摘要:

Cyclosporine and nifedipine therapyproduces gingival overgrowth in many patients. Neither the mechanism underlying this undesirable side effect nor the possibility of synergism between these drugs is known, although many renal transplant patients receive both drugs. This study compared the rates of3H‐glucosamine utilization by three groups of fibroblasts: untreated gingival fibroblasts, fibroblasts from gingival overgrowth tissue of a patient receiving both cyclosporine and nifedipine, and normal gingival fibroblasts exposed to cyclosporine‐A in vitro. Significant differences in the rates of deposition of3H‐glucosamine into the extracellular matrix by each group of gingival fibroblasts were demonstrated, suggesting that increased rates of deposition of proteoglycans into the gingival extracellular matrix by fibroblasts should be further investigated as a biologic mechanism for gingival overgrowth.J Periodontol 1994;65:565–567.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.6.565

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

This clinical study evaluatedthe survival rates ofActinobacillus actinomycetemcomitans, Porphyromonas gingivalis, andPrevotella intermediain periodontal pockets following scaling and root planing and intra‐pocket irrigation with antimicrobial agents in patients with moderate and severe periodontitis. The number of target organisms was determined utilizing DNA probes. Adult periodontitis patients were selected on the basis that the subgingival flora contained at least one of the target organisms. Forty‐eight (48) inflamed pockets ≥ 5 mm in depth with probing attachment loss and containing at least one of the target species were then selected in 7 adult patients who harbored these bacteria. Following baseline clinical and bacterial examination, all patients received thorough scaling and root planing. In addition, 1 or 2 teeth in each patient which harbored the target flora at baseline were randomly assigned to each of the following 4 treatment modalities: 1) control group, no irrigation; 2) saline group, irrigation with 2 cc of physiologic saline; 3) tetracycline group, irrigation with 2 cc of aqueous tetracycline hydrochloride, 50 mg/ml (5%); and 4) Chlorhexidine group, irrigation with 2 cc 0.12% chlorhexidine. All selected sites (5 to 8 per patient) were nonadjacent teeth. Clinical parameters and microbial analysis were recorded again at one week, and one month postirrigation. The survival rate of the target microorganisms was determined and the effect of irrigation with antimicrobial agents on this microflora was compared with the control groups (1 and 2). This investigation, although conducted on a small group of patients, indicated that: 1) thorough scaling and root planing was very effective in reducing the target bacteria below the detectable level (<6,000 cells/site) at the majority of sites and 2) the addition of antimicrobial irrigation did not significantly augment the results obtained from scaling and root planing alone. These results suggest that the effects of shortterm single professional subgingival irrigation with antimicrobial agents does not result in major adjunctive benefits in reduction of subgingival pathogens beyond that achieved by thorough scaling and root planing. Repeat applications, or slow release of topical antimicrobials, may be necessary to achieve adjunctive antimicrobial effects. Furthermore, studies with larger groups of subjects may be necessary to show differences between scaling and root planing and adjunctive professional subgingival irrigation.J Periodontol 1994; 65:568–575.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.6.568

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The purposes of this study were two‐fold: to compare the DNA probe and enzyme linked immunosorbent assay (ELISA) microbial identification tests and correlate the levels of microorganisms with adult periodontitis. A single plaque sample was taken from each of 2 sites in 52 patients. Twelve of these patients were also sampled during and after treatment. The experimental site had clinical indicators of disease (bleeding on probing, probing and attachment loss of ≥ 6 mm) and the contralateral site (control) was clinically healthy. A total of 176 plaque samples were collected, divided, processed, and sent for both types of quantitative microbial analyses. All of these samples were used to compare the DNA probe and ELISA methods while only the initial 104 pretreatment sites were used to correlate microorganisms/method with clinical indicators of adult periodontitis. DNA probes were used to assay forA. actinomycetemcomitans, P. gingivalis, P. intermedia, E. corrodens, F. nucleatum, T. denticola, andC. rectus. An ELISA utilizing monoclonal antibodies was used to assay forP. gingivalis, E. corrodens, T. denticola, andC. rectus.Comparison of the two methods revealed that the ELISA test identifiedP. gingivalisandC. rectussignificantly more often than the DNA probe method and thatT. denticolawas detected more frequently with the DNA probe. The sensitivities and specificities varied widely among organisms and by test.P. gingivalis, as identified by ELISA, had the highest degree of sensitivity and specificity (0.90 and 0.82 respectively) to clinical indicators of adult periodontitis.J Periodontol 1994;65:576–582.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.6.576

