摘要:

Aclassical treatment for chronic adult periodontitisconsists of four to six consecutive sessions of scaling and root planing at a 1‐ to 2‐week interval. Such a so‐called “quadrant or sextant therapy” might result in a reinfection of a previously disinfected area by bacteria from an untreated region. The purpose of this study was to investigate, over an 8‐month period, the clinical benefits of full‐mouth disinfection within a 24‐hour period in the control of chronic periodontitis. Ten adult patients with advanced chronic periodontitis were randomly assigned to a test and a control group. The control group received the standard scheme of initial periodontal therapy, consisting of scaling and root planing per quadrant at 2‐week intervals. In the full‐mouth disinfection group, scaling and root planing of the four quadrants was performed within 24 hours and immediately followed by a thorough supra‐ and subgingival chlorhexidine application to limit any transfer of bacteria. The latter involved tongue brushing with a 1% chlorhexidine gel for 60 seconds, mouthrinsing with a 0.2% chlorhexidine solution twice for 60 seconds, repeated subgingival irrigation of all pockets with a 1% chlorhexidine gel (3 times within 10 minutes), and mouthrinsing twice daily with a 0.2% chlorhexidine solution during 2 weeks. In addition, both groups received thorough oral hygiene instructions. The plaque index, gingival index, probing depth, gingival recession, and bleeding on probing were recorded prior to professional cleaning and at 1, 2, 4, and 8 months afterwards. Although the test group scored higher plaque indices than the control group, especially at months 2 and 4, the gingival index and bleeding tendency showed similar improvements with time. However, when the gingival/plaque ratio was considered, the latter was lower in the test group at all follow‐up visits. For pockets ≥ 7 mm, full‐mouth disinfection showed a significantly (P= 0.01) higher reduction in probing depth at each follow‐up visit with, at month 8, a reduction of 4 mm (from 8 mm to 4 mm), in comparison to 3 mm (from 8 mm to 5 mm) for the classical therapy. The increase in gingival recession in the fullmouth disinfection group remained below 0.7 mm, while in the control group it reached 1.9 mm after 8 months. This resulted in a gain of clinical attachment level of 3.7 mm for the test group versus 1.9 mm for the control group. A radiographical examination also indicated a superior improvement for the test group when compared to the control group. This pilot study suggests that a full‐mouth disinfection in one day results in an improved clinical outcome in chronic periodontitis as compared to searings per quadrant at 2‐week intervals over several weeks.J Periodontol 1996;67:1251‐1259.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.12.1251

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Bone cells derived from human jawwere isolated from expiants and grown in vitro. Subcultures were cultured on plastic (control) and metal substrates for 24 and 48 hours in medium containing3H‐glucosamine and labeled glycosaminoglycan (GAG) accumulation was measured. In bone cells cultured on metal substrates there was an evident reduction in the synthesis and secretion of radiolabeled macromolecules compared to bone cells‐cultured on plastic. Moreover, the accumulation of single GAG classes was specific for each substrate tested. The results showed that titanium was the only metal substrate studied in which the percentage of individual GAG classes remained the same as control cultures. GAG reduction was due to a decreased synthesis and not to an increased degradation as shown by the decrement of exoglycosidase activity. The metals also reduced the activity of transforming growth factor β (TGFβ), measured using interleukin‐1 assay method, a factor involved in the various phases of bone remodeling; in this case, too, cells grown on titanium showed the highest TGFβ activity compared to the other metal substrates studied. The results indicate that the substrate to which the cells adhere do exhibit specific differences in GAG composition and TGFβ activity. The differences observed may be important during in vivo events such as guided tissue regeneration and bone deposition.J Periodontol 1996;67:1260–1266.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.12.1260

