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Biomedical subjects

J Slots

Publications and source records attributed to J Slots.

18 recordsLinked to original sources

Peptostreptococcus micros in human periodontitis.

Peptostreptococcus micros is a recognized pathogen in medical infections, and its association with progressive periodontitis was examined in this study. P. micros was isolated from paper-point subgingival samples on anaerobic enriched blood agar plates and identified on the basis of cellular and colonial morphology and selected biochemical tests. In a cross-sectional study involving 907 people with advanced adult periodontitis, 127 with early-onset periodontitis, and 12 with localized juvenile periodontitis, P. micros in these patient groups occurred with a prevalence of 58-63%. In culture-positive patients, P. micros averaged 12-15% of total viable counts. P. micros demonstrated similar occurrence and proportional recovery in all age groups. In a longitudinal study of 91 adult periodontitis patients on maintenance therapy, P. micros demonstrated a significantly higher prevalence in disease-active than in disease-inactive patients (47% vs 14%). Mechanical subgingival debridement and 0.12% chlorhexidine pocket irrigation was unable to eradicate subgingival P. micros from 18 of 22 adult periodontitis patients. In vitro antimicrobial susceptibility testing showed P. micros to be sensitive to therapeutic levels of penicillin, clindamycin and metronidazole. Our findings indicate that P. micros is a potential pathogen in adult periodontitis. The methods for its eradication from subgingival sites remain to be determined.

Adult

Enterococci in human periodontitis.

Enterococci are potential pathogens in many human body sites. This study determined the subgingival occurrence and the in vitro antimicrobial susceptibility of enterococci in 100 persons with early-onset periodontitis and 545 persons with advanced adult periodontitis. Subgingival microbial samples were collected with paper points, transported in VMGA III and plated onto anaerobic enriched brucella blood agar or selective Enterococcosel agar (BBL Microbiology Systems). Enterococcal speciation was performed using commercial micromethod kit systems. In vitro sensitivity was determined using a commercial kit system and an agar dilution assay. Subgingival enterococci occurred in 1% of early-onset periodontitis patients and in approximately 5% of adult periodontitis patients. Enterococcus faecalis was the only enterococcal species recovered, and all but one isolate belonged to the same biotype. In vitro antimicrobial sensitivity testing revealed subgingival enterococci resistant to therapeutic levels of penicillin G, tetracycline, clindamycin and metronidazole, but relatively sensitive to ciprofloxacin and amoxicillin/potassium clavulanate (Augmentin). Enterococci may populate periodontal pockets as superinfecting organisms and, in heavily infected patients, may contribute to periodontal breakdown.

Adult

Evaluation of a non-radioactive DNA probe for detecting Porphyromonas gingivalis in subgingival specimens.

This study compared the ability of a nonradioactive digoxigenin-labeled DNA probe and anaerobic culture to identify subgingival Porphyromonas gingivalis. Total cellular DNA from P. gingivalis ATCC 33277T was labeled using the Genius kit from Boehringer Mannheim Biochemicals. Anaerobic culture was performed using VMGA III transport medium and enriched brucella blood agar. The DNA probe could detect as little as 1000 P. gingivalis cells added to supragingival plaque. Also, the probe could detect P. gingivalis when it was present in proportions too low to be visualized on overgrown bacterial plates. The probe showed no visible reaction with strains of various oral species or with thousands of non-P. gingivalis colonies from plaque samples. VMGA III could maintain the viability of P. gingivalis for up to 6 days, as evidenced by DNA probing of colony blot of subgingival cultures. A total cellular DNA probe for detecting P. gingivalis seems to offer a simple and reliable method of detecting the organism in subgingival specimens.

Colony Count, Microbial

Wolinella recta in adult gingivitis and periodontitis.

