Objectives: This study aimed to estimate the prevalence and socio-behavioural correlates of oral ... more Objectives: This study aimed to estimate the prevalence and socio-behavioural correlates of oral mucosal lesions (OMLs) in skin diseased patients attending outpatient's facility of Khartoum Teaching Hospital - Dermatology Clinic, Sudan. Methods: A cross-sectional hospital-based study was conducted in Khartoum from October 2008 January 2009. A total of 588 (mean age 37.216 years, 50.3% females) completed an oral examination and a personal interview of which 544 (mean age 37.115.9 years, 50% females) with confirmed skin disease diagnosis were included for further analyses. OMLs were recorded using the World Health Organization criteria. Biopsy and smear were used as an adjuvant technique for confirmation. Data were analysed using the Statistical Package for Social Science (Version 15.0.1). Results: A total of 438 OMLs were registered in 315 (57.9%, males: 54.6% versus females: 45.6%, p<0.05) skin diseased patients. Tongue lesions were the most frequently diagnosed OMLs (23.3%),...
Objectives: Aggressive periodontitis (AgP) is a rapidly progressive type of periodontal disease i... more Objectives: Aggressive periodontitis (AgP) is a rapidly progressive type of periodontal disease in systemically healthy young individuals causing destruction of the supporting tissues of the teeth. Pathogenic bacteria in the dental biofilm initiate the disease and promote inflammation. Recently, an imbalance between pro- and anti-inflammatory lipid metabolites has been indicated as an important factor influencing the course of the inflammatory process. The present study therefore aimed to determine the profile of omega-3 (ω-3) and omega-6 (ω-6) polyunsaturated fatty acids (PUFA) and PUFA metabolites of linoleic acid, arachidonic acid, eicosapentaenoic acid and docosahexaenoic acid in gingival crevicular fluid (GCF), saliva and serum in AgP patients and healthy controls. Methods: In total, 60 lipid mediators were measured using high performance liquid chromatography-tandem electrospray ionisation mass spectrometry (HPLC-ESI-MS-MS) of which 53 could be quantified in this study. Result...
Objective: The aim of this study was to evluate oral health in a group of children with congenita... more Objective: The aim of this study was to evluate oral health in a group of children with congenital heart defects (CHD) attending Ahmed Gasim hospital in Bahri town, Khartoum- Sudan and to test whether there is a difference in the oral health between those children and healthy controls. Method: The sample comprised 100 CHD children from the cardiac centre and 100 controls from schools in Bahri town (54 cases and 83 controls for the comparative analysis). Data were collected with clinical examination in form of DMFT/dmft, GI and PI. Result: Seventy percent of the CHD cases had caries, 75% were with gingival inflammation and 90% had detectable plaque. Upon comparison with the controls, significant differences were found regarding dmft and DMFT between cases and controls. In primary dentition, mean dmft value was 4.5 compared to 2.3 in the controls (P<0.05). The mean DMFT for permanent teeth reported was 1.5 in the cases group compared to 0.6 in the control group (P<0.05). Conclus...
Objectives: Aggressive periodontitis (AgP) has a complex microbial composition making it difficul... more Objectives: Aggressive periodontitis (AgP) has a complex microbial composition making it difficult to identify specific causative agents. The aim of the present study was to investigate the microbial profile of AgP in a group of patients in Sudan. Methods: A study population consisting of 19 patients with AgP was recruited from patients seeking treatment at University of Science and Technology (UST) in Khartoum. Nineteen healthy subjects were included as controls. For each individual, plaque samples were collected with a curette from the subgingival area of mesiobuccal sites of molars or premolars, ten of these sample sites with probing pocket depth between 5 and 11 mm. Plaque samples from 17 of the AgP patients and 15 of the healthy controls were analyzed using a 16S rRNA-based method on Human Oral Microbe Identification Microarrays (HOMIM). Plaque samples from the 19 AgP patients were analyzed using Real-Time PCR for the detection of Aggregatibacter actinomycetemcomitans and Porph...
Aggressive periodontitis (AgP) is prevalent and shows a rapid course in African individuals. Alth... more Aggressive periodontitis (AgP) is prevalent and shows a rapid course in African individuals. Although a strong focus has been placed on Aggregatibacter actinomycetemcomitans, new methods support the existence of a complex subgingival microflora in AgP. The purpose of the present study was to map the subgingival microbiota as well as explore the presence of A. actinomycetemcomitans and the JP2 clone in a group of Sudanese individuals with AgP, using different analytical methods. A study population consisting of 19 patients with AgP was recruited from patients seeking treatment at University of Science and Technology (UST) in Khartoum. Fifteen healthy subjects were included as controls. Plaque samples were analyzed for 272 taxa using human oral microbe identification microarrays and for 26 periodontal taxa using DNA-DNA hybridization checkerboard. Conventional polymerase chain reaction (PCR) was applied for the detection of A. actinomycetemcomitans and the JP2 clone in plaque. Saliva from patients with AgP was analyzed using quantitative PCR (qPCR) for the detection of A. actinomycetemcomitans. Eubacterium yurii was detected more frequently in patients with AgP than in controls, and E. nodatum was found in patients with AgP only. A. actinomycetemcomitans was found in plaque samples of two (12%) patients by human oral microbe identification microarrays and in five (29%) patients with AgP by conventional PCR, as well as in six (32%) of the AgP saliva samples by qPCR. The JP2 clone was identified in only one patient. The classical periodontal pathogens were not present in high amounts in AgP in the population studied here. Species of Eubacterium, which are not typically associated with AgP, were often detected in individuals with disease. Using laboratory methods with different sensitivities and detection levels allowed identification of variances in microbial communities. The findings reported in this study provide a basis for the further understanding of AgP.
