摘要:

Most of our knowledge regarding the natural historyof periodontitis in adults has come from clinical studies of dental patients. However, it is known that dental patients usually are not representative of what actually happens in the population. For this type of information, epidemiologie studies are required. The purpose of this paper is to present the trends in attachment loss over a 3‐year period in a population of communitydwelling elderly blacks and whites. Specifically, this paper presents attachment loss trends both at the person and site level to address the following issues: 1) whether attachment loss during one period in time makes a person at higher risk for attachment loss at a subsequent period; 2) whether sites with deeper periodontal pockets at baseline are more likely to experience future attachment loss; and 3) whether teeth that experience attachment loss during one time period are more likely to be lost at the next time period. In 1988, the University of North Carolina School of Dentistry initiated the Piedmont 65+ Dental Study, which is a subsample of the parent study, the Piedmont 65+ Study of the Elderly under the direction of investigators from Duke University. The dental study subsample was designed to elicit 800 dentate respondents in the 5‐county area who were examined again at 18 and 36 months. Our findings indicated that, for the two 18‐month periods investigated, attachment loss during the first period was related positively to the incidence of attachment loss at a subsequent period at the person level, but not at the site level. This is consistent with an episodic, random hit model of disease which places overall risk at the patient level with variation at the site level due to site characteristics. Our data also indicated that baseline probing depth was positively associated with the proportion of sites that demonstrated break down over the next 3 years. However, the vast majority of sites that experienced attachment loss had probing depths of 3 mm or less. Finally, teeth with more attachment loss at baseline had a higher probability of being lost during the next 3 years and teeth that experienced attachment loss during the initial 18 months were more likely to be lost during the next 18 months than teeth without additional attachment loss. In summary, this population‐based study of older adults who experienced a substantial incidence of attachment loss over a 3‐year period supports the findings from a number of clinical studies that indicate that attachment loss and pocket depth are related to probability of future breakdown in individual sites.J Periodontol 1994; 65:737–743.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.8.737

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Correlations have been reported betweencyclosporine A (CsA)‐induced gingival overgrowth (OG) and plaque‐induced gingivitis, duration of CsA therapy, and blood and tissue drug levels. We evaluated the relative importance of such factors using data from a 2‐year, double‐blind study of CsA therapy in multiple sclerosis (MS) patients. Ninety subjects (40 taking CsA; 50 placebo) were evaluated for plaque, calculus, gingivitis, probing depths, attachment levels, and CsA levels in blood and saliva. OG was determined by a panel of 11 calibrated examiners from standardized clinical photographs taken at the end of the study. Logistic regression was used to determine which factors were associated with occurrence of OG. Four (17%) out of 23 CsA patients with CsA trough blood levels<400 ng/ml exhibited OG. In contrast, 10 (59%) out of 17 CsA patients with CsA trough blood levels a400 ng/ml were affected with OG. Logistic regression analysis resulted in odds ratios of 0.74 (P= 0.009), 17.3 (P= 0.024) and 10.1 (P= 0.030) for the associations between OG and age, CsA trough blood levels 2≥400 ng/ml, and the interaction “color × tone,” respectively. In conclusion, the incidence of CsA induced OG appears to be higher with CsA trough blood levels greater than 400 ng/ml.J Periodontol 1994;65:744–749.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.8.744

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

There are few studies that provide informationon the natural history of calculus formation. The purpose of this study is to evaluate the relationship between pre‐scaling baseline calculus scores, the time since the last prophylaxis before baseline, and scores 8 weeks after scaling in a group of presumed heavy calculus formers. Scaling and polishing were completed on 203 subjects with Volpe‐Manhold Index (VMI) calculus scores of 7 or higher, and the date of the last prophylaxis was noted. All were re‐examined after 3 weeks. The group included 45.8% males and 54.2% females; the mean age was 41.74 (range = 24 to 72). Racial mix was 57.6% African‐American, 39.9% white, and 2.5% other. The mean baseline VMI score was 24.07 (SD = 15.38, range = 7‐97). The VMI scores were directly related (P=<.001) to the date of the last scaling and were highest in subjects whose last scaling was more than 2 years earlier (33.67) and least in subjects whose last scaling was less than 6 months previous (15.12). At 8 weeks the mean VMI score was 9.96 (SD = 7.30; range = 0‐41). The VMI scores at this time were inversely related (P=<.05) to the date of the last scaling before baseline and were lowest in subjects whose last scaling was more than 2 years earlier (9.07) and highest in subjects with the last scaling less than 6 months previous to baseline (13.07). This study concludes that subjects with initial whole mouth VMI scores of 7 and higher tend to maintain high levels of calculus 8 weeks after scaling. Also, subjects with recent scalings formed more calculus than those with greater time since last scaling.J Periodontol 1994;65:750–754.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.8.750

