摘要:

Aseries of993subgingivalmicrobial samples sent to a diagnostic microbiology laboratory included 196 samples that could be identified as compatible with a clinical diagnosis of refractory or recurrent periodontitis. In descending order of prevalence the associated microbiota includedBacteroides forsythus(84%), spirochetes (83%), motile rods (76%),Fusobacterium species(68%),Porphyromonas gingivalis(63%),Campylobacter rectus(47%),Capnocytophagaspecies (38%),Prevotella intermedia(23%),Peptostreptococcus micros(18%),Actinobacillus actinomycetemcomitans(16%),Candida(14%), enteric rods (9%),Staphylococcusspecies, not includingaureus(5.6%).Eikenella corrodens(3%),Staphylococcus aureus(1.5%), andEnterococcusspecies (<1%). Antibiotic resistance to tetracycline, penicillin G, or metronidazole was particularly noticeable for enteric rods,Fusobacteriumspecies,Capnocytophagaspecies,Staphylococcus, andActinobacillus actinomycetemcomitans. It was largely absent forCampylobacter rectus. No antibiotic sensitivity data were obtained forPorphyromonas gingivalisorBacteroides forsythus, as these species were detected by immunofluorescence. The results indicate that a substantial number of microorganisms associated with refractory Periodontitis are variably resistant to commonly‐used antibiotics. Diagnostic microbiology must be considered an essential adjunct to the therapist faced with periodontal lesions refractory to conventional treatment.J Periodontol 1993; 64:155–161.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.3.155

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Polytetrafluoroethylene membranes(ePTFE) used in guided tissue regeneration (GTR) are accessible to colonization by oral bacteria. The bacterial composition of the adherent biomass is unknown. We examined a total of 6 membranes that were retrieved after 4 to 6 weeks from human periodontitis sites, using optical and transmission electron microscopy (TEM) as well anaerobic cultivation. Five of the 6 membranes provided the microbiological data and microscopic data. TEM revealed an organized microbial mass covering the surfaces and also within the interstices of the open microstructure and occlusive portions of the membranes. Numerous bacterial forms including cocci, rods, and filaments with an interbacterial matrix, frequently in microcolonies, were identified. Anaerobic cultivation yieldedStreptococcusandActinomycesspecies with a minor component of Gram‐negative facultative rods comprised mainly ofHaemophilusspecies.Candidaspecies was recovered from one membrane. These data show that ePTFE is heavily colonized by oral bacteria during retention. The impact of bacterial colonization of ePTFE is not known but it seems reasonable to assume that colonization of membranes may affect connective tissue regeneration. Further studies will be needed to examine the effect of systemic antimicrobials on ePTFE colonization and in turn to examine the effect on GTR.J Periodontol 1993;64:162–168.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.3.162

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

The mechanism by which phenytoin(PHT) induces gingival overgrowth remains unclear. We hypothesized that PHT increases macrophage production of platelet‐derived growth factor (PDGF), an important cytokine in connective tissue growth and repair, and that excessive production PDGF in gingiva could lead to redundant growth. To test the hypothesis, rat peritoneal macrophages and human blood monocytes were cultured in the presence of PHT (5 to 20 μg/ml medium) or an equal volume of its solvent for 3 days and tested for expression of PDGF‐B mRNA byin situhybridization. Approximately 300 cells/culture well were examined (3 wells/drug level) for positive indication of PDGFB mRNA. Data were compared by chi square test. All levels of PHT in both cell types induced a 2‐ to 8‐fold increase in PDGF‐B mRNA positive cells, significant in all cases atP<0.001. Northern blot analysis of RNA from similarly cultured rat macrophages confirmed these findings. Cells treated with 10 μg PHT/ml medium or solvent revealed 2.2 ± 0.3 and 1.0 ± 0.2 (mean ± SEM) arbitrary units PDGF mRNA respectively (ttests,P<0.05). Additionally, rat macrophages were cultured in presence of 5 μg PHT/ medium or its solvent and medium was analyzed for PDGF secretion by radioimmunoassay. Mean values (± SEM) were 1.28 ± 0.49 and 0.78 ± 0.07 ng/mg protein respectively (ttest,P<0.05). These data showed that PHT augmented the expression ofc‐sis, the gene for PDGF‐B, and offered a possible explanation for PHT‐induced gingival overgrowth.J Periodontol 1993;64:169–173.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.3.169