Porphyromonas gingivalis has been isolated from periodontitis lesions in subjects from many geogr... more Porphyromonas gingivalis has been isolated from periodontitis lesions in subjects from many geographical locations. The purpose of this investigation was to determine whether similar ribotypes of P. gingivalis could be detected among strains isolated in different countries. A total of 198 isolates of P. gingivalis were obtained from 52 periodontitis patients in Boston (130 isolates), Bergen, Norway (17 isolates), Khartoum, Sudan (26 isolates), and Bucharest, Romania (25 isolates). DNA was isolated from each strain, cut separately by the restriction endonucleases KpnI and PstI. The resulting preparations were subjected to electrophoresis in a 0.8% agarose gel using a Tris-acetate EDTA buffer. Uncut lambda and a 1000-bp fragment of 16S rRNA were included as internal standards in each lane. In addition, a HindIII digest of lambda was present in a separate lane in each run. The DNA fragments were transferred to a nylon membrane by downward capillary transfer. 16S rRNA bands were detected using a 1000-kb digoxigenin-labelled probe generated by a polymerase chain reaction. At the same time, a digoxigenin-labelled probe to lambda was employed to detect the internal and molecular weight standards. The bands were detected using antibody to digoxigenin conjugated to alkaline phosphatase and chemiluminescence. The positions of the bands relative to the internal standards were determined and normalized to correct for run-to-run variations, and the molecular weight of each band was determined by comparison with standards within each gel. The resulting data for the 2 enzymes were combined and subjected to cluster analysis using an average unweighted linkage sort. In some instances, isolates that appeared to be of identical ribotype using one endonuclease gave different ribotypes using the other. Strains of P. gingivalis within a subject were usually identical, except for 3 patients who harbored 2 different ribotypes/individual. All subsequent analyses employed a single ribotype strain for each subject. A total of 32 ribotypes were observed for isolates from distant countries. A total of 11.5% of the patients had isolates exhibiting the same ribotype: ribotype 7a. Identical ribotypes of P. gingivalis can be recovered from subgingival plaque samples of periodontitis patients in different countries.
The aim of this study was to determine the survival in VMGA III of Porphyromonas gingivalis, Prev... more The aim of this study was to determine the survival in VMGA III of Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans and enteric rods in laboratory cultures as well as in subgingival plaque samples. Laboratory strains of the 4 putative periodontal pathogens and Escherichia coli were used in the laboratory part of this study. Also, 31 subgingival plaque samples were obtained from 22 periodontal patients and stored in VMGA III. Each sample, from both the laboratory and the clinical parts, was divided into 3 portions. One portion was cultured within a few hours of collection (baseline), while the second was processed after 24 h (day 2) and the third 48 h later (day 3). The results of the clinical part indicate that the detection frequencies of all 4 periodontal pathogens and their levels in positive samples decreased, to different degrees, by day 2 and decreased further by day 3. Enteric rods were not detected in base line samples. However, they were present in 16.1% and 22.6% of day 2 and day 3 samples, respectively. Similarly, the laboratory results demonstrate a significant decrease in the levels of the 4 periodontal pathogens tested by day 2 and day 3, whereas the opposite occurred for E. coli. P. gingivalis, P. intermedia, and F. nucleatum survived better in the presence of E. coli than alone, whereas A. actinomycetemcomitans survived less well when co-inoculated with E. coli. VMGA III appears to maintain microbial population ratios for periods up to 24 h. After 24 h, the multiplication of enteric organisms may alter the original proportions of the sample.
We obtained clinical isolates of Porphyromonas gingivalis of known ribotype from patients diagnos... more We obtained clinical isolates of Porphyromonas gingivalis of known ribotype from patients diagnosed with adult periodontitis and used Western blot methodology to evaluate profiles of antigens recognized by IgG in heterologous and homologous patient sera. Our aims were to identify isolates belonging to different serogroups, to learn if serogroup membership is related to ribotype to assess variation in IgG responses of patients to antigens is homologous and heterologous ribotypes, and to determine the frequency of shared and variable antigens in different biochemical classes recognized across different serogroups and ribotypes. Blots of separation patterns of 28 isolates were developed in sera from patients and bound IgG was quantified by digital image densitometry. The membership of isolates in different serogroups was determined by correlation and hierarchical cluster analysis of isolate whole-cell IgG binding profiles. Two major isolate clusters, each with two subclusters, were found. Isolates within the same ribotype clustered together in some cases but not others. Homologous isolates ranked high in IgG binding levels relative to those from different patients irrespective of ribotype. Patient subgroups with IgG responses dominant for different ribotypes and serogroups were revealed by correlation analysis. The IgG binding profiles observed for individual protein and proteinase-resistant antigens across both homologous and heterologous isolates were very dissimilar. Furthermore, the frequency of antigens both shared across all ribotypes and recognized by IgG in patient sera was unexpectedly low. Only two protein antigens (Mr 44 kDa and 27 kDa) were strongly recognized across all ribotypes by different sera. We conclude that the IgG response of patients infected with a particular P. gingivalis serotype or ribotype is directed mainly against antigens that are not shared by other potentially infective clonal types.
