摘要:

The inability to examine initiation and progressionof periodontal disease and to assess certain therapies in humans has led to a great interest in the use of animal models in periodontal research. Some of the most prominent animals used are non‐human primates. This article reviews the characteristics of non‐human primate models in periodontal health, in the transition from health to gingivitis to Periodontitis, and in experimental gingivitis and periodontitis. Where possible, the results of these studies are compared with results from human studies. Only a few studies have compared in detail the anatomy, physiology, immunology, and tissue interactions in monkeys with those of humans. With the exceptions of differences and variations in size of the dentition, the number of each tooth type as well as larger canines, presence of diastemata between anterior teeth, and an edge‐to‐edge relationship of the incisors, the dental and periodontal anatomy of nonhuman primates seem quite similar to that of humans. Clinically healthy gingiva can be established and maintained in non‐human primates, and gingivitis as well as Periodontitis occur in these animals. It is possible to induce experimental periodontitis by placement of peri‐dental silk ligatures or orthodontic elastics as well as by surgical removal of alveolar bone. Although the most appropriate model for studies of periodontal disease pathogenesis in non‐human primates appears to involve the application of silk ligatures, some difficulties may occur in establishing periodontal break‐down by using this model. Many clinical, histological, microbiological, and immunological characteristics of spontaneous and experimental marginal inflammation in most non‐human primates are similar to those in humans. The most significant differences between small non‐human primates and humans are the very limited number of lymphocytes and plasma cells in the inflammatory infiltrate of squirrel monkeys (Saimiri sciureus) and marmosets. Therefore, the use of squirrel monkeys and marmosets may not be appropriate in many studies of periodontal disease pathogenesis. The most significant microbial differences between macaque species and humans are a lower proportion ofActinomycesspecies, the presence of a catalase‐producingPrevotella melaninogenicastrain, and the high carrier rate forActinobacillus actinomycetemcomitansin subgingival plaque of macaque species. The significance of these differences is presently unknown. It is concluded that the use of many non‐human primate species due to the apparent close anatomic and biologic similarities to humans is appropriate in experimental studies of periodontal disease, provided the use of laboratory animals is requisite and lower species are not applicable. The increasing use of captive‐born instead of wild‐captured primates as laboratory animals will eliminate many of the problems that plagued researchers heretofore due to greater homogeneity in age, body weight, and dental health status combined with a known medical story of captive‐born animals.J Periodontol 1993; 64:497–508.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.6.497

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

To study the effects of a step‐wise treatmentregimen onActinobacillus actinomycetemcomitans‐(Aa)associated periodontitis, 4 clusters among 33 patients harboring the organism were followed during successive periods of systemic minocycline plus mechanical debridement and minocycline plus modified Widman flap treatment. Localized Periodontitis was found in 2 clusters, one with 7 localized juvenile periodontitis patients and a 24‐year old male with localized destruction and extremely low plaque levels (UP), and the other consisting of 10 patients with plaque and gingivitis and a wider age range (16 to 54 years, LP). Generalized severe and moderate periodontitis was found in 2 clusters which were further discriminated by severe gingivitis and high levels of supragingival plaque (9 patients, GSP), and mild inflammation and low plaque levels (6 patients, GMP). Mean percentages ofAa, as determined by selective cultivation of microbiota from at least 2 periodontal pockets of 6 mm or more were 63, 16, 33, and 7.8% in the clusters (P<0.01). Six months after active treatment, Aa was present in 6/9 patients and 50% of sites in GSP, and 3/6 patients and 46% of sites in GMP patients. In contrast, the organism was virtually eliminated by scaling and flap procedures in the localized periodontitis clusters, and did not reappear after 6 months (P<0.05). Combined antibiotic, mechanical, and surgical therapy resulted in a persistence of 20% of sites with residual probing depth of ≥ 4 mm in GMP patients after active therapy. At this point, 3 of the GMP patients and 1 GSP patient left the study. Multiple regression analysis showed a significant influence of log‐transformed numbers in Aa in cheek and saliva samples at the end of the study, and cluster on the percent residual number of sites with periodontal probing depth of ≥ 7 mm (P<0.001). The present results suggest that the applied therapy would be appropriate in localized forms ofAaPeriodontitis, but inappropriate in more severe and generalized forms to predictably eliminate Aa. Controlled long‐term studies with larger groups of patients will be needed to establish the difference in treatment response suggested by these studies.J Periodontol 1993; 64:509–519.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.6.509

