Oral hygiene and nutritional status of children aged 1-7 years in a rural community.

Ghana Med J. 2006 Mar;40(1):22-5

Authors: Okolo S, Chukwu G, Egbuonu I, Ezeogu F, Onwuanaku C, Adeleke O, Hassan A, Ngoe-Nesoah A

Summary INTRODUCTION: Poor oral hygiene, measles and malnutrition have been implicated as predisposing factors to Acute Necrotizing Ulcerative Gingivitis (ANUG) and cancrum oris, common oral diseases prevalent among children ages 3-6 years in rural communities. OBJECTIVE: The study was aimed at reviewing the oral hygiene, nutritional and immunization status of children 13-84 months of age in a rural community. DESIGN: A cross sectional study. METHODS: Two hundred and thirty seven (237), 168 and 321 children and their parents from Illela, Gada and Gwadabawa respectively were interviewed using a pre-tested questionnaire to record the biodata and social status of the mother and measles immunization status of the children. The oral hygiene status of the children was determined using the plaque/debris index score. Their anthropometric measurements were also recorded. RESULTS: A total of 636 children aged 1-7years were examined. Of these, 8.3% had plaque/debris index of zero. About twenty four percent (23.9%) had plaque/debris index of 1, while 55.2% had plaque/debris index of 2 and 12.6% had plaque/debris index of 3. There was no statistical difference between the females and the males (p=0.333), but a significant difference existed between the age groups (p=0.001). Of the study group, 84.3% were malnourished and only 11.3% were immunized against measles. CONCLUSION: Poor oral hygiene, malnutrition and low measles immunization were common in the community. These conditions predispose to noma. Prompt and adequate intervention programmes such as systematic oral health, immunization and nutrition promotion programmes are urgently needed in these communities.

PMID: 17299560 [PubMed - in process]

Oral lesions in HIV infection in developing countries: an overview.

Adv Dent Res. 2006;19(1):63-8

Authors: Ranganathan K, Hemalatha R

HIV infection is a major global health problem affecting developing and developed countries alike. Oral lesions that are associated with this disease are important, since they affect the quality of life of the patient and are useful markers of disease progression and immunosuppression. Oral lesions in HIV infection have been well-documented in developed countries, but there are fewer reports on oral lesions from developing countries. Oral candidiasis is the most common opportunistic infection seen in all continents. Kaposi's sarcoma has been reported only from Africa and Latin America, while histoplasmosis and penicilliosis were reported in patients with advanced disease from Thailand. HIV-associated salivary gland disease has a high prevalence in Africa and Latin America, especially in the pediatric group. It is clear that there are considerable regional variations in the oral manifestations of HIV infection, depending both on the populations studied and on the clinical expertise available, among other factors. Well-designed and -documented studies are necessary for the correct assessment of the nature and magnitude of the problem in developing countries, if oral health measures are to be effectively formulated for the HIV-infected.

PMID: 16672552 [PubMed - indexed for MEDLINE]

Oral lesions in infection with human immunodeficiency virus.

Bull World Health Organ. 2005 Sep;83(9):700-6

Authors: Coogan MM, Greenspan J, Challacombe SJ

This paper discusses the importance of oral lesions as indicators of infection with human immunodeficiency virus (HIV) and as predictors of progression of HIV disease to acquired immunodeficiency syndrome (AIDS). Oral manifestations are among the earliest and most important indicators of infection with HIV. Seven cardinal lesions, oral candidiasis, hairy leukoplakia, Kaposi sarcoma, linear gingival erythema, necrotizing ulcerative gingivitis, necrotizing ulcerative periodontitis and non-Hodgkin lymphoma, which are strongly associated with HIV infection, have been identified and internationally calibrated, and are seen in both developed and developing countries. They may provide a strong indication of HIV infection and be present in the majority of HIV-infected people. Antiretroviral therapy may affect the prevalence of HIV-related lesions. The presence of oral lesions can have a significant impact on health-related quality of life. Oral health is strongly associated with physical and mental health and there are significant increases in oral health needs in people with HIV infection, especially in children, and in adults particularly in relation to periodontal diseases. International collaboration is needed to ensure that oral aspects of HIV disease are taken into account in medical programmes and to integrate oral health care with the general care of the patient. It is important that all health care workers receive education and training on the relevance of oral health needs and the use of oral lesions as surrogate markers in HIV infection.

PMID: 16211162 [PubMed - indexed for MEDLINE]

Pattern of dental extraction in children in a Nigerian tertiary hospital.

J Contemp Dent Pract. 2005 May 15;6(2):80-90

Authors: Folayan MO, Otuyemi OD, Esan TA, Adeleke AA, Adedigba MA

Changes that occurred in the pattern of tooth extraction in the last 13 years among a population of children in Nigerian were studied. The result of this study was then compared to that of a past study done in the same institution 13 years earlier. Information on age, gender, and indication of tooth extraction was collected prospectively from 379 consecutive patients who visited the outpatient Pediatric Dental Clinic for the first time during the year 2002. Results showed tooth extraction due to caries decreased, while there was an increase in tooth extraction from an apparent increase in orthodontic treatment needs. Acute necrotizing ulcerative gingivitis (ANUG), a significant cause of tooth loss in the last decade, decreased significantly. The pattern of deciduous tooth loss also changed as more anterior teeth were lost for orthodontic reasons in this present study. The pattern of tooth loss in the permanent dentition remains very similar to that of the past study, though more premolars were lost in the present study. There appears to be an increasing need for tooth extractions in orthodontic treatment for this population of children. The focus of planned dental health care provisions, treatment policies, and training emphasis in child dental care may need to shift to addressing orthodontic needs.