Porphyromonas gingivalis clonal types that participate in periodontal infections express serologi... more Porphyromonas gingivalis clonal types that participate in periodontal infections express serologically distinct surface antigens. This investigation sought to determine whether serum antibodies titers against the serotype-specific capsular carbohydrate K antigen and lipopolysaccharide antigens of P. gingivalis might reveal which serotypes are most likely to be responsible for subgingival infections in subjects with adult periodontitis. Immunoglobulin G (IgG) titers to purified K antigen and lipopolysaccharide from different P. gingivalis strains were measured by ELISA for 28 healthy controls and 51 patients with periodontal pockets known to be infected with genetically and serologically distinct P. gingivalis clonal types. Titers to purified K antigen from strains W50, HG184, A7A1-28, 49417, HG1690 and HG1691, representing serotypes K1-K6, respectively, and lipopolysaccharide from strains 381, HG1691 and W50, representing serotypes O1-O3, respectively, were measured for all subjects. Chi-square likelihood ratios, Mann-Whitney tests and receiver-operating characteristic sensitivity-specificity plots were used to compare the accuracy with which titer results for different target antigens classified subjects with or without disease. Results from assays targeting K2, K3, K4, K5, O1 and O2 generally gave poor diagnostic accuracy, whether evaluated separately or as summed titer pairs corresponding to the K/O combinations actually expressed by the target antigen parent strains. Exceptions were O3 (from W50) and K5+O2 (both from HG1690), which gave moderate accuracy in classifying subjects. In contrast, highly significant diagnostic accuracy was achieved using individual K1 (W50) and K6 (HG1691) titer data and K1+O3 (W50) and K6+O2 (HG1691) titer sum values. These observations suggest that P. gingivalis clonal types expressing K/O serotypes matching those of W50 (K1/O3) and HG1691 (K6/O2) are more likely than others to participate in periodontal infections in adult periodontitis patients and thus are more likely than others to express relevant virulence factors.
Aggregatibacter actinomycetemcomitans is considered a possible etiological agent for aggressive p... more Aggregatibacter actinomycetemcomitans is considered a possible etiological agent for aggressive periodontitis. The aim of this study was to determine the prevalence of the JP2 clone and non-JP2 genotypes of A. actinomycetemcomitans in the subgingival plaque of patients with aggressive periodontitis and controls among Sudanese high-school students. In a previous study we examined a large representative sample of students attending high schools in Khartoum, Sudan. In this population, 17 patients with aggressive periodontitis and 17 controls (14-19 years of age) consented to participate in the present study. The subjects underwent a clinical periodontal examination, and subgingival dental plaque samples were collected using paper points. The presence of the A. actinomycetemcomitans JP2 clone and non-JP2 genotypes were assessed using loop-mediated isothermal amplification (LAMP) and the PCR. The JP2 clone of A. actinomycetemcomitans was not detected in the subgingival plaque of either the cases or the controls. Non-JP2 types of A. actinomycetemcomitans were detected in the subgingival plaque of 12 (70.6%) patients with aggressive periodontitis and from only one (5.9%) control subject, showing a significantly higher frequency of detection in cases than in controls (p = 0.0001). The odds ratio for the detection of A. actinomycetemcomitans in the subgingival plaque of the patients with aggressive periodontitis was 38.4 (95% confidence interval: 4.0-373.0; p = 0.002). The PCR and LAMP methods showed identical results pertaining to the identification of non-JP2 types of A. actinomycetemcomitans. The JP2 clone of A. actinomycetemcomitans was not detected in the subgingival plaque of high school subjects in Sudan. The detection of non-JP2 types of A. actinomycetemcomitans may be a useful marker of increased risk for development of aggressive periodontitis in young subjects.
Objectives: To assess the prevalence and clinical features of aggressive periodontitis among high... more Objectives: To assess the prevalence and clinical features of aggressive periodontitis among high school attendees in Khartoum, Sudan, and to study the effect of socioeconomic and demographic factors on disease occurrence. Methods: The study sample consisted of 1,200 students (600 females and 600 males) aged 14-18 years who were selected using a multi-stage, probability sampling design from 38 high schools representative of private and public schools in Khartoum, Sudan. The subjects were examined clinically by a single calibrated examiner, and the measurement of gingival recession, probing depth, and bleeding on probing was performed at 6 sites per tooth, with subsequent calculation of clinical periodontal attachment loss for each site. Aggressive periodontitis was defined as presence of at least 2 first molars and/or 2 incisors with interproximal sites showing ≥4 mm attachment loss. Assessment of demographics, socioeconomic status, and other health-related variables was performed b...
