Adriana Jaramillo

Periodontal disease in children and adolescents of Latin America

Periodontal diseases are a group of infectious diseases that mainly include gingivitis and periodontitis. Gingivitis is the most prevalent form of periodontal disease in subjects of all ages, including children and adolescents. Less frequent types of periodontal disease include aggressive periodontitis, acute necrotizing ulcerative gingivitis and various diseases of herpesviral and fungal origin. This review aimed to retrieve relevant information from Latin America on the prevalence of periodontal diseases among children and adolescents of the region. Gingivitis was detected in 35% of young Latin American subjects and showed the highest frequencies in Colombia (77%) and Bolivia (73%) and the lowest frequency in Mexico (23%). The frequency of gingivitis in subjects from other Latin American countries was between 31% and 56%. Periodontitis may affect <10% of the young population in Latin America, but the data are based on only a few studies. A more precise assessment of the distribution and severity of periodontal disease in children and adolescents of Latin America may help policy makers and dentists to institute more effective public health measures to prevent and treat the disease at an early age to avoid major damage to the permanent dentition.

Biomarkers of cardiovascular disease are increased in untreated chronic periodontitis: A case control study

BACKGROUND The aim of this study was to evaluate the endothelial function, systemic inflammatory biomarkers and subgingival microbial profile associations in patients with and without periodontal disease. METHODS Forty-four patients, half with chronic moderate to severe periodontitis (cases) and half gingivitis and incipient periodontitis (controls) were recruited. Anthropometric, clinical, biochemical parameters, endothelial function, subgingival microbiota, and eight plasma biomarkers of cardiovascular disease were assessed in both groups. RESULTS Both groups were comparable in anthropometric parameters, blood pressure, and number of positive metabolic syndrome components. Univariate analyses demonstrated significantly higher plasma levels of E-selectin (64.5 ± 30.9 vs 43.8 ± 22.2; P = 0.026) and myeloperoxidase (MPO) (103 ± 114.5 vs 49.1 ± 35.6; P = 0.032) in cases than controls. In addition, significantly higher levels of E-selectin, MPO and ICAM-1 were found in periodontitis patients after adjustment by age and waist circumference. Red complex microorganisms were more frequently detected by culture and polymerase chain reaction in patients with severe to moderate periodontitis. CONCLUSIONS Subgingival red complex bacteria and important cardiovascular risk markers were increased in untreated chronic moderate to severe periodontitis cases. Periodontitis seems to be associated with systemic inflammation that could increase the risk of cardiovascular events. The causal relation between periodontal infections and cardiovascular disease requires further research.

Toothbrush contamination in family members

Objective: The purpose of this study was to determine the bacterial contamination of toothbrushes in family members. Materials and Methods: One hundred and two healthy subjects were included in this descriptive study. Every individual was examined clinically and microbiologically using the CPITN index and collecting subgingival plaque samples. Each participant received a toothbrush for home use and after one month they returned it to the investigators. All toothbrushes were cultured to determine the presence of periodontopathic bacteria and enteric rods. Wilkoxon signed rank test and t student test (P ≤0.05) were used to compare differences in the subgingival microbiota and toothbrush contamination and CPITN index among family members. Results: A high proportion of toothbrushes resulted highly contaminated with enteric rods (P ≤0.001) compared to the subgingival environment where periodontopathic bacteria were more prevalent. The most frequent microorganisms found in toothbrushes used by parents and children for one month were Enterobacteriaceae, Pseudomonadaceae species (>50%) and Fusobacterium spp (30%). Conclusions: High levels of enteric rods were commonly detected in toothbrushes used for 1 month among members of the families. These opportunistic organisms may have an important role in oral infections including gingivitis and periodontitis. Monthly replacement or disinfection of the toothbrush can reduce the risk of bacterial transmission/translocation and thus diminish the incidence of biofilm associated oral diseases. Rev. Clin. Periodoncia Implantol. Rehabil. Oral Vol. 3(1); 24-26, 2010.