PMID: 15915207 [PubMed - indexed for MEDLINE]

Necrotising periodontal diseases.

Med Oral Patol Oral Cir Bucal. 2004;9 Suppl:114-9; 108-14

Authors: Bermejo-Fenoll A, Sánchez-Pérez A

Necrotizing gingivitis (NG) or necrotising ulcerative gingivitis (NUG) is considered to be an acute opportunistic gingival infection caused by bacterial plaque. It appears more frequently in undernurished children and young adults as well as patients with immunodeficiency. In its pathogenesis, there are factors related to the oral microbiota with invasion processes on the one hand, and on the other hand, factors associated with the host, such as signs of capillary and immunological disorders as well as undernurishment. The disease is characterized by pain, bleeding and papillary necrosis with tendency to relapse. Diagnosis is made by a simple clinical examination. However, complementary tests ought to be performed in order to eliminate the possibility of illnesses systemic or immunodeficiency. Early and sustained treatment is strongly recommended. Lesions of the gums (craters in the interdental papillae) as an aftermath of the disease is a possibility, or if there is necrotizing periodontitis there will be loss of attachment tissue.

PMID: 15580128 [PubMed - indexed for MEDLINE]

The epidemiology, etiology, and pathophysiology of acute necrotizing ulcerative gingivitis associated with malnutrition.

J Contemp Dent Pract. 2004 Aug 15;5(3):28-41

Authors: Folayan MO

Acute Necrotizing Ulcerative Gingitivitis (ANUG) is a distinct and specific disease. This disease entity has been described as far back as the days of Hippocrates and is known by many synonyms. With the advent of antibiotics and with improved nutritional status, the incidence has decreased and even become extinct in developed countries. However, with the increasing incidence of severe immunodeficiency states such as seen in Acquired Immunodeficiency Syndrome (AIDS) the lesion has once more, become a well recognized and often encountered clinical entity in developed countries. In developing countries, however, the condition is still a commonly diagnosed clinical lesion because of the persistently poor nutritional status. Because of the current campaign for increased focus on global health issues, ANUG, a lesion of significant interest for the developing countries where malnutrition is high and for developing countries because of the AIDS, a global pandemic has resurfaced as a topic for discussions and study. This literature review will provide a better understanding of the epidemiology, etiology, and pathophysiology of ANUG associated with malnutrition.

PMID: 15318254 [PubMed - in process]

Treponema putidum sp. nov., a medium-sized proteolytic spirochaete isolated from lesions of human periodontitis and acute necrotizing ulcerative gingivitis.

Int J Syst Evol Microbiol. 2004 Jul;54(Pt 4):1117-22

Authors: Wyss C, Moter A, Choi BK, Dewhirst FE, Xue Y, Schüpbach P, Göbel UB, Paster BJ, Guggenheim B

So far, little phenotypic heterogeneity has been detected in cultured oral treponemes with trypsin-like proteolytic activity, and all have been assigned to the species Treponema denticola. However, comparisons of protein patterns and antigen expression in our collection of proteolytic oral treponemes occasionally identified isolates with a unique phenotype; e.g. strain OMZ 830 (=ATCC 700768), which qualified as a 'pathogen-related oral spirochaete' due to the presence of a approximately 37 kDa protein reactive with the Treponema pallidum FlaA-specific mAb H9-2. In addition to such single isolates, a homogeneous group of seven independent strains is described that were highly motile, medium-sized, proteolytic but asaccharolytic spirochaetes and were cultured from human gingivitis, periodontitis and acute necrotizing ulcerative gingivitis in medium OMIZ-Pat supplemented with 1% human serum and antibiotics. Growth of these spirochaetes in OMIZ-Pat was not dependent on, but was stimulated by, human or bovine serum. Carbohydrates were neither required nor stimulatory for growth. The protein and antigen patterns of total cell extracts of these organisms separated by SDS-PAGE were distinct from those of all previously cultured spirochaetes, with highest similarity to T. denticola. The novel spirochaete has a 2 : 4 : 2 arrangement of the periplasmic flagella, similar to T. denticola. However, the flagellin pattern as detected by immunostaining or glycan staining of Western blots readily distinguished the novel group from T. denticola. Also, distinct from reference strains of T. denticola, none of the novel isolates displayed sialidase or dentilisin activities, both of which are expressed by most strains of T. denticola. Trypsin-like activity and other enzymes as detected by API ZYM test were similar to those of T. denticola. The status of a novel species is supported by the 16S rRNA gene sequence, with 98.5% similarity to its closest cultured relative, T. denticola. The name Treponema putidum sp. nov. is proposed (type strain OMZ 758T=ATCC 700334T=CIP 108088T).

PMID: 15280279 [PubMed - indexed for MEDLINE]

Role of Treponema denticola in periodontal diseases.

Crit Rev Oral Biol Med. 2001;12(5):399-413

Authors: Sela MN

Among periodontal anaerobic pathogens, the oral spirochetes, and especially Treponema denticola, have been associated with periodontal diseases such as early-onset periodontitis, necrotizing ulcerative gingivitis, and acute pericoronitis. Basic research as well as clinical evidence suggest that the prevalence of T denticola, together with other proteolytic gram-negative bacteria in high numbers in periodontal pockets, may play an important role in the progression of periodontal disease. The accumulation of these bacteria and their products in the pocket may render the surface lining periodontal cells highly susceptible to lysis and damage. T. denticola has been shown to adhere to fibroblasts and epithelial cells, as well as to extracellular matrix components present in periodontal tissues, and to produce several deleterious factors that may contribute to the virulence of the bacteria. These bacterial components include outer-sheath-associated peptidases, chymotrypsin-like and trypsin-like proteinases, hemolytic and hemagglutinating activities, adhesins that bind to matrix proteins and cells, and an outer-sheath protein with pore-forming properties. The effects of T. denticola whole cells and their products on a variety of host mucosal and immunological cells has been studied extensively (Fig. 1). The clinical data regarding the presence of T. denticola in periodontal health and disease, together with the basic research results involving the role of T. denticola factors and products in relation to periodontal diseases, are reviewed and discussed in this article.

