摘要:

Tetracyclines are frequently employedduring the treatment of clinical infections in medicine and dentistry, however, emergence of resistant bacterial strains has decreased the utility of these drugs. Accordingly, there is concern that indiscriminant administration of tetracyclines during periodontal therapy will further contribute to the development of additional resistant microorganisms which can complicate infectious disease therapy. This review paper briefly discusses the utility of tetracyclines as an antimicrobial agent in the treatment of periodontal diseases. It then focuses on the clinical significance of bacterial resistance to tetracyclines. Patterns of resistance that may be associated with the following scenarios are addressed: short‐ and long‐term antibiotic therapy, individuals with a history of prior tetracycline therapy, patients with refractory periodontitis, and following controlled local drug delivery. It appears that selection and development of bacterial resistant strains is an inevitable consequence of antibiotic therapy. Nevertheless, prudent administration of tetracyclines may help delay or prevent the emergence of resistant microorganisms.J Periodontol 1995;66:925–932.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.11.925

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The oral, oral sulcular, and junctionalepithelia of the natural gingiva each possess distinct patterns of differentiation that are demonstrable both ultrastructurally and by their individual patterns of macromolecular synthesis. The supracrestal tissues reformed around oral implants structurally resemble those of natural gingiva but little is known about phenotypic changes occurring in the epithelia. To investigate whether peri‐implant epithelia acquire similar patterns of differentiation to those of natural gingiva, biopsies from the supracrestal regions of five oral implants were examined by immunofluorescent methods using a panel of monoclonal antibodies with specificities for individual‐cytokeratins and ICAM‐1, macromolecules which act as markers of the three gingival epithelial phenotypes. The observed staining patterns indicated the formation of oral, oral sulcular, and junctional epithelia which were phenotypically indistinguishable from those of natural gingival epithelia. This degree of reprogramming of epithelial gene expression is a surprising observation and the potential mechanisms leading to the development of those new epithelial phenotypes are discussed in the context of what is known about the development of natural gingiva, in terms of the possible effects of inflammation, and in relation to the known connective tissue influences on epithelial differentiation.J Periodontol 1995;66:933–943.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.11.933

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

High molecular weight humansalivary sulphated glycoprotein (SGP) inhibits attachment of fibroblasts to cementum in vitro and thus may enhance periodontal wound healing by repair with long junctional epithelium. However, competitive inhibition by serum constituents might prevent adequate binding of SGP for this effect to occur in vivo. The primary aim of this study was to investigate the co‐adsorption in vitro, of SGP, fibronectin (FN), and albumin (ALB) to synthetic hydroxyapatite (HA) from solutions of SGP/FN (62.5/2 μg/mL respectively), or SGP/FN/ALB (62.5/2/4 μg/mL), or from individual solutions of the agents as controls. Desorption of SGP and FN was studied by preabsorbing HA with SGP or FN and subsequently exposing it to the other agent, or to buffer only as control. Adsorbates were assayed after incubation periods of up to 26 hours using specific ELISAs. SGP displaced previously adsorbed FN after 3 hours and significantly inhibited adsorption of FN and ALB compared with controls. Neither FN or ALB had a significant effect on SGP adsorption. These results are consistent with the possibility that salivary adsorption to cementum during surgery might interfere with repopulation of the root by connective tissue cells and thus contribute to wound healing by repair rather than regeneration. Separate studies taken to validate the ELISA used for SGP determination showed that HA‐bound SGP contained all constituents of native SGP as revealed by SDS‐PAGE and that ion exchange chromatography of SGP gave 6 fractions (I through VI), of which only the most ionic (VI) was able to inhibit cell attachment in vitro.J Periodontol 1995;66:944–955.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.11.944

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The effects of various typesof sharpening stones on standard carbon steel Gracey type curets, and the influence of the sharpened curets on periodontally involved root surfaces, during in vitro scaling and root planing, was evaluated by means of scanning electron microscopy (SEM). Six different sharpening stones of varying texture, two of aluminum oxide, two India, and two Arkansas stones were assigned to sharpen six groups of 10 curets each. The curets were first examined under SEM and photographed and all exhibited edge irregularities. They were then sharpened with the different stones and again examined and photographed using SEM. The sharpness of each instrument was graded, related to the type of stone used, and the data compared statistically. A positive correlation was found between the texture of stone used and the surface sharpness it produced on the cutting edge of the instrument. The curets were then used to root plane the root surfaces on periodontally involved, extracted teeth. Replicas of the root surfaces were examined with SEM before and after removal of the smear layer with 10% EDTA. The planed and cleaned root surfaces revealed the effects of the sharpened instruments, with the relative surface roughness of the instrument being imparted to the tooth surface. The curets sharpened with finer grit stones produced smoother surfaces than those sharpened with the rough or coarse grit stone. It may be concluded that the sharpness of curets is related to the type of sharpening stone used and in turn to the smoothness of the planed root.J Periodontol 1995;66:956–961.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.11.956

