• Probiotics/therapeutic use
• Probiotics/administration & dosage
• Humans
• Periodontitis/therapy
• Periodontitis/microbiology
• Treatment Outcome

Generalized periodontitis is a severe periodontal disease characterized by rapid periodontal destruction in healthy persons. This case report describes the treatment of a severe crowding, large overjet, and occlusal collapse due to the loss of anterior guidance with generalized periodontitis.

A 35-year-old female patient with a chief complaint of crowding and maxillary protrusion was diagnosed with generalized periodontitis by clinical and radiographic examinations. To improve crowding and overjet, orthodontic treatment was performed after basic periodontal therapy. Severely damaged upper right lateral incisor and left canine were extracted, and lower right first premolar and left second premolar were also removed to treat severe crowding. After orthodontic treatment, periodontal flap surgery for upper left molars and guided tissue regeneration for the lower left second molar was performed. Then, a dental implant was inserted in the upper left canine legion. The esthetics of the maxillary anterior tooth was improved by prosthetic restorations. The treatment result showed a well-improved occlusion with proper anterior guidance and healthy periodontal tissue after a retention period of 10 years.

Periodontal, orthodontic, and prosthodontic treatments are extremely useful to improve function and stable periodontal tissue for generalized periodontitis.

• Generalized periodontitis
• Orthodontic treatment
• Periodontal regenerative therapy
• Prosthodontic treatment
• Comprehensive dental treatment
• Long-term case study
• Case report

• Aggressive periodontitis
• Periodontal diseases
• Root planning
• Therapeutic irrigation

The possibility of targeting the hypervariable region V3 of the 16S rRNA gene using Ion Torrent Personal Genome Machine (PGM) could provide a complete analysis of subgingival plaque samples, potentially able to identify microbiological species missed by culture-based methods. A 16-year-old female smoker patient, affected by localized aggressive periodontitis, underwent a full-mouth disinfection protocol and was inserted in a 3-month recall program. Microbiological samples were collected at baseline and at 30, 100, 365 days follow-up and analyzed by Ion Torrent PGM. Capnocytophaga, Fusobacterium, Prevotella, and Treponema were the most represented pathogens at baseline. Nonsurgical treatment and systemic antibiotics drastically lowered the anaerobic species, and their presence remained limited after 100 days, while a consistent recolonization by anaerobic bacteria was detected at 365 days. The patient showed a general improvement of periodontal conditions. Differently from polymerase chain reaction and other microarray techniques, Ion Torrent performs a quantitative analysis of the microbiota, irrespective of the searched species. An accurate definition of the shifts of the bacterial community might help periodontal researchers for a better understanding of the impact of different treatment approaches or in intercepting nonresponsive conditions.

• Anaerobic bacteria
• Ion Torrent Personal Genome Machine
• full-mouth disinfection
• localized aggressive periodontitis
• nonsurgical treatment

• Adolescent
• Bacteria/isolation & purification
• Cross-Sectional Studies
• Female
• Gingiva/microbiology
• Humans
• Male
• Periodontal Diseases/epidemiology
• Periodontal Diseases/microbiology
• Periodontium/microbiology
• Saudi Arabia/epidemiology
• Treponema denticola/isolation & purification

• Aggressive periodontitis
• dental implants
• implant-supported prosthesis
• periodontal management

• Aggressive periodontitis
• chronic periodontitis
• diagnosis
• staging
• variations

• All-on-4
• generalized aggressive periodontitis
• immediate implant
• immediate rehabilitation

Periodontal disease (PD) is generated by microorganisms. These microbes can enter the general circulation causing a bacteraemia. The result can be adverse systemic effects, which could promote conditions such as cardiovascular disease. Level A evidence supports that PD is independently associated with arterial disease. PD is a common chronic condition affecting the majority of Americans 30 years of age and older. Atherosclerosis remains the largest cause of death and disability. Studies indicate that the adverse cardiovascular effects from PD are due to a few putative or high-risk bacteria: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola or Fusobacterium nucleatum. There are three accepted essential elements in the pathogenesis of atherosclerosis: lipoprotein serum concentration, endothelial permeability and binding of lipoproteins in the arterial intima. There is scientific evidence that PD caused by the high-risk pathogens can influence the pathogenesis triad in an adverse manner. With this appreciation, it is reasonable to state PD, due to high-risk pathogens, is a contributory cause of atherosclerosis. Distinguishing this type of PD as causal provides a significant opportunity to reduce arterial disease.