PMID: 12002822 [PubMed - indexed for MEDLINE]

Oro-facial gangrene (noma/cancrum oris): pathogenetic mechanisms.

Crit Rev Oral Biol Med. 2000;11(2):159-71

Authors: Enwonwu CO, Falkler WA, Idigbe EO

Cancrum oris (Noma) is a devastating infectious disease which destroys the soft and hard tissues of the oral and para-oral structures. The dehumanizing oro-facial gangrenous lesion affects predominantly children ages 2 to 16 years, particularly in sub-Saharan Africa, where the estimated frequency in some communities varies from 1 to 7 cases per 1000 population. The risk factors are poverty, malnutrition, poor oral hygiene, residential proximity to livestock in unsanitary environments, and infectious diseases, particularly measles and those due to the herpesviridae. Infections and malnutrition impair the immune system, and this is the common denominator for the occurrence of noma. Acute necrotizing gingivitis (ANG) and oral herpetic ulcers are considered the antecedent lesions, and ongoing studies suggest that the rapid progression of these precursor lesions to noma requires infection by a consortium of micro-organisms, with Fusobacterium necrophorum (Fn) and Prevotella intermedia (Pi) as the suspected key players. Additional to production of a growth-stimulating factor for Pi, Fn displays a classic endotoxin, a dermonecrotic toxin, a cytoplasmic toxin, and a hemolysin. Without appropriate treatment, the mortality rate from noma is 70-90%. Survivors suffer the two-fold afflictions of oro-facial mutilation and functional impairment, which require a time-consuming, financially prohibitive surgical reconstruction.

PMID: 12002813 [PubMed - indexed for MEDLINE]

Bacterial diversity in human subgingival plaque.

J Bacteriol. 2001 Jun;183(12):3770-83

Authors: Paster BJ, Boches SK, Galvin JL, Ericson RE, Lau CN, Levanos VA, Sahasrabudhe A, Dewhirst FE

The purpose of this study was to determine the bacterial diversity in the human subgingival plaque by using culture-independent molecular methods as part of an ongoing effort to obtain full 16S rRNA sequences for all cultivable and not-yet-cultivated species of human oral bacteria. Subgingival plaque was analyzed from healthy subjects and subjects with refractory periodontitis, adult periodontitis, human immunodeficiency virus periodontitis, and acute necrotizing ulcerative gingivitis. 16S ribosomal DNA (rDNA) bacterial genes from DNA isolated from subgingival plaque samples were PCR amplified with all-bacterial or selective primers and cloned into Escherichia coli. The sequences of cloned 16S rDNA inserts were used to determine species identity or closest relatives by comparison with sequences of known species. A total of 2,522 clones were analyzed. Nearly complete sequences of approximately 1,500 bases were obtained for putative new species. About 60% of the clones fell into 132 known species, 70 of which were identified from multiple subjects. About 40% of the clones were novel phylotypes. Of the 215 novel phylotypes, 75 were identified from multiple subjects. Known putative periodontal pathogens such as Porphyromonas gingivalis, Bacteroides forsythus, and Treponema denticola were identified from multiple subjects, but typically as a minor component of the plaque as seen in cultivable studies. Several phylotypes fell into two recently described phyla previously associated with extreme natural environments, for which there are no cultivable species. A number of species or phylotypes were found only in subjects with disease, and a few were found only in healthy subjects. The organisms identified only from diseased sites deserve further study as potential pathogens. Based on the sequence data in this study, the predominant subgingival microbial community consisted of 347 species or phylotypes that fall into 9 bacterial phyla. Based on the 347 species seen in our sample of 2,522 clones, we estimate that there are 68 additional unseen species, for a total estimate of 415 species in the subgingival plaque. When organisms found on other oral surfaces such as the cheek, tongue, and teeth are added to this number, the best estimate of the total species diversity in the oral cavity is approximately 500 species, as previously proposed.

PMID: 11371542 [PubMed - indexed for MEDLINE]

Characterization of an autoantigen associated with chronic ulcerative stomatitis: the CUSP autoantigen is a member of the p53 family.

J Invest Dermatol. 1999 Aug;113(2):146-51

Authors: Lee LA, Walsh P, Prater CA, Su LJ, Marchbank A, Egbert TB, Dellavalle RP, Targoff IN, Kaufman KM, Chorzelski TP, Jablonska S

A unique clinical syndrome has been described in which patients have chronic oral ulceration and autoantibodies to nuclei of stratified squamous epithelium. We have characterized the autoantibodies from patients sera and found that the major autoantigen is a 70 kDa epithelial nuclear protein. Sequencing of the cDNA for this protein, chronic ulcerative stomatitis protein, revealed it to be homologous to the p53 tumor suppressor and to the p73 putative tumor suppressor, and to be a splicing variant of the KET gene. The p53-like genes, p73 and the several KET splicing variants, are recently described genes of uncertain biologic and pathologic significance. This study provides the first clear association of a p53-like protein with a disease process.

PMID: 10469295 [PubMed - indexed for MEDLINE]

Pathogenesis of cancrum oris (noma): confounding interactions of malnutrition with infection.

