摘要:

Asplit‐mouth clinical trialwas designed to evaluate the effect of treating deep wide buccal gingival recession with guided tissue regeneration using expanded polytetrafluoroethylene membrane combined with tetracycline HCl (TTC) root conditioning and fibrin‐fibronecfin sealing system (FFSS) application. Eight patients, aged 25 to 57 years, each presenting two similar mucogingival defects, were selected. The two bilateral recessions were randomly assigned in each patient to either test or control treatment procedure. After initial therapy, each patient was examined for assessment of plaque, gingivitis, recession depth (RD), probing depth (PD), probing attachment level (PAL), and keratinized tissue width (KT). The test procedure included the elevation of mucoperiosteal flap at the buccal aspect of the alveolar process. The root was debrided and demineralized with 100 mg/ml TTC solution for 4 minutes using a burnishing technique with cotton pellets. A teflon membrane was secured and a film of FFSS was applied between the membrane and the root surface. The buccal flap was sutured to completely submerge the membrane. Control treatment included gingival flap surgery with barrier membrane alone. After 6 weeks, the membrane was removed. Healing was evaluated 6 months after surgery. Both test and control procedures resulted in highly significant recession reduction (3.0 mm ± 1.1 and 2.6 mm ± 1.2, respectively) and attachment gain (3.6 mm ± 1.7 and 2.6 mm ± 1.1, respectively). Mean root coverage was of 67% in the TTC+FFSS treated sites and 60% in membrane‐only treated sites. However, only treatment with TTC+FFSS significantly reduced PD and increased KT (P<0.05). When treatments were compared, changes in PD and PAL were significantly greater in TTC + FFSS treated sites (P<0.05). These findings suggest that guided tissue regeneration with barrier membrane is a predictable procedure to treat gingival recession. Clinical results appear to be enhanced by the additional application of fibrin‐fibronectin glue to tetracycline treated roots.J Periodontol 1995; 66:313–320.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.5.313

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The purpose of this study was to determinethe clinical course of early onset periodontitis and to investigate factors which may influence its clinical course. For the past 15 years we have been conducting a study of families with early onset periodontitis, and have examined 142 localized juvenile periodontitis and 185 severe generalized early onset periodontitis patients. In order to study the clinical course of early onset periodontitis we recalled our subject population to determine their periodontal status. Forty (40) patients with localized early onset periodontitis (LJP) and 48 with generalized early onset periodontitis (SP) were re‐examined. The time since the most recent visit for LJP patients was approximately 3 years and for SP patients almost 4 years. LJP patients who received periodontal therapy on the average gained periodontal attachment. In contrast, LJP patients who did not receive therapy lost periodontal attachment. SP patients lost periodontal attachment regardless of whether or not they had periodontal therapy. SP patients also lost an average of one tooth during the approximately 4 years of observation. LJP patients lost very few teeth with only 4 teeth being lost in 40 patients. The results of this study suggest that localized juvenile periodontitis is a stable disease in most individuals. In contrast, patients with severe generalized early onset periodontitis continued to lose both periodontal attachment and teeth.J Periodontol 1995; 66:321–328.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.5.321

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Systemic non‐steroidal anti‐inflammatory drugs(NSAIDs) have been shown to reduce alveolar bone loss in periodontitis. This study assesses the efficacy of a topical NSAID rinse, containing ketorolac tromethamine as the active agent. Adult periodontitis patients (n = 55) were studied in this 6‐month randomized, double blind, parallel, placebo and positive‐controlled study. Each patient had a least 3 sites at high risk for bone loss as assessed by low dose bone scan. Groups, balanced for gender, were assigned to one of three regimens: bid ketorolac rinse (0.1%) with placebo capsule; 50 mg bid flurbiprofen capsule (positive control) with placebo rinse; or bid placebo rinse and capsule. Prophylaxes were provided every 3 months. Monthly examinations assessed safety, gingival condition, and gingival crevicular fluid PGE2. Standardized radiographs were taken at baseline and at 3 and 6 months for digital subtraction radiography. A significant loss in bone height was observed during the study period in the placebo group (‐0.63±0.11;P<0.001), but not in the flurbiprofen (‐0.10±0.12;P= 0.40) or ketorolac rinse (+0.20±0.11 mm;P= 0.07) groups. Nested ANOVA revealed that ketorolac and flurbiprofen groups had less bone loss (P<0.01) and reduced gingival crevicular fluid PGE2levels (P<0.03) compared to placebo. ANOVA suggests (P= 0.06) that ketorolac rinse preserved more alveolar bone than systemic flurbiprofen at the dose regimens utilized. These data indicate that ketorolac rinse may be beneficial in the treatment of adult periodontitis.J Periodontol 1995; 66:329–338.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.5.329