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

We investigated the expressionof interleukin‐1 receptors (IL‐1R) on the surfaces of cultured gingival fibroblasts derived from healthy and inflamed gingiva and the effects of IL‐1α and IL‐1β and prostaglandin E2(PGE2) on IL‐1R expression. Fibroblasts were obtained from expiant culture of both healthy and inflamed gingiva. IL‐1R on cell surfaces was detected immunohistochemically using an anti‐human IL‐1R monoclonal antibody. IL‐1R expression was assessed quantitatively using an enzyme linked immunosorbent assay (ELISA). Positive staining for IL‐1R was more evident on cells from inflamed gingiva compared with cells from healthy gingiva. The ELISA showed a significantly increased number of IL‐1R on cells from inflamed gingiva compared with cells from healthy gingiva (P<0.05). Treatment with IL‐1 but not PGE2increased expression of IL‐1R on fibroblasts. These findings suggest that gingival fibroblast responses to IL‐1 may represent a mechanism for amplification of gingival inflammation.J Periodontol 1996;67:1267–1273.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.12.1267

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Quiescent and non‐quiescent humangingival fibroblasts (HGF) were incubated for 24 hours withActinobacillus actinomycetemcomitanslipopolysaccharide (LPS) and/or growth factors (interleukin‐1β [IL‐1β], insulin, epidermal growth factor [EGF], platelet‐derived growth factor [PDGF], fibroblast growth factor [FGF], and transforming growth factor‐β [TGF‐β]) to examine the ability of LPS to modify HGF proliferation in response to these autocrine and paracrine growth factors.A. actinomycetemcomitansLPS at high concentrations (≥ 9 μg/well) generally resulted in a reduction in DNA synthesis in quiescent and non‐quiescent fibroblasts; however, LPS at low concentrations (<9 μg/well) showed a minimal enhancement of DNA synthesis (40 to 60%) in quiescent and non‐quiescent cells. HGF co‐incubated with mitogenic agents and LPS (9 μg/well) exhibited suppression of growth factor‐induced3H‐Tdr uptake compared to growth factor‐stimulated controls. In contrast,3H‐Tdr uptake was slightly elevated with addition of LPS at low concentrations (0.09 μg/well). These trends were seen with all growth factors tested. Non‐quiescent cells, in general, were more responsive to the growth factors and LPS/growth factor combinations when compared to the quiescent HGF. HGF were further tested for the ability of LPS to alter growth factor responsiveness by pretreating the cells with LPS prior to incubation of the growth factor, as well as, subsequent addition of LPS to growth factor‐pretreated cells. Similar patterns were observed as above, except IL‐1μ‐pretreated quiescent and nonquiescent HGF followed by LPS addition demonstrated a marked elevation in proliferation when compared to IL‐1μ stimulated controls. These findings suggest that LPS may potentially modulate the proliferative rate of connective tissue undergoing inflammatory or growth factor‐induced reparative processes in periodontal lesions.J Periodontol 1996;67:1274–1280.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.12.1274

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Adequate root preparationin periodontal procedures includes the removal of plaque, calculus, and perhaps contaminated cementum and dentin. The purpose of this study was to evaluate and compare the amount of root surface removal and residual surface texture using similarly shaped regular (US) and both fine (FINDIAM) and medium (MEDDIAM) grit diamond‐coated ultrasonic inserts. Forty‐five (45) premolars extracted for orthodontic reasons were randomly divided into 3 groups of 15 teeth each. They were individually mounted in a jig and instrumented with a standardized 500 gram force while they were moved a precise horizontal distance of 12 mm over a 1.2 second period‐using specially designed and computer controlled instrumentation. Three measurements were made to the nearest 0.0005″ at 3 points along the test area before instrumentation and after 10 and 20 strokes. The mean depth of root structure removed was US 5.8 ± 6.6 μm, FINDIAM 50.1 ± 14.2 μm, MEDDIAM 30.8 ± 12.1 μm, after 10 strokes, and US 12.7 μ 10.9 μm, FINDIAM 83.3 ± 20.1 μm, MEDDIAM 58.7 ± 17.9 μm after 20 strokes, respectively. All 3 instruments were different from each other (P<0.001) in the 10 stroke group, while in the 20 stroke group FINDIAM and MEDDIAM were different from US (P<0.001), but not from each other. Only FINDIAM showed a significant difference between 10 and 20 stroke values for depth of root removal. Modified loss of tooth substance index SEM scores indicated increasingly greater root surface roughness from US to FINDIAM to MEDDIAM. Substantially greater root surface removal and greater residual root surface roughness occurred with diamond‐coated ultrasonic inserts under standardized in vitro conditions. These results suggest that caution should be used with diamond‐coated ultrasonic instruments during periodontal root planing procedures.J Periodontol 1996;67:1281–1287.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.12.1281