Ethnic differences in craniofacial dimensions and proportional relationships means that ethnicity... more Ethnic differences in craniofacial dimensions and proportional relationships means that ethnicity-specific data is required for both diagnosis and treatment planning. This investigation establishes normative craniofacial anthropometric values for the Sudanese female (SF) population, compares with North American White (NAW) and African-American females (AA), and analyses the occurrence of neoclassical norms within the study sample. Standardized frontal and profile facial photographs were taken of 100 female participants. Five vertical and five horizontal anthropometric measurements were determined. Significant differences were found between the 3 populations. The sample showed very poor compliance with the neoclassical norms. The upper face height of the SF was ∼ 20-mm taller than the AA faces (p &amp;amp;amp;amp;amp;amp;lt; 0.001). Midface, nasal and lower face heights were also significantly taller, by 15-mm, 10-mm and 10-mm respectively (p &amp;amp;amp;amp;amp;amp;lt; 0.001). SF showed significant reduction in bizygomatic width (∼ 30-mm), compared to NAW and AA (p &amp;amp;amp;amp;amp;amp;lt; 0.001). Eye width was ∼ 5-mm less than the AA sample and 3-mm less than the NAW sample (p &amp;amp;amp;amp;amp;amp;lt; 0.001). Mouth width was ∼ 5-mm less in SF than the other two groups (p &amp;amp;amp;amp;amp;amp;lt; 0.001). The SF exhibited a reduced interalar width compared with AA (p &amp;amp;amp;amp;amp;amp;lt; 0.001), but wider than the NAW (p &amp;amp;amp;amp;amp;amp;lt; 0.001). The average SF face is significantly taller and narrower than the AA or NAW female face. The neoclassical proportional norms appear to be unreliable guides in relation to the SF face, and should not be used in comparative diagnosis and treatment planning. Use of the normative anthropometric data presented in this article, both linear and proportional values, should be considered in the diagnosis and treatment planning of young adult female patients of Sudanese descent.
This study aimed to examine early posttreatment changes in the periodontal microflora. Paper poin... more This study aimed to examine early posttreatment changes in the periodontal microflora. Paper point sampling and conventional bacterial cultivation were used to monitor the effects of surgical and non-surgical periodontal therapy on the detection frequency of Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans, and Capnocytophaga species in deep periodontal pockets. Ten patients, 5 men and 5 women (mean age 44 years), with advanced periodontal disease were selected from the dental school patient population for the study. A total of 245 teeth in 10 defined areas of the dentition were treated by oral hygiene instruction followed by scaling and root planing alone (121 sites) or with surgical interventions (124 sites). Ninety sites, 47 surgical and 43 non-surgical, with initial pocket depth greater than or equal to 6 mm were sampled at baseline and 3 months after completion of therapy. Treatment by both procedures resulted in significant clinical improvements as assessed by all clinical parameters used. Baseline results may indicate that the level of P. gingivalis was reduced in the presence of P. intermedia, while A. actinomycetemcomitans seemed to be reduced in the presence of P. gingivalis and/or P. intermedia. Three months after therapy, the detection frequency of P. gingivalis was significantly reduced (P less than 0.05) in surgical and non-surgical sites while the reduction for P. intermedia was significant only for surgical sites (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Twenty-five sudanese and 18 norwegian adult periodontitis patients were selected to participate i... more Twenty-five sudanese and 18 norwegian adult periodontitis patients were selected to participate in this study. The purpose was to compare cultivation results of Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, and Capnocytophaga species as well as various enteric rods in both populations. In addition, DNA probe analysis was used to identify P. gingivalis, P. intermedia, A. actinomycetemcomitans, F. nucleatum, and Bacteroides forsythus in the Sudanese patients and results were compared with those obtained by cultivation. The paper point technique was used to sample 99 sites in the Sudanese group (4 paper points/site) and 119 sites in the Norwegian patients (3 paper points/site). In the Sudanese subjects, the fourth paper point was used for the DNA probe analysis. The chi-square test and the Wilcoxon signed rank test were used to test for statistically significant differences between Sudanese and Norwegian cultivation results as well as between cultivation and DNA results in the Sudanese group. Cultivation results indicated that the Sudanese subjects had significantly lower prevalence of P. gingivalis, P. intermedia, and F. nucleatum (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01), significantly higher prevalence of Capnocytophaga species (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), and similar prevalence of A. actinomycetemcomitans. Almost all Sudanese subjects tested positive for various enteric rods, while none of the Norwegians did so. The extent to which unrestricted use of antibiotics and transport media influenced the levels of enteric species is not known, however.(ABSTRACT TRUNCATED AT 250 WORDS)
Objectives: This study aimed to estimate the prevalence and socio-behavioural correlates of oral ... more Objectives: This study aimed to estimate the prevalence and socio-behavioural correlates of oral mucosal lesions (OMLs) in skin diseased patients attending outpatient's facility of Khartoum Teaching Hospital - Dermatology Clinic, Sudan. Methods: A cross-sectional hospital-based study was conducted in Khartoum from October 2008 January 2009. A total of 588 (mean age 37.216 years, 50.3% females) completed an oral examination and a personal interview of which 544 (mean age 37.115.9 years, 50% females) with confirmed skin disease diagnosis were included for further analyses. OMLs were recorded using the World Health Organization criteria. Biopsy and smear were used as an adjuvant technique for confirmation. Data were analysed using the Statistical Package for Social Science (Version 15.0.1). Results: A total of 438 OMLs were registered in 315 (57.9%, males: 54.6% versus females: 45.6%, p<0.05) skin diseased patients. Tongue lesions were the most frequently diagnosed OMLs (23.3%),...