Wolinella recta has been associated with adult periodontitis, but its role in the disease remains uncertain. This report clarifies the distribution of W. recta in periodontally healthy and diseased subjects, and treated patients with recurrent disease. A specific polyclonal rabbit antiserum against W. recta strain 372 was used for indirect immunofluorescence localization of W. recta in dental plaque from untreated and treated patients. Supragingival plaque was collected from 15 periodontally healthy individuals (H), 10 adults with mild gingivitis (G1), 8 with severe gingivitis (G2) and 15 with periodontitis (AP). Subgingival samples from 23 diseased sites (G2 and AP) were examined as well. There was a significant difference (p = 0.000) between the proportions of W. recta in subgingival (4.4%) vs. supragingival (0.3%) plaque samples from AP. A significant difference (p = 0.000) in W. recta proportions was also detected between subgingival plaque samples of AP (4.4%) vs. G2 (1.2%). No significant difference in the mean % of W. recta was found between supragingival plaque of AP (0.3%) and G2 (0%), and samples of G1 (0.01%) and H (0.1%). In a separate study, 85 adults previously treated for moderate to severe adult periodontitis were monitored over a 12-month period for evidence of disease recurrence. Recurrent disease was detected at 32 sites in 18 subjects. Of these, 20 sites in 13 subjects were positive for W. recta. With subjects as the experimental unit, a significant increase in the proportions of W. recta was found at sites with recurrent disease (3.12%) as compared to stable, paired control sites (0.24%), but only when sites with breakdown and positive for W. recta were compared with their controls. These results indicate that W. recta is associated with some, but not all sites with advanced adult periodontitis. The association of W. recta with gingivitis was not statistically significant.

Adult

Subgingival microflora of advanced periodontitis in the Dominican Republic.

A study of the predominant subgingival microflora was carried out in 24 periodontitis patients, 18 to 60 years of age, in Santo Domingo, Dominican Republic. Paper point sampling, transport in VMGA III, and conventional microbiological techniques were utilized. Direct microscopic examination revealed that cocci and nonmotile organisms made up 85% of the total organisms and spirochetes as little as 3%. Nonselective culturing showed Gram-negative organisms to constitute 53% of total isolates. Fusobacterium nucleatum averaged 15%, black-pigmented anaerobes 7%, and Peptostreptococcus micros 10% of the cultivable microflora. Enteric rods and acinetobacter species were recovered from 16 patients and comprised 23% of the cultivable flora. Enterobacter cloacae occurred in 8 patients, Klebsiella oxytoca in 3 patients, and 7 other species in 10 patients. Parallel studies have found a significantly lower prevalence of enteric rods in advanced periodontitis patients in the USA. In conclusion, fewer spirochetes and markedly more enteric rods seem to inhabit adult periodontitis lesions in Santo Domingo patients compared to those in USA. High levels of subgingival enteric rods in periodontitis patients in Santo Domingo may have important prophylactic and therapeutic implications.

Adolescent

Microbial composition of monkey dental plaque (Macaca arctoides and Macaca fascicularis).

The supragingival and subgingival dental plaque flora of Macaca arctoides and Macaca fascicularis monkeys were examined using mylar strip impressions, direct smears, and culture techniques. In smears, samples generally contained 40--50% cocci, 20--30% rods 8--20% fusiform bacteria, and 4--5% each of filaments, vibrios and spirochetes. Differences in the ratios of the various bacterial groups related to age and sex were found. Several monkey bacterial species were similar to those in human dental plaque. The present results indicate that the Macaca female monkey can be a suitable animal model for the experimental studies of dental diseases.

Aerobiosis

Longitudinal study of experimentally induced periodontal disease in Macaca arctoides: relationship between microflora and alveolar bone loss.

Macaca arctoides monkeys develop periodontal disease, and they harbor a periodontopathic indigenous flora largely similar to that of humans. This study showed that various Haemophilus isolates and H2O2-splitting asaccharolytic Bacteroides melaninogenicus strains constituted major segments of the monkey periodontal microflora. These organisms have not been previously identified among human isolates. Furthermore, the present data revealed that asaccharolytic B. melaninogenicus strains increased in proportion from a few percent to about 66% of the total isolates concomitant with the development of a significant loss of alveolar bone mass. Hence, this study strongly implicates B. melaninogenicus subsp. asaccharolyticus and closely related strains as important pathogens in actively destructive periodontal disease.

Alveolar Process

Direct hemagglutination technique for differentiating Bacteroides asaccharolyticus oral strains from nonoral strains.

A simple and economical method for differentiating Bacteroides asaccharolyticus of oral sources from nonoral sources is described. The present data indicate that oral strains of B. asaccharolyticus strongly agglutinate sheep erythrocytes, whereas isolates from various nonoral sites typically are devoid of hemagglutination activity. The direct hemagglutination test may aid in determining the source of B. asaccharolyticus present in an infection, and thus the procedure has potential value as a means of biotyping.

Animals

Periodontal therapy in humans. I. Microbiological and clinical effects of a single course of periodontal scaling and root planing, and of adjunctive tetracycline therapy.

