Periodontitis is characterized by subgingival biofilm dysbiosis, inflammation and tissue destruction. Current treatment involves mechanical biofilm disruption known as non-surgical periodontal therapy (NSPT). This study sought to characterise the impact of treatment on microbial diversity and overall community, and the parallel impact on host inflammation in the oral cavity. Fourty-two periodontitis patients were included in this study, with periodontal clinical parameters, subgingival plaque and saliva samples collected at baseline and 90 days after treatment. Salivary cytokines were quantified, and subgingival plaque was analysed using 16S rRNA sequencing. After treatment, there were marked health-associated alterations in microbial composition and diversity, including differential abundance of 42 genera and 61 species. These changes were accompanied by substantial clinical improvement (pockets ≥ 5 mm, 27.50% to 9.00%, p < 0.001) and a decrease in salivary IL-1β (p < 0.001)—a putative marker of periodontal inflammation. Despite significant reductions in disease associated anaerobes, several genera (Fusobacterium, Prevotella, Tanenerella, Treponema) remained present and formed a distinct subnetwork associated with residual disease. Collectively, this study shows that current periodontal treatment results in partial restoration of a healthy microbial ecosystem, but features of biofilm dysbiosis and host inflammation remain in some patients, which were surprisingly independent of clinical response.

Objective: This study sought to investigate whether the immediate systemic inflammatory response following full-mouth debridement differs following use of hand compared with ultrasonic instruments.Methods: Thirty-nine periodontitis patients were randomized to treatment with full-mouth debridement using either hand or ultrasonic instrumentation completed within 24 hr. Serum and periodontal clinical parameters were collected at baseline, day 1, day 7 and day 90 post-treatment. Differences in systemic inflammatory markers were assessed using general linear models at each timepoint, corrected for age, gender, smoking status, body mass index and baseline levels of each marker.Results: Across all patients, serum C-reactive protein increased at day 1, with no differences between hand and ultrasonic groups (p(adjusted) = .22). There was no difference between groups in interleukin-6 (p(adjusted) = .29) or tumour necrosis factor α (p(adjusted) = .53) at day 1. Inflammatory markers returned to baseline levels by day 7. Treatment resulted in equal and marked improvements in clinical parameters in both groups; however, total treatment time was on average shorter for ultrasonic instruments (p(adjusted) = .002).Conclusions: Ultrasonic instrumentation resulted in shorter treatment time with comparable clinical outcomes. Levels of serum C-reactive protein at day 1 were similar following debridement with hand or ultrasonic instruments.

IT is surprising that so little attention has been paid to the incidence and prevention of urinary infection following colporrhaphy. In the multiplicity of operations described for the cure of urinary symptoms in the female those writers who mention the problem comment briefly that the patient should be dismissed with a sterile urine.Our interest in this subject was stimulated by an increasing awareness of the part played by urinary infection in the residual symptomatology after colporrhaphy. When we investigated what was, at that time, our standard post-operative practice we were appalled by the incidence of urinary infection revealed. Alteration of our post-operative technique produced some diminution in the incidence of urinary infection but significant improvement did not occur until the introduction of our present combined aseptic and antiseptic technique. We present the results of 176 cases, divided into three series according to the clinical methods employed. MATERIAL AND METHODSGram-stained film and by culturing on bloodagar and MacConkey plates for eighteen hours. Strains of Staphylococcus aureus, Streptococcus faecalis and Proteus spp. were identified in the usual way. Most strains of Staph. aureus were phage-typed. Gram-negative bacilli which fermented lactose were grouped as coliform bacilli. Evans' "Sentest" tablets were employed to assess the antibiotic sensitivities. A specimen of urine was considered to be infected when pus cells and organisms were present on the direct film and a positive culture was obtained. A light growth of organisms in the absence of pus cells was disregarded.When an in-dwelling catheter was employed, this was inserted in the theatre at the end of the operation. Intermittent catheterization was at first done as follows. A boiled glass catheter was introduced after the urethral meatus had been swabbed with 1 / 1,000 solution of chlorhexidine.The hands were scrubbed but not dried. The instillation of chlorhexidine was carried out through a small glass funnel attached to the end of the catheter by means of a short piece of rubber tubing. The funnel and tubing were Catheter specimens of urine were collected at separately boiled. We have discarded the-use of carefully specified times which will be separately a soft rubber catheter as it cannot be introduced detailed for each of the three series and these without considerable handling by the attendant specimens were examined within two hours of who in a busy ward cannot find the time to collection. The centrifuged deposit of each decontaminate his hands effectively between specimen was examined by microscopy of a each patient. 394

Periodontitis (PD) shows an association with rheumatoid arthritis (RA) and systemic inflammation. Periodontal pathogens, namely Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, are proposed to be capable of inducing citrullination of peptides in the gingiva, inducing the formation of anti-citrullinated protein antibodies (ACPAs) within susceptible hosts. Here, we sought to investigate whether periodontal treatment influenced systemic inflammation and antibody titres to P. gingivalis, A. actinomycetemcomitans, Prevotella intermedia and ACPA in 42 systemically health patients with periodontal disease. Subgingival plaque and serum samples were collected from study participants before (baseline) and 90 days after treatment to analyse the abundance of specific bacteria and evaluate anti-bacterial antibodies, C-reactive protein (CRP), tumour necrosis factor α (TNF-α), interleukin 6 (IL-6) and ACPA in serum. Following treatment, all patients showed reduced periodontal inflammation. Despite observing a weak positive correlation between CRP and IL-6 with periodontal inflammation at baseline, we observed no significant reductions in any indicators of systemic inflammation 90 days after treatment. In contrast, anti-P. gingivalis IgG significantly reduced post-treatment (p < 0.001, Wilcoxon signed rank test), although no changes were observed for other antibody titres. Patients who had detectable P. gingivalis in subgingival plaques had significantly higher anti-P. gingivalis IgG and ACPA titres, suggesting a potential association between P. gingivalis colonisation and systemic antibody titres.

A 7 year collection of calculi from short- and long-term studies with Sprague-Dawley rats showed that although the incidence of rats with urolithiasis was small (0·5%), the variety of sizes and composition of the calculi could be of general interest.