Am J Trop Med Hyg. 1999 Feb;60(2):223-32

Authors: Enwonwu CO, Falkler WA, Idigbe EO, Afolabi BM, Ibrahim M, Onwujekwe D, Savage O, Meeks VI

This study showed that impoverished Nigerian children at risk for cancrum oris (noma) had significantly reduced plasma concentrations of zinc (< 10.8 micromol/L), retinol (< 1.05 micromol/L), ascorbate (< 11 micromol/L), and the essential amino acids, with prominently increased plasma and saliva levels of free cortisol, compared with their healthy counterparts. The nutrient deficiencies, in concert with previously reported widespread viral infections (measles, herpesviruses) in the children, would impair oral mucosal immunity. We postulate, subject to additional studies, that evolution of the oral mucosal ulcers including acute necrotizing gingivitis to noma is triggered by a consortium of microorganisms of which Fusobacterium necrophorum is a key component. Fusobacterium necrophorum elaborates several dermonecrotic toxic metabolites and is acquired by the impoverished children via fecal contamination resulting from shared residential facilities with animals and very poor environmental sanitation.

PMID: 10072140 [PubMed - indexed for MEDLINE]

Diagnosis of oral ulcers.

Mt Sinai J Med. 1998 Oct-Nov;65(5-6):383-7

Authors: Schneider LC, Schneider AE

Ulcers commonly occur in the mouth. Their causes range from minor irritation to malignancies and systemic diseases. Innocent solitary ulcerations, which result from trauma and infections, must be distinguished from squamous cell carcinomas, which also typically present as solitary ulcers. Multiple oral ulcers may be classified as acute, recurrent and/or chronic. The most common causes of rapid-onset oral ulcers include acute necrotizing ulcerative gingivitis, allergies and erythema multiforme. The two common forms of acute (short-term) recurrent oral ulcers, "cold sores" or "fever blisters," which are caused by the herpes simplex virus, and recurrent aphthous ulcers ("canker sores"), may be distinguished largely on the basis of their location. Most types of multiple chronic oral ulcers are associated with disturbances of the immune system. They include erosive lichen planus, mucous membrane pemphigoid and pemphigus vulgaris. Clinical criteria which are most useful in identifying the cause of oral ulcers are vesicles or bullae, which may not be seen because they rupture rapidly in the oral environment; constitutional signs and symptoms; and lesions on the skin and/or other mucosa. In some cases, diagnosis depends upon culture or biopsy, particularly with the application of immunofluorescence to the surgical specimen.

PMID: 9844367 [PubMed - indexed for MEDLINE]

Periodontal problems related to HIV-1 infection.

Adv Dent Res. 1995 Jul;9(2):147-51

Authors: Barr CE

The prevalence of periodontal diseases in HIV-infected infected persons is unresolved. While numerous reports have been published, the data are conflicting in part due to different populations studied, lack of consensus criteria for disease, study location, and biased samples. This presentation will be a collation of information available for the diagnosis and treatment of HIV/AIDS-associated periodontal diseases. The use of "HIV" is no longer accepted as a diagnostic designation. Instead, the diagnostic categories of atypical gingivitis (erythematous gingival banding), necrotizing gingivitis, necrotizing periodontitis, and necrotizing stomatitis and distinguishing characteristics will be presented. It is essential that a distinction be made between those periodontal lesions that may occur in seropositive and seronegative individuals and those which appear to have more specific signs and symptoms associated with HIV infection and with immunosuppression in general. A simplified algorithm has been developed to help differentiate between periodontal diseases specific to the HIV-positive individual and those in the general population. Additionally, the grid may also be used to distinguish the different periodontal diseases known to be associated with HIV infection.

PMID: 7546138 [PubMed - indexed for MEDLINE]

Acyclovir given as prophylaxis against oral ulcers in acute myeloid leukaemia: randomised, double blind, placebo controlled trial.

BMJ. 1995 May 6;310(6988):1169-72

Authors: Bergmann OJ, Ellermann-Eriksen S, Mogensen SC, Ellegaard J

OBJECTIVES--To evaluate (a) the prophylactic effect of the antiherpetic drug acyclovir on oral ulcers in patients with acute myeloid leukaemia receiving remission induction chemotherapy and thus (b), indirectly, the role of herpes simplex virus in the aetiology of these ulcers. DESIGN--Randomised, double blind, placebo controlled trial. SUBJECTS--74 herpes simplex virus seropositive patients aged 18-84. Thirty seven patients received acyclovir (800 mg by mouth daily) and 37 placebo. The patients were examined daily for 28 days. MAIN OUTCOME MEASURES--Occurrence of herpes labialis, intraoral ulcers, and acute necrotising ulcerative gingivitis. RESULTS--The two populations were comparable in age, sex, type of antineoplastic treatment, and history of herpes labialis. Acute oral infections occurred in 25 of the acyclovir treated patients and 36 of the placebo treated patients (relative risk 0.69 (95% confidence interval 0.55 to 0.87)). This difference was due to a reduction in the incidence of herpes labialis (one case versus eight cases; relative risk 0.13 (0.02 to 0.95)), intraoral ulcers excluding the soft palate (one case versus 13 cases; relative risk 0.08 (0.01 to 0.56)), and acute necrotising ulcerative gingivitis (one case versus eight cases; relative risk 0.13 (0.02 to 0.95)). However, ulcers on the soft palate were diagnosed with similar frequency in the two groups. Isolation of herpes simplex virus type 1 in saliva was reduced from 15 cases in the placebo group to one case in the acyclovir group (relative risk 0.07 (0.01 to 0.48)). CONCLUSION--Intraoral ulcers excluding the soft palate are most often due to infection with herpes simplex virus, whereas ulcers on the soft palate have a non-herpetic aetiology. The findings suggest that acute necrotising ulcerative gingivitis may also be due to herpes simplex virus. Prophylaxis with acyclovir should be considered for patients with acute myeloid leukaemia during remission induction therapy.

