Prevalence of Periodontal Breakdown in Adolescents and Presence of Actinobacillus actinomycetemcomitans in Subjects With Attachment Loss

Abstract

The present investigation was carried out to study the prevalence and clinical appearance of destructive periodontal disease in a school population of 15to 16-year old adolescents in Amsterdam. In addition the prevalence of Actinobacillus actinomycetemcomitans was studied in those subjects showing attachment loss. Attachment loss was diagnosed in 230 of the 4565 subjects participating which is about 5% of the population studied. Within this population males were more frequently affected than females (P = 0.008). Extensive periodontal destruction was found in 16 subjects (0.3%). In this group a female/ male ratio was found of 1.3:1. As a result of the epidemiological survey, 105 subjects with attachment loss volunteered for further investigation. The results showed that presence of plaque, redness and swelling of the gingiva, and bleeding on probing were general phenomena. In addition, the bleeding/plaque ratio, as determined for each subject at sites without attachment loss, increased with the severity of periodontal disease as expressed by the number of sites with attachment loss (P = 0.0038) as well as by the amount of destruction at these sites (P = 0.002). A. actinomycetemcomitans could be identified in 18 of the 105 subjects with attachment loss. Analysis showed that A. actinomycetemcomitans was more frequently isolated in subjects with moderate to severe periodontal breakdown than in subjects with mild breakdown (P < 0.02). When estimating the percentage of juvenile Periodontitis patients on the basis of the classically accepted criteria, it seems likely that between 0.1% to 0.2% of the population in Amsterdam is suffering from this disease entity. (J Periodontol 1989;60:604-610.)

Pathogenicity of the highly leukotoxic JP2 clone ofAggregatibacter actinomycetemcomitansand its geographic dissemination and role in aggressive periodontitis

“…This association had not been clear in the first Moroccan cohort study where no power calculation was carried out before the initiation of the study (32). Non-JP2 genotypes of A. actinomycetemcomitans also being associated with the development of periodontal attachment loss are in concordance with results from other longitudinal studies performed in Indonesia (JAVA-project) and in the United States (74, 83, 84). The discrepancy in the conclusions concerning the role of the non-JP2 genotypes of A. actinomycetemcomitans between the first and the second Moroccan cohort study can be explained by a number of factors, for example, the disease status at baseline and the sample size of the study populations.…”

Periodontal Disease as a Specific, albeit Chronic, Infection: Diagnosis and Treatment

“…(i) Localized juvenile periodontitis. LJP occurs among teenagers, with a prevalence of about 1 to 5 in 1,000 (36,217,310). In its classic form, the pathology is confined to the teeth that erupt in the mouth at about 6 years of age, i.e., first molars and incisors, although deep pockets are usually not discovered until after puberty (344).…”

“…There are two studies in which epidemiological principles were used to relate the bacteriological findings to a wider population of young individuals. Van der Velden et al (310) examined the periodontal condition of all school children in Amsterdam during their last year of compulsory education, i.e., 4,565 subjects with an average age of 15.8 years. A total of 230 subjects (5%) had attachment loss, and 105 of them volunteered to participate in a follow-up bacteriological study.…”

Pathogenesis of Periodontal Diseases

“…However, the results of susceptibility studies of localized early onset periodontitis may not be transferable to chronic periodontitis since localized early onset periodontitis develops as the individual passes through puberty, a defi ned and limited time period, as opposed to chronic periodontitis, which can begin and progress across the entire adult life span. Nonetheless, studies from the Netherlands [ 12 ] and Indonesia [ 13 ] also suggest that chronic adult periodontitis has a genetic basis for disease susceptibility since a statistically signifi cant clustering of periodontitis cases were found within the families studied. But it is diffi cult using a familial study design to distinguish between the relative contributions of genetic versus environmental factors to disease susceptibility.…”