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

This study examined the dental cuticle(DC) at the interface with cementum surface, as well as its relationship to the overlying subgingival plaque (SP), the so‐called plaque‐free zone (PFZ), the junctional epithelium (JE), and the coronal fibers of the residual periodontal ligament (PL) by transmission electron microscopy (TEM) and histochemistry. Material comprised of 41 extracted, adult periodontitis‐affected teeth (AP). Following extraction, 20 teeth were fixed in 3% glutaraldehyde in 0.1M sodium cacodylate, post‐fixed in 1% osmium tetroxide, embedded in araldite, decalcified in EDTA, re‐embedded in araldite, and sectioned. En bloc histochemistry was undertaken on the remaining 21 teeth, using ruthenium red, alcian blue‐lanthanum nitrate, or safranin‐O, and processed as above. Results show that the DC covered the cementum surface from the SP to the JE, and formed an interface with these structures. No DC was observed at the interface with PL. Morphological variations in DC surface were observed at the interface with the SP and at the so‐called PFZ where bacteria were always in close contact with or surrounded by the DC. At the interface with JE, the DC appeared homogeneous, although layers varying in electron density were distinguishable. Teeth treated histochemically revealed a positive reaction of DC and bacteria to the three methods, suggesting the presence of anionic polymers including glycoproteins in the DC. It was concluded that on adult periodontitis affected teeth, the DC always covers exposed cementum and may mediate bacterial adhesion, and adsorb components from the peridontal pocket.J Periodontol 1993; 64:520–528.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.6.520

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

The aim of the investigationwas to provide quantitative and qualitative histologic data on marginal inflammation around osseointegrated implants. The significance of the lack of a periodontal ligament in the initial breakdown phase of supporting tissues in implants was examined by comparing stereologic and histologic manifestations of ligature‐induced marginal inflammation around osseointegrated implants with those around ankylosed and normal control teeth in 8 cynomolgus monkeys (Macaca fascicularis). Clinical and radiographic findings have been reported elsewhere. The marginal connective tissue around ligated implants was infiltrated by a significantly increased total number of lymphocytes, plasma cells, and neutrophils compared to non‐ligated implants and teeth. The total number of lymphocytes around ligated implants was significantly higher than around ligated ankylosed and normal control teeth. There were, however, no significant differences in the total number of plasma cells and neutrophils within the ligated group. Osteoclasts were exclusively observed around ligated implants and ankylosed teeth. Although variations in microbiota and susceptibility of different jaw positions to periodontal break‐down may influence the results of the present study, the results seem to substantiate the theory that marginal inflammation around implants and ankylosed teeth may have more serious implications than does marginal inflammation around teeth with a periodontal ligament. Since presence of osteoclasts was not related to the absence of cervical cementum with inserting gingival fibers around ligated ankylosed teeth, the increased susceptibility of bone loss of implants is probably not caused by the absence of these tissue components. In contrast, the histologic observations seem to support that the increased susceptibility for bone loss around implants may be related to the absence of a periodontal ligament.J Periodontol 1993; 64:529–537.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.6.529

