摘要:

CyclosporineA (CsA)is a widely used immunosuppressantfor transplant patients and is also used for the treatment of a wide variety of systemic diseases with immunologic components. A prominent side effect of CsA administration is gingival overgrowth. It has been postulated that CsA alters fibroblast activity through effects on various cytokines such as the interleukins, however, as yet, data concerning the molecular mechanisms involved in connective tissue proliferation are still preliminary in nature. The purpose of this study was to evaluate interleukin‐6 (IL‐6) gene expression in gingival tissues of patients receiving CsA therapy and exhibiting gingival overgrowth. Radioimmunoassay (RIA) demonstrated a significant difference in tissue levels of IL‐6 as mean ± SEM. IL‐6 content in CsA‐stimulated tissue was 184.3 ±30.2 ng/mg total protein versus 23.3 ± 6.5 ng/mg total protein in control tissue.In situhybridization indicated that overgrown gingival tissues from patients taking CsA had a significantly higher content of IL‐6 mRNA when compared to control tissues. Expressing IL‐6 mRNA levels as silver grains/cell, CsA‐stimulated tissue had 166.9 ± 12.0 grains of IL‐6 mRNA/cell while control tissue had 12.8 ± 3.0 grains of IL‐6 mRNA/cell. These results demonstrate that CsA therapy results in increased levels of IL‐6 protein and IL‐6 mRNA in overgrown human gingival tissues. This is the first report of CsA‐upregulated IL‐6 gene expression in vivo, and may explain in part the molecular mechanisms responsible for CsA‐induced gingival overgrowth.J Periodontol 1994;65:895–903.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.10.895

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

This study was a first stageevaluation of the plaque inhibitory properties of an experimental cetylpyridinium chloride (CPC)/essential oil mouthrinse. The study was a formulation, not ingredient, evaluation and comparisons were made with established mouthrinse products. The 5 rinses tested were: the experimental formulation; a triclosan/copolymer prebrushing mouthrinse; two negative control rinses, which differed only in color; and as a positive control, a 0.2% chlorhexidine mouthrinse. The study used a 5 cell, 4‐day plaque regrowth, double‐blind crossover design in which 15 subjects participated. Allocation of mouthrinse sequences was accomplished using 3 replicates of a 5 × 5 Latin square, incorporating balance for carryover. On Day 1, subjects received a scaling and polishing to reduce plaque, ceased toothcleaning, and commenced rinsing twice daily, under supervision, with the randomly assigned rinse. Rinsing time for the experimental and one negative control rinse was 30 seconds and for the other rinses was 60 seconds. On Day 5, plaque was scored by both index and area. Differences in plaque regrowth between the rinse groups were highly significant. The order of efficacy from the most effective was: chlorhexidine rinse (positive control); experimental CPC/essential oil rinse; triclosan/copolymer rinse; and the negative control rinses. From the calculated confidence intervals each rinse differed significantly from each other rinse, except for the two negative control rinses which were comparable to each other. Proportionately, the CPC/essential oil rinse was positioned 30 to 50% between the triclosan/copolymer rinse and the chlorhexidine (positive control). These findings suggest that the CPC/phenolic rinse would seem worthy of further evaluation for adjunctive benefits to oral hygiene.J Periodontol 1994;65:904–907

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.10.904

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

We compared the accuracy, consistency, time, comfort, and cost of probing with a conventional hand probe (CP) with 3‐mm banded markings, a manual pressure‐regulated probe (MP), and two electronic probes (IP and FP). Twenty (20) examiners used all four probes on a test block to determine accuracy; measurements compared favorably to the reference block. Two calibrated examiners probed the Ramfjord teeth of 10 periodontal patients on maintenance regimens, six sites per tooth (n = 708), with all four probes; measurements were repeated after one week. Wilcoxon signed‐rank test showed the CP measured more deeply (P<0.0001) than MP, FP, and IP with mean differences of 0.40, 0.67, and 0.58 respectively. MP measured more deeply (P<0.001) than FP and IP, with mean differences of 0.27 and 0.18 mm. There was no difference between FP and IP. Time (min:sec) required by one examiner to perform full mouth probing on six subjects (minimum of 26 teeth each) was CP = 3:59; MP = 4:18; FP = 6:16; and IP = 7:23. Subjects rated FP and IP as slightly more uncomfortable than CP or MP. Cost per 1,000 uses was computed based on available data. The IP and FP took longer to perform and cost more per procedure than did the CP and MP. Spearman rank‐order correlation revealed that only probe depths measured by CP and MP were well correlated (rs= 0.67). Although some statistically significant differences were found between probes, no differences were considered to be of clinical significance when probing periodontally healthy or maintenance patients. Electronic probes were more expensive per use and more time‐consuming than hand probes.J Periodontol 1994;65:908–913.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.10.908