• endothelium
• intimal binding
• lipoprotein
• pathogenesis
• periodontal disease

• Aggressive Periodontitis/drug therapy
• Humans
• Photochemotherapy

• ELISA
• Aggressive periodontitis
• malondialdehyde
• melatonin
• superoxide dismutase

• Aggregatibacter actinomycetemcomitans
• Black pigment producing microorganisms
• Photosensitizer
• Reactive oxygen species
• Tissue invasion

• Aggressive periodontitis
• herpes viruses
• periodontal microorganisms

• Actinomyces
• Chronic periodontitis
• MALDI-TOF
• Plaque

• Aggregatibacter actinomycetemcomitans
• Generalized severe chronic periodontitis/aggressive periodontitis
• Oral microbiology/diagnosis
• Polymerase chain reaction
• Porphyromonas gingivalis
• Sampling strategies
• Subgingival plaque
• Tannerella forsythia
• Treponema denticola

• causality
• cohort studies
• epidemiology
• germ theory of disease
• infection
• periodontitis

• Cohort Studies
• Germ Theory of Disease
• Humans
• Periodontitis/epidemiology
• Periodontitis/microbiology

Aggressive periodontitis, especially in its severe form, was traditionally considered to have an unfavourable prognosis. It required a complex treatment and its stabilization was often achieved by surgical therapy. The aim of this study was to investigate the results of nonsurgical periodontal treatment in severe generalized forms of aggressive periodontitis.

Patients with advanced generalized aggressive periodontitis were included in the study. Probing depth (PD) of pockets ≥7 mm and clinical attachment level (CAL) of sites with attachment loss ≥5 mm were measured at baseline before nonsurgical periodontal treatment, at re-evaluation, and after treatment. The following other parameters were recorded: resolution of inflammation and bone fill. We compared the baseline values with re-evaluation and posttreatment values using the Friedman test. The Wilcoxon test with the Bonferroni correction was used for both re-evaluation and posttreatment values.

Seven patients with 266 periodontal sites were examined. A significant difference was found between values, reported as medians with interquartile ranges, for PD at baseline (7.94 [7.33-8.19] mm) and both re-evaluation (4.33 [3.63-5.08] mm) and posttreatment (3.54 [3.33-4.11] mm) values (P=0.002). A significant difference was also found between values for CAL at baseline (9.02 [7.5-9.2] mm) and both re-evaluation (6.55 [6.30-6.87] mm) and posttreatment (6.45 [5.70-6.61] mm) (P=0.002). Inflammation was resolved and angular bone defects were repaired in all cases.

These therapeutic results suggest that this form of periodontitis could have positive outcomes after nonsurgical periodontal treatment. The reparative potential of tissue affected by severe aggressive periodontitis should encourage clinicians to save apparently hopeless teeth in cases of this form of periodontitis.

• Aggressive periodontitis
• Periodontal debridement
• Treatment outcome

• biofilm
• complement
• humans
• inflammation
• periodontitis

Rehabilitation of severely atrophied maxillae is often a challenge and patients with generalized aggressive periodontitis (GAP) make it even more complicated. This clinical report describes rehabilitation of GAP patients with zygomatic implants and followed-up for 2 years. Two patients of age 33 and 44 reported to a private dental practice and were diagnosed with GAP. Various treatment options were considered after which it was decided to do a full mouth implant supported fixed rehabilitation, with a combination of conventional and zygomatic implants. Two zygomatic and four conventional implants were placed and immediately loaded with a provisional prosthesis. After 6 months, definitive prosthesis was delivered. Implants and prostheses were followed-up for 2 years. No implant failures occurred, but a few biological complications were observed. The most common clinical observation in these patients during recall visits was peri-implant soft-tissue inflammation, which is a biological complication. This was with no trouble, controlled by using proper oral hygiene aids and maintenance. Within the limitations of this study, we can state that it can definitely be considered as a viable treatment option treating patients with GAP. However, studies with more follow-up time and controlled clinical trials should be performed in order to document the longevity of this treatment modality.

• Atrophic maxillae
• generalized aggressive periodontitis
• zygomatic implants

• CD14
• meta
• periodontitis
• polymorphism

• Aggregatibacter actinomycetemcomitans
• Aggressive periodontitis
• Doxycycline
• Lactobacilli
• Probiotic

The purpose of this study was to analyze the current literatures and to assess outcomes of implant treatment in patients with generalized aggressive periodontitis.

Studies considered for inclusion were searched in Pub-Med. The literature search for studies published in English between 2000 and 2012 was performed. Our findings included literature assessing implant treatment in patients with a history of generalized aggressive periodontitis (GAP). All studies were screened according to inclusion criteria. The outcome measures were survival rate of superstructures, marginal bone loss around implant and survival rate of implants. All studies were divided into two follow-up period: short term study (< 5 years) and long term study (≥ 5 years).

Seven prospective studies were selected, including four short-term and three long-term studies. The survival rates of the superstructures were generally high in patients with GAP, i.e. 95.9 - 100%. Marginal bone loss around implant in patients with GAP as compared with implants in patients with chronic periodontitis or periodontally healthy patients was not significantly greater in short term studies but was significantly greater in long term studies. In short term studies, the survival rates of implants were between 97.4% and 100% in patients with GAP-associated tooth loss, except one study. The survival rates of implants were between 83.3% and 96% in patients with GAP in long term studies.

Implant treatment in patients with GAP is not contraindicated provided that adequate infection control and an individualized maintenance program are assured.

• Agrressive periodontitis
• Dental implantation
• Dental implants
• Systematic review

• Actin polymerization level
• aggressive periodontitis
• fluorescence activated cell sorter
• polymorphonuclear leukocyte
• β-integrin expression