摘要:

Low pHaqueous solutionsof citric acid have been used in surgical periodontal therapy mainly for two reasons. It dissolves smear after a relatively short exposure time and it has been claimed to selectively remove root surface‐associated mineral exposing collagen to varying degrees. The use of low pH etching agents has recently been challenged in both experimental in vitro and in vivo studies based on their necrotizing effect on the surrounding periodontal tissues. The purpose of the present study was to assess the efficacy of subgingival application of an EDTA gel preparation in removing smear and exposing collagen fibers in root surfaces following non‐surgical periodontal therapy. Root surfaces which were root planed did not reveal any patent dentinal tubuli or collagen fibers. This was in contrast to the findings seen after root planing followed by etching, where intertubular surfaces were covered by a dense fibrillar network extending into patent dentinal tubuli. In high magnification these intertubular fibers displayed the cross‐striated texture typical for collagen fibers. Etching of root planed surfaces with EDTA may thus enhance the effect of non‐surgical root debridement in the same way as has been shown during experimental surgical procedures.J Periodontol 1996;67:841–845.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.9.841

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Dipeptidyl peptidase(DPP) II and IV activities were demonstrated in unfixed cryostat sections of gingival tissue from chronic periodontitis patients using histochemistry with 2‐methoxy‐4‐naphthylamine (MNA) substrates. In the case of DPP IV, enzyme localization was confirmed by immunocytochemistry with mouse. monoclonal antihuman DPP IV (CD26) antibody. Inflammatory cells containing enzyme were identified in adjacent sections with mouse monoclonal antibodies directed against leukocyte differentiation antigens. Lys‐Ala‐MNA and Ala‐Pro‐MNA staining in acid buffer for DPP II was only found in a few fibroblasts in superficial tissue. Staining with Gly‐Pro‐MNA and Ala‐Pro‐MNA in alkaline buffer for DPP IV was localized in some CD4 and CD8 positive T lymphocytes, CD68 positive macrophages, and fibroblasts and these cells also reacted with the enzyme antibody. DPP IV‐containing macrophages and T lymphocytes were seen in the epithelium. In deeper granulomatous tissue Gram positive and negative bacteria stained with the histochemical substrates, but not the DPP IV antibody. Fibroblast DPP II and IV might participate in cellular interactions with collagen, while T lymphocyte DPP IV may be involved in cell signalling.J Periodontol 1996;67:846–852.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.9.846

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The purpose of this methodological studywas to compare methods used to assess reliability for gingival inflammation and plaque. Duplicate examinations were conducted by one examiner on 17 subjects (506 scoring sites), using the gingival index (GI), bleeding points index (BPI), and plaque index (PI). The percentage of agreement, the weighted and unweighted kappa coefficients, and Pearson correlation coefficients were calculated as statistics of reliability for mesial buccal site scores and whole mouth mean scores when appropriate. For mesial buccal sites the respective values of the GI, BPI, and PI for weighted kappas were: 0.47, 0.49, and 0.75; for the correlation coefficients: 0.47, 0.49, and 0.76; for unweighted kappas, 0.39, 0.49, and 0.39; and for percentage of agreement 66.2%, 76.1%, and 51.2%. For whole mouth means the correlation coefficients for the GI, BPI, and PI were 0.87, 0.59, and 0.87, respectively. In conclusion, the most useful statistics in assessing the intraexaminer reliability of a solo examiner in descending order were the weighted kappa coefficient, Pearson correlation coefficient, the unweighted kappa coefficient, and percentage of agreement.J Periodontol 1996;67:853–859.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.9.853

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The aim of this studywas to evaluate the efficacy of 3 commercially available periodontal systems for local delivery of antibiotics as adjuncts to scaling and root planing in treatment of sites with persistent periodontal lesions following a course of scaling and root planing. Fifty‐four patients with 4 pockets ≥ 5 mm and bleeding on probing and/or suppuration were randomized in 4 treatment groups including: scaling and root planing plus application of 25% tetracycline fiber (S + Tet) (13 patients), scaling and root planing plus application of 2% minocycline gel (S + Min) (14 patients), scaling and root planing plus application of 25% metronidazole gel (S + Met) (14 patients), and scaling and root planing alone (S) (13 patients). Clinical measurements were taken at baseline and 6 weeks after the end of treatment periods. All treatments were applied using the distributors' recommended protocols and resulted in significant improvement in probing depth, attachment level, bleeding on probing and the modified gingival index (MGI) scores. The improvements in clinical parameters were greater in all three adjunctive treatment groups than scaling and root planing alone. The mean probing depth reductions were: S + Tet = 1.35 mm, S + Met = 0.95 mm, S + Min = 0.87 mm and S = 0.60 mm. The probing depth reduction was significantly greater in the scaling plus tetracycline fiber group than the scaling and root planing alone group (P= 0.002). The difference between groups in improvement of attachment level or bleeding on probing was not significant. Scaling plus tetracycline fiber treatment resulted in the greatest reduction in the MGI scores which was significantly greater than all other groups. While the frequency of sites with suppuration was markedly reduced following all treatments, it reached zero in the scaling plus tetracycline fiber group. No serious adverse effects were observed or reported for any treatment. While all three locally applied antimicrobial systems seem to offer some benefit over scaling and root planing alone, a treatment regimen of scaling and root planing plus tetracycline fiber replacement gave the greatest advantage in the treatment of persistent periodontal lesions at least during the 6‐week period following treatment.J Periodontol 1996;67:860–865.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.9.860

