摘要:

The purpose of this study was to compare, using cell blot analysis, the association of gingival tissue mononuclear cells (GTMC) isolated from lesions displaying histories of early‐onset periodontitis (EOP; typically B‐lymphocyte dominated) and gingivitis (typically T‐lymphocyte dominated) with the B‐cell stimulating cytokine, interleukin (IL)‐4, and the T‐cell stimulating cytokine, IL‐2. Eleven EOP patients and 11 age‐ and gender‐similar gingivitis control (GC). subjects participated. Gingival tissue adjacent to the alveolar crest normally removed during surgery was digested in collagenase‐containing media and GTMC were isolated by density gradient centrifugation. Cells were separated into four aliquots. One was left unstimulated; the remainder were stimulated for 2 hours withPorphyromonas gingivalisouter membrane protein, mitogen Concanavalin A, or common antigen tetanus toxoid. Cells then were centrifuged onto transfer membranes and incubated in RPMI 1640 media for 6 hours to allow adsorption of secreted cytokine. Membranes were treated with monoclonal anti‐IL‐2 or anti‐IL‐4, followed by a biotin‐conjugated second layer, streptavidin‐alkaline Phosphatase and nitro blue tetrazolium/5‐bromo‐4‐chloro‐indolyl‐phosphate (NBT/BCIP) color development. A higher percentage of GTMC from EOP patients were IL‐2+when stimulated withP. gingivaliscompared with GTMC from GC patients (20 ± 2% vs. 12 ± 2%,P<0.003). A higher percentage of non‐stimulated GTMC from EOP patients produced IL‐4 than from GC (22 ± 4% vs. 6 ± 3%,P<0.00007), as well as when stimulated withP. gingivalis(22 ± 3% vs. 13 ± 2%,P<0.01). Analysis of IL‐2/IL‐4 positive GTMC ratios revealed significant differences between EOP and GC for non‐stimulated cultures (0.5 ± 0.2 vs. 2.9 ± 1.0,P<0.02). Digital analysis indicated significantly greater areas of IL‐4 staining for EOP than GC GTMC in non‐stimulated cultures (P<0.006). These data would support the hypothesis that altered IL‐2/IL‐4 activities are associated with the periodontitis lesion.J Periodontol 1994;65:807–813.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.9.807

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The aim of the present study was to assessthe incidence of early radiographic bone loss in a birth cohort over 8 years and to assess possible associations between incidence of bone loss and reported dental behavior, ethnic background, and previous orthodontic treatment. In a case control study comprising a proportion of the study population, the detection of black pigmentedBacteroidesandActinobacillus actinomycetemcomitansand their association with early radiographic bone loss was assessed. At the beginning of the study in 1984, there were 2,767 subjects. In 1992 sets of bite‐wing radiographs were obtained from 215 subjects, who also filled out a questionnaire concerning their present and past dental behavior, ethnic background, and orthodontic treatment. Radiographic alveolar bone loss was recorded if the distance from the cemento‐enamel junction to the alveolar crest exceeded 2 mm. Thirteen subjects (6%) showed new sites with bone loss over the 8‐year period. Subgingival plaque was sampled from these 13 subjects and from 13 control subjects. None of the independent variables could be associated with the observed incidence of radiographic bone loss in this cohort, with the possible exception of the presence ofA. actinomycetemcomitanswhich was detected in about 50% of the new sites with bone loss.J Periodontol 1994; 65:814–819.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.9.814

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The aim of this investigationwas to study the topographic distribution ofActinobacillus actinomycetemcomitansin patients with adult periodontitis before and after mechanical periodontal treatment (repeated oral hygiene instructions, systematic deep scaling, and root planing). In 10A. actinomycetemcomitans‐positive patients, subgingival microbial samples were obtained from the mesial and distal aspect of every tooth (38 to 56 sites per patient, 479 sites in total) before and one month after treatment. The samples were cultured on TSBV agar.A. actinomycetemcomitanswas identified based on phenotypical and serological criteria.A. actinomycetemcomitanswas present in 40% of the samples taken before and in 23% of the samples taken after treatment. Before treatment, the frequency ofA. actinomycetemcomitans‐positive samples per patient was wide spread and ranged from 7 to 90%. After treatment, two patterns ofA. actinomycetemcomitansdistribution could be recognized: the majority of the patients showed only a limited percentage of positive samples and yielded less than 105A. actinomycetemcomitans. In three subjects, however, relatively high numbers of positive sites were still present, and many of these positive sites showed highA. actinomycetemcomitanscounts. Logistic multiple regression showed the presence ofA. actinomycetemcomitansbefore treatment depended strongly on the individual and was significantly associated with probing depth (P<0.001) and bleeding upon sampling (P= 0.07). The highest chance of detectingA. actinomycetemcomitansexisted in deep pockets which bled upon sampling. After treatment, there was a strong individual influence and an influence of probing depth (P<0.001). The highest chance of detectingA. actinomycetemcomitansexisted in residual pockets in the range of 5 mm.J Periodontol 1994; 65:820–826.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.9.820