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Hypophosphatasia is a congenital diseasecharacterized by defective bone mineralization, deficiency of alkaline phosphatase (ALP) activity, increased excretion of the phosphoethanolamine (PEA) in the urine, and premature loss of the deciduous teeth. A male hypophosphatasia patient (aged 15 years 6 months) with premature exfoliation of the deciduous teeth was referred to our hospital because of severe periodontal destruction in the permanent dentition. Blood and urine tests as well as oral and periodontal examinations were performed. Serum antibody titers against 7 periodontopathic bacteria by the enzyme‐linked immunosorbent assay (ELISA), monocyte and neutrophil chemotaxis measurements, and cellular immunity tests were also performed. Low levels of ALP in serum and PEA in the urine were found. Monocyte and neutrophil chemotaxis exhibited normal values. Slightly depressed CD2+, CD3+, and CD4+ and slightly elevated activity of NK cells were found. An elevated level of serum antibody toPorphyromonas gingivaliswas observed. Oral radiographic examination showed a mirror pattern of alveolar bone loss which is similar to that seen in localized juvenile periodontitis. Periodontal treatment of this patient was carried out for 4 years. The severely affected sites, the lower right and left first molars and the upper right first molar, had to be extracted. However, the other sites were well maintained. The serum IgG level againstP. gingivaliswas decreased after 4 years of periodontal treatment. Infection withP. gingivaliswas suspected to be associated with the destruction of this patient's hypophosphatasia, but other dental abnormalities such as abnormal enamel, dentin, and cementum formation may also have contributed to the periodontal pathology.J Periodontol 1993;64:174–180.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.3.174

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Chemical plaque removal is onemechanism whereby an agent could improve oral hygiene and ginvigal health. As with toothpastes most agents, when delivered as rinses, would be considered adjunctive to mechanical tooth cleaning procedures. The aim of this study was to determine whether selected commercial rinses exhibited clinically significant plaque removal properties alone or when combined with toothbrushing with water or a toothpaste. A group of 12 volunteers took part in this single blind, randomized placebo‐controlled, 12 cell cross‐over study, employing 6 rinses. During each regimen subjects accumulated plaque from a zero baseline over 72 hours. Plaque removal was then measured by index and area after first a single rinse of product and second a subsequent brushing with water or toothpaste. Prebrushing rinsing removed less than 5% of the plaque with little difference between agents. No rinse was more adjunctive than water to postrinse brushings. Most statistically significant differences arose with the chlorhexidine rinse being apparently less effective. However, the possibility of a disclosing dye interaction cannot be discounted as explaining this anomalous result. This study could not support any claim of a direct prebrushing rinse benefit greater than that provided by water to mechanical plaque removal by any of the products tested.J Periodontol 1993;64:181–185.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.3.181

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

The purpose of this studywas to quantify glycosaminoglycans (GAG) released into the gingival crevicular fluid (GCF) during health, gingivitis, and adult periodontitis. The investigation tested the hypothesis that increased amounts of GAG can be measured in GCF associated with gingivitis and adult periodontitis as compared to health. An individual patient's sampling sites were assigned to either a health (control) group or 1 of 3 experimental groups, gingivitis, periodontal “maintenance” (perio‐M), or periodontal “non‐maintenance” (perio‐NM) according to standard clinical criteria of pocket probing depth, bleeding on probing, and radiographic evidence of bone loss. The perio‐M group was defined as a periodontal patient who had received a dental prophylaxis and/or root planing within 6 months prior to GCF collection. The perio‐NM group had received no periodontal therapy during the previous 6 months. Subsequent to air‐drying and isolation, GCF was collected by a microcapillary pipette held at the gingival margin. All fluid samples were digested overnight at 37°C with 25 μg of papain and analyzed for GAG content using a chondroitin‐4‐sulfate standard. Data generated from safranin “O” dye binding assays of GAG revealed 4.41 ± 9.82 ng GAG from the health (control) group (n = 23); the gingivitis group (n = 13) showed 15.23 ± 11.85 ng GAG/sample; perio‐M group (n = 11) showed 23.64 ± 12.98 ng GAG/sample and the perio‐NM group (n = 12) exhibited 119.08 ± 33.14 ng GAG/sample. Using Dunn's multiple comparison procedure, statistically significant differences were found between the perio‐NM and health groups; perio‐M and perio‐NM; and perio‐NM and gingivitis groups atP<0.01 while significance atP<0.05 was found between health and perio‐M groups. However, no significant differences were observed between gingivitis and health groups or gingivitis and perio‐M groups. The safranin “O” assay method may be a useful indicator of osseous and connective tissue changes within the periodontium.J Periodontol 1993;64:186–190.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.3.186

