摘要:

Probability computations are usedto characterize new periodontal diagnostic tests and are an integral facet of risk assessment for periodontal diseases. However, misinterpretation of these data can result in confusion and erroneous conclusions regarding the relationship of test results to the presence or absence of disease in a subject, or to episodes of periodontal destruction at specific sites. This paper was written to provide clinicians with a primer to help in understanding calculations used to evaluate diagnostic tests and risk assessment.J Periodontol 1995;66:659–666.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.8.659

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

There is little informationavailable on the effects of periodontal therapy on tissue levels of interleukin‐6 (IL‐6). This study compares IL‐6 concentrations in gingiva and gingival crevicular fluid (GCF) from patients requiring surgical procedures following Phase I periodontal therapy. Sites requiring surgery due to “unresolved” intrabony pockets were compared to sites not requiring surgery (“resolved”) in each patient. Resolved sites had minimal histologic evidence of chronic inflammation and IL‐6 accumulation; unresolved sites contained a substantial number of chronic inflammatory cells and IL‐6 was widely distributed. IL‐6 levels in GCF were ‐significantly greater at resolved than at unresolved gingival sites (P<0.001); however, IL‐6 tissue levels were significantly greater at unresolved than in resolved gingival sites (P<0.01). These results suggest that IL‐6 levels were elevated in gingival connective tissue adjacent to intrabony pockets which had not been resolved following Phase I therapy. Thus, intrabony pocket resolution may be affected by accumulation of IL‐6 in the adjacent gingival connective tissue, which may result from increased rates of synthesis or reduced rates of release from gingiva into the GCF.J Periodontol 1995;66:667–672.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.8.667

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The objective of this studywas to assess the effectiveness of surgical debridement versus various guided tissue regeneration techniques for the treatment of localized juvenile periodontitis (LJP). Seven patients, 14 to 18 years old, were selected on the basis of having: 1) vertical bone loss on at least 3 first molars; 2) probing attachment loss ≥ 5 mm; 3) presence ofActinobacillus actinomycetecomitans(Aa) as determined by the DNA probe test; 4) no systemic diseases; and 5) not taken antibiotics for 6 months prior to treatment. Each patient was randomly assigned by first molar involvement to one of four treatment modalities: 1) surgical debridement alone (DEBR); 2) ePTFE membrane alone (G); 3) ePTFE membrane plus root conditioning (G+D); or 4) ePTFE membrane plus root conditioning plus composite graft (G+D+B). Standardized clinical attachment level measurements (CAL) were taken at baseline, 6, 12, and 18 months. Hard tissue measurements were evaluated radiographically (RAD) at baseline, 6, 12, and 18 months, and volumetrically at baseline and 12 months postsurgery. At 12 months re‐entry, all residual defects were re‐treated with a composite graft consisting of calcium sulfate + DFDBA + doxycycline. Results were evaluated 6 months post‐retreatment using CAL and RAD measurements. Statistical analysis of the data showed: 1) a significant gain in clinical attachment as well as increased volumetric bone fill of the defects 12 and 18 months following the various treatment modalities when compared to baseline (P0.05). It may be concluded that surgical debridement in conjunction with systemic administration of doxycycline is as effective as regenerative techniques in treating patients with LJP.J Periodontol 1995;66:673–678.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.8.673

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Oral malodor was measured using a portable sulphide monitor in 2,672 individuals aged 18 to 64 years. In addition, dental (DMFT) and periodontal conditions (CPITN and attachment loss), dental plaque, and tongue coating status were assessed. Before clinical examination, subjects were interviewed about their oral health habits, smoking habits, and medical history. Data on volatile sulphur compounds (VSC) were analyzed by gender, age group, and time of measurement. There were no significant differences observed in the VSC between males and females in any age group. In each age group, the measured values of oral malodor were highest in the late morning group (58.6 ppb in average), followed by the late afternoon group (52.1 ppb), while lowest values were shown in the early afternoon group (39.4 ppb). Significant correlation was observed only between the VSC value and periodontal conditions and tongue coating status. The results also suggest that oral malodor might be caused mainly by tongue coating in the younger generation and by periodontal diseases together with tongue coating in older cohorts in the general population. Age was not a risk factor for increasing VSC.J Periodontol 1995;66:679–684.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.8.679