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The technique of guided tissue regenerationusing expanded polytetrafluoroethylene (ePTFE) membranes has been shown to be effective in implant dentistry (bony defects, extremely thin alveolar ridges, and implants placed in fresh extraction sockets). One of the drawbacks associated with the use of membranes is their premature exposure with consequent bacterial contamination. The aim of this study was to examine the possibility that oral bacteria migrate through the occlusive portion of ePTFE membranes and to determine the time needed for microorganisms to pass from the outer surface to the inner surface of the membranes. A removable acrylic device was adapted to the molarpremolar region of one quadrant of the jaws in each of three volunteers. Five cylindrical teflon chambers were glued to the buccal aspect of each device. The chambers were divided into two rooms separated by the inner portion of a ePTFE membrane. The outer room was open to the oral cavity allowing plaque accumulation; the inner room was isolated from the oral cavity by the ePTFE membrane. One of the 5 chambers was completely closed and used as control. The test period lasted for 4 weeks. Every week, one chamber was removed from each device and processed for scanning electron microscopic and histologic examinations. Our study showed the possibility that oral bacteria may contaminate ePTFE membranes exposed to the oral cavity. One specimen showed partial bacterial penetration after 2 and 3 weeks, but after 4 weeks, all membrane specimens demonstrated bacterial contamination. Complete bacterial penetration through the membrane and contamination of the inner surface was observed in one specimen after 3 weeks and in two specimens after 4 weeks of exposure to the oral cavity. Therefore, the partially occlusive porosity of the membranes seems to be able to delay bacterial penetration through the membrane for approximately 3 to 4 weeks. After this time, prematurely exposed membranes should probably be removed to prevent bacterial infection of the underlying regenerating tissues.J Periodontol 1994;65:755–761.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.8.755

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Aprevious clinical screening studydemonstrated that a cetylpyridinium chloride (CPC) essential oil mouthrinse inhibited plaque regrowth to a significantly greater extent than a negative control or a triclosan/copolymer rinse when used without toothbrushing. The purpose of this study was to evaluate the same ingredient combination as a prebrushing rinse over a 6‐week period. The study employed a 4 group parallel design with a minimum of 50 subjects per group. Subjects with a minimum baseline plaque index of 1.95 were recruited. The formulations employed were two variations of a CPC/essential oil rinse, a triclosan/copolymer product, and a hydroalcohol negative control. Subjects were rendered plaque free at baseline and then rinsed twice daily before toothbrushing with their allocated product. Plaque was scored at 6 days and 6 weeks. Plaque scores were reduced at 6 days compared to baseline but there were no significant differences between any of the groups. At 6 weeks, plaque scores were significantly lower in both CPC/essential oil groups compared to control. Although both CPC/essential oil groups showed plaque scores which were lower than the triclosan group, in only one of the groups was the difference significant. The triclosan product was not significantly different from control. The results support the previous findings that a CPC/essential oil rinse could be a useful adjunct to oral hygiene when used prior to normal toothbrushing.J Periodontol 1994; 65:762–765.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.8.762

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Peri‐implantitis, an inflammatory responsearound implants, has a poorly defined etiology and pathogenesis. To better understand the role of specific microorganisms in this disease process, clinical and microbiological parameters were examined in 24 patients with 98 osseointegrated implants. Sites were evaluated for probing depth (PD), plaque/calculus index (PI), gingival bleeding index (GBI), mobility, and crevicular fluid flow rate (CFFR).Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, andPrevotella intermediain subgingival plaque were identified by latex agglutination assays. Clinically, a statistically significant correlation (P<0.001) was observed between probing depth and the length of time an implant was present. Mobility was also significantly greater (P<0.001) in the maxillary than in the mandibular implants. Subgingival sites harboring one of the three microorganisms had significantly greater PD, GBI, and CFFR than non‐colonized sites. Implants in partially edentulous patients more frequently were colonized withP. gingivalis/P. intermediathan edentulous patients. The incidence of these microorganisms also correlated with fixture longevity. Implants present for 3 to 4 years had a significantly greater frequency of test microorganisms than implants present for 1 to 2 years. These findings suggest that microbial pathogens associated with periodontitis occur more commonly around implants exhibiting gingival inflammation (GBI) and may contribute to peri‐implantitis.J Periodontol 1994; 65:766–770.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.8.766