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

This multicenter prospective studyon the use of an implant system involved 9 centers and reports on the periodontal aspects after 3 years of observation. A total of 558 implants in 159 patients with 197 bridges all independent from natural teeth were originally included. Because of failures and patient withdrawals the number of implants was reduced to 460 and bridges to 174. The cumulative success rate for implants, starting from implant placement, is 94.3% after 2 years and 93.9% after 3 years indicating a leveling of implant loss. Failures concentrated in patients with a high plaque index. The loss of marginal bone was during the second and third years only 0.03 mm per year as an average while it was 0.4 mm during the first year. There were no reports of intense gingival inflammation in any of the patients and the plaque and gingivitis index behaved similarly around abutments and teeth. The probing pocket depth was significantly reduced over the observation time. The resistance towards marginal bone loss around these implants confirms the previous studies on fully edentulous patients.J Periodontol 1993; 64:538–541.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.6.538

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

In recent years, the focusof dental implant research has been the nature of the boneimplant interface associated with osseointegration, yet the transgingival portion of endosseous dental implants has received little attention. The purpose of this study was to determine the attachment of human gingival fibroblasts to three different implant materials: commercially pure titanium, non‐porous hydroxyapatite, and porous hydroxyapatite. Cell attachment was quantified by radiolabeling gingival fibroblasts with tritiated thymidine and counting attached cells by liquid scintillation following incubation for periods of 20, 40, and 60 minutes. Additional studies coating implant surfaces with fibronectin were also performed. The nature of the implant material itself appeared to affect the number of attached cells. Determined on a surface area basis, fibroblast attachment was greatest to titanium followed by non‐porous hydroxyapatite. Porous hydroxyapatite demonstrated the least amount of fibroblast attachment. When incubated with fibronectin at a concentration of 50 μg/ml, no increase in the number of cells attached to the various implant materials was observed. A small but statistically significant increase in the number of fibroblasts attached to porous hydroxyapatite at 40 minutes was observed when implant materials were pre‐treated with fibronectin.J Periodontol 1993;64:542–546.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.6.542

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Ascanning electron microscopy(SEM) study was conducted to evaluate the effects of Nd:YAG laser radiation on removal of a root surface smear layer after root planing in comparison with citric acid treatment. The experimental materials were 15 human teeth affected by severe periodontal disease, which were extracted because of a hopeless prognosis. The teeth had at least 5 mm of attachment loss on the proximal surface tested. After removing all visible calculus using an ultrasonic sealer, each proximal surface was vigorously scaled and root planed with a Gracey curet. Thirty specimens were cut from the root‐planed proximal surfaces and assigned randomly to one of two groups: Group A (25 specimens) was divided into 5 subgroups and irradiated with a Nd:YAG laser, using non‐contact delivery (3 mm beam diameter, distance from the tip to the specimen 5 cm), at a measured power of 20 W for 0.3, 0.5, 1.0, 2.0, or 3.0 seconds corresponding to energy densities of 84.93, 141.54, 283.09, 566.17, or 849.26 J/cm2; Group B (5 specimens) was not irradiated, but treated for 3 minutes with saturated citric acid (pH 1). The center of each specimen in Group A was used as the experimental area (Exp A) treated by laser irradiation and the peripheral area of the specimen served as a control (Cont A). In Group B, one half of the specimen was used as the experimental area (Exp B) treated by citric acid and the other half served as a control (Cont B). The specimens were then fixed and examined by SEM. The surface of the root‐planed specimens (Cont A and B) was irregular, corresponding to the presence of a smear layer, and had an amorphous appearance. Both root surfaces of Exp A and B exhibited clear orifices of dentinal tubules and intertubular dentin without a smear layer. Although the root surface of Exp A showed clear orifices of dentinal tubules with a flat morphology, the root surface of Exp B showed widened funnel‐shaped dentinal tubule orifices with a fibrillar, mat‐like morphology. The present results indicate that Nd:YAG radiation effectively removes the smear layer, uncovers dentinal tubules, and exposes collagen fibers on the root surface without widening the orifices of dentinal tubules after root planing.J Periodontol 1993; 64:547–552.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.6.547

