摘要:

This study compared the relative amountsofActinobacillus actinomycetemcomitans (Aa),Eikenella corrodens (Ec), and black‐pigmented anaerobic rods, and the proportions of coccoid forms, nonmotile rods, motile rods, spirochetes, and total motile organisms in subgingival plaque samples from 2 groups of young adults with generalized moderate to severe periodontitis. Two groups of 12 untreated patients were selected based on the relative amounts of subgingival calculus detected. Subgingival plaque samples (2 sites/patient) were taken with a sterile curet, dispersed, and plated under anaerobic conditions on ETSA, ETSA‐kanamycin, ETSA‐clindamycin, and TSBV agar. Appropriate biochemical tests were performed to confirm suspected microorganisms. Phase‐contrast microscopy also was used to count the relative numbers of coccoid forms, nonmotile rods, motile rods, and spirochetes in each of the samples. Patients with no clinically detectable subgingival calculus harbored significantly greater proportions (%) of coccoid forms andAaand greater amounts (CFU/mg) ofAathan did patients with obvious amounts of subgingival calculus. Subjects with clearly detectable subgingival calculus possessed greater proportions of motile rods, total motile organisms, and black‐pigmented anaerobic rods than did subjects with little or no subgingival calculus. Young adult patients with generalized moderate to severe disease and little or no detectable subgingival calculus may possess a subgingival microbiota with relatively higher numbers ofAaand coccoid forms, and a lower percentage of BPB, motile rods, and total motile organisms as compared to similar patients with greater amounts of subgingival calculus.J Periodontol 1991; 62:591–597.

ISSN:1049-8885    

DOI:10.1902/jop.1991.62.10.591

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

The objective of the present studywas to assess the effect of bilayered/collagen barriers enriched with fibronectin and heparan sulfate on the prevention of apical migration of the epithelium during the initial stage of periodontal wound healing. Experimental osseous defects were produced on the labial aspect of maxillary canines in dogs. Experimental sites were treated with either bilayered enriched collagen barriers or with nonenriched bilayered collagen barriers, using the guided tissue regeneration technique. Control sites were treated with monolayered collagen barriers that were not enriched with fibronectin and heparan sulfate. Histologic and histomorphometric examinations performed on specimens obtained 20 days post‐operative indicate the formation of a short junctional epithelium in the experimental sites treated with enriched collagen barriers. In this group, 95% of the occlusal‐apical length of the defects was repopulated by connective tissue cells. In the other 2 groups, a long junctional epithelium developed with only 65% of the occlusal‐apical length of the defects being repopulated by connective tissue cells. These findings suggest that the enrichment of collagen barriers with fibronectin and heparan sulfate may be important to enhance the repopulation of exposed root surfaces by connective tissue cells and prevent the apical migration of the epithelium during the initial stages of periodontal wound healing.J Periodontol 1991;62:598–601.

ISSN:1049-8885    

DOI:10.1902/jop.1991.62.10.598

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

The purpose of this study was to determinethe incidence of bacteremia after a single professional subgingival irrigation with a 0.12% Chlorhexidine gluconate mouthrinse (CHX) as well as after a subsequent scaling and root planing (S/RP) during the same visit. Thirty subjects each with at least 1 site that probed 4 mm or more and bled on probing were randomly assigned to the following groups: 1) irrigation with 0.12% CHX; 2) irrigation with sterile water; and 3) non‐irrigated controls. To begin the study blood was drawn just before and 2 minutes after irrigation. Thirty minutes later, blood was drawn again just before and 2 minutes after S/RP at the same site. Specimens were cultured for anaerobic and aerobic microorganisms using standard cultural techniques. Eighteen blood cultures from 15 subjects yielded positive cultures resulting in 23 isolates. Gram‐positive rods comprised 34.8% of the total isolates; Gram‐positive cocci 34.8%, Gram‐negative rods 21.7%, and Gram‐negative cocci 8.7%. In the CHX group, bacteremia was detected in 5 subjects after irrigation and in 2 other subjects after S/RP. In the water group, bacteremia was detected in one subject after irrigation and in 4 subjects after S/RP. The control group had 3 bacteremias after S/RP. There was no significant difference between the incidence of bacteremia associated with irrigation by CHX or sterile water (P= 0.141). There was also no significant difference in the incidence of bacteremia after S/RP between the CHX and sterile water irrigation groups and in patients who did not receive irrigation (control group) (P= 0.88). Thus it appears that subgingival irrigation, with or without medication, has no effect on the incidence of bacteremia following a subsequent S/RP.J Periodontol 1991; 62:602–607.