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

This study examined histologic and histometric responsesto 2 bioabsorbable membranes made from a synthetic copolymer of glycolide and lactide. They were tested for their biocompatibility, resorption characteristics, and ability to support periodontal regeneration. Expanded polytetrafluoroethylene (ePTFE) was used as control. Nine fox hound dogs with no periodontal disease were used. They were sedated and their teeth thoroughly scaled and root planed. Plaque control was maintained. Two weeks later, each dog was anesthetized using gas anesthesia. Buccal and lingual mucoperiosteal flaps were reflected in the mandibular premolar areas. Randomly selected, buccal alveolar bone was reduced on the 2nd and 4th premolare to a level 5 to 8 mm apical to the cemento‐enamel junction creating a Class II buccal furcation defect on one quadrant, while the other quadrant received a Class II buccal defect only on the 4th premolar. Root surfaces were denuded of periodontal ligament and cementum, and notches were placed at the bone level of each root. In one quadrant, one site received Type I membrane and the other site received Type II. The contralateral quadrant received ePTFE. Flaps were positioned slightly coronally and sutured. Sutures were removed 1 week later. One month after surgery, 3 dogs were sacrificed and ePTFE barriers were removed from the remaining 6 dogs. Of these, 3 were sacrificed 3 months after surgery and the other 3 at 6 months. Undemineralized experimental tissues were embedded in methylmethacrylate and 8 to 10 μm thick sections were cut in a bucco‐lingual direction throughout the mesiodistal extension of the tooth. These sections were evaluated by descriptive histology and linear measurements of the periodontal tissues made. A two‐factor analysis of variance was carried out on these measurements to test for differences between control and test membranes within an animal for connective tissue attachment, cementum, bone, and epithelium. Analyses were performed on data 1, 3, and 6 months post‐healing. Histologic and histometric evaluation demonstrated that, in spite of early resorption of resorbable membranes associated with the normal inflammatory reaction, the reformation of a connective tissue attachment was favored by the placement of the membranes. New cementum with inserting collagen fibers was observed on the previously denuded surfaces of test roots, similarly to that seen in the controls. Hence, these findings indicate that, from a clinical and histological stand point, similar results can be achieved in guided tissue regeneration procedures, whether bioabsorbable barriers or the non‐bioabsorbable ePTFE is applied.J Periodontal 1994;65:583–591.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.6.583

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Twenty‐six mandibular classIIIfurcation defectswere treated in 26 subjects using a regenerative therapy that included citric acid root conditioning, placement of freeze‐dried decalcified bone allograft and coronally positioned flaps secured by crownattached sutures. In addition to this therapy, expanded polytetrafluoroethylene (ePTFE) membranes were placed in 14 of the 26 defects. The effect of these therapies was evaluated after 52 to 60 weeks through a series of soft and hard tissue probing measurements including residual furcation classification. For both treatments, mean improvements were observed for furcal probing attachment levels, furcal bone levels, and defect volumes. However, only a few of these through‐and‐through defects had become closed as judged by a panel of 3 independent examiners. Four defects in each of the 2 treatment groups had changed from Class III to Class I/II or Class II/II evaluated with the soft tissue in place. One defect treated without membrane and 3 defects treated with membranes had changed from Class III to Class II as recorded after reflection of the soft tissues at re‐entry. Little difference was observed between defects treated with and without membranes. Further studies with larger sample sizes and longer observation times are needed to fully evaluate these regenerative procedures and their potential for healing Class III furcation defects.J Periodontology 1994;65:592–597.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.6.592

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The purpose of this study was to comparethe changes in clinical attachment when either a non‐resorbable ePTFE membrane or an absorbable collagen membrane was used as a barrier during surgical treatment of class II molar furcation defects. Thirteen patients, mean age 43.2 years, with two comparable class II molar defects were treated using a split mouth design. Pre‐surgical standardized probings were made using an automated probe at a constant force of 25 grams. Four to 6 weeks after initial therapy, the furcations were surgically debrided, the membranes placed to occlude separate furcation defects in each patient, and the sites closed. The ePTFE membrane was removed 6 weeks after placement. Six months postsurgery, the clinical measurements were repeated. Studentttest was used to compare the results. There were no significant differences in the mean initial measurements between the treatment groups. The mean decrease in vertical probing depth was 1.40±1.68 mm for the collagen treated sites and 1.07±0.81 mm for the ePTFE treated sites. The decrease in horizontal probing depth was 1.49±1.97 mm for the collagen treated sites and 0.79±2.16 mm for the ePTFE treated sites. No significant differences were found between any of the clinical parameters measured. Based on the results of this short‐term clinical study, the absorbable collagen membrane was statistically equivalent to the non‐resorbable ePTFE membrane in the clinical resolution of class II furcation defects.J Periodontol 1994;65:598–604.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.6.598