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

In contrast to monolayer cell culture, the use of a 3‐dimensional culture system creates an environment which is more physiologically comparable to conditions in vivo. This study aimed to investigate the effects of culture environment on growth and protein biosynthesis by 6 human gingival fibroblast cell lines exposed to cyclosporin A (CsA). Fibroblasts were grown both in monolayer culture on plastic and embedded within collagen gel. Cyclosporin A was added to cultures at a range of concentrations between 10−5and 10−9g/ml. Under both culture conditions CsA had little effect on cell growth at low concentrations but at the highest concentration of 10−5g/ml, there was a significant inhibitory effect on growth (P<0.05). Protein production was not significantly affected by CsA in either culture system. Total collagen production appeared to be inhibited at high concentrations of CsA when cells were grown on plastic but remained unaffected when the cells were grown in collagen gel. Total protein and collagen production per cell in collagen gel was substantially greater compared with cells grown on plastic. We conclude that under the conditions of this investigation CsA did not directly stimulate growth or matrix‐synthesis by normal human gingival fibroblasts cultured in 3‐dimensional collagen gel or as monolayers on plastic.J Periodontol 1995; 66:339–344.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.5.339

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Factors such as age, the dose of nifedipine administeredin the diet, serum drug level, duration of drug administration, and sex which may influence nifedipine‐induced gingival overgrowth were examined in a rat model using 20‐, 50‐, and 90‐days‐old male and female rats. Oral administration of nifedipine (50 to 250 mg/kg diet) increased the serum level of the drug in a dose‐dependent manner in both males and females. However, a higher serum level was required in females than males to attain the same degree of gingival overgrowth. The minimum dietary concentrations of the drug required to elicit gingival overgrowth in males and females were 150 and 100 mg/kg, respectively, which gave respective minimum serum levels of 800 and 1100 ng/ml. The degree of overgrowth depended on the serum concentration of the drug after it had reached the required minimum in male and female animals. Administration of nifedipine (250 mg/kg diet) for 20 days was enough to induce maximal overgrowth, but this induction occurred only in rats that started to receive the drug when they were 20 days old, not in those that started at 50 and 90 days of age for the same administration period of 55 days, and the overgrowth regressed and the gingiva were normal 40 days after ceasing drug administration. These results suggest that gingival overgrowth occurred in accordance with the drug concentration in the diet, as well as that in the serum, and was more likely to occur in males and younger individuals.J Periodontol 1995; 66:345–350.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.5.345

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The mouse abscess modelhas been used extensively to demonstrate protection after challenge with periodontopathic organisms. In the present study, an outer membrane (OM) preparation ofP. gingivalisATCC 33277 was used to immunize BALB/c mice prior to challenge with liveP. gingivalisorganisms. This OM preparation, particularly at the highest dose level of 100 μg/immunization, was able to induce high levels of specific antibody and subsequent protective immunity. Protection in all immunized mice was noted by the rapid healing of the primary lesions, a low incidence of secondary lesions, and, in the highest dose group, an absence of septicemia. Non‐immunized animals demonstrated a slower development as well as healing of primary lesions, with higher numbers and larger sizes of secondary lesions. Weight loss and behavior patterns such as hunched bodies, ruffled hair, and stiffness of the hind legs were particularly noted in this group. Depletion of CD4 T cells in mice prior to immunization with 100 μgP. gingivalisOM resulted in significantly depressed serum levels of anti‐P. gingivalisantibody and an increase in the physical signs of disease compared with both the immunized and control groups. Western blot analysis demonstrated three antigen bands (63.3, 50.1, and 45.1) recognized by all immunized groups and also the control non‐immunized group, although the latter recognition occurred only after challenge. A further antigen band of 36.1 kDa was recognized by sera from the highest dose group only. This study has demonstrated the ability ofP. gingivalisOM to provide protection against challenge with liveP. gingivalisorganisms. The increased physical signs of disease seen in the CD4 depleted animals compared with the control group not only illustrate the protective role of serum antibody, but also suggest a possible role for T cell mechanisms in control of the lesion locally. The ability of specific OM antigens to provide similar protective immunity remains to be ascertained.J Periodontol 1995; 66:351–362.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.5.351

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Porphyromonas gingivalisis an important oral pathogen with a strong association with adult periodontitis. Significant titers of specific IgG antibodies toP. gingivaliscan be found in the sera of both gingivitis and periodontitis patients. Since IgG subclasses have different biological characteristics, the present study dealt with the serum IgG subclass response to outer membrane antigens ofP. gingivalis. Western blot analysis ofP. gingivalisouter membrane was carried out using 20 adult periodontitis and 20 age‐ and sex‐matched gingivitis patients. Antibodies in sera of both adult periodontitis and gingivitis patients recognized 38 antigen bands, ranging in molecular mass from 11.1 to 161 kDa. IgG2 was the predominant antibody subclass response in both patient groups in terms of the numbers of outer membrane antigens recognized, followed by IgG3, IgG1, and IgG4. More antigens in all IgG subclasses except IgG4 were recognized in adult periodontitis cases. Of the 23 antigens identified by IgG2 antibodies, 9 were recognized predominantly in adult periodontitis and 3 in the gingivitis group. In the IgGl subclass, 4 antigens were recognized predominantly in the adult periodontitis group while only 1 antigen was recognized significantly more in the gingivitis group. The IgG3 response identified 14 antigens ranging in molecular mass from 11.1 to 61.2 kDa in both groups. Ten antigens were recognized significantly by the adult periodontitis group. The lowest response was seen by IgG4 antibodies, with only 3 antigens of molecular mass 61.2, 52.3, and 38.8 kDa recognized, the latter two significantly in the adult periodontitis group. Overall, the results demonstrate that adult periodontitis patients respond to a greater number of antigens on the outer membrane ofP. gingivalisthan do gingivitis patients. Furthermore, the greatest response is seen in the IgG2 subclass, suggesting a stronger response to carbohydrate antigens.J Periodontol 1995; 66:363–368.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.5.363