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

The systemic use of a singleantibiotic was compared to that of a sequential antibiotic regimen in the treatment ofA. actinomycetemcomitansand/orP. gingivalis‐associated periodontitis. Eleven patients with recurrent/progressive periodontitis and demonstrating subgingival infection with A.a. and/or P.g. were selected. Six patients received oral administration of doxycycline (Do), 200 mg the first day and 100 mg for 4 days thereafter, and then amoxicillin/clavulanate potassium (Au), 500 mg 3 times daily for 5 days. The other 5 patients received only doxycycline for 10 days. Eight sites with ≥5 mm probe depth per patient were selected, of which 4 received root planing at time 0. Clinical measurements (GI and PI, probing pocket depth, probing attachment level, and bleeding upon probing/suppuration) and microbial infection levels (2 sites/patient as per DNA probe) for A.a. and P.g. were recorded at 0, 4, 12, and 25 weeks. Clinical data were subjected to statistical analysis of variance andt‐tests for significance. The Do + Au groups produced significant reduction in probing pocket depth (PPD) at 4, 12, and 25 weeks (1.1, 1.3, and 1.1 mm, respectively). The Do group produced significant reduction in PPD only at 4 and 12 weeks (0.8 and 0.8 mm); the Do + Au group produced significant gain of 0.8 mm in probing attachment level at 4 and 12 weeks; and the Do + Au group in conjunction with root planing produced the most sustained reduction in PPD and gain in PAL. These findings suggest that the sequential use of multiple antibiotic agents may offer greater promise as an adjunctive treatment approach for the management of recurrent and/or progressive periodontitis than a single antibiotic regimen.J Periodontol 1993; 64:553–558.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.6.553

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Twenty‐eight patients diagnosedas having rapidly progressive periodontitis (RPP) were enrolled in a study in which samples of subgingival microflora were harvested from test teeth and assayed for the presence ofPorphyromonas gingivalis, and GCF collected and analyzed by ELISA for specific antibody forP. gingivalis. Clinical conditions were measured and recorded, and treatment by scaling and root planing provided at baseline and at 3, 6, 9, and 12 months. Reduction in pocket depth, stabilization of attachment level, and resolution of inflammation were comparable to previously reported values. By 3 months, mean and median specific antibody concentration had decreased, and continued to decrease through 12 months. The proportion of samples in which specific antibody was not detectable increased from 27% at baseline to 73% at month 12. GCF samples from sites at whichP. gingivaliswas present had greater than 2‐fold higher median specific antibody than samples from P. gingivalis‐negative sites. At baseline, specific antibody titer of 30‐second GCF samples positively correlated with pocket depth, and GCF volume significantly correlated with antibody titer and concentration, and with pocket depth. In addition, change in specific antibody titer of 30‐second samples from baseline to both 6 and 12 months correlated positively with pocket depths. Thus sites infected byP. gingivalismanifested high levels of specific antibody, and levels were related to clinical status. Following treatment, antibody levels decreased significantly as pocket depths decreased, attachment levels stabilized, and inflammation resolved.J Periodontol 1993; 64:559–565.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.6.559

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

The periodontal status andtreatment of three teenagers in a Finnish family with familial neutropenia is described. The mother was also diagnosed with neutropenia. At initial examination, the 15‐year‐old male and the 10‐year‐old female had severe periodontitis, whereas the 13‐year‐old male had oral ulcerations but no significant periodontal disease. The two siblings with periodontitis were treated and followed approximately 5 years. It was concluded that periodontal therapy including scaling, surgery, and use of antimicrobial agents can be successful in patients with familial neutropenia, and that such patients are not necessarily candidates for full mouth extraction. The role of granulocyte colony‐stimulating factor in which was used in the treatment of these patients remains to be established.J Periodontol 1993;64:566–570.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.6.566

出版商:Wiley    

年代:1993

数据来源: WILEY