Objectives: Aggressive periodontitis (AgP) is a rapidly progressive type of periodontal disease i... more Objectives: Aggressive periodontitis (AgP) is a rapidly progressive type of periodontal disease in systemically healthy young individuals causing destruction of the supporting tissues of the teeth. Pathogenic bacteria in the dental biofilm initiate the disease and promote inflammation. Recently, an imbalance between pro- and anti-inflammatory lipid metabolites has been indicated as an important factor influencing the course of the inflammatory process. The present study therefore aimed to determine the profile of omega-3 (ω-3) and omega-6 (ω-6) polyunsaturated fatty acids (PUFA) and PUFA metabolites of linoleic acid, arachidonic acid, eicosapentaenoic acid and docosahexaenoic acid in gingival crevicular fluid (GCF), saliva and serum in AgP patients and healthy controls. Methods: In total, 60 lipid mediators were measured using high performance liquid chromatography-tandem electrospray ionisation mass spectrometry (HPLC-ESI-MS-MS) of which 53 could be quantified in this study. Result...
Objective: The aim of this study was to evluate oral health in a group of children with congenita... more Objective: The aim of this study was to evluate oral health in a group of children with congenital heart defects (CHD) attending Ahmed Gasim hospital in Bahri town, Khartoum- Sudan and to test whether there is a difference in the oral health between those children and healthy controls. Method: The sample comprised 100 CHD children from the cardiac centre and 100 controls from schools in Bahri town (54 cases and 83 controls for the comparative analysis). Data were collected with clinical examination in form of DMFT/dmft, GI and PI. Result: Seventy percent of the CHD cases had caries, 75% were with gingival inflammation and 90% had detectable plaque. Upon comparison with the controls, significant differences were found regarding dmft and DMFT between cases and controls. In primary dentition, mean dmft value was 4.5 compared to 2.3 in the controls (P<0.05). The mean DMFT for permanent teeth reported was 1.5 in the cases group compared to 0.6 in the control group (P<0.05). Conclus...
Objectives: Aggressive periodontitis (AgP) has a complex microbial composition making it difficul... more Objectives: Aggressive periodontitis (AgP) has a complex microbial composition making it difficult to identify specific causative agents. The aim of the present study was to investigate the microbial profile of AgP in a group of patients in Sudan. Methods: A study population consisting of 19 patients with AgP was recruited from patients seeking treatment at University of Science and Technology (UST) in Khartoum. Nineteen healthy subjects were included as controls. For each individual, plaque samples were collected with a curette from the subgingival area of mesiobuccal sites of molars or premolars, ten of these sample sites with probing pocket depth between 5 and 11 mm. Plaque samples from 17 of the AgP patients and 15 of the healthy controls were analyzed using a 16S rRNA-based method on Human Oral Microbe Identification Microarrays (HOMIM). Plaque samples from the 19 AgP patients were analyzed using Real-Time PCR for the detection of Aggregatibacter actinomycetemcomitans and Porph...
Aggressive periodontitis (AgP) is prevalent and shows a rapid course in African individuals. Alth... more Aggressive periodontitis (AgP) is prevalent and shows a rapid course in African individuals. Although a strong focus has been placed on Aggregatibacter actinomycetemcomitans, new methods support the existence of a complex subgingival microflora in AgP. The purpose of the present study was to map the subgingival microbiota as well as explore the presence of A. actinomycetemcomitans and the JP2 clone in a group of Sudanese individuals with AgP, using different analytical methods. A study population consisting of 19 patients with AgP was recruited from patients seeking treatment at University of Science and Technology (UST) in Khartoum. Fifteen healthy subjects were included as controls. Plaque samples were analyzed for 272 taxa using human oral microbe identification microarrays and for 26 periodontal taxa using DNA-DNA hybridization checkerboard. Conventional polymerase chain reaction (PCR) was applied for the detection of A. actinomycetemcomitans and the JP2 clone in plaque. Saliva from patients with AgP was analyzed using quantitative PCR (qPCR) for the detection of A. actinomycetemcomitans. Eubacterium yurii was detected more frequently in patients with AgP than in controls, and E. nodatum was found in patients with AgP only. A. actinomycetemcomitans was found in plaque samples of two (12%) patients by human oral microbe identification microarrays and in five (29%) patients with AgP by conventional PCR, as well as in six (32%) of the AgP saliva samples by qPCR. The JP2 clone was identified in only one patient. The classical periodontal pathogens were not present in high amounts in AgP in the population studied here. Species of Eubacterium, which are not typically associated with AgP, were often detected in individuals with disease. Using laboratory methods with different sensitivities and detection levels allowed identification of variances in microbial communities. The findings reported in this study provide a basis for the further understanding of AgP.