ISSN:1049-8885    

DOI:10.1902/jop.1991.62.10.602

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Anational survey of the oral health ofU.S. children aged 5 to 17 was conducted by the National Institute of Dental Research during the 1986‐87 school year. Eleven thousand and seven adolescents aged 14 to 17 years received a periodontal assessment. Their patterns of loss of periodontal attachment as assessed by probing at mesial sites were used to classify adolescents as cases of early onset periodontitis. Approximately 0.53% of adolescents nation‐wide were estimated to have localized juvenile periodontitis (LJP), 0.13% to have generalized juvenile periodontitis (GJP), and 1.61% to have incidental loss of attachment (LA) (≥3 mm on 1 or more teeth). The total number of adolescents affected were not trivial. Close to 70,000 adolescents in the U.S. were estimated to have LIP in 1986‐87. More destructive GJP affected an estimated 17,000 adolescents. Another 212,000 adolescents were estimated to have incidental LA. Blacks were at much greater risk for all forms of early onset periodontitis than whites. Males were clearly more likely (4.3 to 1) to have GJP than females when other variables were statistically controlled. Gender associations were more complicated for LJP because gender interacted with race. Black males were 2.9 times as likely to have LJP as black females. In contrast, white females were more likely than white males to have the disease by about the same odds. When interactions among demographic variables exist, caution must be taken in comparing results from different studies.J Periodontol 1991; 62:608– 616.

ISSN:1049-8885    

DOI:10.1902/jop.1991.62.10.608

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

The purpose of this studywas to test the efficacy and safety of sanguinaria‐containing regimens with and without fluoride using the American Dental Association guidelines for evaluating chemotherapeutic agents. The study was a 6‐month, double‐blind, 4‐cell, placebo‐controlled, parallel investigation involving 120 subjects. Following screening procedures, subjects were randomly assigned to 4 groups. Group 1 received a dentifrice containing 0.075% sanguinaria extract (SaE) and 2.0% zinc chloride (ZnCl2) in a dicalcium phosphate base, plus an oral rinse containing 0.03% SaE and 0.2% ZnCl2‐ Group 2 received identical products without SaE or ZnCl2. Group 3 received a dentifrice containing 0.8% sodium monofluorophosphate, 0.075% SaE, and 0.05% ZnCl2in a silica base, plus an oral rinse containing 0.03% SaE and 0.2% ZnCl2. Group 4 products were identical to those of Group 3 but without SaE and ZnCI2. Supragingival plaque and gingival inflammation were scored at 0, 1, 2, 1.5, 3, 4.5, and 6 months; bleeding upon probing was measured at 1, 1.5, 3, and 6 months. Microbiological samples were taken from plaque, tongue, and cheek areas. The active products produced statistically significantly lower scores than the placebo agents for all indices (P<.0001). Six‐month plaque scores were 13.1% lower for Group 1 and 17.4% lower for Group 3 compared to placebo products. When the Plaque Severity Index was applied, the percentage reductions were 33% for Group 1 and 41% for Group 3 compared to placebos. Gingival inflammation scores were 16.7% lower for Group 1 and 18.1% lower for Group 3 at 6 months compared to placebo scores. Gingival bleeding upon probing scores were 31.5% lower for Group 1 and 41.2% lower for Group 3 compared to placebo groups at 6 months. Microbiological changes were not significant. Only 1 subject experienced an adverse reaction attributable to the use of active products. The active regimens of dentifrice plus oral rinse were significantly better than placebos and were clinically safe, with no evidence of deleterious microbiological changes.J Periodontol 1991;62:617–622.

ISSN:1049-8885    

DOI:10.1902/jop.1991.62.10.617

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Few reported studies have evaluated the periodontalstatus of individuals infected by human immunodeficiency virus (HIV). The majority of these reports have evaluated the periodontal status of individuals presenting to dental care facilities due to oral problems. These reports suggest that severe gingival inflammation and attachment loss are often associated with HIV seropositive patients. The purpose of this study was to evaluate the periodontal status of HIV seropositive patients without biasing the data towards those presenting to dentists with oral problems. Sixty‐three consenting male patients presenting to the infectious disease clinic at the Medical College of Virginia Hospitals were examined to determine the status of their periodontal health. Gingival index, plaque index, pocket depths, and attachment loss were determined using standard indices. Participants were first grouped according to the modified CDC Classification System for HIV infection and then categorized according to HIV risk factors for purposes of statistical analysis. No significant differences could be found in the gingival or periodontal status of subjects who were HIV seropositive versus those with AIDS. Periodontal status was also not significantly different for individuals based upon risk group. Periodontal health of the participants was similar to the general population (HIV status unknown). This would indicate that, although HIV gingivitis and HIV periodontitis have been documented in a number of HIV‐infected patients, the frequency of affected individuals is less than previous reports would suggest.J Periodontol 1991;62:623–627.