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The purpose of this controlled double‐blind, parallel, randomized clinical study was to determine the effect of antiseptic mouthrinse on parameters important to dental implant maintenance. Plaque, peri‐implant gingivitis, gingival bleeding, probing depth, and attachment level were assessed over a 3‐month test period. Twenty healthy adult patients each of whom had at least two dental implants, a modified gingival index>1.5, and a modified Quigley‐Hein plaque index score>1.7 were enrolled into the study. After a thorough oral prophylaxis, patients were randomly assigned to either the antiseptic mouthrinse or a 5% hydroalcohol placebo mouthrinse group and instructed to rinse twice daily for 30 seconds with 20 ml of their assigned mouthrinse as an adjunct to their usual oral hygiene procedures. The baseline examination included plaque index, gingival index, bleeding index, probing depth measurement, and attachment level measurements. The plaque and gingival indices were rescored at 1, 2, and 3 months. Probing depths, attachment levels, and bleeding index were determined again at 3 months only. At the end of 3 months, the antiseptic mouthrinse group had statistically significant reductions in plaque index, gingival index, and bleeding index compared to the placebo group. There were no significant differences between groups in probing depth or attachment level. The results of this clinical study indicate that twice daily use of an antiseptic mouthrinse may provide benefits in the maintenance of dental implants.J Periodontol 1995;66:962–965.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.11.962

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The metabolic conversion of14C‐testosterone by human gingival tissue in response to IGF was studied. Androgen metabolic studies were also performed in 5 to 7 celllines of cultured gingival fibroblasts, using 14C‐testosterone and 14C‐4‐androstenedione as initial substrates. Duplicate incubations of gingival tissue were performed after establishing the wet weight, in Eagle's MEM + 10% FCS and optimal stimulatory concentrations of IGF for 24 hours. Similar incubations were performed in duplicate with cell‐line's of gingival fibroblasts, control/IGF, and 14C‐testosterone/14C4‐androstenedione. At the end of the incubation period, the radioactive metabolites were extracted, evaporated, subjected to thin layer chromatography for their separation, and quantified by scanning in a Berthold's linear analyzer. With the gingival tissue samples, IGF caused a 4‐fold increase in 5a‐dihydrotestosterone (DHT) synthesis (n = 5;P<0.1, Wilcoxon signed rank test for paired observations) and a 3.5‐fold increase in 4‐androstenedione formation (n = 5;P<0.1) from 14C‐testosterone. When similar incubations were performed with cell‐lines of fibroblasts and 14C‐testosterone, average values of duplicate incubations showed a 2.5‐fold increase in DHT synthesis in response to IGF (n = 7;P<0.002) and a 2.3‐fold increase in 4‐androstenedione formation (n = 7;P<0.002). With 14C‐4‐androstenedione as substrate, IGF stimulated a 2.7‐fold increase in DHT synthesis (n = 5;P<0.1) compared with controls and a 1.8‐fold increase in testosterone formation (n = 5;P<0.1). Since both DHT and IGF are implicated in protein turnover by fibroblasts, significant stimulation of DHT synthesis by IGF in gingiva and cultured fibroblasts is suggestive of a possible mechanism for mediating inflammatory repair via the androgen metabolic pathway.J Periodontol 1995;66:966–972.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.11.966

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The purpose of this studywas to evaluate the long‐term (10 years ± 15 months) periodontal response to resin bonded bridges (RBRs). A total of 103 patients who had RBRs bonded between 1980 and 1984 were recalled. Periodontal evaluations were made by two clinicians for all abutment teeth and for selected control teeth with intact, non‐restored lingual surfaces. Periodontal indices consisted of: plaque index (PI), gingival index (GI), gingival recession, probing depth, and loss of attachment. Paired t tests indicated no significant difference in overall GI between experimental and control sites, but a significant difference in PI and probing depth with experimental sites (abutment teeth) showing higher PI and greater probing depths. Significant differences were found in overall recession and attachment loss, again with more recession and attachment loss observed on the abutment teeth as compared to the controls. Site specific analyses for PI, probing, and loss of attachment showed small but significant differences between experimental and control teeth in 15 of 21 sites. Although these findings may be statistically significant, the clinical impact for resin bonded restorations functioning for over 10 years is minimal and is comparable to periodontal response to other types of restorations.J Periodontal 1995;66:973–977.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.11.973