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Ten systemically healthy subjects(ages 28 to 60 years) with untreated moderate to severe periodontal disease and evidence of presence ofA. actinomycetemcomitansunderwent standard mechanical periodontal treatment consisting of oral hygiene instruction and systematic deep scaling and root planing. Before, and 4 to 5 weeks after treatment, clinical measurements and separate subgingival microbiological samples were taken from the mesial and distal aspect of every tooth, with the exception of the third molars.A. actinomycetemcomitanscould still be detected in all patients after treatment. In 9 of the 10 patients, all tested isolates from both examinations were of a single type. Two patients carried serotype a; 2 serotype b; 2 serotype c; and 1 serotype e. Two individuals showed only non‐typeable isolates lacking serotype a, b, c, d, or e specific antigens. Another subject was colonized by serotype c and, in addition, yielded a nontypeable isolate. Persistence ofA. actinomycetemcomitansafter treatment was significantly correlated with the frequency ofA. actinomycetemcomitansbefore treatment (P<0.001) and the mean probing depth before treatment (P<0.05). No serotype‐specific patterns of treatment outcome could be recognized. The analysis of the site specific effect of treatment showed a significant relationship between post treatment levels ofA. actinomycetemcomitansand both probing depth reduction as well as attachment gain. Individuals showing evidence ofA. actinomycetemcomitansin a multitude of sites appeared to be more difficult to treat than patients with few positive sites only. Within such individuals, the deeper pockets showed the greater resistance to eradication ofA. actinomycetemcomitans.J Periodontol 1994; 65:827–834.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.9.827

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Acase of post‐juvenile periodontitisin a 28‐year‐old female patient is described along with new periodontal treatment modalities. Administration of minocycline‐HCl with local drug delivery system was introduced as a part of initial periodontal therapy following microbiological and immunological examinations. The lesions were subsequently treated by guided tissue regeneration, which resulted in considerable gain of attachment with minimal recession of marginal gingiva. This observation suggests that the local delivery of antibiotics and regenerative therapy may prove to be effective alternative modalities in treatment of post‐juvenile periodontitis.J Periodontol 1994; 65:835–839.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.9.835

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The purpose of this study was to assessthe clinical and microbiological effects of a newly developed root conditioning gel system containing tetracycline or a mixture of tetracycline and citric acid on non‐surgical periodontal therapy. Sixty‐four (64) singlerooted teeth with a probing depth of 4 to 6 mm were randomly subjected to one of the following four treatments; 1) root planing alone (RP group); 2) tetracycline‐containing gel alone (TCG group); 3) root planing plus tetracycline‐containing gel (RP+TCG group); or 4) root planing plus a mixture of tetracycline and citric acid‐containing gel (RP+TC‐CAG group). Probing depth, attachment level, and tooth mobility were measured and the presence of dental plaque and gingival inflammation was recorded at baseline and after 2, 4, 8, and 12 weeks. Subgingival plaque samples from each site were collected at the same visits and examined with phase contrast microscopy for proportions of motile rods and spirochetes. Plaque index, gingival sulcus bleeding index (SBI), probing depth, and attachment level decreased significantly in all groups compared to the baseline values (P<0.05). A significant decrease in probing pocket depth was noted after 12 weeks in RP+TC‐CAG group compared to the other groups (P<0.05). Significantly more gain in attachment was detected in the RP+TC‐CAG group compared to the TCG group (P<0.05). Tooth mobility scores also decreased later in the study. A significant decrease in the proportion of motile rods was found primarily in the RP+TC‐CAG group. There was a significant decrease of the proportion of spirochetes in all groups. The results indicated that use of a mixture of tetracycline and citric acid containing‐gel was effective in improving gingival health and in changing subgingival microflora.J Periodontol 1994; 65:840–847.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.9.840

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Although supragingival plaque control is essentialto successful periodontal therapy, the role of plaque control following systemic antibiotic use in periodontal disease has not been well defined. This study evaluated, following antibiotic use, which clinical and microbial parameters appeared to be influenced primarily by the antibiotics, independent of plaque control, and which outcomes appeared to be dependent on plaque control. Two hundred thirty‐six patients (236) with moderate to severe periodontitis were clinically evaluated and microbial samples were taken by their private‐practice periodontists. All patients were treated with scaling and root planing and a variety of systemic antibiotics, which were selected based on the microbial and clinical profile of the patient. Three months after therapy, patients were reevaluated and grouped by post‐treatment plaque control, as either having very good oral hygiene (LoPl: N = 143; ≥ 10% plaquecovered surfaces) or poor oral hygiene (HiPl: N = 93; ≥ 25% plaque‐covered surfaces). The two groups had different plaque and bleeding scores initially, but similar numbers of pockets probing>5 mm and similar microbial patterns. Although the LoPl group had a significantly greater reduction in plaque than the HiPl group, bleeding scores and probing depths changed comparably in both groups after antibiotic therapy. Plaque control influenced outcomes significantly, but in a complex manner. The LoPl group exhibited a significantly greater reduction in certain bacteria, for exampleP. gingivalis. Interactions between plaque control and specific microbial parameters significantly affected clinical outcomes, although neither alone was sufficient to predict outcomes following antibiotic therapy. In general, good oral hygiene appears to be important in achieving the best clinical and microbial response when antibiotics are used to treat periodontitis. The impact of plaque control on clinical outcomes may be best understood as a complex interaction with the presence or absence of specific microorganisms.J Periodontol 1994; 65:848–854.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.9.848