The present results showed that maarked and long-lasting changes in the subgingival microflora associated with periodontal disease could be achieved by a single course of periodontal treatment. Immediately following therapy, the total number of subgingival organisms decreased 10- to 100-fold and the proportions of cultivable Gram negative organisms and anaerobic organisms generally decreased 3- to 4-fold or more. After treatment, most periodontal pockets were populated by a scant microflora predominated by facultative Actinomyces and Streptococcus species. The kinetics of the subgingival bacterial recolonization revealed that the total cell counts and the proportions of spirochetes and Capnocytophaga species did not reach their pretreatment levels even after 6 months. Other Gram negative anaerobic species returned to pretreatment proportions after 3 to 6 months. Several Gram positive species exhibited higher posttreatment than pretreatment proportions throughout the 6 months study. The microbiological shifts paralleled significant changes in the clinical status of the periodontal tissues. Following therapy, the periodontal pocket depths decreased generally 1 to 4 mm, the gingival inflammatory index, the gingival fluid flow, and the suppurative index were generally lower, and nine of 33 test pockets examined showed apposition of alveolar bone. The microbiological and clinical changes described were exhibited by two patients treated with periodontal scaling and root planing alone and by two patients treated with the adjunctive use of systemic tetracycline therapy. In two other patients, mechanical periodontal therapy only slightly reduced the total number of subgingival organisms and the proportions of spirochetes and other Gram negative anaerobic rods. A shift in the subgingival microbial composition was achieved in these two patients after tetracycline therapy. The following model for treatment of periodontal disease is proposed: (1) Conventional therapy including thorough periodontal scaling and root planing; (2) Monitoring the subgingival flora and the clinical course; and (3) Use of antimicrobial therapy in refractory cases. Further studies are needed to develop means for rapid identification of refractory patients, and to determine the optimal antimicrobial agent, the optimal route of administration, and the optimal dosage regime.

Actinomyces

Ultrastructure of the subgingival microflora in juvenile periodontitis.

The ultrastructure of the subgingival deposits on the root surfaces of teeth affected by juvenile periodontitis was studied on 12 teeth from nine individuals, 15--30 years of age. The deposits consisted of either microbial masses associated with a pellicle, or of a cuticular material almost free of bacteria. Gram-negative rods and filaments were the predominant microorganisms. "Corncob" configurations consisting of filamentous bacteria surrounded by Gram-positive cocci, and "bristle brush" formations comprising corncobs surrounded by long rods were observed in the superficial layer of the plaque. Spirochetes and flagellated rods constituted a major segment of the microflora. The present data indicated that the deep pockets in juvenile periodontitis harbor a sparse but relatively characteristic microbial population.

Adolescent

Microbiota of gingivitis in man.

A study on the predominant cultivable microorganisms inhabiting gingival crevices affected with a chronic gingivitis was carried out using the roll tube culture technique. Samples were obtained from nine individuals 25--42 years of age. Gram-positive rods make up 29.1% of the isolates and included mainly Actinomyces naeslundii, Actinomyces israelii, and Actinomyces viscosus. Streptococcus mitis and Streptococcus sanguis together made up 26.8% of the cultivable organisms. Peptostreptococcus averaged 3.0% of the organisms recovered. Gram-negative anaerobic rods constituted 25.0% of the total isolates with Fusobacterium nucleatum, Bacteroides melaninogenicus ss. intermedius. Bacteriodes ochraceus, other Bacteroides species, Selenomonas sputigena, and Campylobacter sputorum as the most predominant isolates. Haemophilus parainfluenzae averaged about 14% and Veillonella species 4.3% of the cultivable microflora. The data presented indicate that the subgingival microflora of a chronic gingivitis differs from those of healthy periodontium and advanced adult and juvenile periodontis. This might suggest that different infectious processes may be operative in various clinical entities of periodontal disease.

Actinomyces

Attachment of Bacteroides melaninogenicus subsp. asaccharolyticus to oral surfaces and its possible role in colonization of the mouth and of periodontal pockets.