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Scanning electron microscopywas used to evaluate surface characteristics of periodontitis‐exposed instrumented human cementum and dentin surfaces following topical application of tetracycline HCl (TTC). Specimens were randomly assigned to application of sterile saline for 1 minute (control); TTC (10 mg/ml) for 1 minute and 4 minutes, respectively; and TTC (100 mg/ml) for 1 minute and‐4 minutes, respectively. Solutions were applied with a cotton pellet using a burnishing technique. Control specimens exhibited an amorphous irregular surface smear layer. TTC treatment of cementum for 1 minute resulted in a relatively debris‐free, nonhomogeneous surface. The 4‐minute application resulted in a surface exhibiting a densely fibrillar, matlike texture. Dentin specimens conditioned for 1 minute showed a smooth surface with many tubule openings partially occluded by debris. The 4‐minute treatment exposed a 3‐dimensional network of intertubular and peritubular collagen fibrils. No consistent morphologic differences were observed between cementum or dentin specimens treated with TTC at concentrations of 10 and 100 mg/ml, respectively. The results suggest that topical application of TTC produces morphologic alterations of periodontitis‐exposed cementum and dentin that appear related to application interval rather than concentration of the drug.J Periodontol 1995;66:685–691.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.8.685

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The purpose of this investigationwas to evaluate the clinical efficacy of controlledrelease tetracycline fiber therapy in adult periodontitis patients. One hundred‐twentytwo (122) adult patients from 3 dental centers were enrolled at baseline for this study. Each patient provided at least one site in each of four quadrants that was ≥ 5 mm and bled on probing. One or two such sites were selected as test sites and were randomly assigned to receive one of four treatments: scaling and root planing (S), scaling and root planing plus tetracycline fiber for 10 days (SF), fiber therapy alone for 10 days (F), or two 10‐day serial fiber applications (FF). After treatment, no periodontal maintenance or supportive care was provided until the end of this 12month study. Probing depth (PD), clinical attachment level (CAL), plaque, and bleeding on probing (BOP) were measured at baseline and at 1, 3, 6, 9, and 12 months following treatment. Repeated PD and CAL measurements were taken at three locations within each site and averaged for each site. One hundred‐sixteen (116) subjects completed the study. All treatments resulted in similar improvements in clinical parameters compared to baseline and were equally effective in the treatment of periodontitis as measured by probing depth reduction, clinical attachment level gain, and reduction of bleeding on probing. The clinical response, established primarily by 3 months following therapy, was generally sustained in all treatment groups for 12 months without the benefit of supportive maintenance therapy.J Periodontol 1995;66:692–699.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.8.692

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

In a12‐month multi‐center study of116 adult periodontitis subjects, six putative periodontal pathogens were monitored by DNA probe methods in a subset of 31 subjects. Monitored species includedPorphyromonas gingivalis(Pg),Prevotella intermedia(Pi),Fusobacterium nucleatum(Fn),Eikenella corrodens(Ec),Campylobacter rectus(Cr), andActinobacillus actinomycetemcomitans(Aa) with an average detection limit of 1.8 × 104bacterial colony forming units/sample. The microbiological response to four periodontal treatments was studied, one treatment in each quadrant: scaling and root planing (S), scaling and root planing with tetracycline (TC) fiber (SF), a single application of TC fiber (F) and two serial applications of TC fiber (FF). Generally two sites were sampled in each quadrant, however, in some quadrants only one site was selected. These treatments were evaluated at baseline; immediately following therapy; and post‐treatment at 1, 3, 6, and 12 months. The study was conducted with a split‐mouth design with no maintenance therapy over a 12‐month period. At baseline, 70.8% of sites had detectableFn; 42.9%Pg; 63.5%Pi; 29.7%Ec; 28.3%Cr; and 5.5%Aa. No significant differences were seen in baseline proportions of these species between centers. Numbers and proportions of detectable pathogens (with the exception ofPg) exhibited a triphasic temporal response: a precipitous initial decrease immediately following therapy; a rise in proportions in the 1‐ to 3‐month post‐therapy period; and a spontaneous decline in the absence of therapy over the 3‐ to 12‐month period. This response was particularly prominent withEc, where numbers of sites with detected organisms at 1 month were approximately equal to or greater than numbers of positive sites at baseline, suggesting an opportunistic characteristic. The immediate post‐treatment levels ofPiwere substantially greater than other species, suggesting the relative difficulty in eliminating this species. Detected numbers of sites withAawere too low to provide data for meaningful analysis. In general all treatments reduced the numbers of sites positive for each of the species tested throughout the 1‐year monitoring period, although exceptions were observed. At 12 months, however, differences in microbiological presence related to initial therapy of each of the pathogens were small and statistically insignificant. Numerically elevated post‐therapy levels ofCrwere associated with sites that lost ≥ 1 mm between the 3‐ to 12‐month post‐treatment period. However, statistically this increase was not significant. Certain differences in detectable microbial presence between treatments were noted. Sites treated by TC fiber (F, FF, SF) exhibited lower post‐therapy percentages of detectableFn, Pg, Pi, andCrin 56 out of 60 comparisons with scaling and root planing (S) over the monitoring period. Though each individual comparison was not generally statistically significant, the probability of this repeated observation occurring by chance alone is extremely low. Similarly, when compared with scaling and root planing (S) alone, the adjunctive use of TC fiber (SF) consistently resulted in a lower percentage of sites with detectable levels ofFn, Pg, Pi, andCr.J Periodontol 1995;66:700–707.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.8.700

