摘要:

The association of periodontal disease with diabetes was studied in non‐insulin dependent diabetes mellitus (NIDDM) patients. In a cross‐sectional design, 100 patients (46 males and 54 females) were selected in 4 groups according to age and years since diagnosis of diabetes. The groups were: group 1,>55 years old, diabetes diagnosed ≥ 5 years; group 2, ≤ 55 years old, diabetes diagnosed ≥ 5 years; group 3,>55 years, diabetes diagnosed<5 years; and group 4, ≤ 55 years, diabetes diagnosed<5 years. Buccal and lingual pockets were deeper and lingual and buccal recessions greater for groups diagnosed 5 or more years ago, (P<0.0001). In groups diagnosed less than 5 years, higher recession indices were found for patients older than 55. The loss of buccal insertion was also greater for groups diagnosed 5 or more years ago (P<0.0001). For groups diagnosed less than 5 years ago, the loss was greater in the group older than 55 (P= 0.01). There was a marginal difference in gingival bleeding among the 4 groups (P= 0.047).Post‐hocanalysis showed differences between the 2 groups who had been diagnosed less than 5 years, with lower indices for patients ≤ 55. All groups were statistically different regarding bone loss (P<0.0001), with higher indices for the groups with older age, and for groups with 5 or more years since diagnosis. There was no difference in dental mobility among the 4 groups (P= 0.0981). It was concluded that years since diagnosis of diabetes is more significant than age for severity of periodontal disease in NIDDM.J Periodontol 1994; 65:991–995.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.11.991

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Epidemiological studieshave shown that loss of teeth is associated with increasing age. This was explained as the result of the action of microorganisms which, as components of dental plaque, destroyed the tooth by causing caries or periodontitis. Routine prevention programs therefore concentrated on removal of plaque, resulting in good oral hygiene. Despite good oral hygiene some individuals developed periodontitis. Studies have indicated that smoking may be a risk factor for this disease. This study was undertaken to determine whether or not smoking is also a risk factor for tooth loss. A total of 273 individuals were followed for 10 years, during which 93 individuals lost a total of 260 teeth. Younger individuals and especially males smoking more than 15 cigarettes a day were found to have the highest relative risk of losing teeth (4.55 and 3.18 respectively). In the younger age groups the proportional attributable risk was also highest; 78% for smokers smoking more than 15 cigarettes a day. The combination of a high plaque score and smoking was, together with age, the strongest predictor of tooth loss. The findings of this study suggest that smokers, especially those in the age group<50 years, are a high risk group for tooth loss.J Periodontol 1994; 65:996–1001.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.11.996

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Human gingival fibroblasts(HGF) may have an important role in the orchestration of immuno‐participant cells infiltrating the gingiva in response to continuously recurring bacterial infection. To examine the cytokine network regulating HGF‐derived interleukin (IL)‐8, a potent neutrophil chemotactic cytokine, we analyzed the effects of inflammatory cytokines alone and in combination on IL‐8 production by HGF. IL‐1β, tumor necrosis factor‐α(TNF‐α), interferon‐γ(IFN‐γ), IL‐6, and IL‐8 were used as stimulants. HGF secreted IL‐8 in a dose‐dependent manner after stimulation with either IL‐1βor TNF‐γ, but not with IFN‐γor IL‐6. Furthermore, IL‐8 itself did not affect IL‐8 mRNA accumulation in HGF in an autocrine manner. The combination of IL‐1β and TNF‐α synergistically enhanced the secretion of IL‐8, whereas IFN‐γsuppressed IL‐8 secretion by IL‐1β‐ or TNF‐α‐stimulated HGF. These effects were also observed at each level of IL‐8 mRNA expression in HGF. IL‐8 secretion by cytokine‐stimulated HGF was not influenced by the inhibition of PGE2synthesis with indomethacin, indicating that endogenous PGE2was not involved in IL‐8 production by HGF. These results indicate that IL8 production by HGF is synergistically stimulated by specific cytokines, IL‐1βand TNF‐α, and suggest that these stimulatory effects are down‐regulated by IFN‐γat the transcriptional level through PGE2‐independent pathways. Thus, neutrophil‐mediated processes in periodontal disease may be regulated in part by HGF in the cytokine network of immuno‐participant cells.J Periodontol 1994;65:1002–1007.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.11.1002

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The purpose of this studywas to measure inflammatory changes associated with implantation of anorganic bovine bone and bovine bone/collagen composite grafts, and to compare the response to that obtained following grafting with hydroxyapatite. Anorganic bovine bone, either with or without bovine collagen, as well as granular and block forms of synthetic hydroxyapatite, were implanted subcutaneously in Wistar rats. Saline and turpentine oil were used as controls. Biopsies were obtained after 3 days and at 1, 2, 4, 6, and 8 weeks. A panel of 6 monoclonal antibodies was used to detect monocytes, several distinct macrophage subsets, Ia‐antigen expression, and T‐ and B‐lymphocytes. Cells identified by each antibody were counted after immunocytochemical staining, and sera obtained 6 weeks after grafting were used in immunoblotting assays to detect antibodies to bovine serum proteins and collagen. Anorganic bovine bone, bovine bone/collagen, and hydroxyapatite all produced a transient macrophage infiltrate that was maximum 3 days after implantation, but resolved to normal levels within 6 to 8 weeks. Lymphocyte infiltration was not elicited by any bovine graft material, and antibodies to bovine serum proteins or type I collagen were not detected in any of the animals examined. These data indicate that a systemic or local immune response does not develop following implantation with anorganic bovine bone or with anorganic bovine bone/collagen materials. It appears appropriate to explore further the merits of these materials for periodontal regenerative procedures.J Periodontol 1994; 65:1008–1015.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.11.1008

