about the usage of antibiotics.

Amoxicillin↗

[How sensible are bacteriological tests in periodontology?].

Periodontitis is a mixed infection with subgingival bacteria that belong to the microflora of the host. The bacteriological tests (Microscopy, Culture, Omnigene, Affirm DP and Evalusite) are mainly aimed at spirochetes or A. actinomycetemcomitans, P. gingivalis and P. intermedia. The detection limits of the different tests vary and, therefore, the detection levels are between 0.01-10% of the subgingival microflora. However, threshold levels to distinguish between diseased and carrier state are not established and the low sensitivity and specificity of the tests limit their diagnostic usefulness. The correlation between the tested bacteria and periodontitis does not mean a causal relationship. As a result, the justification of the elimination of the tested bacteria is questionable. The tests of the subgingival plaque do not only add to the microbiological knowledge, but might also promote the overtreatment with antibiotics, such as the in the Netherlands popular combination of amoxicilline and metronidazole. The balance between host and microflora can be restored in most patients by mechanical elimination of the mainly Gram negative anaerobic subgingival plaque. In special occasions metronidazole can be empirically prescribed in order to support the subgingival debridement. In the relatively rare occasions of superinfection, a sensitivity test of the subgingival microbiota is recommended.

Aggregatibacter actinomycetemcomitans↗

Attachment of Treponema denticola strains to monolayers of epithelial cells of different origin.

The attachment of 10 different Treponema denticola strains to monolayers of 4 types of epithelial cells derived from rat palatal epithelium, guinea pig ear, human buccal epithelium and human corneal epithelium was screened microscopically. Most T. denticola strains were able to attach to all four types of epithelial cells. The T. denticola strains seemed to attach better to epithelial cells derived from primary cultured material. The T. denticola strains showed different degrees of attachment. Scanning electron microscopy studies revealed that the attachment of T. denticola was not only tip-associated but occurred also at random points in close contact with microvilli of the epithelial cells. Attached spirochetes were non-uniformly distributed over the monolayers, indicating the presence of receptive subpopulations of epithelial cells in the monolayers.

Analysis of Variance↗

Involvement of treponemal surface-located protein and carbohydrate moieties in the attachment of Treponema denticola ATCC 33520 to cultured rat palatal epithelial cells.

We studied the nature of attachment of Treponema denticola ATCC 33520 to a microscopically distinct population of rounded rat palatal epithelial cells. The motility of the freshly harvested spirochetes appeared not be a prerequisite for attachment. Treatment of T. denticola ATCC 3350 with proteinase-K, heat, glutaraldehyde, formaldehyde and periodate oxidation decreased the attachment to the rounded rat palatal epithelial cells, indicating the involvement of protein and carbohydrate moieties. Trypsin treatment had no effect on the attachment. The attachment of T. denticola ATCC 33520 was decreased after treatment with native non-immune rabbit serum, native polyclonal rabbit serum, D-mannose, N-acetyl-D-galactosamine and sialic acid. The results indicate that the attachment of T. denticola ATCC 33520 to rounded rat palatal epithelial cells is mediated by trypsin-resistant adhesin(s) of protein and carbohydrate nature, with affinity for D-mannose, N-acetyl-D-galactosamine and sialic acid.

Analysis of Variance↗

Mutans streptococci in caries-active and caries-free infants in Tanzania.

The occurrence of mutans streptococci species was investigated in Tanzanian infants aged between 1.0 and 3.5 years with rampant caries and without caries using biochemical and immunological techniques. These infants came from Turiani and Singida, where the caries prevalence for this age group was 12.8% and 1.6% respectively. Streptococcus mutans was found to be the only mutans streptococcal species. The other species, including the previously reported Streptococcus rattus, were not found. Consequently, the differences in caries experience observed between and within the two populations could not be explained by differences in mutans streptococcal species.

Child, Preschool↗

Attachment of T. denticola strains ATCC 33520, ATCC 35405, B11 and Ny541 to a morphologically distinct population of rat palatal epithelial cells.

In the present study an assay for the attachment of T. denticola to epithelial cells is described. An indirect immunohistochemical staining method, using two native polyclonal antisera, revealed dark-brown coloured spirochetes attached to rat palatal epithelial cell (RPE) monolayers. In addition, two morphologically distinct populations of RPE cells could be distinguished in the monolayers when using phase contrast microscopy. One minor population consisted of isolated rounded RPE cells that were lying on top of a confluent monolayer of flattened RPE cells. The rounded RPE cells were more receptive for the attachment of T. denticola than the flattened cells. The rounded RPE cells were evenly distributed over the monolayer, but the attachment of spirochetes to the rounded cells was greater at the edge than in the centre of the monolayers. The percentage of rounded RPE cells with attached spirochetes depended on the incubation time (optimum 6 h), temperature (optimum 37 degrees C) and pH (optimum 7.0). It is speculated that the attachment of T. denticola is a physical/chemical process of yet unknown nature and that differences in the number of microvilli and/or the amount of available receptors, between the two morphologically distinct cell types, accounts for the differences in the numbers of attached spirochetes.

Analysis of Variance↗

[A.a.: the bacterium with the long name].

The introduction of Kodak's chairside test kit, Evalusite, for Actinobacillus actinomycetemcomitans (A.a.) and two other oral bacteria has stimulated this study of the relation between A.a. and periodontal destruction. A.a. has been associated with oral abscesses, brain abscesses, endocarditis and localized juvenile periodontitis. However, in all periodontal studies A.a. also has been observed in 'ordinary' periodontal pockets and subjects without active periodontal destruction. Based on longitudinal studies it is concluded, that there is no proof for a causal relationship between A.a. and periodontal destruction, that the detection of A.a. is not indicative for future alveolar bone loss and that the sensitivity of a test of A.a. is too low for the diagnosis of progressive periodontitis. The sheer presence of A.a. in spite of its virulence factors is not sufficient to cause periodontal destruction. It is stated that, in order to prevent overtreatment and medicalization, the use of bacteriological tests and broad spectrum antibiotics should be restricted to patients with progressive periodontal destruction not responding to standard treatment.

Actinobacillus Infections↗