摘要:

Drug‐induced gingival overgrowthis a side effect associated principally with 3 types of drugs: anticonvulsant (phenytoin), immunosuppressant (cyclosporine A), and various calcium channel blockers (nifedipine, Verapamil, diltiazem). In this review, we describe the features of phenytoin‐, cyclosporine A‐ and nifedipine‐induced gingival overgrowth in rats and discuss factors influencing the onset and severity of these disorders. There are several features common to the gingival overgrowth induced by these drugs: 1) gingival overgrowth is more conspicuous in the buccal than in the lingual gingiva and less severe in the maxilla than in the mandible; 2) once the blood concentration of the drug reaches a certain level as a result of increasing the dose, the incidence of gingival overgrowth is 100% and its severity is dependent on the blood level, the most severe overgrowth being induced by cyclosporine A; 3) the duration of drug administration for maximal gingival overgrowth to develop is about 40 days; 4) the gingival overgrowth regresses spontaneously after discontinuing the drug; 5) accumulation of dental plaque is not essential for the onset of overgrowth, but plays a role in its severity; and 6) more severe overgrowth is induced in young than in old rats. Furthermore, male rats are more susceptible than females to nifedipine‐induced gingival overgrowth. These results suggest that drug‐induced gingival overgrowth in rats is dependent on the oral drug dose, blood drug level, age, and sex and that preexisting gingival inflammation is a factor relevant to its severity. Since these factors have also been suggested to be important determinants for human drug‐induced gingival overgrowth, the rat model may prove valuable in the future for elucidating the molecular pathogenesis of the disorder.J Periodontol 1996;67:463–471.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.5.463

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Previous studies have noteda positive correlation between gingival inflammation and crevicular pH, which reportedly varies from 6.5 to 8.5. In the present study, we characterized the manner in which deviation from the “physiological” pH of blood (7.2) influences activation of chemotaxis, phagocytosis, superoxide generation, and degranulation by human polymorphonuclear leukocytes (PMNs). Purified PMNs were suspended in HEPES‐buffered balanced salts solutions adjusted to pH 6.7, 7.2, 7.7, or 8.2. In a modified Boyden chamber, the chemotactic response to fMet‐Leu‐Phe was maximal at pH 7.2. In comparison, chemotaxis was significantly depressed at pH 7.7 and pH 8.2 (P<0.05), but was not significantly different at pH 6.7. Activation of the respiratory burst by fMet‐Leu‐Phe was optimal at pH 7.2, but was significantly depressed at pH 6.7 and 8.2 (P<0.05). pH had little effect on N‐acetyl‐β‐glucosaminidase release from primary granules. However, lactoferrin release from the secondary granules of fMet‐Leu‐Phe‐activated PMNs was significantly lower at pH 7.2 than at pH 6.7 or 8.2 (P<0.05). Moreover, phagocytosis of opsonized bacteria was significantly lower at pH 7.2 than at pH 7.7. In addition to these effects on functional activation, extracellular pH influenced the magnitude of intracellular Ca2+mobilization. Peak fMet‐Leu‐Phe‐induced Ca2+levels were significantly higher at pH 8.2 than at pH 7.2 (P<0.01). These findings suggest that the pH of the periodontal environment can selectively influence PMN activation, thereby altering the balance between bacteria and the host response.J Periodontol 1996;67:472–477.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.5.472

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The aim of this studywas to investigate the effect of conventional periodontal treatment on the prevalence ofActinobacillus actinomycetemcomitans, Porphyromonas gingivalis, andPrevotella intermediaon oral mucous membranes in patients with periodontitis. Fifteen patients were selected with moderate to severe periodontitis (mean age: 39.8 years, range: 26 to 58). From each patient the 4 deepest sites with bleeding on probing were selected for clinical and microbiological evaluation. At baseline, 6 weeks after oral hygiene instruction and extensive scaling and root planing, and 3 months after periodontal surgery, clinical parameters and microbiological samples including saliva, oral mucous membranes, and supra‐ and subgingival plaque were evaluated for the presence of the 3 test bacteria using indirect immunofluorescence. All clinical variables, except redness, showed a significant improvement after surgery. After treatment, the subgingival prevalence of the 3 putative periodontal pathogens had decreased significantly. However, almost no concomitant reduction in the prevalence of the bacteria was seen on the oral mucous membranes. This suggests that the oral mucous membranes may serve as a source for reinfection of the periodontium after treatment.J Periodontol 1996;67:478–485.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.5.478