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The efficacy of two oral hygiene training programson the control of plaque and the prevention of gingival inflammation in adolescents was evaluated during a 3‐year period. A population of 227 Brazilian schoolchildren were divided into 3 groups. The first group received a comprehensive program based on individual needs and included information sessions pertaining to the etiology and prevention of dental diseases together with extensive training in self‐diagnosis and oral hygiene. In addition, an information session was arranged for parents and teachers of these children. The second group received a less comprehensive program consisting of conventional oral hygiene training. The third group (control) received no preventive program. The programs were presented through frequent initial training sessions ensued by infrequent follow‐up visits. During the experimental period, the two oral hygiene training programs involved 3.5 and 1.5 hours per child, respectively. The children were examined clinically at baseline and annually over the next 3 years to assess plaque and gingival bleeding and the data were analyzed by a multi‐level variance component analysis. All children showed a perpetual improvement in their oral hygiene and gingival state during the course of the study. However, the improvements observed in the comprehensive group were significantly better than that of the control group. Results from the less comprehensive group were not significantly different from the control group. Longer exposure to the programs appeared to produce more improvement; children with higher plaque and gingivitis scores prior to the program showed less favorable results; girls exhibited better results than boys. In addition, anterior teeth and buccal sites showed more improvement. It was concluded that comprehensive training in self‐diagnosis and oral hygiene can be effective in maintaining satisfactory gingival health in adolescents.J Periodontol 1994; 65:605–610.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.6.605

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

A 12‐month clinical trial was conductedto compare the effectiveness of a prebrushing rinse (PBR) in plaque removal with that of water. Four groups participated in the study; group 1 (test group) rinsed with PBR before brushing; group 2 rinsed with plain tap water; group 3 brushed only; and group 4 rinsed with sterile water (same color as the PBR). Pre‐brushing and post‐brushing plaque scores were recorded at baseline, 3 months, 6 months, 9 months (Ramjford surfaces) and 12 months for groups 1, 2, and 3 and at baseline, 3 months and 6 months for group 4. Pre‐brushing minus post‐brushing plaque scores (decrements) were significantly higher in the PBR group at baseline, and 6, 9, and 12 months. Using a single criterion (gingival bleeding index) there were no differences between the 4 groups at any of the 5 assessments, hence, the clinical significance of the higher plaque removal scores in the PBR group remains in doubt.J Periodontol 1994; 65:611–615.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.6.611

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Automated probing systemshave been developed to provide a more precise method of evaluating periodontal pocket depths and attachment levels. The purpose of this study was to assess the clinical performance (reproducibility, time, and comfort) of a new electronic probe (E.P.) compared to the UNC 15 conventional probe (C.P.). Paired measurements 2 hours apart were performed by one examiner on 20 patients with moderate to advanced localized or generalized adult periodontitis. Both the E.P. and C.P. were used on each patient in a random manner. Overall reproducibility (± 1.5 mm) was: E.P. 94% (n = 1181); C.P. 96.5%. (n = 1254); E.P./C.P. used interchangeably 82.4% (n = 830). In assessing the reproducibility of bleeding on probing, using the Wilcoxon matched pairs signed ranks test, only the mid‐facial surface, when using the C.P. exhibited differences between measurements (P<0.017). Pairedttest revealed E.P. took significantly longer per exam (4 minutes, 46 seconds). Comfort levels, evaluated with a visual analog scale, were not significantly different between probes as shown by the Mann Whitney U test. The data suggest that, in general, there was no major significant difference in reproducibility measurements between the E.P. and the C.P. The E.P. took more time. Comfort levels were similar for both probes.J Periodontol 1994;65:616–622.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.6.616

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Early‐onset periodontitis(EOP) refers to a group of severe periodontal diseases with age of onset near puberty that are characterized by rapid destruction of the tissues supporting the teeth in othewise healthy individuals. Mixed model segregation analyses of 100 families, ascertained through 104 probands with EOP, were carried out to test major locus and multifactorial hypotheses for the etiology of EOP. Heterogeneity tests were used to compare the parameter estimates and conclusions obtained in Black families from those from non‐Black families. The data in these families confirmed that the oftenreported female preponderance of EOP appears to be an ascertainment bias. The segregation analysis results were consistent with an autosomal major locus being sufficient to explain the family patterns of EOP in the entire dataset, and also in both the Black and non‐Black subsets. A dominant mode of transmission was most likely, with penetrance of about 70%. Although the etiologic conclusions were the same for Black and non‐Black families, there was significant heterogeneity in parameter estimates. In particular the Black allele frequency was 0.016 versus the non‐Black frequency of 0.001.J Periodontol 1994;65:623–630.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.6.623

出版商:Wiley    

年代:1994

数据来源: WILEY