PMID: 7767151 [PubMed - indexed for MEDLINE]

Adsorption and biotin-streptavidin amplification in serologic tests for diagnosis of Lyme borreliosis.

J Clin Microbiol. 1991 Sep;29(9):1761-4

Authors: Magnarelli LA, Anderson JF

Serum samples from persons with Lyme borreliosis, periodontitis, or acute necrotizing ulcerative gingivitis were analyzed by an enzyme-linked immunosorbent assay (ELISA) with and without adsorption and amplification procedures. When biotin and streptavidin reagents were used as an amplification procedure in ELISA without the use of commercially prepared sorbent (Treponema phagedenis biotype Reiter), sensitivity increased. Of the 85 serum samples collected from persons with erythema migrans but no detectable antibodies to Borrelia burgdorferi by standard ELISA, 17 (20%) were reactive after amplification. Adsorption of serum samples with a 1:10 dilution of T. phagedenis biotype Reiter sorbent used in conjunction with amplified ELISA also improved the sensitivity of this method. However, cross-reactivity could not be completely eliminated. An adsorbed-amplified ELISA may be helpful in the diagnosis of Lyme borreliosis in the laboratory, particularly during early weeks of infection, when antibodies to B. burgdorferi can be present at a low concentration.

PMID: 1774293 [PubMed - indexed for MEDLINE]

Pathogen-related spirochetes identified within gingival tissue from patients with acute necrotizing ulcerative gingivitis.

Infect Immun. 1991 Aug;59(8):2653-7

Authors: Riviere GR, Weisz KS, Simonson LG, Lukehart SA

The purpose of this investigation was to determine whether monoclonal antibodies against pathogen-restricted antigens of Treponema pallidum subsp. pallidum could be used as probes for spirochetes in diseased gingival tissue from subjects with acute necrotizing ulcerative gingivitis. A biotin-streptavidin system was used to identify spirochetes bound by monoclonal antibodies in cryostat sections of tissue. Twelve of 16 tissue samples from diseased sites, but none of 8 tissue specimens from healthy sites, reacted with pathogen-restricted antibodies. Organisms were found in intact epithelium and connective tissues adjacent to ulcers. Staining intensity was often high in perivascular locations and around vesicular spaces. Monoclonal antibodies to Bacteroides gingivalis and Treponema denticola were each reactive with diseased gingival tissues, but staining was usually restricted to ulcerated areas. These studies extend recent observations that showed that subjects with acute necrotizing ulcerative gingivitis had both pathogen-related spirochetes in dental plaque and serum immunoglobulin G to pathogen-restricted antigens on T. pallidum subspecies, suggesting that pathogen-related spirochetes may be associated with the pathogenesis of certain periodontal diseases.

PMID: 1855985 [PubMed - indexed for MEDLINE]

Cross-reactivity of nonspecific treponemal antibody in serologic tests for Lyme disease.

J Clin Microbiol. 1990 Jun;28(6):1276-9

Authors: Magnarelli LA, Miller JN, Anderson JF, Riviere GR

Serum samples obtained from 59 persons who had acute necrotizing ulcerative gingivitis, periodontitis, syphilis, or Lyme disease were tested against Treponema phagedenis biotype Reiter, Treponema denticola, Treponema vincentii, and Treponema scoliodontum by indirect fluorescent-antibody staining methods. Although there were positive reactions for sera representing each of these study groups and for 20 (13%) of 156 samples collected from the general population (premarital screening for syphilis), titration endpoints were relatively low (less than or equal to 1:256). Serum samples from 18 persons who had gingivitis or periodontitis but no history of Lyme borreliosis were tested by enzyme-linked immunosorbent assay for antibodies to Borrelia burgdorferi. Of these, five (28%) had immunoglobulin M antibody and four (22%) contained immunoglobulin G antibodies to this spirochete. Adsorption with either sorbent commercially prepared from T. phagedenis biotype Reiter or with washed, whole cells of T. phagedenis biotype Reiter reduced cross-reactivity in the enzyme-linked immunosorbent assay for Lyme borreliosis.

PMID: 2380356 [PubMed - indexed for MEDLINE]

Serological studies of oral Bacteroides intermedius.

Infect Immun. 1988 Jun;56(6):1647-51

Authors: Nakazawa F, Zambon JJ, Reynolds HS, Genco RJ

Bacteroides intermedius is a gram negative, anaerobic microorganism associated with certain forms of human periodontal disease, including adult periodontitis and acute necrotizing ulcerative gingivitis. Previous studies have indicated the presence of two DNA homology groups which could be distinguished by analysis of protein patterns on polyacrylamide gel electrophoresis, as well as at least two serogroups within B. intermedius. The present study examined the serology of B. intermedius and determined the distribution of B. intermedius serogroups in clinical isolates and patient plaque samples. Serological reactions with unabsorbed rabbit antisera and antisera immunoabsorbed with B. intermedius strains demonstrated a previously unreported antigenic group within B. intermedius, serogroup C, in both immunodiffusion and immunofluorescence assays. Of 79 B. intermedius isolates from 68 subjects examined with specific antisera, 55% of the isolates and 52% of the subjects were categorized in serogroup C, 40% of the isolates and 46% of the subjects were in serogroup B, and 5% of the isolates and 6% of the subjects were in serogroup A. In 31 samples of subgingival dental plaque from adolescents known to harbor B. intermedius, 81% demonstrated serogroup B, 16% had serogroup A, and 3% had serogroup C.

PMID: 3131249 [PubMed - indexed for MEDLINE]

A case-control study of plasma ascorbate and acute necrotizing ulcerative gingivitis.

