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Exotoxins
of Aggregatibacter
actinomycetemcomitans and
periodontal attachment
loss in adolescents
Carola Hglund berg
Department of Odontology
Ume University 2013
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Carola Hglund berg
Ume University, Sweden
Ume 2013
Copyright Carola Hglund berg

New Series No. 131
ISBN 978-91-7459-787-5
ISSN: 0345-7532
Printed by: Print & Media
Ume, Sweden 2013
To my beloved children Jonas and Minna!
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ABSTRACT.................................................................................................. iii
ABBREVIATIONS......................................................................................... v
ORIGINAL PAPERS.....................................................................................vii
INTRODUCTION .......................................................................................... 1
Periodontal disease ....................................................................................2
Epidemiology of periodontal diseases ...........................................................5
Aetiology and pathogenesis of periodontal disease ....................................... 10
Aggregatibacter actinomycetemcomitans .................................................... 16
Exotoxins of A. actinomycetemcomitans ..................................................... 21
AIMS......................................................................................................... 29
METHODS.................................................................................................. 30
Study design ........................................................................................... 30
Study population ..................................................................................... 31
Questionnaire.......................................................................................... 32
Clinical measurements ............................................................................. 32
Outcome measures .................................................................................. 33
Statistics ................................................................................................ 33
Microbial detection methods of A. actinomycetemcomitans ........................... 35
Experimental studies (Papers III and IV) .................................................... 37
Genetic characterization of A. actinomycetmcomitans isolates ....................... 38
Detection of biological and cytotoxic effects ................................................ 40
Haemolytic activity .................................................................................. 43
RESULTS AND DISCUSSION ...................................................................... 45
Main findings........................................................................................... 45
Methodological considerations ................................................................... 45
Papers I and II ........................................................................................ 48
Paper III................................................................................................. 53
Paper IV ................................................................................................. 56
CLINICAL IMPLICATIONS ......................................................................... 64
CONCLUSIONS .......................................................................................... 67
ACKNOWLEDGEMENTS .............................................................................. 68
REFERENCES ............................................................................................. 71
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Ume University, SE-901 87 Ume, Sweden
www.odont.umu.se
ISBN: 978-91-7459-787-5
ISSN: 0345-7532
New series: 131

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Exotoxins

Carola Hglund berg

Copyright Carola Hglund berg

To my beloved children Jonas and Minna!

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