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The present study compared recordingreproducibility and image homogeneity after applying two techniques for recording of serial intra‐oral radiographs: 1) a technique previously described in 1990 based on mechanical fixation between the patient, the film holder, and the x‐ray tube; and 2) a newly developed technique which operates with an optical alignment provided by a light beam. Twenty adults participated in the study. Two intra‐oral radiographs were taken with a 30‐minute time interval of the mandibular premolar/molar and the incisor region in each individual with either of the methods. All radiographs were scanned and digitized. Subtractions were performed between the two radiographs taken of the same individual and region with the same method. The standard deviation (SD) of the histogram defining the distribution of the grey shades in the subtraction image was used as the statistical test parameter. Subtractions were performed with an automated method and using a reference point‐based program in order to test recording reproducibility and image homogeneity, respectively. Pairedt‐tests revealed that the average SDs obtained by the mechanical fixation method and the optical method were not statistically significantly different neither when applying the automated nor the reference point‐based subtraction method (P>0.05). The SDs increased significantly when the automated method was used compared to the reference point‐based method (P= 0.001). In conclusion, the optical method and the mechanical method provided images of similar recording reproducibility and homogeneity.J Periodontol 1996;67:1288–1291.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.12.1288

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

This study describes the variationsin the reproducibility of attachment level recordings for different subjects at different examinations. Twenty patients with different degrees of periodontal disease were recruited and examined bi‐monthly for their attachment levels using an electronic probe in two quadrants and a conventional probe in the other two quadrants. At each of the 7 examinations attachment level recordings were repeated with the appropriate probe after approximately 30 minutes. Results demonstrate that the reproducibility of attachment level recordings was slightly better for the conventional probe than for the electronic probe. Attachment level recording reproducibility varied considerably between subjects and between examinations for the same subject. Aggregation of attachment level recordings in the form of mean tooth values or mean individual values reduced the range of the differences, but considerable between‐subject and between‐examination variation was still seen. These results indicate that no single uniformly valid estimate of attachment level reproducibility exists which can be used to set diagnostic thresholds such that a minimum number of incorrect diagnoses are made.J Periodontol 1996;67:1292–1300.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.12.1292

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Clinical outcome followingthe concurrent use of a porous resorbable calcium carbonate (CC) implant and guided tissue regeneration (GTR) in intrabony periodontal defects was evaluated in a randomized four‐treatment parallel arm study. Eighty (80) patients, each contributing one interproximal intrabony defect, were assigned to the four treatments (20 patients per treatment) including the CC implant and GTR (CC+GTR), GTR alone (GTR control), CC implant alone (CC control), and gingival flap surgery alone (GFS control). Fourteen patients treated with CC+GTR, 19 patients treated with the GTR control, 13 patients treated with the CC control, and 18 patients treated with the GFS control completed the study. Clinical healing was evaluated 6 months postsurgery and included changes in probing depth, clinical attachment level, probing bone level, and gingival recession. Postsurgery probing depth reduction was 4.5 ± 1.7 mm (CC+GTR;P<0.01), 4.8 ± 1.8 mm (GTR;P<0.01), 3.7 ± 2.2 mm (CC;P<0.01), and 3.3 ± 1.6 mm (GFS;P<0.01). Clinical attachment gain amounted to 3.3 ± 1.4 mm (CC+GTR;P<0.01), 4.0 ± 2.1 mm (GTR;P<0.01), 3.0 ± 2.4 mm (CC;P<0.01), and 2.0 ± 1.7 mm (GFS;P<0.01). The CC+GTR and GTR treatments exhibited significantly greater improvements compared to GFS (P<0.05). Postsurgery probing bone level gain amounted to 4.0 ± 1.7 mm (CC+GTR;P<0.01), 4.1 ± 1.5 mm (GTR;P<0.01), 4.0 ± 2.2 mm (CC;P0.05). The CC+GTR, GTR, and CC treatments exhibited significantly greater improvements compared to GFS (P<0.05). Gingival recession increased significantly compared to presurgery for GTR, CC, and GFS treatments (−0.9 ± 1.2, −0.7 ± 0.7, and −1.2 ± 1.4 mm, respectively;P<0.01). The results suggest that the concurrent use of a porous resorbable CC implant and GTR has limited adjunctive effect in the treatment of intrabony periodontal defects.J Periodontol 1996;67:1301–1306.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.12.1301

