Preliminary results from the present study suggest an association between poor oral status and CHD, and provide evidence that the improvement of periodontal status may influence the systemic inflammatory and haemostatic situation.
The present study suggests an association between poor oral status and CHD, and provides evidence that inflammatory and haemostatic factors could play an important role in this association.
Treponema denticola and Porphyromonas gingivalis have been identified in atheromatous plaques of two patients suffering from atherosclerosis by PCR and fluorescence in situ hybridization (FISH). The use of the FISH technique suggested that these periodontopathic micro-organisms might be metabolically active within the wall of arteries, under the atherosclerotic lesion.
Case reportsCase 1. The patient was a 73-year-old caucasian Italian male with a 12 year history of atherosclerosis and systemic hypertension. The patient also had a previous history of smoking and dislipidemia. He underwent percutaneous transluminal coronary angioplasty (PTCA) of the left coronary artery in 1991, and 2 years later he underwent coronary artery by-pass grafting (CABG). In 2003 an ecotomodoppler study of his carotid arteries showed a bilateral stenosis (70 % in the right vessel and 50 % in the left vessel). Consequently a computerized tomography (CT) scan was performed, which revealed the presence of partially calcified atheromatous plaques located at the carotid bulbs. The patient was then scheduled to undergo an endarterectomy to remove the plaque in the right bulb followed by the application of a dacron patch. Clinical and radiological examinations of the patient immediately before surgery showed a very poor periodontal situation, as indicated by a high value (103) of CPSS (clinical periodontal sum score: the sum of the number of sites with probing pocket depths of 4 mm or greater, the number of gingival sites with bleeding after probing or visible suppuration on probing, and the number of furcation lesions exceeding grade 1), which was the system used to evaluate the periodontal situation (Mattila et al., 2000).The crevicular fluid was sampled by using a paper cone inserted into the periodontal pockets and stored at À80 8C until it was processed for DNA extraction. During surgery, a section of the arterial wall including the atheromatous plaque was removed and longitudinally cut into two sections that were used for PCR and FISH testing.The PCR protocol has previously been reported (Donati et al., 1997) and was performed as described by Mättö et al. (1998) and by Siqueira et al. (2000) for the detection of Porphyromonas gingivalis and Treponema denticola, respectively. DNA extracted from in vitro grown P. gingivalis (ATCC 33277) and T. denticola (ATCC 35405) was used as a positive control; DNA extracted from Treponema pallidum (Nichols strain) (Sambri et al., 2001) was used as a negative control in each PCR reaction set. DNA was extracted from the vessel biopsy as follows: the tissue was treated with a mechanical homogenizer and then 700 mg was incubated with buffer K [10 mM Tris (pH 8 . 3), 50 mM KCl, 1 . 75 mM MgCl 2 , 0 . 01 % (w/v) bovine serum albumin, 0 . 45 % (v/v) Tween 20, 0 . 45 % (v/v) Nonidet P-40 and 100 ìg ml
À1Proteinase K) at 56 8C for 7 h. After incubation the sample was extracted with phenol/chloroform, precipitated with 0 . 3 M sodium acetate and 2-propanol, and resuspended in 200 ìl of TE buffer.The PCR analy...
The results suggest that GO necessarily develops in responders within 6 months from heart transplantation and in most subjects may be a time-related side-effect probably due to a progressive reduction in the sensitivity of the periodontum to CsA.
The present pilot study seems to indicate that bone and periodontal response and microbiological status around submerged dental implants in immunocompromised organ-transplanted patients do not differ 1 year after loading from those observed in control patients and that this particular population of patients may be successfully rehabilitated with dental implants.
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