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The effect on periodontal healingafter guided tissue regeneration (GTR) in association with local application of metronidazole gel was evaluated in this study. Twelve patients with one pair of vertical periodontal bone defects of comparable size and configuration participated in the study. In a matched paired design, the test defects were treated by GTR using expanded polytetrafluoroethylene (ePTFE) membranes in combination with local application of metronidazole gel. The controls were treated in the same way except for application of metronidazole. During the first month of membrane implantation, no statistically significant differences between test and control surfaces were noted with respect to inflammation of the marginal gingiva. Six weeks following insertion, the membranes were removed. Six months after removal of the membrane, the median gain in probing attachment level as a percentage of the initial defect depth was 92% for test defects and 50% for control defects (P=.001). No statistically significant differences were found between test and control sites regarding plaque, bleeding on probing, reduction in pocket depth, gain in bone height, or recession of the gingival margin. In conclusion, the results of the present study indicate that local application of metronidazole gel has a beneficial effect on healing of periodontal vertical defects treated by guided tissue regeneration. J Periodontol 1994;65:914–920.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.10.914

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The bacteriological colonization of healingperiodontal defects was investigated after treatment with guided tissue regeneration using expanded polytetrafluoroethylene membranes together with local metronidazole gel (25%, 250 mg/g). Twelve patients, each with one pair of comparable defects, had the test defect treated with the membrane plus metronidazole gel and the control defect treated with the membrane alone. Thirty weeks after removal of the membrane, the median gain in probing attachment level as a percentage of the initial defect depth was 92% for the test defects and 50% for the control defects (P= 0.001). The median number of cultivable bacteria decreased from 1.2 × 106at the presurgical examination to 3.0 × 105at the one week examination in the test group (P= 0.02), whereas an increase was observed in the control group. Similarly, a lower median proportion of black‐pigmented Gram‐negative anaerobic rods was observed one week postsurgically in the test group (0.004%) compared to the control group (3.5%) (P= 0.02). Two weeks after membrane insertion, and at all following examinations, no microbiological differences between test and control group were observed. Consequently, the influence of the metronidazole gel on the treatment result appears to have been confined to the initial regeneration phase. Despite the good clinical results in the test group, all membranes from both test and control pockets were heavily colonized with bacteria at the time of removal. To ensure maximal periodontal regeneration with formation of bone, future research in this area should concentrate on reducing the microbial colonization of the wound area.J Periodontol 1994;65:921–928.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.10.921

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Thirty(30) ClassIandClassIIrecessionsin 30 subjects were treated with a subepithelial connective tissue graft procedure. In one group (15 sites), the surgery was carried out in a traditional fashion: the epithelial collar of the graft was preserved and left exposed (CTG group). In the second group (15 sites), the epithelial collar of the graft was removed and the recession areas were conditioned with citric acid. The graft was then sutured and completely immersed under the facial flap which was coronally repositioned (CR group). Clinical assessments included probing depth, probing attachment level, surface area of the recession, and gingival width. These measurements were taken at baseline and at 6 months. In addition, an esthetic evaluation was done. The differences between treatments were not statistically significant except for the augmentation of gingiva (P≤0.05). Based on the midfacial measurements taken in the central area of the recession, the mean percentage of root coverage was 69.2%. In the CR group, 3 of the 15 recessions exhibited complete root coverage; the gingival augmentation was 65.5%. In the CTG group, 5 of the 15 recessions exhibited complete root coverage; the gingival augmentation was 94.4%. The mean surface area of root exposure was reduced from 13.82 mm2and 13.67 mm2to 2.15 mm2and 2.34 mm2for the CR group and the CTG group, respectively. One‐hundred percent (100%) of good‐to‐moderate esthetic results were found by a panel of independent examiners; there was tendency toward better results in the CR group. The results of this study indicate that partial success could be expected with subepithelial connective tissue grafting in Class I or Class II recession therapy. It is suggested that the CR group procedure gives better esthetic results than the CTG group procedure. However, when larger augmentation with keratinized tissue is needed, the CTG group procedure is preferred.J Periodontol 1994;65:929–936.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.10.929

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The use of smokeless tobacco(st)productsis associated with mucosal lesions, gingival recession, and attachment loss at the site of tobacco placement. Monocytes/macrophages are primary producers of PGE2and IL‐1β, inflammatory mediators which are thought to play a role in the destruction of the periodontium. The purpose of this study was to determine the effect of ST alone and in combination with a major stimulator of inflammation, bacterial lipopolysaccharide (LPS), on monocyte secretion of these mediators. Peripheral blood monocytes (PBM) were isolated by counterflow centrifugal elutriation from 15 healthy donors who were non‐ST users. PBM were incubated for 24 hours in RPMI 1640 containing various concentrations of ST (0%, 0.005%, 0.01%, 1%) with or without 10 μg/ml LPS (Porphyromonas gingivalisLPS orEscherichia coliLPS). Of the ST preparations, only 1% ST resulted in PBM mediator secretion (7.7 ± 2.0 ng/ml for PGE2and 1.3 ± 0.2 ng/ml for IL‐1β) above that of control (unstimulated) cultures. Furthermore, the combination of 1% ST and LPS resulted in a potentiation of PGE2release (5‐fold forE. coliLPS + 1% ST and 10‐fold forP. gingivalisLPS + 1% ST;P<0.0001, one‐way ANOVA) relative to the LPS preparations alone. In contrast, PBM IL‐1β release decreased more than 2‐fold uponE. coliLPS and 1% ST exposure, relative to treatment withE. coliLPS alone (P<0.0001, one‐way ANOVA). PBM IL‐1β release either increased or decreased following treatment withP. gingivalisLPS + 1% ST, depending on the magnitude of theP. gingivalisLPS response alone. These data indicate that ST has profound effects on monocyte secretion of PGE2and IL‐1β, and modulates the LPS‐mediated monocyte response.J Periodontol 1994;65:937–941.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.10.937