Porphyromonas gingivalis has been isolated from periodontitis lesions in subjects from many geogr... more Porphyromonas gingivalis has been isolated from periodontitis lesions in subjects from many geographical locations. The purpose of this investigation was to determine whether similar ribotypes of P. gingivalis could be detected among strains isolated in different countries. A total of 198 isolates of P. gingivalis were obtained from 52 periodontitis patients in Boston (130 isolates), Bergen, Norway (17 isolates), Khartoum, Sudan (26 isolates), and Bucharest, Romania (25 isolates). DNA was isolated from each strain, cut separately by the restriction endonucleases KpnI and PstI. The resulting preparations were subjected to electrophoresis in a 0.8% agarose gel using a Tris-acetate EDTA buffer. Uncut lambda and a 1000-bp fragment of 16S rRNA were included as internal standards in each lane. In addition, a HindIII digest of lambda was present in a separate lane in each run. The DNA fragments were transferred to a nylon membrane by downward capillary transfer. 16S rRNA bands were detected using a 1000-kb digoxigenin-labelled probe generated by a polymerase chain reaction. At the same time, a digoxigenin-labelled probe to lambda was employed to detect the internal and molecular weight standards. The bands were detected using antibody to digoxigenin conjugated to alkaline phosphatase and chemiluminescence. The positions of the bands relative to the internal standards were determined and normalized to correct for run-to-run variations, and the molecular weight of each band was determined by comparison with standards within each gel. The resulting data for the 2 enzymes were combined and subjected to cluster analysis using an average unweighted linkage sort. In some instances, isolates that appeared to be of identical ribotype using one endonuclease gave different ribotypes using the other. Strains of P. gingivalis within a subject were usually identical, except for 3 patients who harbored 2 different ribotypes/individual. All subsequent analyses employed a single ribotype strain for each subject. A total of 32 ribotypes were observed for isolates from distant countries. A total of 11.5% of the patients had isolates exhibiting the same ribotype: ribotype 7a. Identical ribotypes of P. gingivalis can be recovered from subgingival plaque samples of periodontitis patients in different countries.
The aim of this study was to determine the survival in VMGA III of Porphyromonas gingivalis, Prev... more The aim of this study was to determine the survival in VMGA III of Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans and enteric rods in laboratory cultures as well as in subgingival plaque samples. Laboratory strains of the 4 putative periodontal pathogens and Escherichia coli were used in the laboratory part of this study. Also, 31 subgingival plaque samples were obtained from 22 periodontal patients and stored in VMGA III. Each sample, from both the laboratory and the clinical parts, was divided into 3 portions. One portion was cultured within a few hours of collection (baseline), while the second was processed after 24 h (day 2) and the third 48 h later (day 3). The results of the clinical part indicate that the detection frequencies of all 4 periodontal pathogens and their levels in positive samples decreased, to different degrees, by day 2 and decreased further by day 3. Enteric rods were not detected in base line samples. However, they were present in 16.1% and 22.6% of day 2 and day 3 samples, respectively. Similarly, the laboratory results demonstrate a significant decrease in the levels of the 4 periodontal pathogens tested by day 2 and day 3, whereas the opposite occurred for E. coli. P. gingivalis, P. intermedia, and F. nucleatum survived better in the presence of E. coli than alone, whereas A. actinomycetemcomitans survived less well when co-inoculated with E. coli. VMGA III appears to maintain microbial population ratios for periods up to 24 h. After 24 h, the multiplication of enteric organisms may alter the original proportions of the sample.
We obtained clinical isolates of Porphyromonas gingivalis of known ribotype from patients diagnos... more We obtained clinical isolates of Porphyromonas gingivalis of known ribotype from patients diagnosed with adult periodontitis and used Western blot methodology to evaluate profiles of antigens recognized by IgG in heterologous and homologous patient sera. Our aims were to identify isolates belonging to different serogroups, to learn if serogroup membership is related to ribotype to assess variation in IgG responses of patients to antigens is homologous and heterologous ribotypes, and to determine the frequency of shared and variable antigens in different biochemical classes recognized across different serogroups and ribotypes. Blots of separation patterns of 28 isolates were developed in sera from patients and bound IgG was quantified by digital image densitometry. The membership of isolates in different serogroups was determined by correlation and hierarchical cluster analysis of isolate whole-cell IgG binding profiles. Two major isolate clusters, each with two subclusters, were found. Isolates within the same ribotype clustered together in some cases but not others. Homologous isolates ranked high in IgG binding levels relative to those from different patients irrespective of ribotype. Patient subgroups with IgG responses dominant for different ribotypes and serogroups were revealed by correlation analysis. The IgG binding profiles observed for individual protein and proteinase-resistant antigens across both homologous and heterologous isolates were very dissimilar. Furthermore, the frequency of antigens both shared across all ribotypes and recognized by IgG in patient sera was unexpectedly low. Only two protein antigens (Mr 44 kDa and 27 kDa) were strongly recognized across all ribotypes by different sera. We conclude that the IgG response of patients infected with a particular P. gingivalis serotype or ribotype is directed mainly against antigens that are not shared by other potentially infective clonal types.