J Dent Res. 1988 May;67(5):855-60

Authors: Melnick SL, Alvarez JO, Navia JM, Cogen RB, Roseman JM

Data from animal studies and from studies of patients with acute necrotizing ulcerative gingivitis (ANUG) have provided suggestive evidence for an association between ascorbate deficiency and disease risk. Further, there is biological plausibility for such an association, due to the role of ascorbate in collagen synthesis and leukocyte function. A case-control study of plasma ascorbate and ANUG was performed on 60 patients with a history of ANUG infection and 60 age-race-sex-matched controls. No cases had had active lesions for at least two months prior to their vitamin assay to avoid any potential reduction of dietary intake of ascorbic acid due to the presence of painful mouth lesions. According to results obtained by use of a modification of the 2,4-dinitrophenylhydrazine method for determination of total plasma ascorbate, the mean and standard error of the mean of plasma ascorbate for all ANUG cases was 0.07 +/- 0.006 mmol/L; the mean for all controls was 0.10 +/- 0.006 mmol/L. Paired differences in plasma ascorbic acid concentrations between cases and controls were significantly different from zero (p less than 0.001). The unadjusted relative risk (RR) of ANUG as obtained by conditional logistic regression for subjects whose plasma ascorbic acid concentration was at or below the median value for controls, relative to subjects with higher values, was 7.3 (90% confidence interval, 3.0 - 17.4; one-sided p value less than 0.001). Patients with a history of ANUG ingested a daily average of 1.2 +/- 0.2 servings of dietary ascorbic acid, as compared with a daily average of 1.9 +/- 0.2 servings for healthy controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 3163353 [PubMed - indexed for MEDLINE]

Allelic variants for complement factors C3, C4, and B in acute necrotizing ulcerative gingivitis.

J Dent Res. 1988 May;67(5):851-4

Authors: Melnick SL, Go RC, Cogen RB, Roseman JM

Impaired immune defense mechanisms and genetic factors appear to play a role in susceptibility to acute necrotizing ulcerative gingivitis (ANUG). Therefore, possible etiological mechanisms might involve genes at the Major Histocompatibility Complex, which include the complement factor loci. We have tested for a possible association between certain complement factor alleles and ANUG using a case-control study design. Specific alleles at complement factors C3 and C4, and properdin factor B (Bf) loci were determined indirectly by high voltage agarose gel electrophoresis in 58 subjects with a history of ANUG and in 58 age-sex-matched healthy controls. The highest relative risk of ANUG, as obtained by conditional logistic regression, for alleles at the C3 locus was 1.9 (90% confidence limits 0.8 to 4.8; p = 0.229) for C3*F-positive individuals. The highest relative risk for alleles at the C4 locus was 2.6 (0.5 to 14.9; p = 0.358) for C4A*3-positive individuals. There was no evidence for an association between Bf allotype and risk of ANUG, with a relative risk of 1.2 for Bf*F- and relative risk of 1.0 for B*S-positive individuals. None of our estimates was statistically significant. We conclude, therefore, that it is unlikely that there is any association between complement factor gene haplotype and susceptibility to ANUG.

PMID: 3163352 [PubMed - indexed for MEDLINE]

Subinhibitory concentrations of tetracycline alter fibrinogen binding by Bacteroides intermedius.

Antimicrob Agents Chemother. 1987 Dec;31(12):1915-8

Authors: Lantz MS, Ray T, Krishnasami S, Pearson DE

Previous studies from our laboratory have shown that a strain of Bacteroides intermedius, VPI 8944, an organism isolated originally from a patient with acute necrotizing ulcerative gingivitis, binds human fibrinogen rapidly, reversibly, specifically, saturably, and with high affinity (M.S. Lantz, L.M. Switalski, K.S. Kornman, and M. H&#xF6;ök, J. Bacteriol. 163:623-628, 1985). We examined the effect of growth in subinhibitory levels (sub-MICs) of tetracycline on fibrinogen binding by these bacteria and found concentration-dependent inhibition of fibrinogen binding by bacteria grown in the presence of tetracycline over the range of tetracycline concentrations from 1/64 to 1/8 the MIC. Analysis of the binding data suggests that bacteria grown in the presence of sub-MICs of tetracycline bind fewer fibrinogen molecules per cell than do bacteria grown in the absence of the drug. If fibrinogen-mediated adherence is important in the establishment B. intermedius in periodontal lesions and lesions of acute necrotizing ulcerative gingivitis, then tetracycline may be effective in disrupting establishment of these organisms at concentrations well below those required to achieve a bacteriostatic effect.

PMID: 3439801 [PubMed - indexed for MEDLINE]

Interactions of Bacteroides gingivalis with fibrinogen.

Infect Immun. 1986 Dec;54(3):654-8

Authors: Lantz MS, Rowland RW, Switalski LM, H&#xF6;ök M

Results of previous studies from our laboratory have shown that a strain of Bacteroides intermedius isolated originally from a patient with acute necrotizing ulcerative gingivitis binds and degrades human fibrinogen (M.S. Lantz, L.M. Switalski, K.S. Kornman, and M. Hook, J. Bacteriol. 163:623-628, 1985). We report that strains of Bacteroides gingivalis, an organism implicated in the etiology of several forms of periodontitis, also bind and degrade fibrinogen. The binding is rapid, reversible, saturable, and specific. The number of fibrinogen-binding sites per cell varies from 500 to 1,500 in different batches of bacteria, and the dissociation constant for the complex is on the order of 10(-8) M. B. gingivalis possesses cell-associated fibrinogenolytic activity that is activated by dithiothreitol and blocked by thiol protease inhibitors. Interaction with fibrinogen may mediate colonization and establishment of these organisms in the periodontal microbiota.

