We report on the microbiological and clinical effects of mechanical debridement in combination with metronidazole plus amoxicillin therapy in 118 patients with Actinobacillus actinomycetemcomitans‐associated periodontitis. Patients were categorized into 3 groups: 28 had localized periodontitis; 50 had generalized periodontitis, and 40 had refractory periodontitis. After initial treatment and metronidazole plus amoxicillin therapy 114 of 118 (96.6%) patients had no detectable A. actinomycetemcomitans. Significant reduction in pocket probing depth and gain of clinical attachment were achieved in almost all patients. Four patients were still positive for A. actinomycetemcomitans after therapy. Metronidazole resistance (MIC > 25 μg/ml) was observed in 2 of 4 strains from these patients. Patients still positive for A. actinomycetemcomitans or Porphyromonas gingivalis showed a significant higher bleeding tendency after therapy. It was concluded that mechanical periodontal treatment in combination with the metronidazole plus amoxicillin therapy is effective for subgingival suppression of A. actinomycetemcomitans in patients with severe periodontitis. J Periodontol 1992;63:52–57.
Summary. Porphyromonas gingivalis is associated strongly with severe periodontitis, but little information is available on possible transmission routes of this species. This study evaluated three DNA-based molecular typing methods for use in epidemiological surveys of P. gingivalis. In total, 32 isolates from eight married couples were investigated by : (i) restriction endonuclease analysis (REA) of whole chromosomal DNA; (ii) hybridisation of DNA fragments with ribosomal DNA (ribotyping); and (iii) amplification of DNA by the polymerase chain reaction with arbitrary primers (AP-PCR). The data obtained with the three methods were in broad agreement : in six of the eight couples, the isolates from husband and wife were indistinguishable, but isolates from unrelated individuals showed distinct types with all three methods. For some isolates, minor differences in REA pattern were obtained which could not be correlated with differences in ribotype or AP-PCR type. Ribotyping showed differences between isolates from one individual, which were indistinguishable with the other two methods. The patterns obtained with ribotyping or AP-PCR were simple in comparison to the relatively complex REA patterns. Although all three methods were concordant, AP-PCR was found to be the least time-consuming method. The data support the suggestion that P. gingivalis can be transmitted between spouses.
The purpose of this study was to evaluate the survival in 3 transport media of 3 suspected periodontal pathogens, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia. Subgingival samples were taken from 10 patients with severe periodontitis, all harboring at least two of the above-mentioned species. The material was dispersed and aliquots were added to vials containing reduced transport fluid, reduced transport fluid containing 10% Fildes extract, or viability-maintaining microbiostatic medium, anaerobically prepared (VMGA III). Viable counts were determined after 1, 2, 4, 24 and 48 h of storage at 4 degrees C or at room temperature. The results showed that, for up to 4 h of storage, no significant differences existed for all parameters tested. A large increase of the total viable counts was found in VMGA III at room temperature after 24 and 48 h. This was due to an outgrowth of mainly streptococci. Incubation at 4 degrees C yielded often a significantly higher recovery compared to room temperature. After storage at room temperature, the tested bacteria were below detection level in some samples.
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