Porphyromonas gingivalis clonal types that participate in periodontal infections express serologi... more Porphyromonas gingivalis clonal types that participate in periodontal infections express serologically distinct surface antigens. This investigation sought to determine whether serum antibodies titers against the serotype-specific capsular carbohydrate K antigen and lipopolysaccharide antigens of P. gingivalis might reveal which serotypes are most likely to be responsible for subgingival infections in subjects with adult periodontitis. Immunoglobulin G (IgG) titers to purified K antigen and lipopolysaccharide from different P. gingivalis strains were measured by ELISA for 28 healthy controls and 51 patients with periodontal pockets known to be infected with genetically and serologically distinct P. gingivalis clonal types. Titers to purified K antigen from strains W50, HG184, A7A1-28, 49417, HG1690 and HG1691, representing serotypes K1-K6, respectively, and lipopolysaccharide from strains 381, HG1691 and W50, representing serotypes O1-O3, respectively, were measured for all subjects. Chi-square likelihood ratios, Mann-Whitney tests and receiver-operating characteristic sensitivity-specificity plots were used to compare the accuracy with which titer results for different target antigens classified subjects with or without disease. Results from assays targeting K2, K3, K4, K5, O1 and O2 generally gave poor diagnostic accuracy, whether evaluated separately or as summed titer pairs corresponding to the K/O combinations actually expressed by the target antigen parent strains. Exceptions were O3 (from W50) and K5+O2 (both from HG1690), which gave moderate accuracy in classifying subjects. In contrast, highly significant diagnostic accuracy was achieved using individual K1 (W50) and K6 (HG1691) titer data and K1+O3 (W50) and K6+O2 (HG1691) titer sum values. These observations suggest that P. gingivalis clonal types expressing K/O serotypes matching those of W50 (K1/O3) and HG1691 (K6/O2) are more likely than others to participate in periodontal infections in adult periodontitis patients and thus are more likely than others to express relevant virulence factors.
Aggregatibacter actinomycetemcomitans is considered a possible etiological agent for aggressive p... more Aggregatibacter actinomycetemcomitans is considered a possible etiological agent for aggressive periodontitis. The aim of this study was to determine the prevalence of the JP2 clone and non-JP2 genotypes of A. actinomycetemcomitans in the subgingival plaque of patients with aggressive periodontitis and controls among Sudanese high-school students. In a previous study we examined a large representative sample of students attending high schools in Khartoum, Sudan. In this population, 17 patients with aggressive periodontitis and 17 controls (14-19 years of age) consented to participate in the present study. The subjects underwent a clinical periodontal examination, and subgingival dental plaque samples were collected using paper points. The presence of the A. actinomycetemcomitans JP2 clone and non-JP2 genotypes were assessed using loop-mediated isothermal amplification (LAMP) and the PCR. The JP2 clone of A. actinomycetemcomitans was not detected in the subgingival plaque of either the cases or the controls. Non-JP2 types of A. actinomycetemcomitans were detected in the subgingival plaque of 12 (70.6%) patients with aggressive periodontitis and from only one (5.9%) control subject, showing a significantly higher frequency of detection in cases than in controls (p = 0.0001). The odds ratio for the detection of A. actinomycetemcomitans in the subgingival plaque of the patients with aggressive periodontitis was 38.4 (95% confidence interval: 4.0-373.0; p = 0.002). The PCR and LAMP methods showed identical results pertaining to the identification of non-JP2 types of A. actinomycetemcomitans. The JP2 clone of A. actinomycetemcomitans was not detected in the subgingival plaque of high school subjects in Sudan. The detection of non-JP2 types of A. actinomycetemcomitans may be a useful marker of increased risk for development of aggressive periodontitis in young subjects.
Objectives: To assess the prevalence and clinical features of aggressive periodontitis among high... more Objectives: To assess the prevalence and clinical features of aggressive periodontitis among high school attendees in Khartoum, Sudan, and to study the effect of socioeconomic and demographic factors on disease occurrence. Methods: The study sample consisted of 1,200 students (600 females and 600 males) aged 14-18 years who were selected using a multi-stage, probability sampling design from 38 high schools representative of private and public schools in Khartoum, Sudan. The subjects were examined clinically by a single calibrated examiner, and the measurement of gingival recession, probing depth, and bleeding on probing was performed at 6 sites per tooth, with subsequent calculation of clinical periodontal attachment loss for each site. Aggressive periodontitis was defined as presence of at least 2 first molars and/or 2 incisors with interproximal sites showing ≥4 mm attachment loss. Assessment of demographics, socioeconomic status, and other health-related variables was performed b...