PMID: 3096886 [PubMed - indexed for MEDLINE]

Cellular fatty acid and soluble protein profiles of oral fusobacteria.

J Dent Res. 1983 Dec;62(12):1181-5

Authors: Calhoon DA, Mayberry WR, Slots J

We compared the cellular fatty acid and protein content of 43 strains of oral fusobacteria isolated from patients with chronic gingivitis, acute necrotizing ulcerative gingivitis, and juvenile and adult periodontitis, as well as from the stump-tailed macaque, to that of eight reference strains of oral and non-oral Fusobacterium species. A gas-liquid chromatographic examination of trimethylsilyl derivatives of the fatty acid methyl esters revealed n14:0, 3-OH-14:0, n16:0, 16:1, 3-OH-16:0, n18:0, and 18:1 in each of the 51 study strains, and a variable occurrence of 14 other fatty acids. The n16:0 to 3-OH-16:0 ratio distinguished between Fusobacterium nucleatum and the non-oral species Fusobacterium varium, Fusobacterium necrophorum, Fusobacterium russii, Fusobacterium necrogenes, Fusobacterium mortiferum, and Fusobacterium naviforme. The soluble protein content, as determined by polyacrylamide gel electrophoresis, varied considerably among the oral fusobacterial strains studied, and underscored the heterogenous nature of these organisms. "Fingerprinting" of oral fusobacteria may be readily accomplished by polypeptide analysis.

PMID: 6581193 [PubMed - indexed for MEDLINE]

Serum antibodies to oral Bacteroides asaccharolyticus (Bacteroides gingivalis): relationship to age and periondontal disease.

Infect Immun. 1981 Jan;31(1):182-92

Authors: Mouton C, Hammond PG, Slots J, Genco RJ

An enzyme-linked immunosorbent assay microplate method was used for measuring levels of antibody specific for the oral serotype of Bacteroides asaccharolyticus (Bacteroides gingivalis) in serum samples obtained from umbilical cords, infants, children, periodontally normal adults, and edentulous adults. Serum from patients with various periodontal diseases, including adult periodontitis, localized juvenile periodontitis, generalized juvenile periodontitis, post-localized juvenile periodontitis, and acute necrotizing ulcerative gingivitis, were also studied. A positive correlation between increase in age and increase in both prevalence and level of specific antibody in the G, A, and M classes of immunoglobulins was observed. This indicates that antibodies reactive with oral B. asaccharolyticus found in up to 84% of normal adults are natural antibodies, presumably with a protective role. Among the patient groups, those with adult periodontitis were found to have levels of immunoglobulin G antibodies to oral B. asaccharolyticus that were five times higher than the antibody levels found in control subjects. The levels of IgG antibodies to this organism in the other patient groups were comparable to the levels found in the control group. However, 50% of the individuals in the generalized juvenile periodontitis group had high levels of immunoglobulin G antibodies to B. asaccharolyticus, suggesting heterogeneity with respect to immune response in these patients. These results indicate that antibodies to oral B. asaccharolyticus (B. gingivalis) occur at low levels in most normal children and adults and that the rise in titer of the specific antibodies of each major class of immunoglobulins parallels the ontogenic change in serum levels of that isotype. In contrast, there is a marked increase in titer of immunoglobulin G antibodies to oral B. asaccharolyticus in the group of patients with adult periodontitis and in patients with the generalized form of juvenile periodontitis.

PMID: 7216444 [PubMed - indexed for MEDLINE]

Bovine papular stomatitis incidence in veterinary students.

Can J Comp Med. 1980 Jul;44(3):239-43

Authors: Schnurrenberger PR, Swango LJ, Bowman GM, Luttgen PJ

Five cases of probable bovine papular stomatitis in faculty and students in a university veterinary clinic precipitated an intensive surveillance program. A senior class of veterinary medical students was questioned at the beginning of their clinical training to determine their history of exposure to cattle and presence of lesions resembling bovine papular stomatitis. Fifty-nine of the 115 students reported having had their hands in the mouths of cattle frequently. One of the 59 had experienced a hand lesion resembling bovine papular stomatitis. This class was maintained under close surveillance for bovine papular stomatitis-like lesions during the final 12 months of their clinical experience in veterinary school. One case developed in 8483 person days spent in the three high risk areas of beef cattle service, dairy cattle service and large animal anesthesiology. These two bovine papular stomatitis cases compare in frequency with five class members who had been vaccinated as a result of exposure to rabid animals and two class members with brucella antibodies in their sera. The findings suggest bovine papular stomatitis infections are not unusual in veterinary students but the mild clinical manifestations make the condition relatively unimportant.

PMID: 6253033 [PubMed - indexed for MEDLINE]

Recurrent oral ulceration treated with Mysteclin: a controlled study.

Br Med J. 1979 May 12;1(6173):1248-9

Authors: Denman AM, Schiff AA

Twenty patients with recurrent oral ulceration participated in a placebo-controlled, double-blind trail of Mysteclin syrup (tetracycline hydrochloride and amphotericin) used as a mouthwash. Though a small, consistent improvement occurred with placebo, there was a significant reduction in mean pair scores and numbers of new ulcers recorded daily during the active-treatment periods, the effect lasting for at least four weeks after treatment was stopped. In contrast to topical steroid preparations, Mysteclin syrup is efficacious when begun at any stage of the disorder and is not associated with adverse systemic effects.

PMID: 378317 [PubMed - indexed for MEDLINE]

Oral ulceration and Behçet's syndrome.