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Postsurgical flap placementmight affect the outcome of the operative procedure. Modified Widman flap surgery with primary closure and flap approximation (usually away from the bone crest) and apically positioned flap surgery with near crestal bone positioning are both widely used in surgical periodontal treatment. Several comparative investigations have studied these modalities, however, none have been able to show conclusively that either is superior to the other. The purpose of this longitudinal study was to explore the optimal postsurgical flap placement in respect to final probing depth and changes in clinical attachment level. Following routine hygienic phase of treatment, 12 subjects (186 teeth) with adult periodontitis received surgical periodontal treatment. Prior to the flap surgery, probing depth and clinical attachment level were recorded. Sounding depth measurements were taken to record postoperative flap placement. Patients were placed on a 3‐month maintenance program. Probing depth and clinical attachment level were again measured at 2 years postoperatively and compared to baseline measurements. An overall positive correlation (R= 0.43;P= 0.0248) was found between immediate postoperative sounding measurements and probing depth after 2 years. Conversely, attachment level changes over the 2‐year period showed only weak inverse correlation (R= 0.27;P= 0.0121) with sounding depth measurement immediately postsurgically. Sites where postoperative sounding depth were ≤ 3 mm had a mean probing depth (2.52 mm) which was significantly (P<0.001) smaller compared to sites with sound depth ≥ 4 mm (3.58 mm). Changes in clinical attachment level varied between sites and sounding depth groups; however, none of these differences were statistically significant. Based on our findings it is suggested that following periodontal flap surgery, in those cases where minimal probing depth is desired, the flap be secured to the underlying structures at or slightly coronally to the bone crest (≤ 3 mm). Such an approach is likely to result in optimal pocket reduction with minimal attachment loss, which when supplemented with maintenance care and personal oral hygiene is likely to remain unchanged and prevent future periodontal relapse.J Periodontol 1994;65:855–858.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.9.855

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Periodontal health reflects a balance betweenharmful and protective elements in the gingival margin area. The total plaque mass, specific periodontopathogens, and local environmental factors may challenge this balance. The aim of this retrospective study was to evaluate the effect of proximal root grooves as a risk factor in periodontal attachment loss. One‐hundred and three (103) extracted, formalin‐stored, single‐rooted teeth showing loss of attachment and having one non‐grooved and one grooved proximal root surface were selected for the study. Following staining in 0.1% toluidine blue to visualize attached periodontal ligament remnants, the teeth were examined in a light microscope under incident light. On each tooth, loss of attachment was measured along the long axis of the root from the cemento‐enamel junction to the most coronal level of the stained periodontal ligament remnants on mesial as well as on distal surfaces. Incisors and premolars were grouped separately. For both groups, a statistically significant greater loss of attachment was present on grooved than on non‐grooved surfaces (P<0.0001). Generally, there was a direct relationship between groove location and maximum loss of attachment. The results indicate that proximal root grooves should be considered in periodontal diagnosis, prognosis, and treatment planning.J Periodontol 1994;65:859–863.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.9.859

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

This study assesses the role of poor oral hygieneand forceful toothbrushing as risk factors for recession. As part of a cross‐sectional root surface caries study, 298 subjects, 42 to 67 years of age, with at least one exposed root surface, were examined. Since 66% of the root surface exposure and practically all the abrasion was on buccal surfaces, the analyses focused only on the buccal surface. Analysis of variance on subject means for buccal recession showed both calculus and presence of buccal root surfaces with abrasion to be significantly associated with recession after adjusting for age and gender. Root surface abrasion was considered a surrogate variable for forceful brushing. An additional analysis utilized means for each tooth, aggregating across subjects. For each of the 32 tooth types mean buccal recession, percent of exposed root surfaces with abrasion (%ra), and mean debris and calculus scores were calculated. Partial correlation coefficients across tooth types between recession and calculus, adjusting for abrasion, and for recession and abrasion adjusting for calculus, were 0.55. Interpretation of the %ra as a crude measure of forceful brushing is supported by its strong negative correlation across tooth types, with mean debris (r = −0.8) and mean calculus (r = −0.7). Separate analyses on premolars and on molars suggested that recession on premolars may be primarily due to brushing force and on the molars may be primarily due to debris and calculus. The findings suggest that recession is positively associated with percent abrasion (reflecting forceful brushing) and with poor oral hygiene.J Periodontol 1994;65:864–871.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.9.864

出版商:Wiley    

年代:1994

数据来源: WILEY