Ethnic differences in craniofacial dimensions and proportional relationships means that ethnicity... more Ethnic differences in craniofacial dimensions and proportional relationships means that ethnicity-specific data is required for both diagnosis and treatment planning. This investigation establishes normative craniofacial anthropometric values for the Sudanese female (SF) population, compares with North American White (NAW) and African-American females (AA), and analyses the occurrence of neoclassical norms within the study sample. Standardized frontal and profile facial photographs were taken of 100 female participants. Five vertical and five horizontal anthropometric measurements were determined. Significant differences were found between the 3 populations. The sample showed very poor compliance with the neoclassical norms. The upper face height of the SF was ∼ 20-mm taller than the AA faces (p &amp;amp;amp;amp;amp;amp;lt; 0.001). Midface, nasal and lower face heights were also significantly taller, by 15-mm, 10-mm and 10-mm respectively (p &amp;amp;amp;amp;amp;amp;lt; 0.001). SF showed significant reduction in bizygomatic width (∼ 30-mm), compared to NAW and AA (p &amp;amp;amp;amp;amp;amp;lt; 0.001). Eye width was ∼ 5-mm less than the AA sample and 3-mm less than the NAW sample (p &amp;amp;amp;amp;amp;amp;lt; 0.001). Mouth width was ∼ 5-mm less in SF than the other two groups (p &amp;amp;amp;amp;amp;amp;lt; 0.001). The SF exhibited a reduced interalar width compared with AA (p &amp;amp;amp;amp;amp;amp;lt; 0.001), but wider than the NAW (p &amp;amp;amp;amp;amp;amp;lt; 0.001). The average SF face is significantly taller and narrower than the AA or NAW female face. The neoclassical proportional norms appear to be unreliable guides in relation to the SF face, and should not be used in comparative diagnosis and treatment planning. Use of the normative anthropometric data presented in this article, both linear and proportional values, should be considered in the diagnosis and treatment planning of young adult female patients of Sudanese descent.
This study aimed to examine early posttreatment changes in the periodontal microflora. Paper poin... more This study aimed to examine early posttreatment changes in the periodontal microflora. Paper point sampling and conventional bacterial cultivation were used to monitor the effects of surgical and non-surgical periodontal therapy on the detection frequency of Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans, and Capnocytophaga species in deep periodontal pockets. Ten patients, 5 men and 5 women (mean age 44 years), with advanced periodontal disease were selected from the dental school patient population for the study. A total of 245 teeth in 10 defined areas of the dentition were treated by oral hygiene instruction followed by scaling and root planing alone (121 sites) or with surgical interventions (124 sites). Ninety sites, 47 surgical and 43 non-surgical, with initial pocket depth greater than or equal to 6 mm were sampled at baseline and 3 months after completion of therapy. Treatment by both procedures resulted in significant clinical improvements as assessed by all clinical parameters used. Baseline results may indicate that the level of P. gingivalis was reduced in the presence of P. intermedia, while A. actinomycetemcomitans seemed to be reduced in the presence of P. gingivalis and/or P. intermedia. Three months after therapy, the detection frequency of P. gingivalis was significantly reduced (P less than 0.05) in surgical and non-surgical sites while the reduction for P. intermedia was significant only for surgical sites (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Twenty-five sudanese and 18 norwegian adult periodontitis patients were selected to participate i... more Twenty-five sudanese and 18 norwegian adult periodontitis patients were selected to participate in this study. The purpose was to compare cultivation results of Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, and Capnocytophaga species as well as various enteric rods in both populations. In addition, DNA probe analysis was used to identify P. gingivalis, P. intermedia, A. actinomycetemcomitans, F. nucleatum, and Bacteroides forsythus in the Sudanese patients and results were compared with those obtained by cultivation. The paper point technique was used to sample 99 sites in the Sudanese group (4 paper points/site) and 119 sites in the Norwegian patients (3 paper points/site). In the Sudanese subjects, the fourth paper point was used for the DNA probe analysis. The chi-square test and the Wilcoxon signed rank test were used to test for statistically significant differences between Sudanese and Norwegian cultivation results as well as between cultivation and DNA results in the Sudanese group. Cultivation results indicated that the Sudanese subjects had significantly lower prevalence of P. gingivalis, P. intermedia, and F. nucleatum (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01), significantly higher prevalence of Capnocytophaga species (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), and similar prevalence of A. actinomycetemcomitans. Almost all Sudanese subjects tested positive for various enteric rods, while none of the Norwegians did so. The extent to which unrestricted use of antibiotics and transport media influenced the levels of enteric species is not known, however.(ABSTRACT TRUNCATED AT 250 WORDS)
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