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Although gingivitis is initiatedby plaque and plaque removal controls gingivitis, gingival irrigation with water has been shown to reduce gingivitis without reducing plaque. This study attempted to explore possible mechanisms involved in the treatment of gingivitis by water irrigation. Patients (n = 125) with more than 20 teeth, less than 4 sites with probing depth (PD) deeper than 6 mm, bleeding on probing (BOP) frequency of 30% or higher, and no systemic disease were randomized to one of four treatment groups: toothbrushing alone (brush), toothbrushing plus chlorhexidine 0.12% rinse 2×/day (CHX), toothbrushing plus water irrigation 1×/day (irr+H2O), or toothbrushing plus Chlorhexidine 0.04% irrigation 1×/day (irr+CHX). Six sites/tooth were examined at baseline, and at 3 and 6 months for BOP and PD using an automated probe, and for gingival index (GI) and plaque index (PI) by standard means. A prophylaxis and oral hygiene instructions were provided after baseline and 6 month measurements. Subgingival microbial samples and crevicular fluid (GCF) were collected from 2 teeth/subject at each time point. Microbial samples were processed for anaerobic culture and the predominant cultivable flora was determined. CHX and irr+CHX had a 30 to 35% decrease in mean PI, while brush and irr+H2O had only a 12 to 16% decrease. BOP was reduced by 14% in the brush group and 23 to 24% in the other groups. GI was significantly correlated with PI in the brush, CHX, and irr+CHX groups, but not in the irr+H2O group. Prevotella intermedia was significantly reduced in both irrigation groups, but not CHX or brush groups. Comprehensive analysis of selected components of the gingival crevice fluid is in progress and will be reported in the future. The current findings indicate that the mechanism of gingivitis reduction by water irrigation is not related to plaque reduction but may involve specific host‐microbiota alterations in the subgingival environment.J Periodontol 1994;65:1016–1021.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.11.1016

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Twenty patients suffering fromabscess of periodontal origin were treated and followed clinically and microbiologically for 6 months. Microbiological examination was performed by culture technique. One deep and one shallow periodontal pocket in the same patient were examined concomitantly. Serum was collected and analyzed for specific antibody level using ELISA methodology. Treatment included supragingival scaling, drainage, and irrigation of the periodontal pocket with 0.85% sodium chloride and systemic tetracycline administration, 1 g per day for 2 weeks. At baseline, 90% of the abscesses harboredPorphyromonas gingivalisand/orPrevotella intermedia. After 6 months, abscess sites demonstrated a reduced probing depth, less bleeding on probing, and gain of attachment. Abscess sites showed noP. gingivalisand the proportion ofP. intermediawas significantly reduced 6 months after treatment. In deep periodontal pockets a similar pattern was seen. Shallow pockets demonstrated few clinical signs of inflammation and the number of bacteria was generally low.Campylobacter rectus, Capnocytophagaspp, andFusobacterium nucleatumwere frequently seen in low numbers in most sites during the study period, whileActinobacillus actinomycetemcomitanswas detected only in a few sites. The IgG levels in patient sera against antigens of homologous bacterial strains remained fairly constant for 6 months. The result of the present study indicates thatP. gingivalisandP. intermediaare involved in periodontal abscess formation. Also, treatment where drainage is combined with tetracycline administration promotes healing and reattachment.J Periodontol 1994; 65:1022–1028.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.11.1022

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Recent research has focusedupon the utilization of an absorbable collagen membrane in guided tissue regeneration (GTR). Concern exists as to whether this type of membrane is beneficial in the treatment of periodontal defects. The purpose of this study was to evaluate the effect of a type I bovine collagen membrane on treatment of Class II furcation defects. Twelve systemically healthy patients (six male and six female, ages 32 to 68) were treated. Each had bilateral mandibular furcation defects with attachment loss ≥6 mm. Prior to surgery all patients completed initial therapy including scaling and root planing. At the time of the surgery, teeth were randomly assigned to either a control (flap debridement alone) or test (flap debridement plus collagen membrane) group. Data were collected on the day of surgery, and 2, 4, and 6 months post‐surgery and at the 12 month re‐entry surgery. Clinical measurements included probing depth (PD), clinical attachment level (CAL), gingival recession (GR), Stent to base of defect (SB), crestal bone to base of defect (CB), width of defect, and mobility. Statistical analysis was performed utilizing the pairedttest. Both control and test groups demonstrated significant (P<0.05) improvement at 12 months re‐entry in PD, CAL, SB, and CB when compared to the presurgery status. While there is no significant difference in PD, CAL, GR, width of defect, and mobility between control and test groups, sites treated with the collagen membrane had significantly higher bone fill (SB and CB) at re‐entry. A significant improvement of furcation horizontal bone repair and defect improvement was noted in the collagen membranes‐treated sites as compared to the presurgery status. No foreign body reaction was observed in either group during this study. This study suggests that the use of absorbable collagen membrane may have beneficial effects in the treatment of Class II furcal defects.J Periodontol 1994; 65:1029–1036.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.11.1029