Gut. 1977 Jun;18(6):491-511

Authors: Lehner T

PMID: 326640 [PubMed - indexed for MEDLINE]

Influence of amino acids on the growth of Bacteroides melaninogenicus.

J Bacteriol. 1976 Aug;127(2):899-903

Authors: Miles DO, Dyer JK, Wong JC

Addition of individual amino acids to a Trypticase-yeast extract-hemin medium affected growth rates and final yields of an asaccharolytic strain and a saccharolytic strain of Bacteroides melaninogenicus. L-Aspartate or L-asparagine produced maximal growth enhancement for both strains. L-[14C]aspartate was fermented by resting cells of the asaccharolytic strain. L-Cysteine or L-serine also enhanced growth for the saccharolytic strain. However, growth of the saccharolytic strain was inhibited by L-lysine, L-glutamate, L-glutamine, L-isoleucine, L-leucine, and L-proline; growth of the asaccharolytic strain was inhibited by DL-valine and L-serine. Both strains were inhibited by L-histidine, DL-methionine, L-tryptophan, L-arginine, and glycine.

PMID: 8425 [PubMed - indexed for MEDLINE]

Association between HL-A2 antigen and various periodontal diseases in young adults.

J Dent Res. 1975 Mar-Apr;54(2):424

Authors: Kaslick RS, West TL, Chasens AI, Terasaki PI, Lazzara R, Weinberg S

PMID: 1054359 [PubMed - indexed for MEDLINE]

Typing Herpesvirus hominis antibodies and isolates by inhibition of the indirect hemagglutination reaction.

Appl Microbiol. 1974 Sep;28(3):400-5

Authors: Back AF, Schmidt NJ

Inhibition of the indirect hemagglutination reaction (IHA inhibition) was compared to several other methods for type-specific identification of Herpesvirus hominis (HVH) antibodies and isolates. The method appears to have the greatest value for typing antibodies for HVH type 1 and HVH type 2 in human sera; identification of antibody type was relatively simple and results were definitive. The IHA-inhibition test permitted serological diagnosis of HVH type 2 infection in three young adults with meningoencephalitis, thus extending the mounting evidence that nervous system involvement with this virus type is not limited to neonatal infections. II/I indexes of neutralizing or IHA antibody gave an accurate indication of the presence of HVH type 2 antibody in those sera containing type 2 antibody by IHA inhibition, but they indicated the presence of HVH type 2 antibody in one-half or more of the sera shown to contain only HVH type 1 antibody by IHA inhibition. For typing HVH isolates, the IHA-inhibition test gave results identical to those obtained by direct fluorescent-antibody staining using cross-absorbed conjugates, but the IHA-inhibition test was much more cumbersome and time-consuming to perform than was direct fluorescent-antibody staining. A microneutralization technique for virus typing also gave results identical to those obtained with direct fluorescent-antibody staining and IHA inhibition. However, typing HVH isolates by plaque size or the differential effect of incubation temperature was found to be less definitive and accurate.

PMID: 4371294 [PubMed - indexed for MEDLINE]

Letter: Oral ulceration and infective agents.

Br Med J. 1974 Mar 30;1(5908):643

Authors: MacFarlane TW, Ross CA, Cohen BJ

PMID: 4362451 [PubMed - indexed for MEDLINE]

Historical aspects of Vincent's disease.

Proc R Soc Med. 1973 Jul;66(7):695-8

Authors: Pickard HM

PMID: 4582311 [PubMed - indexed for MEDLINE]

Food antibodies in oral disease: a study of serum antibodies to food proteins in aphthous ulceration and other oral diseases.

J Clin Pathol. 1973 May;26(5):371-4

Authors: Thomas HC, Ferguson A, McLennan JG, Mason DK

We have investigated the incidence of antibodies to food antigens in patients with recurrent minor aphthous ulceration and in patients with other oral ulcerative diseases. The incidence of these antibodies was the same in both groups of patients and was significantly greater than the incidence in a control group of normal people. There was no evidence to support the hypothesis that aphthous ulceration is primarily due to hypersensitivity to food antigens. The factors which might contribute to the absorption of antigenic molecules from the mouth and to the increased immune response in patients with oral disease have been considered.

PMID: 4740333 [PubMed - indexed for MEDLINE]

Acute ulcerative gingivitis: immune complex.

J Dent Res. 1972 Nov-Dec;51(6):1639-41

Authors: Dolby AE

PMID: 4565556 [PubMed - indexed for MEDLINE]

Apparent digital vasomotor hypotonicity in the remission stage of acute necrotizing ulcerative gingivitis.

J Dent Res. 1969 May-Jun;48(3):431-8

Authors: Giddon DB, Clark RE, Varni JG

PMID: 5254485 [PubMed - indexed for MEDLINE]

The microbiology of acute ulcerative gingivitis with reference to the culture of oral trichomonads and spirochaetes.

Proc R Soc Med. 1968 Feb;61(2):131-6

Authors: Blake GC

PMID: 4866550 [PubMed - indexed for MEDLINE]

TREATMENT OF VINCENT'S STOMATITIS WITH METRONIDAZOLE.

Br Med J. 1964 May 2;1(5391):1149-50

Authors: DAVIES AH, MCFADZEAN JA, SQUIRES S

PMID: 14120807 [PubMed - indexed for MEDLINE]

Treatment of aphthous ulceration of the mouth.

Br Med J. 1958 Mar 15;1(5071):603-7

Authors: TRUELOVE SC, MORRIS-OWEN RM

PMID: 13510742 [PubMed - indexed for MEDLINE]

APHTHOUS ulceration of mouth.

Br Med J. 1957 Nov 9;2(5053):1099-100

Authors:

PMID: 13472062 [PubMed - indexed for MEDLINE]