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Fructosamine assay is a newtest used in the diagnosis and monitoring of diabetic patients. This assay may be of interest to the periodontist for, while the traditional plasma glucose value would give a general view and information about diabetic control at a certain point, the fructosamine concentration gives an indication of the plasma glucose level over a considerable period of time, such as 1 to 3 weeks. We investigated whether there was any relation between the diseased state of the periodontal tissues and plasma fructosamine and the plasma glucose values in non‐insulin dependent diabetes mellitus (NIDDM) patients. We found that fructosamine correlated with the degree of gingival bleeding, however serum glucose levels had little or no correlation.J Periodontol 1993;64:191–194.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.3.191

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Previous studies of the systemic antibodyresponse in necrotizing ulcerative gingivitis (NUG) have elicited varying results. The purpose of this study was to determine the humoral response to site‐specific isolates of microbiota associated with NUG. Sera from 21 active NUG subjects and 21 age‐sex‐race matched controls were assessed for IgG and IgM antibodies to 4 clinical isolates ofPrevotella intermediaand 3 clinical isolates of Treponema species.P. intermediaand Treponema strains were isolated from active and inactive sites of NUG patients and gingivitis sites of controls.P. intermediawas also isolated from noninflamed sites of the controls. IgG and IgM serum levels to these 7 bacteria were measured by ELISA. Compared to control subjects, the NUG sera exhibited significantly lower IgG and IgM levels to all 4 isolates ofP. intermedia(P≤0.001). It was also noted that sera from NUG subjects had elevated IgM levels to all 3 spirochete isolates but significantly higher only to the spirochete isolated from a gingivitis site of a control subject (P≤0.005). The data suggest that failure to mount a substantial antibody response toP. intermediamay be associated with onset of disease activity in NUG. However, the assumed lack of “biological significance” between differences in antibody responses measured indicates the relationship is weak or nonexistent. It also appears that antibody response to spirochetes is not associated with onset of NUG.J Periodontol 1993; 64:195–201.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.3.195

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

The purpose of this studywas to histologically evaluate the effectiveness of polylactide:polyglycolide 50:50 (DL‐PLGA) as a barrier to prevent epithelial migration and to promote new connective tissue attachment. Mucoperiosteal flaps were performed on 17 human teeth. DL‐PLGA membrane was placed over the roots and alveolar bone. DLPLGA was not placed over control teeth. Ninety days following surgery, block sections were obtained and processed for histologic evaluation. All specimens revealed a mean length of epithelial attachment within physiologic limits and recession of the gingival margin. There was little or no reattachment of the connective tissue. It is concluded that this copolymer barrier did not prevent epithelial migration nor enhance connective tissue attachment to human roots with severe horizontal bone loss and active periodontal disease.J Periodontol 1993;64:202–210.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.3.202

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

The histoimmunological responseof 8 individuals was studied longitudinally in relation to the development of experimental gingivitis during pregnancy and post‐partum. At day 0 as well as at day 14 of experimental gingivitis the mean periodontal pocket bleeding index (PPBI) was higher during pregnancy than post‐partum, whereas the amount of plaque that accumulated was similar. The number of CD1 positive cells (mainly Langerhans) in the oral epithelium was found to be higher during pregnancy. In the sulcular epithelium, however, the number of these cells tended to decrease during pregnancy as compared to post‐partum. The number of CD4 positive cells in oral and sulcular epithelium was increased during pregnancy (P<0.05). It was speculated that this increase in the number of CD4 positive cells is confined to the Th‐1 subset, since the number of CD14 positive cells (mainly macrophages and granulocytes) together with the number of B cells was found to be decreased during pregnancy. Th‐1 cells are known to be cytotoxic against these HLA class II antigen bearing cells. Consequently, cytotoxicity directed against B cells and macrophages may result in diminished immunoresponsiveness in pregnancy gingivitis.J Periodontol 1993; 64:211–218.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.3.211

出版商:Wiley    

年代:1993

数据来源: WILEY