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The purpose of this investigationwas to examine periodontal disease recurrence from 3 to 12 months following various treatments with scaling and root planing and controlled‐release tetracycline fibers. One‐hundred‐twenty‐two (122) adult volunteers with at least one bleeding pocket ≥ 5 mm in each of four quadrants were enrolled in this study. One or two such sites in each quadrant were selected as test sites. Quadrants were randomly assigned to receive one of four treatments: scaling and root planing (S); scaling and root planing plus tetracycline fiber for 10 days (SF); fiber therapy alone for 10 days (F); or fiber therapy alone for 20 days (FF). After treatment, no supportive care was provided during the 12‐month study period. Probing depth (PD), attachment loss (AL), plaque, and bleeding on probing were measured at baseline, and at 1,3, 6, 9, and 12 months after treatment. PD and AL measures were taken at three locations within each site and averaged for each site. Disease recurrence was defined as ≥ 1 mm mean attachment loss at a site during the 3‐ to 12‐month period. Onehundred‐sixteen (116) subjects completed the study. Sites treated with SF experienced significantly (P<0.05) less disease recurrence (4%) than S, F, or FF (9%, 10%, and 12%, respectively). Results of this study suggest that, compared to S, F, or FF, scaling and root planing in conjunction with tetracycline fiber therapy for 10 days can significantly reduce disease recurrence 3 to 12 months following treatment in the absence of supportive care.J Periodontol 1995;66:708–715.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.8.708

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The origin of fibroblasts, their proliferativeactivity and roles in the early stages of periodontal repair were investigated in order to better understand the periodontal healing process in furcation defects of the beagle dog after guided tissue regenerative therapy. Newly divided cells were identified by immunolocalization. of bromodeoxyuridine (BrdU) injected 1 hour prior to sacrificing the animals. At 1 and 2 weeks after creation of the defects, the lesions were occupied primarily by granulation tissue. Under this condition, periodontal ligaments (PDL) fibroblasts in a coronal portion of the remaining PDL close to wounds proliferated actively, migrated along the root surface and formed fibrous connective tissue on the surface. Similarly, the fibroblasts adjacent to the bone surface also showed proliferative activity and engaged in active formation of fibrous connective tissue on the bone surface. The majority of labeled cells in both areas were located in the extravascular area. At 3 and 4 weeks, the defects were filled with an increased amount of new connective tissue and bone. The labeled fibroblasts were preferentially found in the most coronal portion of connective tissue formed on the root surface that was in direct contact with inflamed tissue, and the collagen fibers projected into granulation tissue. In areas of active bone formation, numerous labeled fibroblasts were located in connective tissue adjacent to the newlyformed bone. However, fibroblasts in the endosteum of new bone were rarely labeled. These results indicate that fibroblasts involved in periodontal repair originate primarily from both the remaining PDL and alveolar bone, and actively engage in fibrous connective tissue formation in the early stages of periodontal repair. The ability of PDL fibroblasts to proliferate, migrate, and form connective tissue on the root surfaces in the early repair stages appears to play a crucial role in the formation of the PDL and cementum, and consequently, in periodontal regeneration in the absence of root resorption and ankylosis. As the formation of new connective tissue and bone continues, the precursor cells for fibroblasts and osteoblasts are supplied locally through the continued divisions of the fibroblastic cells in association with the newly‐formed connective tissue. Paravascular and endosteal cells appear to be minor contributors to new cell population during furcation defect repair in the beagle dog.J Periodontol 1995; 66:716–730.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.8.716

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

This case reports ona 14‐year‐old boy with multiple radiolucent lesions widely distributed in the mandible, particularly in the right side (body‐angle‐ascending ramus). The lesion was first diagnosed as early‐onset periodontitis and treated accordingly. It continued to grow very quickly, however, over a 6‐month period, resulting in involvement of the entire mandible, with complete destruction of the lingual cortical bone, erosion of the external cortex with expansion in the neighboring soft tissues, and with a periosteal reaction in some areas. This case may serve to illustrate the rapid progress of eosinophilic granuloma, the importance and the difficulties of an early diagnosis, and the consequences of late diagnosis and treatment.J Periodontol 1995;66:731–736.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.8.731

出版商:Wiley    

年代:1995

数据来源: WILEY