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The aim of this studywas to measure tissue levels of immunoreactive prostaglandin E2(iPGE2), immunoreactive leukotriene B4 (iLTB4), and pain after periodontal surgery and to evaluate the effect of the non‐steroidal anti‐inflammatory drug (NSAID), ibuprofen, on these levels. Two contralateral quadrants in each of nine patients were selected to undergo separate surgical procedures, one with ibuprofen (800 mg 1 hour presurgery and 400 mg postsurgery) and one with a placebo. Intra‐operatively, a custom‐made microdialysis probe, with a 3,000 dalton molecular weight cut‐off, was inserted beneath the soft tissue flap and a dialysate collected every 20 minutes for 4 hours after surgery. Pain perception was measured at the same time intervals using two pain scales. Dialysate samples were assayed using two enzyme immunoassays. Mean tissue levels of iPGE2in the placebo group increased from 74 nM at 40 minutes to a peak of 261 nM at 200 minutes. Mean tissue levels of iLTB4 in the placebo group fluctuated between 0.2 and 0.6 nM. Pain levels in this group increased continuously with time, peaking at 4 hours. Mean tissue levels of iPGE2in the ibuprofen group were significantly suppressed, exhibiting more than a 95% reduction. This was accompanied by a significant reduction in pain. Ibuprofen had no detectable effect on tissue levels of iLTB4. These data indicate that iPGE2and iLTB4 are present at relatively high concentrations in the periodontal tissues after surgery. Since these concentrations exceed the Kd values for binding to their respective receptors, PGE2and LTB4 may be associated with the development of postsurgical pain and inflammation. These data also indicate that ibuprofen can successfully inhibit iPGE2production in the periodontal tissues and in this way may help reduce postoperative pain and inflammation.J Periodontol 1996;67:1307–1316.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.12.1307

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

An aluminum wedge can be used to quantifyvolumetric change in crestal alveolar bone which has been identified through subtraction radiography. This study compares two methods for using an aluminum wedge for this purpose: 1) the aluminum wedge is present in both radiographs and used to determine the aluminum equivalent bone density present in the region of change for each radiograph; and 2) the aluminum wedge is present in only one radiograph and the difference image of the wedge in the subtraction image is used to calculate the aluminum equivalent change in bone density. Pairs of standardized x‐rays were taken with synthetic bone chips of known weights placed when the second x‐ray was taken. The volumetric change produced by the bone chips was calculated by the two methods. The relationship of the calculated volumes to the chip weights had a higher r2value (P<0.05) for the two‐wedge method than for the one‐wedge method. The two‐wedge method is recommended for volumetric quantification of alveolar bone change. The influence of the clarity of the aluminum wedge image in the x‐ray pairs was also examined in this study and found to be significant. Attention must be given to factors which affect the aluminum wedge image characteristics to achieve optimal results.J Periodontol 1996;67:1317–1321.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.12.1317

出版商:Wiley    

年代:1996

数据来源: WILEY