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Guided tissue regeneration(GTR) may result in the formation of new bone, cementum, and periodontal ligament. The purpose of this study was to assess the efficacy of a resorbable synthetic material, which has been used extensively in general surgery for wound support, to promote GTR. Forty healthy patients with adult periodontitis, each having a Class II furcation defect, participated in the study. After initial therapy, mucoperiosteal flaps were elevated and furcations debrided with hand and rotary instruments. In 20 patients the molar Class II furcation defects were treated with a GTR procedure using the resorbable synthetic material (experimental), and 20 patients received a mucoperiosteal flap debridement procedure without barrier placement (control). Probing depth and attachment level measurements were taken immediately before surgery, at 6 weeks, and 2, 3, 4, 5, and 6 months after surgery. All areas healed uneventfully. Comparison of clinical attachment level measurements indicated significantly greater gain of attachment at sites receiving barriers. Fifteen of 20 Class II furcations in the synthetic barrier group, but only one of 20 in the control group, were converted to Class I defects. Barriers were still clinically detectable at 4 weeks, but were absent at 6 weeks. The synthetic barriers enhanced gain of clinical attachment in human Class II furcation defects.J Periodontol 1994; 65:1037–1045.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.11.1037

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Twenty‐fiveSudanese and18 Norwegianadult periodontitis patients were selected to participate in this study. The purpose was to compare cultivation results ofPorphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, andCapnocytophagaspecies as well as various enteric rods in both populations. In addition, DNA probe analysis was used to identifyP. gingivalis, P. intermedia, A. actinomycetemcomitans, F. nucleatum, andBacteroides forsythusin the Sudanese patients and results were compared with those obtained by cultivation. The paper point technique was used to sample 99 sites in the Sudanese group (4 paper points/site) and 119 sites in the Norwegian patients (3 paper points/site). In the Sudanese subjects, the fourth paper point was used for the DNA probe analysis. The chi‐square test and the Wilcoxon signed rank test were used to test for statistically significant differences between Sudanese and Norwegian cultivation results as well as between cultivation and DNA results in the Sudanese group. Cultivation results indicated that the Sudanese subjects had significantly lower prevalence ofP. gingivalis,P. intermedia, andF. nucleatum(P<0.01), significantly higher prevalence ofCapnocytophagaspecies (P<0.05), and similar prevalence ofA. actinomycetemcomitans. Almost all Sudanese subjects tested positive for various enteric rods, while none of the Norwegians did so. The extent to which unrestricted use of antibiotics and transport media influenced the levels of enteric species is not known, however. In the Sudanese group, DNA results showed higher levels ofP. gingivalisandP. intermedia(P<0.01), andF. nucleatum(P<0.05), while lower levels ofA. actinomycetemcomitans(P<0.05), as compared to cultivation results.B. forsythuswas detected by DNA probe analysis in 96% of the Sudanese patients (57.6% of sites). Except for the high levels of enteric rods in the Sudanese samples, the present investigation demonstrated that both patient populations harbored the species monitored in levels similar to those commonly perceived among adult periodontitis patients in the West.J Periodontol 1994; 65:1046–1052.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.11.1046

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The few previous cultivation studieson the in vivo associations between various periodontal microbial species have shown several positive and negative associations. The present investigation utilized DNA probe analysis to examine possible in vivo associations between the periodontal pathogensPorphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, andBacteroides forsythusin subgingival plaque samples obtained from 25 Sudanese untreated adult periodontitis patients. The standard paper point technique was used to sample 99 sites with a mean probing depth of 6.8 mm (range 6.0 to 10.0). Microbial associations were determined by detecting the effect of the presence or absence of one species (effector) on the occurrence of the other 3 species (target). The Wilcoxon signed rank test was used to examine variations in occurrence of each target bacteria in the presence or absence of the effector. In addition, the Spearman's rank correlation test was used to assess the relationship between the level of each bacteria to that of the other 3. Results showed bacterial associations with the following effectoron‐target effects:F. nucleatum(P<0.01 Wilcoxon;PP. gingivalis(P<0.01 Wilcoxon;P<0.001 Spearman), andB. forsythus(P<0.05 Wilcoxon;PP. intermedia(P<0.01 Spearman). The study demonstrated positive associations between the 4 species investigated, while no neutral or negative associations were revealed. The most striking finding was the effect exerted byF. nucleatumon the colonization ofP. intermedia;P. intermediawas never detected in a site unlessF. nucleatumwas also present.J Periodontol 1994; 65:1053–1057.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.11.1053

出版商:Wiley    

年代:1994

数据来源: WILEY