Search

Aim: The aim of the present study was to evaluate the association between the occurrence of periodontopathogens with cortisol levels in chronic periodontitis patients., Methods: Seventy-five chronic periodontitis patients were invited to participate in the present study. Cortisol levels in serum were measured using an immunoassay method. Porphyromonas gingivalis (P. gingivalis) Tannerella forsythia, Treponema denticola, and Aggregatibacter actinomycetemcomitans were detected by polymerase chain reaction using primers designed to target the respective 16S rRNA gene sequences., Results: Severe chronic periodontitis patients showed higher mean levels of cortisol (P < 0.05). Twenty-six patients had hypercortisolemia. High cortisol levels showed a positive significant correlation with P. gingivalis (r = 0.237, P < 0.01). Of the 26 patients with hypercortisolemia, 81% had P. gingivalis, of which 86% had severe chronic periodontitis (P < 0.001). There were higher levels of cortisol with the presence of P. gingivalis (478.65 ± 122.57 vs 402.58 ± 139.60, P = 0.01). The adjusted logistic regression model showed a significant association between high cortisol levels and P. gingivalis (odds ratio = 1.7, 95% confidence interval = 1.6-1.8)., Conclusions: This research offers support for the association between P. gingivalis and higher levels of cortisol in chronic periodontitis patients. These results suggest that high levels of cortisol could increase the occurrence of P. gingivalis in the biofilm., (© 2015 Wiley Publishing Asia Pty Ltd.)

Objective: Dyslipidemia, a disorder in the levels of cholesterol or lipoproteins in the plasma, is a feature of atherosclerosis, leading to cardiovascular disease. The objective of this study was to evaluate whether Tanerella forsythia and Treponema denticola are related to reduced levels of antiatherogenic high density lipoprotein (HDL)., Method and Materials: In this cross-sectional study, 108 patients were invited to participate. The diagnosis of chronic periodontitis and the diagnosis of adipose tissue disorders were made based on criteria previously defined. The presence of T forsythia and T denticola was detected by polymerase chain reaction., Results: A total of 61 women and 19 men with chronic periodontitis, and 18 women and 10 men without periodontitis were studied. The serum levels of total cholesterol and low density lipoprotein were similar in both groups. Inversely, the levels of triglycerides (TG) were higher in periodontitis patients compared to subjects without periodontitis (178 mg/dL vs 165 mg/dL; P < .05), and the levels of HDL were lower (44 mg/dL vs 50 mg/dL; P < .05), respectively. The presence of T denticola was associated with low levels of HDL in periodontitis patients after adjustment for possible confounders (OR, 3.03; 95% CI, 1.2-7.2)., Conclusion: Higher levels of TG and lower levels of HDL were associated with the presence of T denticola in chronic periodontitis. These results may suggest that the presence of T denticola could reduce the antiatherogenic potency of HDL and may increase the risk for cardiovascular disease in patients with chronic periodontitis.

Background: Periodontal disease (PD) is an infectious clinical entity characterized by the destruction of supporting tissues of the teeth as the result of a chronic inflammatory response in a susceptible host. It has been proposed that PD as subclinical infection may contribute to the etiology and to the pathogenesis of several systemic diseases including Atherosclerosis. A number of epidemiological studies link periodontal disease/edentulism as independent risk factor for acute myocardial infarction, peripheral vascular disease, and cerebrovascular disease. Moreover, new randomized controlled clinical trials have shown an improvement on cardiovascular surrogate markers (endothelial function, sICAM, hsPCR level, fibrinogen) after periodontal treatment. Nonetheless, such trials are still limited in terms of external validity, periodontal treatment strategies, CONSORT-based design and results consistency/extrapolation. The current study is designed to evaluate if periodontal treatment with scaling and root planning plus local delivered chlorhexidine improves endothelial function and other biomarkers of cardiovascular disease in subjects with moderate to severe periodontitis., Methods/design: This randomized, single-blind clinical trial will be performed at two health centers and will include two periodontal treatment strategies. After medical/periodontal screening, a baseline endothelium-dependent brachial artery flow-mediated dilatation (FMD) and other systemic surrogate markers will be obtained from all recruited subjects. Patients then will be randomized to receive either supragingival/subgingival plaque cleaning and calculus removal plus chlorhexidine (treatment group) or supragingival plaque removal only (control group). A second and third FMD will be obtained after 24 hours and 12 weeks in both treatment arms. Each group will consist of 49 patients (n = 98) and all patients will be followed-up for secondary outcomes and will be monitored through a coordinating center. The primary outcomes are FMD differences baseline, 24 hours and 3 months after treatment. The secondary outcomes are differences in C-reactive protein (hs-CRP), glucose serum levels, blood lipid profile, and HOMA index., Discussion: This RCT is expected to provide more evidence on the effects of different periodontal treatment modalities on FMD values, as well as to correlate such findings with different surrogate markers of systemic inflammation with cardiovascular effects., Trial Registration Number: ClinicalTrials.gov Identifier: NCT00681564.

Background and Objective: The increasing rate of resistance of microorganisms to penicillin and other antibiotics has generated concern among health authorities in Latin America. The present investigation determined the in vitro susceptibility of Porphyromonas gingivalis, Fusobacterium nucleatum, black-pigmented Prevotella spp. and Aggregatibacter actinomycetemcomitans to metronidazole, amoxicillin, amoxicillin/clavulanic acid, clindamycin and moxifloxacin in patients with chronic periodontitis., Material and Methods: Subgingival plaque samples from patients with periodontitis were collected and cultured on selective and nonselective culture media. The antimicrobial susceptibility of periodontopathogenic isolates was studied in chronic periodontitis patients in Colombia. Metronidazole, amoxicillin, amoxicillin/clavulanic acid, clindamycin and moxifloxacin were tested on all bacterial isolates and the percentage of resistant strains was calculated., Results: Of the 150 bacteria identified, 51 were P. gingivalis, 45 were black-pigmented Prevotella spp., 36 were F. nucleatum and 18 were A. actinomycetemcomitans. All the isolates were sensitive to amoxicillin/clavulanic acid and to moxifloxacin, but exhibited variable susceptibility patterns to the other antimicrobial agents tested., Conclusion: The results of the present study suggest that periodontal microorganisms in patients with chronic periodontitis can be resistant to the antimicrobial agents commonly used in anti-infective periodontal therapy. We suggest that the indiscriminate use of antimicrobials could result in the appearance of more highly antibiotic-resistant strains of bacteria associated with periodontal diseases in our population compared with the populations of other countries.