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Cellular and biochemical observationswere made of fibroblasts harvested from ligature‐induced periodontitis and treated gingivitis areas in four adult female cynomolgus monkeys (Macaca fascicularis) to define the changes that occur in the early periodontitis lesion. Compared with fibroblasts from the treated sites, fibroblasts from the diseased areas had a significantly higher rate of proliferation, produced about two‐thirds the amount of total protein and collagen, and failed to respond to TGF‐β, which normally stimulates extracellular matrix formation in mesenchymal cells. The diseased cells were also deficient in the activity of poly(ADP‐ribose) synthetase, an enzyme involved in the repair of DNA breaks such as occur from the insults of Superoxide and other active radicals present in inflamed areas. Although the precise nature of these biochemical defects is not fully elucidated, they may have an important bearing on chronic periodontitis cases with a „downhill” course.J Periodontol 1994;65:771–775.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.8.771

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Collagen mRNAlevels in the gingival cellsof molars and incisors in rats were measured and correlated with the ratio of interstitial collagen to DNA in these regions. Hybridization of 32P‐labeled specific cDNA probes for collagen types I and III with total RNA isolated from gingival tissue of rat molars and incisors showed that the steadystate levels of mRNAs of type I was significantly higher in the molars than in the incisors (molars/incisors = 2.12±0.12,P<0.004). However, the ratio of interstitial collagen to DNA in the gingiva of the molars was significantly lower than that found in the incisors (collagen/DNA = 4.13±0.90 and 12.89±1.24 respectively,P<0.001). It is suggested that the difference between the mRNA levels and those of interstitial collagen may reflect an intrinsic characteristic presumably associated with the different modes of mastication between molars and incisors of the rat.J Periodontol 1994;65:776–780.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.8.776

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

This study was designed to determinethe histologic response of regenerated tissue to plaque, using an adult Taiwan monkey model with chronically‐inflamed, surgically‐created, periodontal defects. Standardized 2‐walled periodontal defects were surgically created at the mesial of the mandibular lateral incisor on one side. Sutures, 3‐0 braided silk, were placed for 8 weeks and tissues positioned so that denuded root surfaces were exposed to plaque, with the subsequent development of the chronically‐inflamed periodontal tissues. At 8 weeks the defects were subjected to guided tissue regeneration procedures using expanded polytetrafluoroethylene membrane and allowed to heal for 6 months. Contralateral clinically healthy sites, without surgical procedures, were used as controls. In both experimental (membrane) and control sites, silk ligatures were placed to allow plaque accumulation for 2 or 10 weeks. Four monkeys were sacrificed at each time point and specimens processed for histologic and histometric study. The results indicated that plaque‐induced inflammation was less at sites treated by guided tissue regenerative procedures when compared to originally clinically‐healthy sites exposed to plaque for the same duration. However, histologically the newly formed osseous tissue was compromised under these conditions.J Periodontol 1994; 65:781–787.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.8.781

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The present paper describes 18 consecutively‐treatednon‐human primates (Macaca mulatta) as part of a balanced block design study of 36 animals to examine osseointegration in root‐ and plate‐form implants prepared by atraumatic preparation of bone. Clinical measurements around selected teeth and digital radiology were utilized to monitor periodontal disease and bone deposition around the unloaded implants. Once a month scaling procedures were utilized as a means of preventing further advance of periodontal disease. Results indicate that once‐monthly regimen of scaling and root planing can prevent attachment loss of natural teeth and will not interfere with the healing of either type of implant; once‐monthly scalings produce significant reduction in redness (P<.05) and reduced probing depths (P=.01). A second finding is that both root and blade implants show radiographie evidence of osseointegration in this primate model. The quantitative analysis demonstrates bone gain is not stabilized until 6 months after healing. The data may indicate that occlusal loading of mandibular implants at 3 months may be premature.J Periodontol 1994;65:788–795.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.8.788

出版商:Wiley    

年代:1994

数据来源: WILEY