Clinical and microbiological findings in elderly subjects with gingivitis or periodontitis

Abstract

The objective of the present study was to study the supra- and subgingival microflora by culture and cDNA probe methods in 20 elderly subjects who were between 62 and 93 years of age. 10 of them had gingivitis only, and 10 had periodontitis. B. forsythus (BF), P. gingivalis (PG), P. intermedia (PI), P. nigrescens (PN), A. actinomycetemcomitans (AA), T. denticola (TD), and pathogen-related oral spirochetes (PROS) were studied. Oral hygiene was similar and poor in both groups. The mean probing depth at sample sites was 6.7 mm (S.D+/-1.3) in the periodontitis group and 2.2 mm (S.D.+/-1.5) in the gingivitis group (F=17.75, p<0.001). Mean clinical attachment levels (CAL) were 4.3 mm (S.D.+/-2.0) and 1.7 mm (S.D.+/-0.9) respectively (p<0.001). Total viable counts >1.0x10(5) in supra-gingival plaque samples were found in all periodontitis and in eight gingivitis subjects. 70x more black-pigmented organisms were found in supra-gingival and 185 times more in sub-gingival plaque from the periodontitis group (p<0.01). Culture data showed P. nigresecens in 10% periodontitis and 50% gingivitis subjects (p<0.03). In supra-gingival samples by the Affirm DP test, BF was present in 50% periodontitis and 60% gingivitis while culture data were negative for all subjects. PG was found in 30% periodontitis and 50% gingivitis subjects with TD in 70% periodontitis and in 30% gingivitis subjects. In the sub-gingival plaque samples 80% periodontitis and 70% gingivitis subjects had >1x10(5) anaerobes. The total count of black-pigmented organisms was significantly greater in the periodontitis elders (p<0.001). cDNA probes by the Affirm DP test identified subgingival presence of BF (80%) PG (80%), PI (80%), AA (0%), TD (50%) in periodontitis subjects with BF (70%), PG (40%), PI (30%) and TD (20%) in gingivitis subjects. PROS were found in (80%) samples from periodontitis and in (60%) of gingivitis elderly. Only the quantities of PI (r=0.48, p<0.01) and TD (r=0.37, p<0.01) were associated with the disease definition. The smoking habit in the periodontitis group was significantly higher (p<0.01). A history of smoking may contribute significantly to periodontitis in the presence of pathogens.

Apoptotic Genes are Differentially Expressed in Aged Gingival Tissue

“…Consistent with age being a modifier for the prevalence or severity of periodontal disease, important biological differences in the composition and complexity of the oral microbial ecology, as well as the oral/systemic immune-inflammatory responses during aging, have been described in humans and animal models (Schlegel-Bregenzer et al, 1998;Nonnenmacher et al, 2001;Ebersole et al, 2008). Paradoxically, the reduced immunity in aging is accompanied by chronic inflammation (Back et al, 2007), which may reflect a perturbation of the innate immune mechanisms associated with age (Agrawal et al, 2007).…”

Motility and Chemotaxis in Tissue Penetration of Oral Epithelial Cell Layers byTreponema denticola

“…denticola is frequently isolated from inflamed sites of the periodontal pocket and is thought to be implicated in periodontal disease (27,43,49,53,61). Periodontal disease appears to be a very complex mixed infection involving virulence factors such as adhesion to the tissue, immune suppression, and tissue invasion and destruction (1).…”

Effects of Age and Oral Disease on Systemic Inflammatory and Immune Parameters in Nonhuman Primates

“…This oral disease is an outcome of complex oral infections, chronic immunoinflammatory responses, and resulting destruction of soft and hard tissues of the periodontium (37,78,80,82,84). In both humans and nonhuman primates, the extent of disease is predicted to be controlled by the quality and quantity of the host response and likely is modulated by systemic disease (48), environmental stressors (6, 76, 85), and the genetic backgrounds of the individuals (3, 70, 84).The oral microbial characteristics of subgingival biofilms in younger and older individuals demonstrate differences in composition and complexity, which have been suggested to contribute directly to the microbial infections that trigger the destructive disease of oral tissues that occurs during aging (4,35,49,53,67,83). It is clear that levels of gram-negative periodontal pathogens increase with age, although studies of young humans and nonhuman primates demonstrate that many microorganisms associated with periodontal pathogenesis are acquired early in life and become integrated into the commensal autochthonous oral microbial ecology (9,29,30,56).…”

“…The oral microbial characteristics of subgingival biofilms in younger and older individuals demonstrate differences in composition and complexity, which have been suggested to contribute directly to the microbial infections that trigger the destructive disease of oral tissues that occurs during aging (4,35,49,53,67,83). It is clear that levels of gram-negative periodontal pathogens increase with age, although studies of young humans and nonhuman primates demonstrate that many microorganisms associated with periodontal pathogenesis are acquired early in life and become integrated into the commensal autochthonous oral microbial ecology (9,29,30,56).…”