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Serum samples from41periodontally healthy childrenaged 1 to 16 years were examined by ELISA for the presence of antibodies against a glass bead‐EDTA cell surface extract (GBE) and LPS ofPorphyromonas gingivalisstrain ATCC 33277.P. gingivaliswas detected by immunofluorescence, using a species‐specific monoclonal antibody, in 41% (17/41) of the children, and isolated from a single subject (2.4%). IgM, IgG, and IgA against GBE were detected in respectively 39/41 (95%), 41/41 (100%), and 27/41 (66%) of the sera. In 22/39 sera, the IgG titer was below 50% that of a reference pool of adult sera (RP). In 13/41, the IgM titer was higher than that of the RP, mostly in the deciduous dentition group. Detectable IgA titers were always below 67% that of the RP. A polarized distribution of the children appeared, separating 21 non‐ and low IgA responders (IgA titer below 10% that of the RP) from the remaining 20 subjects. Anti‐LPS IgG, IgM, and IgA were detected in 41/41 (100%), 39/41 (95%), and 23/38 (61%) respectively of the children. In 32/41 sera, the anti‐LPS IgG titer was below 50% that of the RP, while in 20/39 sera, IgM titers were higher. A clearcut dichotomy in IgA response was observed, allowing us to distinguish non‐IgA responders (39%) and IgA responders to LPS (61%). Our results indicate that serum antibodies toP. gingivalisare highly prevalent in children, suggesting that an active primary immune response and a secondary immune response are well underway. Discordant results between detection rate, either by culture or by immunofluorescence, and prevalence of antibodies suggest that few but highly immunogenic cells ofP. gingivalisare distributed at discrete sites in the oral cavity where they escape sampling for detection procedures. Thus our data support the hypothesis ofP. gingivalisbeing a member of the endogenous oral microflora in humans.J Periodontol 1995; 66:369–376.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.5.369

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

This multi‐center study evaluated guided tissue regeneration(GTR) in Class II furcation defects using a polylactic acid biodegradable barrier in 29 patients with mandibular and maxillary molar defects. Following an initial hygienic phase, surgical flaps were elevated, and the sites scaled and root planed. Furcation defect perimeter was measured and a customized barrier (thickness 600 to 750 μ) was applied to cover the defect. Barriers adhered directly to tooth and bone. At baseline, sites were measured for probing depth (PD) (6.0 ± 0.2 [SE] mm), gingival margin location (GML) (−0.2 ± 0.2 mm), and attachment level in both vertical (AL‐V) (6.2 ± 0.2 mm) and horizontal (AL‐H) (5.4 ± 0.2 mm) directions. After the surgical procedure, there was good compatibility between the gingival tissues and barrier material. Clinically, barriers fragmented and became displaced in 3 to 6 weeks. Substantial granulation tissue was sometimes present between barrier and root surfaces. Comprehensive periodontal examination parameters were measured 3, 4, 6, 9, and 12 months after baseline. A repeated measures ANOVA was used to evaluate changes from baseline. At 6 and 12 months postsurgery, GML was close to the presurgical level (−0.5 ± 0.2 mm). There was clinically and statistically significant improvement in all other parameters: mean PD reduction (2.2 mm), AL‐V gain (1.7 mm), and AL‐H gain (2.5 mm). These results indicated favorable clinical regenerative outcomes after using this barrier material in Class II furcation defects in humans.J Periodontol 1995; 66:377–385.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.5.377

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The mechanism of accelerated periodontaldestruction around teeth with occlusal trauma and increased mobility remains unclear. One possibility is that tooth mobility creates a subgingival environment conducive to overgrowth by periodontal pathogens. This study compared the subgingival microflora in mobile and non‐mobile teeth of 35 adults on supportive maintenance therapy and 15 with untreated adult periodontitis. In each subject, subgingival paper‐point samples were obtained from a mobile tooth with a probing depth of 4 mm or greater and from a non‐mobile tooth with similar probing depth and gingival index. Samples were transported in VMGA III medium. Pockets around mobile teeth harbored significantly higher proportions ofCampylobacter rectus(P= 0.001) andPeptostreptococcus micros(P= 0.05) than pockets with non‐mobile teeth: Mobile teeth also tended to show elevated levels ofPorphyromonas gingivalis, but this did not reach statistical significance. This study suggests that tooth mobility may constitute a risk for periodontal breakdown due to an increased subgingival occurrence of specific periodontopathogens. This hypothesis needs to be verified in longitudinal clinical and microbiological studies.J Periodontol 1995; 66:386–390.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.5.386

出版商:Wiley    

年代:1995

数据来源: WILEY