ISSN:1049-8885    

DOI:10.1902/jop.1991.62.10.623

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Our previous studies have demonstratedthat early‐identified lesions of localized juvenile periodontitis (LJP) can be treated by the use of systemically administered tetracycline alone (1 gm/day for 6 weeks). This therapy results in arrest of disease progression, decreased pocket depths, gains in clinical attachment, and significant repair of alveolar defects. This paper reports on the long‐term clinical and radiographic improvement in 4 subjects followed for 1 to 4 years after the completion of tetracycline therapy. Four patients (mean age 14 years) were examined 1 to 4 years following the completion of a single 6 week course of tetracycline. Mean pocket depth was reduced from the initial level of 7.1 mm to 3.6 mm. Mean attachment loss was reduced from 3.8 mm to 0.9 mm and angular bone defects had filled by an average of 72%. Pocket depths and attachment loss continued to decrease during the entire study period, while alveolar bone repair continued to increase. The findings support those of our previous investigation and confirm that: 1) early identified lesions of LJP can be effectively treated with 6 weeks of tetracycline therapy alone; 2) decreases in pocket depth, gains in clinical attachment, and repair of alveolar defects remain stable up to 4 years following antibiotic therapy; 3) clinical and radiographic improvement continues over time and may lead to complete resolution of some lesions; and 4) the reparative/regenerative potential of the periodontium in early onset disease in young individuals may exceed that observed in chronic adult periodontitis.J Periodontol 1991;62:628–633.

ISSN:1049-8885    

DOI:10.1902/jop.1991.62.10.628

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Although current data suggest thatperiodontitis may actually be multiple diseases each with varying responses to therapy, little evidence exists to support this theory in adult patients. This report describes the design and initial findings of a longitudinal field trial involving the diagnosis and treatment of adult and refractory periodontitis patients in private practice. Adult patients (N = 221) who met specific clinical criteria were selected from the private practices of 22 periodontists. Clinical characteristics were recorded and subgingival plaque samples were sent to microbiology laboratories at either UCLA or The University of Texas Health Science Center at San Antonio (UTHSCSA). Samples were processed according to protocols standardized between the 2 centers. Five different combinations of the initial clinical and microbial findings were evaluated for patterns in the data by means of cluster analysis. Plaque, bleeding on probing, bone loss scores, probing depth distributions, and microbial findings produced multiple cluster solutions. Solutions involving 6 clusters explained 39.4% to 76.4% of the variation between patients and produced ratios for variation between clusters to variation within clusters of 5.2 to 15.3. The optimal cluster solution incorporated both clinical and microbial findings, with some clusters characterized by high plaque and moderate bleeding on probing and bone loss, whereas others had low plaque but high bleeding on probing and bone loss. Microbial findings of each cluster exhibited distinct patterns with some clusters having a high prevalence (83% to 100%) of specific target bacterial species while other clusters had an absence of these species. This unique multicenter study demonstrated that it is possible to cluster adult and refractory periodontitis patients into distinct clinical and microbial patterns. This approach provides the basis for determining whether certain diagnostic information may truly be of value in targeting periodontal therapy. In addition, the potential advantages and disadvantages of conducting studies in a field trial format are discussed.J Periodontol 1991;62:634–642.

ISSN:1049-8885    

DOI:10.1902/jop.1991.62.10.634

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Angioedema is a diffuse swellingof the subcutaneous or submucosal tissues that occurs in both hereditary and non‐hereditary forms. It can be a temporarily disfiguring condition, but not usually a serious one unless the airway is compromised. In the majority of cases, no underlying cause can be identified. In this report, a case of “idiopafhic” angioedema that occurred while performing a periodontal surgical procedure is presented. This case is interesting because the patient was on long‐term use of an angiotensinconverting enzyme [ACE] inhibitor for hypertension, and recent evidence has shown that ACE inhibitors suppress the breakdown of circulating bradykinins. With high plasma levels of bradykinins, a local anesthetic, periodontal surgical procedures, or even emotional stress may trigger an attack of angioedema. Practitioners should be aware of the pharmacologic side effects of ACE inhibitors and be prepared to handle an emergency if a patient's airway becomes compromised.J Periodontol 1991;62:643–645.

ISSN:1049-8885    

DOI:10.1902/jop.1991.62.10.643

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:1049-8885    

DOI:10.1902/jop.1991.62.10.646

出版商:Wiley    

年代:1991

数据来源: WILEY