Effect of periodontal therapy on the subgingival microbiota in preeclamptic patients

INTRODUCTION Few studies have described subgingival microbiota in pregnant women with mild preeclampsia. OBJECTIVE Clinical periodontal and subgingival microbiota changes were identified in pregnant women with mild preeclampsia after periodontal treatment. MATERIALS AND METHODS In a secondary analysis of a randomized clinical trial, 57 preeclamptic women were studied at Hospital Universitario del Valle in Cali, Colombia. Thirty one women were randomized to the periodontal intervention group (subgingival scaling and planing ultrasonic and manual) during pregnancy and 26 to the control group (supragingival prophylaxis). Periodontal clinical parameters and subgingival microbiota were characterized at the time of acceptance into the study and again at postpartum. Eight periodontopathic bacteria and 2 herpesviruses were assessed by polymerase chain reaction. Chi-square, McNemar or Students t tests were used, with a significance level of p≤0.05. RESULTS Both groups were comparable in the clinical and microbiological variables at baseline. Periodontal treatment reduced the average pocket depth in the intervention group from 2.4±0.3 to 2.3±0.2 mm (p<0.001) and in control group 2.6±0.4 to 2.44±0.4 mm, (p<0.001) and bleeding index 16.4±1.5% to 7.9±0.7% in the intervention group(p<0.001) and 17.1±1.8% to 10±0.9% in the control group (p=0.002). The frequency of detection of microorganisms did not differ significantly between groups. CONCLUSION Scaling/root planning and supragingival prophylaxis significantly reduced the probing depth and gingival bleeding index. Periodontal treatment was not more effective than prophylaxis in reducing periodontopathic organisms or herpesvirus.INTRODUCTION Listeria monocytogenes is an intracellular, opportunistic pathogen which can cause severe infections such as meningitis, encephalitis and bacteremia. It can also cause abortions in human beings. Foods are the vehicle for infection of the host. Serotypification has discriminated 13 serotypes: 1/2a,1/2b, 1/2c, 3a, 3b, 3c, 4a, 4ab, 4b, 4c, 4d, 4e, 7. 4b is the cause of the majority of cases of listeriosis in the world. OBJECTIVE The frequency of serotypes of L. monocytogenes was determined in bacteria isolated from foods in Colombia. MATERIALS AND METHODS The study is descriptive and retrospective. Over a 10-year period, 2000-2009, 1,599 isolates were examined. All were confirmed as Listeria monocytogenes and other strains of Listeria, using biochemical tests recommended by the Food and Drug Administration (USA) and API Listeria and serotyped using the Seeliger and Höhne method. RESULTS Of the 1,599 isolates, 1,424 were confirmed as L. monocytogenes. Serotypes identified were: 1/2a, 135 (9.5%); 1/2b, 154 (10.8%); 1/2c, 68 (4.8%); 3a, 4 (0.3%); 3b, 29 (2.0%); 3c, 2 (0.1%); 4a, 44 (3.1%); 4b, 820 (57.6%); 4c, 6 (0.4%); 4d- 4e, 140 (9.8%); 4e, 17 (1.2%); 7, 2 (0.1%); not susceptible of serotypification, three cases, (0.2%). Isolates came mainly from the Capital District of Bogotá, 1,035 (73%); from Antioquia 199 (14%), from Nariño, 109 (8%); from Valle del Cauca 50 (3,5%) and from other provinces 33 (2.3%). CONCLUSION Of the analyzed isolates, 1,424 (89%) belonged to L. monocytogenes, showing a good quality in isolation and identification. Most of these isolates belonged to serotype 4b, 820 (57.6%), a highly virulent serotype. Obligatory surveillance of this microorganism is recommended.

[Enteric Gram negative rods and unfermented of glucose bacteria in patients with peri-implant disease].

INTRODUCTION Implants can be colonized by microorganisms from oral biofilms and may affect peri-implant tissues health. Among these bacteria, pathogens typically associated with periodontitis can be found, such as Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis, as well as Gram negative enteric bacilli not typically associated with periodontal diseases. OBJECTIVE Superinfecting bacteria were characterized from peri-implant lesions in patients with history of periodontitis. MATERIALS AND METHODS Sixty-eight implants were studied in 55 patients; the average patient age was 56 years. Forty-nine implants had peri-implant lesions and 19 were considered stable. Subgingival samples were obtained in affected and stable implants. The samples were streaked on Mac-Conkey agar and incubated at 37°C for 24 hours. The colonies were identified with the kit-BD BBL Crystal E/NF®. RESULTS Superinfecting organisms were detected in 20 patients--they were seen more frequently at diseased implants (n=15) than at healthy implants (n=5). The prevalence of superinfecting bacteria on the selected implants was 33.8% (n=23/68). These bacteria were more prevalent among affected implants (n=17 or 25%) than those with stable implants n=6 (8.8%). Klebsiella pneumoniae was the most frequent Gram negative rod detected (n=12). CONCLUSIONS One-third of the implants had superinfecting organisms. Implants with a peri-implant lesion had a higher frequency of superinfecting bacteria. Klebsiella pneumoniae was the most common superinfecting organism isolated. A multiple infection caused by superinfecting bacteria was present only at diseased implants. These microbial agents potentially affect implant stability.