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Subgingival plaque samples were obtained from 162 sites in 27 adult periodontitis patients and 162 sites in 27 healthy patients using a standardized lavage technique. The distribution of 10 different microbial morphotypes was determined by darkfield microscopy. The lavage technique selectively samples the loosely adherent plaque at the base of the periodontal pocket and not the tooth-associated, adherent plaque. This standardized technique permits quantitative comparisons of numerical density of morphotype composition at different sites, in addition to qualitative comparisons or relative proportions. There was a significant positive association between the numerical density of each morphotype within the non-adherent plaque and the number of sites at which the organism was detected in both healthy and diseased subjects. A previously undescribed darkfield morphotype, has been detected with this method. This morphotype, a small motile coccobacillus (S-MO-CB) has been found to be the numerically dominant species in both health and disease. This morphotype has been recovered in pure culture following passage through a 0.4 μ filter and includes organisms of the Wollinella and Campylobacter genus. Non-motile organisms comprised less than 1-2% of the sample from healthy and diseased sites. Motile forms, such as spirochetes, had a high frequency of detection in healthy individuals. Analysis of pooled plaque samples revealed that the prevalence of cocci and fusiforms was significantly elevated in patients with healthy periodontium, as compared to patients with adult periodontitis. In adult periodontitis patients, the frequency of occurrence of medium spirochetes, filaments and small nonmotile rods was significantly elevated in pooled plaque. Analysis of individual sites indicated that the proportion and numerical density of most morphotypes within the non-adherent plaque were not significantly different in disease as compared to health. Disease is characterized by an increased % of small spirochetes and fusiforms at each site. At diseased sites which harbor small spirochetes, the numerical density is elevated four-fold, as compared to healthy sites which have small spirochetes. The numerical density of other morphotypes is not significantly different comparing healthy sites to diseased sites. Thus, the increase in the % of small spirochetes in disease in due to a site-localized four-fold increase in numerical density within the non-adherent plaque. [ABSTRACT FROM AUTHOR]

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The effect of the nonsteroidal anti-inflammatory drug flurbiprofen has been studied in the ligature-induced and spontaneous peridontitis model in the rehsus monkey, Macaca mulatta. Twenty -four adult monkeys with incipient peridontits were divided into three disease-matched groups. Two groups received flurbioprofen at dosages of either 0.27 mg/kg/d or 7.1 mg/kg/d delivered systimatically via osmotci minipump. A split-mouth approach was used, placing lignatures on one side and monitoring the progression of periodontitis at regular interval for 6 months. Clinical measurements included standardized radiographs, Ramfjord attachment level determination and assessments of redness, edema and bleeding on probing. There was a statistically significant inhibition of attachment loss (p<0.05), gingival redness (p<0.05) and bleeding on probing (p<0.05) in ligature-induced and spontaneous peridontits in the flurbiprofen-treated animals at 6 months. Eight of 8 ligated control monkeys losts attachment (mean loss of 1.06 mm/site). Only 3 of 15 flurbiprofen-treated ligated monkeys lost any significant attachment with an overall mean loss of 0.34 mm/site, which was significantly less than the control loss of 1.06 mm/site at p=4.46 × 10-3. The odds of a control ligated monkey undergoing attachment loss in 6 months are elevated 29.3-fold as compared to the flurbiprofen-treated cohort monkey group. Flurbiprofen treatment also significantly inhibited spontaneous attachment loss for 6 months as compared to control monkeys at p<0.005 . These data provide further evidence for the central role of cylcooxygenase product in the progression of periodontal disease. The ability of flurbiprofen to inhibit periodontal attachment loss, even in the presence of loss plaque accumulation, has significant implications for the potential use of flurbiprofen as an adjunctive periodontal therapeutic modality. [ABSTRACT FROM AUTHOR]

The measurement of crevicular fluid PGF (CF-PGE) as an indicator of periodontal disease status was investigated. The association between CF-PGE levels and the PGE content of the adjacent periodontal tissues was found to be highly significant (P = 5.3 × 10). The high correlation (r = 0.925) between the log CF-PGE level and the tissue PGE concentration indicates that CF levels can be used to reliably predict tissue levels. The CF-PGE measurements at each periodontal site were found to be highly reproducible. Samples from adult and juvenile periodontitis patients demonstrated that the mean CF-PGE levels were correlated with disease severity, as determined by mean attachment loss. The mean CF-PGE level in juvenile periodontitis patients was almost three-fold higher than that present in adult periodontitis (144.0 ± 28.0 ng/ml vs 57.5± 8.7 ng/ml, mean±S.E., significant at P = 0.002). The use of CF-PGE concentrations as an indicator of disease activity (i.e. longitudinal attachment loss) cannot be demonstrated by this cross-sectional study. However, the CF-PGE measurement has been demonstrated to be a non-invasive, sensitive, reproducible, and reliable reflection of tissue levels of PGE2. The association of increasing levels of CF-PGE with increased severity and aggressiveness of disease is consistent with PGE as an inflammatory mediator of tissue destruction. [ABSTRACT FROM AUTHOR]