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

There are a large number ofmouthrinse products available to the general public for use as adjuncts to oral hygiene. Many have not been evaluated and relatively few comparisons of products have been made. This study compared 4 mouthrinse products containing cetylpyridinium chloride (CPC), chlorhexidine, C31G, or triclosan with saline rinse included as a placebo control. Twenty dentate volunteers took part in this 4‐day plaque regrowth study which had a single blind, randomized cross‐over design balanced for residual effects. On day 1 of each study period, volunteers were rendered plaque free by a professional prophylaxis, suspended normal oral hygiene measures, and rinsed twice daily for 1 minute with 15 mL of the allocated rinse. On day 5, subjects were scored for disclosed plaque by plaque index and plaque area. By both measures the order of decreasing product efficacy was chlorhexidine, CPC and triclosan, C31G, and saline. All the differences in favor of the chlorhexidine product were highly significant as were those in favor of the other rinses compared to saline. It is concluded that the findings of this study reflect the actual chemical benefits of the products divorced from the indeterminate variable of toothbrushing.J Periodontol 1996;67:486–489.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.5.486

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The use of membranes for periodontal regenerationis well established. In clinical use, the exposure of membranes to the oral microflora may result in a pathway for periodontal infections. An important role in this process is played byPorphyromonas gingivalis. The purpose of the present study was to examine the colonization of 6 different bioresorbable and nonresorbable membranes for periodontal regeneration by the strain DSM 20709 ofP. gingivalisand to determine the time needed by this microorganism to pass through the membranes. A device consisting of a tube sealed with the membranes and filled with a medium suitable for the growth ofP. gingivaliswas incubated in a bigger tube containing the same medium to study the process of colonization and the crossing of membranes. The outer tube was inoculated with 104cells ofP. gingivalisDSM 20709. The passage of bacteria through the membranes was monitored at 6, 24, and 48 hours by counting the number of cells in the inner tube. The colonized membranes were observed using a scanning electron microscope. Differences in the behavior of the 6 membranes analyzed were demonstratedJ Periodontol 1996;67:490–496.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.5.490

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The analytical performance of a membrane‐basedimmunoassay for the simultaneous detection and differentiation ofActinobacillus actinomycetemcomitans, Porphyromonas gingivalis, andPrevotella intermedia(includingPrevotella nigrescens) was investigated. Positive reactions were observed for 71 of 71 reference strains and recent oral isolates ofA. actinomycetemcomitans, P. gingivalis, andP. intermedia. No cross‐reactivity was observed with 39 other common oral and environmental species. The specificity of the test was unaffected by the presence of potential oral interferents including whole blood, white blood cells, mucin, saliva, toothpastes, and oral rinses. A proficiency test by dental professionals using a standardized set of unknown simulated samples yielded a sensitivity of 97% (116/120) and a 100% specificity (240/240). An additional group including dental professionals and high school students was shown to be 99% proficient (1385/1397) in distinguishing proper from improper test function when processing control samples with normal test devices and devices with simulated error conditions. Comparisons to a culture standard for 104 subgingival plaque samples collected from 26 adult periodontitis patients yielded>98% specificity for each of the test bacteria. In addition, the detection threshold for the test was determined to be equivalent to 104cultivable test bacteria when compared to the culture standard. The data indicate that this membrane immunoassay is a valid and easy‐to‐use method for the detection ofA. actinomycetemcomitans, P. gingivalis, andP. intermediain subgingival plaque, at levels above the detection threshold of the test.J Periodontol 1996;67:497–505.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.5.497

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Specially‐formulated low‐dose doxycycline(LDD) regimens have been found to reduce collagenase activity in the gingival tissues and crevicular fluid (GCF) of adult periodontitis subjects in short‐term studies. In the current, double‐blind, placebocontrolled study, adult periodontitis patients were administered for 6 months a “cyclical” regimen of either LDD or placebo capsules; and various clinical parameters of periodontal disease severity, and both collagenase activity and degradation of the serum protein, a,‐PI, in the GCF were measured at different time periods. No significant differences between the LDD‐ and placebo‐treated groups were observed for plaque index and gingival index. However, attachment levels, probing depth, and GCF collagenase activity and a,‐PI degradation were all beneficially and significantly (P<0.05) affected by the drug regimen. We propose: 1) that LDD inhibits tissue destruction in the absence of either antimicrobial or significant anti‐inflammatory efficacy; and 2) that long‐term LDD could be a useful adjunct to instrumentation therapy in the management of the adult periodontitis patient.J Periodontol 1996;67:506‐514.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.5.506