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The objective of this studywas to evaluate if the biologic membrane utilized for GTR can be impregnated by tetracycline hydrochloride and if the chemotherapeutic agent, once impregnated, can be released in minimal inhibitory concentrations for a period compatible with clinical application. Initially, an in vitro study was done with cellulose membranes cut in pieces measuring 9 cm2. A volume of 100 μl containing a 72,000 μg/ml solution of tetracycline was dispensed onto each fragment, and dried for 70 minutes at 37°C. Four pieces measuring 0.5 cm2were cut from different points of the 9 cm2membrane (presumably, containing 400 μg of tetracycline), placed in test tubes containing 4 ml of sterile deionized water, and agitated for 2 minutes. A standard curve was made from known concentrations of tetracycline and compared to 10 μl of the test solutions obtained by the elution of the 0.5 cm2fragments. The concentrations were determined through the bioassay technique in 3 duplicate experiments. The samples recovered from the membrane fragments had a mean of 101 μg/ml of tetracycline liberated, demonstrating that the membrane was impregnated homogeneously by the chemotherapeutic agent. In a second phase, an in vivo study was carried out to determine the length of time the drug was liberated from the membranes and at which concentrations, in the presence of an inflammatory process. Fourteen 0.5 cm2fragments containing 400 μg of tetracycline were placed in 14 polypropylene chambers containing 200 μl of thioglycolate medium. The chambers were implanted in the peritoneal cavities of 14 mice, one chamber per animal, and left in from 1 to 14 days. They were then removed and the concentrations of tetracycline determined from 20 μl samples using a bioassay. The results showed that the antibiotic was released slowly from the 1st through the 12th day in decreasing concentrations that varied from 218 to 20.8 μg/ml. The impregnated cellulose membrane can probably be used in GTR acting as a membrane and as a slowrelease device, liberating the chemotherapeutic agent in concentrations high enough to eliminate periodontopathic microorganisms.J Periodontol 1995;66:978–983.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.11.978

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The furcation involvementof 200 molars in 50 patients suffering from advanced periodontitis was investigated. Presurgically, the horizontal probing attachment levels (CAL‐H) within the furcations of 4 molars per patient was assessed twice within 14 days. Within a subset of 11 patients duplicate measurements of clinical probing depths (PD) and vertical clinical attachment levels (CAL‐V) at the same molars were performed. To determine the measurement error of CAL‐H, PD and CAL‐V, respectively, the standard deviation of single measurements was calculated. The CAL‐II measurements were repeated intrasurgically and compared with presurgical assessments of furcation measurements. The overall standard deviation of single measurements was 0.759 mm. For Class 0, I, and II furcations, the standard deviations were 0.879 mm, 0.664 mm, 0.682 mm, respectively. The standard deviation of PD single measurements and CAL‐V single measurements varied from 0.393 mm to 0.993 mm (PD) and from 0.555 mm to 1.161 mm (CAL‐V), respectively. The agreement of replicate measurements of furcation degrees was moderate for furcation locations which showed a CAL‐H ≤ 3 mm and a CAL‐H>3 mm, respectively (weightedk‐coefficients 0.500 and 0.691). At sites with furcation involvement Class 0 and II there was no statistically significant difference between presurgical and intrasurgical measurements. At sites with Class I furcations there was a statistically significant mean difference of 0.255 mm between presurgically and intrasurgically assessed CAL‐H. There was no statistically significant difference between furcation classes as assessed presurgically and intrasurgically (x2between 1.9 and 4.4).J Periodontol 1995;66:984–989.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.11.984

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Necrotizing ulcerative gingivitis(NUG), necrotizing ulcerative periodontitis (NUP), and necrotizing stomatitis (NS), collectively termed necrotizing gingivostomatitis (NG), represent a dramatic, but rare oral infection associated with diminished systemic resistance, including HIV infection. Over a 5‐year period, 68 consecutive NG patients from a population with known HIV status were evaluated and treated. Lesions were staged (modified Pindborg), and clinical findings and predictor variables were compared to 68 random control subjects without NG. Most cases (52%) were stage 1, with necrosis of the tip of the interdental papilla only; 19% were stage 2, with the entire papilla affected; 22% had necrosis of marginal (stage 3) or attached gingiva (stage 4); and 7% were more advanced, with mucosal necrosis or bone exposure. Attachment loss was a feature of stage 2 or greater NG. Beside HIV infection, significant predisposing factors included poor oral hygiene, unusual life stress, inadequate sleep, Caucasian race, age 18 to 21 years, and recent illness. Ten of 68 NG patients were HIV‐positive. These patients were older than seronegative patients, less likely to be Caucasian, and maintained better oral hygiene and sleep. HIV‐positive NG cases were clinically indistinguishable from HIV‐negative cases in this series.J Periodontol 1995;66:990–998.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.11.990

出版商:Wiley    

年代:1995

数据来源: WILEY