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Recent investigations implythat a key mechanism in the pathogenesis of periodontal disease may be the ability of oral microorganisms to induce production and/or activation of matrix metalloproteinases (MMPs) in the host tissues. It has been suggested that the pharmacologic inhibition of MMP activity could play an important role in achieving a desirable outcome in periodontal therapy. The efficacy of locally delivered antibiotics on the level of gingival crevicular fluid (GCF) stromelysin (SL) and tissue inhibitor of metalloproteinases (TIMP) on sites with a history of a poor response to mechanical treatment was studied. Fifty‐two patients with 4 periodontal pockets ≥ 5 mm and bleeding on probing were randomized into four groups of 13 patients. One group received scaling and root planing alone and the other three groups received scaling and root planing plus a locally delivered antimicrobial system. These included 25% tetracycline fiber, 2% minocycline gel, and 25% metronidazole gel. The GCF samples taken at baseline and 6 weeks after treatments were analyzed using an enzyme linked immunosorbent assay (ELISA). GCF SL levels significantly decreased after adjunctive tetracycline fiber (pairedt‐test,P= 0.020) and minocycline gel (pairedttest,P= 0.023) treatments whereas it remained almost unchanged in the other two groups. While the GCF TIMP level did not change significantly in the scaling and root planing alone group, it significantly increased for all three adjunctive antimicrobial treatments (for tetracycline fiberP<0.001, minocycline gelP= 0.005, metronidazole gelP<0.001). The use of adjunctive locally delivered antimicrobial systems, particularly the tetracycline family, may offer an advantage in changing the metalloproteinase profile of the GCF to one more compatible with periodontal health.J Periodontol 1996;67:866–870.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.9.866

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Within the in vivo environmenthuman gingival fibre‐blasts (HGF) may be challenged with bacteria or bacterial products. This interaction may result in the release of cytokines which are directly or indirectly involved in connective tissue and bone catabolism, such as interleukin (IL)‐1β, IL‐6, and IL‐8. Our investigation has tested the hypothesis that HGF fromActinobacillus actinomycetemcomitans(Aa)‐infected patients with rapidly destructive forms of periodontitis, such as localized juvenile periodontitis (LJP), respond toAachallenge with an exaggerated secretion of IL‐1β, IL‐6, and IL‐8. We have compared the in vitro profiles of these cytokines byAachallenged HGF obtained from 2 healthy subjects, 2Aa‐infected, slowly progressing adult periodontitis (AP) patients and 2 LJP patients. HGF were challenged throughout a 48‐hour period with formalinized whole bacterial cells, and culture supernatants were analyzed for cytokine content using RIA. No differences were noted in the IL‐1β secretion levels among the different HGF cultures. Although basal (unchallenged) IL‐6 and IL‐8 production was similar in all HGF cultures, HGF from the two LJP patients responded toAachallenge with a more rapid IL‐6 and a more pronounced IL‐8 secretion than healthy or AP HGF. We also tested the ability of human serum antibodies againstAato moderate theAa‐elicited HGF cytokine secretion by adding human serum, with normal or elevated antibody content. Both sera appeared to have an upregulating effect on IL‐6 and IL‐8 secretion. Depletion of 95% of the anti‐Aaantibody from serum by absorption did not affect its activity. Based on the response of HGF from two LJP patients, we propose thatAa‐induced pathology in LJP may be modulated by stimulation of rapid and/or exaggerated secretion of cytokines with potential ‐catabolic effects, although studies with a larger group of LJP patients are needed to further test this hypothesis. Furthermore, serum antibodies against this microorganism do not appear to have a neutralizing effect in cytokine‐eliciting HGF‐Aainteractions.J Periodontol 1996;67:871–878.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.9.871