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Periodontitis is a chronic inflammatorydisease of the soft and hard supporting tissues of the teeth and is a major cause of tooth loss in adults. The local host response to periodontopathic bacteria results in the release of inflammatory mediators and cytokines. Since cytokines are indicative of effector functions, we compared the pattern of cytokine production in periodontal patients and healthy controls. Specifically, we investigated the simultaneous presence of cytokines produced by T helper (Th)l, Th 2, and inflammatory cells which could be involved in periodontitis. We also compared the expression of these cytokine mRNAs in healthy and diseased tissues. No significant differences were detected at the protein or mRNA levels of the cytokines in the systemic circulation of patients and controls. The surface markers CD 16 and CD56 were expressed on significantly fewer peripheral mononuclear cells of patients when compared to controls. γδ+ T cells were found in half of the diseased tissues, but in none of the healthy tissues of either patients or controls. Finally, significant differences were observed between healthy and inflamed gingival tissues in the cytokine mRNA profile. Expression of IL‐6 and IFN‐α mRNA was significantly higher in diseased tissues compared to healthy tissues in patients.J Periodontol 1996;67:515–522.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.5.515

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The present longitudinal studywas designed to explore the long‐term efficacy of guided tissue regeneration (GTR) in Class II furcation defects and establish the factors that might be responsible for modifying this response. Subjects with two or more mandibular molars, one of which had Class II furcation defects, received the hygienic phase of therapy followed by baseline clinical measurements and subgingival plaque sampling. GTR procedure was performed in furcation defect sites using expanded polytetrafluoroethylene (ePTFE) membranes, while the other non‐furcated molars received only scaling and root planing. Twenty‐eight subjects (13 females, 15 males) aged 27 to 66 were included in this longitudinal analysis. Postsurgical treatment included routine home care supplemented with daily Chlorhexidine rinse and systemic tetracycline. Membranes were retrieved 4 to 6 weeks after surgery. During the first year, patients were initially seen bi‐weekly and subsequently monthly for professional prophylaxis. At the end of this year, clinical measurements and samples were obtained. For the next 2 years, patients were seen bi‐annually for maintenance visits. Clinical measurements and microbiological samples were then repeated. Next, a tighter maintenance protocol was established and patients were seen quarterly for scaling and oral hygiene reinforcement. Final measurements and samples were taken again 1 year later (4 years postoperative). Significant probing reduction (3.00 mm) and gain in horizontal attachment (2.59 mm) were obtained 1 year postsurgery for the GTR sites. These changes were maintained over 4 years with a slight decline at the end of year 3. Changes in probing depth (PD) from year 1 to 4 served to dichotomize the sites into stable (Δ PD ≤ 0.9 mm), and unstable (PD increase ≥ 1 mm). Of the 54 sites available for this analysis only 5 (9.3%) were unstable while 49 (90.7%) were stable or even further improved. Sites which exhibited minimal or no plaque (plaque index [PI] ≤ 1) over the tight maintenance period had a further decrease in mean probing depth (0.43 mm) compared with a slight increase (−0.06 mm) in mean probing depth in sites with PI ≥ 2 mm (P= 0.0235). The same phenomenon was observed for changes in relative attachment level (RAL): mean gain in RAL was 0.61 mm compared to 0.25 mm for the 2 groups, respectively (P= 0.07).Actinobacillus actinomycetemcomitanswas only isolated from 2 sites at year 3, and none at year 4, compared to 21.45% of the sites at baseline.Porphyromonas gingivalispositive sites showed a continual decline over the years: 14.28% at baseline, 10.71% at year 1, and 5.1% at year 4. On the contrary,Prevotella intermedia (Pi)andBacteroides forsythus (Bf)infected sites remained at approximately the same rate throughout the 4 years of the study (40% to 50% and 30% to 40% forPiandBf, respectively). Of these,Pi‐infected sites exhibited less favorable clinical results compared to sites which were not infected with this microorganism. In summary, furcation defects treated with membrane barriers can be maintained in health for at least 4 years; however, good oral hygiene and frequent recall visits as part of a complete anti‐infective therapy are essential. Finally, once treated, these teeth are comparable to similar molar teeth with no previous history of furcation pathosis.J Periodontol 1996;67:523–527.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.5.523

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

CyclosporinAis an endecapeptidethat has been used clinically since 1978 as an immunosuppressant agent. Although cyclosporine appears to be uniformly beneficial in the treatment of a wide variety of disorders, its use may result in a number of side effects. One of the most important adverse effects is gingival overgrowth. This report relates a case of severe gingival overgrowth in a 31‐year‐old female who had received cyclosporine therapy in conjunction with a kidney transplant. Because of the severe gingival overgrowth, we analyzed a biopsy, which was positive for human papillomavirus. The case was treated and followed for 18 months.J Periodontol 1996;67:528–531.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.5.528

出版商:Wiley    

年代:1996

数据来源: WILEY