This investigation examined the ability of cells of Bacteroides melaninogenicus subsp. asaccharolyticus 381 to adhere to surfaces that might be important for its initial colonization of the mouth and its subsequent colonization in periodontal pockets. Of 48 asaccharolytic strains of B. melaninogenicus, 47 agglutinated human erythrocytes, whereas none of 20 fermentative strains, which included reference cultures of the subspecies intermedius and melaninogenicus, were active. Electron microscopy indicated that both asaccharolytic and fermentative strains possessed pili; hence, the presence of pili did not correlate with the hemagglutinating activities of B. melaninogenicus strains. Both asaccharolytic and fermentative B. melaninogenicus strains suspended in phosphate-buffered saline adhered in high numbers to buccal epithelial cells and to the surfaces of several gram-positive bacteria tested, including Actinomyces viscosus, A. naeslundii, A. israelii, Streptococcus sanguis, and S. mitis. B. melaninogenicus subsp. asaccharolyticus 381 also attached, but in comparatively low numbers, to untreated and to saliva-treated hydroxyapatite. Addition of clarified whole saliva to suspensions of strain 381 almost completely eliminated adherence to buccal epithelial cells and to hydroxyapatite surfaces, but saliva had no detectable effect on attachment to gram-positive plaque bacteria. Both fermentative and nonfermentative strains of B. melaninogenicus also attached in high numbers to crevicular epithelial cells derived from human periodontal pockets, but normal human serum strongly inhibited attachment. Serum also inhibited attachment of strain 381 to saliva- and serum-treated hydroxyapatite, but it had little effect upon attachment to gram-positive bacteria. These observations suggested that salivary and serum components would strongly inhibit the attachment of B. melaninogenicus cells to several oral surfaces, but not to the surfaces of certain gram-positive bacteria commonly present in human dental plaque. This was confirmed by an in vivo experiment in which streptomycin-labeled cells of B. melaninogenicus 381-R were introduced into the mouths of two volunteers. After 10 min, several hundred-fold higher numbers of the organism were recovered from preformed bacterial plaque present on teeth than from clean tooth surfaces or from the buccal mucosa and tongue dorsum. High numbers of B. melaninogenicus cells were also recovered from preformed plaque after 150 min, but virtually no cells of the organism were recovered from the other surfaces studied. These data suggest that the presence of dental plaque containing Actinomyces and other gram-positive bacteria may be essential for the attachment and colonization of B. melaninogenicus cells after their initial introduction into the mouth. Similarly, the presence of subgingival plaque containing gram-positive bacteria may be necessary for its secondary colonization in periodontal pockets.

Adult

Microflora in the healthy gingival sulcus in man.

The roll tube culture technique was utilized to examine quantitatively and qualitatively the predominant cultivable microflora inhabiting the clinically healthy gingival sulcus. Seven periodontists aged 32-54 years were included in the study. From a total of 350 isolates, 85 (24.3%) were obligate anaerobes, 53 (15.0%) were Gram negative, and 197 (56.3%) were categorized as rods. Actinomycetes predominated in three samples. Four samples were dominated by Streptococcus species. The flora as revealed in the present study comprised a markedly lower proportion of Gram-negative organisms than that found at the base of deep periodontal pockets.

Actinomyces

The predominant cultivable organisms in juvenile periodontitis.

Quantitative and qualitative examinations of the predominant cultivable microflora of the advanced tissue destruction (pocket) associated with juvenile periodontitis and of control pockets without loss of attachment were carried out by using anaerobic tube culture technique. The microflora from the control sites consisted primarily of streptococci, Gram-negative rods, and Gram-positive rods. In contrast, the test pockets had a relatively stable and characteristic microflora, dominated by various Gram-negative, anaerobic rods. The Gram-negative rods were divided into main groups, but a satisfactory classification of many of these microorganisms could not be performed with the methods used and the data available. The predominating Gram-negative rods differed from individual to individual. The role of the Gram-negative rods in the etiology of juvenile periodontitis is unknown. Some potential pathogenic mechanisms of these microorganisms are discussed.

Actinomyces

Comparison of five growth media and two anaerobic techniques for isolating bacteria from dental plaque.

Five agar media in combination with the Hungate roll tube technique and conventional anaerobic jar technique (Baird & Tatlock¿ jars) were evaluated to determine the most suitable medium for non-selective isolation of the viable microorganisms in dental plaque. The highest colony count was obtained by using "Modified Medium 10" with the roll tube technique. About twice as many plaque colonies were recovered by roll tube technique as by the conventional anaerobic technique. With the MM 10 roll tube technique, 7 d of incubation revealed only 93% of the colonies that could be detected after 14 d of incubation.

Adult

The predominant cultivable microflora of advanced periodontitis.

A study on the predominant cultivable microorganisms harbored in the base of deep periodontal pockets of eight patients aged 34-48 years was carried out using the roll tube culture technique. From a total of 475 isolates, 425 (89.5%) were obligate anaerobes, 356(74.9%) were Gram-negative, and 441(92.8%) were categorized as rods. Bacteroides melaninogenicus and Fusobacterium nucleatum constituted the majority of the isolates in seven samples, but their mutual proportions differed considerably between the samples. One sample was dominated by Actinomyces species. Some periodontopathic potentials of the predominating Gram-negative rods are summarized.

Actinomyces