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Sixteen patients with advanced periodontitis(more than 3 sites with a probing depth ≥ 6 mm) were treated with the aim of eliminatingActinobacillus actinomycetemcomitansandPorphyromonas gingivalisand reducingPrevotella intermediabelow 5% of the total viable count. The patients were followed clinically and microbiologically for over 5 years and showed a Highly individual pattern with respect to presence of indicator bacteria, type of treatment needed to accomplish treatment goals, clinical response, and bacterial and disease recurrencies. The results of this study suggest that presence of the indicator bacteria in microbial samples taken after treatment may identify patients at risk for recurrent periodontitis.J Periodontol 1996;67:879–887.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.9.879

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

DNAtyping was performedon 24 Japanese patients with early‐onset periodontitis (EOP) using the PCR‐RFLP method to investigate an association of the susceptibility to EOP with the particular HLA class II alleles (HLA‐DRB1, ‐DQA1, and ‐DQB1). DRB1* 1401, DRB1* 1501, DQB1* 0503, and DQB1* 0602 were found more frequently (“susceptible”) in the EOP patients than in healthy controls. In contrast, DRB1* 0405 and DQB1* 0401 were found less frequently (“resistant”) in EOP patients. All patients carrying DQB1* 0602 had an atypicalBamHI site in the intron upstream of the third exon of the DQB1 gene, which in our previous studies appeared to be a susceptible marker for EOP. A comparative analysis of the amino acid sequences of these susceptible and resistant HLA‐DRB1 and DQB1 alleles elucidated some differences in antigen‐derived peptide binding sites related to the susceptible or resistant alleles. Especially, DQB1* 0503 and DQB1* 0602 alleles carrying aspartic acid at position 57 and glycine at position 70 are increased significantly in EOP. Since amino acid residues at positions 57 and 70 on the DQB1 molecule are supposed to be involved in antigen binding, amino acid substitutions at these positions may affect the immune responsiveness to the periodontopathic antigen. Our results suggest that the DQB1 molecule plays a crucial role in the pathogenesis of EOP and that the susceptibility to EOP may be determined by the binding ability between the peptide and HLA‐DQ antigens.J Periodontol 1996;67:888–894.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.9.888

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The electronically guided alignmentdevice (EGAD) has been demonstrated to function well with a custom fabricated stent for taking radiographs for subtraction. The objective of this study is to demonstrate that this device functions well when used with an impression bite‐block rather than a full arch acrylic stent. Nineteen subjects participated. Two vinyl siloxane impressions were made for each subject and a pair of x‐rays was taken with each impression. The location for study was divided among 7 for the maxillary premolar‐1st molar region, 6 for the mandibular premolar‐1st molar region, and 6 for the incisor‐canine region. To simulate bone change 3 bone chips (approximately 1, 7, and 10 mg) were positioned in the mucobuccal fold when one of each pair of x‐rays was taken. Pairs of radiographs were subtracted and the bone change (chips) isolated by thresholding to determine their area. An aluminum ramp was used to determine volume. A strong linear relationship between actual chip weight and equivalent aluminum volume (r2= 0.64,P<0.001) was obtained for all regions of the mouth when considered together. The strongest relationship of the 3 regions was for mandibular premolar‐1st molar sites, r2= 0.78. These data indicate that the EGAD/impression technique is suitable for taking radiographs in all areas of the mouth for quantitative digital substraction.J Periodontol 1996;67:895–899.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.9.895

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

This single‐blind, 8‐week studycompared the efficacy of a sonic toothbrush and a manual brush in 40 patients with adult periodontitis. Qualitative clinical indices and quantitative laboratory methods were used to monitor the periodontal status of 3 pockets 5 to 7 mm deep in each subject. Patients were randomly assigned either a sonic or manual toothbrush. The two groups were comparable with respect to age, gender, and anatomical location of the test sites. Data were collected from all sites at baseline and at 2, 4, and 8 weeks. Over the 8‐week period, both groups showed significant improvements in the clinical indices used. Descriptive statistics indicated the sonic brush group had greater improvement than the manual group in the clinical parameters (gingival index, bleeding index, probing depth, and clinical attachment level). Gingival crevicular fluid (GCF) flow was significantly lower in the sonic brush group (P= 0.018). Considerable variation was present in the levels detected for both inflammatory cytokines tested, however, concentration of interleukin‐1 beta was significantly lower in the GCF of sonic group patients (P= 0.05), while concentration of interleukin‐6 was significantly reduced in both groups (P≤ 0.05) (ttests). Under these conditions, there is some evidence to suggest that the sonic toothbrush is more beneficial in resolving inflammation in patients with moderate periodontal disease.J Periodontol 1996;67:900–908.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.9.900

出版商:Wiley    

年代:1996

数据来源: WILEY