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The relationship between implant surfacesand decontamination treatments was studied in vitro to determine which implant surfaces were most effectively decontaminated, and which treatment was most effective for treating a particular implant surface. The implants used in the study were press fit cylindrical titanium units with machined, plasma sprayed, and hydroxyapatite‐coated surfaces. Radioactive endotoxin (125I‐LPS) was prepared fromPorphyromonas gingivalis(ATCC 33277). Implants were coated with125I‐LPS and treated by burnishing with a cotton pellet soaked in water, citric acid solution (CA), or 0.12% chlorhexidine (CHX); or treated with an air‐powder abrasive (AIR). Radioactivity was determined after each of two treatment cycles. The results for each implant surface were analyzed using ANOVA to determine differences between treatments. The remaining125I‐LPS after two treatment cycles were: for machined implants AIR

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.10.942

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

We analyzed the cell‐cell adherence relatedto CD11/CD18 and CD18 mRNA in individuals with decreased CD11/CD18 expression on their neutrophil surface. Epstein Barr virus‐transformed B cell lines were developed from one localized juvenile periodontitis (LJP) patient with decreased CD11/CD18 in the peripheral blood neutrophils and without systemic diseases; two siblings with generalized prepubertal periodontitis (GPP) caused by leukocyte adhesion deficiency (LAD); another LJP patient; one localized prepubertal periodontitis. (LPP) patient; and two healthy subjects. Adhesion of leukocytes to each other was measured as cluster formation by aggregation assay. The length and the amount of CD18 mRNA expressed in the cell lines were analyzed by Northern blotting using the32P‐labeled CD18 cDNA. The coding region of the mRNA was analyzed by the reverse transcription‐polymerase chain reaction method. Base‐mismatches between CD18 mRNA and the32P‐labeled RNA probe synthesized from CD18 cDNA were analyzed by RNase protection assay. In the adherence assay, cells from the LJP patients with decreased CD11/CD18 formed more clusters of smaller size and fewer cells than those of the other subjects. The cells from GPP and LAD patients did not aggregate and did not form clusters either in the absence or presence of PMA. There were no differences in the length and the amount of mRNA between the LJP patients and the other subjects, while GPP‐LAD patients expressed a small amount of long mRNA. The whole coding region (2,313 base pairs) of all subjects was amplified except for the GPPLAD patients, and the 5′‐region (1,119 base pairs) was amplified from all subjects. Basemismatches were detected on the coding region from 965 to 1,450 nucleotides of CD18 mRNA in GPP‐LAD patients. No mismatch was detected on other regions of CD18 mRNA in any subject. These results suggest that the LJP patient with an anomaly of qualitative aggregation related to CD11/CD18 is not related to sequence abnormalities of CD18 mRNA suggesting other mechanisms. In contrast, the adherence defect in two GPP‐LAD patients was related to heterogeneous molecular mutations on CD18.J Periodontol 1994;65:949–957.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.10.949

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Sinus augmentation to facilitatethe placement of cylindrical endosseous implants in the posterior maxilla has become more commonplace, and many different materials have been used for the sinus graft. The results of two sinus augmentation procedures, one grafted with demineralized freeze‐dried bone (DFDB) and the other with autogenous iliac bone, are presented. Bone cores were obtained with a trephine drill from the grafted regions at the time of implant placement. Eight implants were placed into the grafted areas in each subject. The sample from the sinus grafted with autogenous bone was obtained 8 months postoperatively and the bone core from the sinus grafted with DFDB was taken 16 months postoperatively. The bone specimens were subsequently examined under light microscopy. The autogenous specimens demonstrated new bone formation with increased quantity and improved quality when compared to the specimens obtained from the sites grafted with allogeneic bone. All 8 implants placed into the autogenous grafts were clinically osseointegrated at stage 2. At 16‐months postsurgery, the bone core taken from the site grafted with DFDB demonstrated poor bone quality and still contained remnants of the graft material in the region approximating the sinus membrane. Two of the 8 implants placed into the allogeneic grafts failed at stage 2. These findings suggest that autogenous sinus grafts produce bone of adequate quantity and quality for implant placement, whereas DFDB sinus grafts are not completely remodeled by the host and may produce bone of insufficient quality and quantity for predictable implant placement.J Periodontol 1994;65:958–966.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.10.958

出版商:Wiley    

年代:1994

数据来源: WILEY