摘要:

This study sought to evaluatethe ability of gingival crevicular fluid (GCF) elastase to predict attachment and bone loss in human Periodontitis. Thirty subjects who were medically healthy and had a history of progressive Periodontitis were studied with an automated probe. Five sites in each patient were monitored bi‐monthly for a 6‐month period for attachment loss. Subtraction radiography was utilized at the beginning and end of the study to monitor bone loss. GCF elastase was measured at 0 month and then bi‐monthly by collecting GCF on paper strips impregnated with PMN leukocyte elastase substrate inserted into the gingival crevice for 15 seconds. After 8 minutes of reaction time, the strips were scored relative to fluorescent standards in an ultraviolet view box. Strips were then eluted in methanol and total elastase measured by spectrofluorometry. Total elastase was significantly higher in sites demonstrating progressive attachment loss than in inactive sites (2.81 ±.29 verus 2.03 ±.07, P<0.0005) and sites demonstrating bone loss (2.32 ±.17 versus 2.01 ±.08 P<0.05). When considering the joint presence of bone loss and attachment loss of 1.0 mm or greater in the 6‐month period following a visual elastase kit score of 2 or greater, the test kit shows a sensitivity and specificity of 82% and 66%, respectively. This study demonstrated that GCF elastase levels are significantly higher in sites demonstrating progressive periodontal attachment and bone loss assessed 6 months later and may serve as a predictor of future bone and attachment loss.J. Periodontol 1992; 63:237–242.

ISSN:1049-8885    

DOI:10.1902/jop.1992.63.4.237

出版商:Wiley    

年代:1992

数据来源: WILEY

摘要:

This study concerns the apical border(AB) plaque in relation to chronic adult Periodontitis (AP). Fifty‐six teeth from 24 patients with AP were examined by transmission electron microscopy (TEM). The AB was not discrete with islands of bacteria in the so‐called plaque‐free zone (PFZ). Coronal to the AB, the established plaque commonly consisted of three to four layers of Gram‐positive and Gram‐negative cocci, rods, filaments, and spirochetes and a superficial layer, mainly of spirochetes, but including filaments, “test tube brush,” and “corn‐cob” formations. The most apical apparently intact organisms in the PFZ were in bacterial islands or in isolation and were predominantly Gram‐negative cocci and rods, with occasional other morphotypes. The most apical microorganisms were invariably ghost cells. A cuticle of varying thickness and structure was present at the plaque/tooth interface. It was concluded that there was a limited range of intact bacterial morphotypes in the apical border plaque in chronic periodontitis.J Periodontol 1992; 63:243–252.

ISSN:1049-8885    

DOI:10.1902/jop.1992.63.4.243

出版商:Wiley    

年代:1992

数据来源: WILEY

摘要:

The aim of this studywas to characterize the plaque matrix and relevant aspects of metabolism of the apical border plaque in relation to teeth affected by chronic adult Periodontitis. The material comprised 56 teeth from 24 patients. Ruthenium red, alcian blue, lanthanum nitrate, and safranin 0 were used to label matrix polyanionic macromolecules and periodic acid‐thiosemicarbazide‐silver proteinate for intracellular Polysaccharide (IPS). The matrix components were amorphous, fibrillar, or globular. Many intact bacteria exhibited extracellular Polysaccharides or glycocalyces associated with their cell wall and cytoplasmic IPS granules. The latter varied in size and distribution and were evident even in the most apically‐advanced intact microorganisms. The results indicate that the matrix and IPS features of the apical border plaque in chronic Periodontitis in certain respects resemble those of subcontact area plaque on children's teeth, associated with chronic gingivitis and approximal caries. They also suggest the establishment of acidic regions in the microniches of the periodontal pocket.J Periodontol 1992;63:253–261.

ISSN:1049-8885    

DOI:10.1902/jop.1992.63.4.253

出版商:Wiley    

年代:1992

数据来源: WILEY

摘要:

In an earlier report, we examinedthe relationship of patient‐derived clinical and epidemiological variables to the risk for future clinical attachment loss (CAL) in chronic adult Periodontitis. We determined that the extent of the patient's existing periodontal disease as measured by mean attachment loss (MAL) and the patient's age were the most important patient‐derived risk indicators for CAL among those factors evaluated. In this study, we examined the tooth and site variables that were associated with CAL. Seventyfive patients with chronic adult Periodontitis were followed for 6 months. Clinical data at baseline, including attachment level and probing depth, were obtained from six sites per tooth. The hazard rate for CAL at all sites was 2.0%, and 4.1% of teeth displayed at least one site with CAL. Mandibular and maxillary molars and maxillary premolars displayed the highest incidence of CAL (6.1%, 5.6%, 5.5%, respectively), while maxillary anterior teeth (1.8%) and mandibular premolar teeth (2.1%) demonstrated the lowest incidence. The greatest number of sites demonstrating CAL had an existing attachment level of 4 to 7 mm and a probing depth of ≤ 5 mm. When the data were converted to hazard rates, however, an increase in hazard rate was seen with increasing existing attachment loss or probing depth. When MAL was considered, patients with mild and moderate Periodontitis demonstrated a relatively low incidence of CAL at sites with ≤ 7 mm of existing attachment loss. Patients with severe Periodontitis exhibited greater hazard rates for sites with 0 to 3, 4 to 5 and 6 to 7 mm of existing attachment loss. Regardless of the patient category, all sites with ≥ 8 mm of existing attachment loss demonstrated a significantly higher incidence of CAL. Similar results were seen for probing depth. When age was considered as a patient variable, all sites in patients who were in the 30 to 49 year‐old group demonstrated low hazard rates for CAL. For patients who were 50 to 59 years old, the hazard rate gradually rose with increasing existing attachment loss or increasing probing depth. For patients in the 60 to 69 year‐old group, sites with ≤ 5 mm of existing attachment loss and ≤ 3 mm probing depth did not differ in hazard rate from that seen in patients who were 50 to 59 years old. In the oldest group, sites with ≥ 6 mm of existing attachment loss and ≥ 4 mm of probing depth demonstrated hazard rates that were significantly greater than what was observed in the younger groups. These results suggest that both patient‐derived and site‐derived variables should be considered when developing a risk profile for CAL. These data may be useful in both treatment planning and selection of appropriate therapeutic modalities.J Periodontol 1992; 63:262–269.

ISSN:1049-8885    

DOI:10.1902/jop.1992.63.4.262

出版商:Wiley    

年代:1992

数据来源: WILEY

摘要:

Subgingival plaque sampleswere collected from individuals with advanced periodontitis before and 3 to 11 weeks after scaling and root planing periodontal treatment. The plaque levels ofTreponema denticolaandPorphyromonas gingivalisantigens were measured before and after treatment by a quantitative immunoassay procedure using monoclonal antibodies specific for these oral bacteria. A decrease in mean levels ofT. denticola(P<.05) andP. gingivalisantigens (P<. 09) were observed following periodontal therapy. Improved health, as measured by a decrease in probing depth, was associated with a decrease inT. denticolaantigen (P<.05). These results suggest that theT. denticolalevels of successfully treated sites decreased, while non‐responding sites had levels of this microbial marker which were equal to or greater than the pre‐treatment levels. These results provide additional evidence thatT. denticolais associated with human adult severe periodontal disease, and can serve as a prognostic marker for disease recurrence.J Periodontol 1992;63:270–273.

ISSN:1049-8885    

DOI:10.1902/jop.1992.63.4.270

出版商:Wiley    

年代:1992

数据来源: WILEY

摘要:

Agroup of poorly‐controlledinsulin dependent diabetes mellitus (IDDM) patients were examined in a cross‐sectional design for total microbial levels, microbial incidence, and the percent levels of selected periodontal microorganisms. These organisms were selected on the basis of prior reports that associated them with either periodontal disease or health. One periodontally‐healthy and one periodontally‐diseased site were examined in each IDDM patient. Increased levels of the periodontal pathogensPrevotella intermedia, P. melaninogenicaspp.,Bacteroides gracilis, Eikenella corrodens, Fusobacterium nucleatumandCampylobacter rectus(formerlyWolinella recta) were found at the periodontal diseased sites. Increased prevalence of the organismsP. intermedia, P. melaninogenicaspp., andC. rectuswere found at the diseased sites. A significantly higher percentage ofP. intermediawas found at the sites exhibiting deep pockets and attachment loss.J Periodontol 1992; 63:274–279.

ISSN:1049-8885    

DOI:10.1902/jop.1992.63.4.274

出版商:Wiley    

年代:1992

数据来源: WILEY

摘要:

The antibacterial activityof 4 triclosan‐containing toothpastes was compared to a conventional fluoride dentifrice and triclosan and sodium lauryl sulphate (SLS), both singly and in combination. A panel of 17 bacteria was tested by an agar dilution method. At concentrations typical of those found in toothpastes, triclosan and SLS displayed approximately equal antibacterial activity. A paste containing triclosan and zinc citrate appeared more active than the other triclosan pastes which, in general, showed marginal superiority over the conventional paste. SLS, although included in dentifrice formulations for its detergent properties, may significantly contribute to the antibacterial profile of a product. The need for appropriate controls when evaluating experimental toothpastes is emphasized.J Periodontol1992; 63:280–282.

ISSN:1049-8885    

DOI:10.1902/jop.1992.63.4.280

出版商:Wiley    

年代:1992

数据来源: WILEY

摘要:

This study compared theintra‐ and inter‐examiner measurement error of the Florida Probe, Florida Disk Probe, and conventional periodontal probe in persons having moderate to severe periodontitis. Single pass measurements using the conventional probe were compared to both single and double pass (corrected) measurements using the Florida Probe and Florida Disk Probe. The mean intra‐examiner standard deviations of differences in repeated site probing depth measurements ranged from 0.60 to 0.93 mm for the Florida Probe and from 0.52 to 0.89 mm for the conventional probe. Based on overall averages, the conventional probe measured deeper probing depths than the Florida Probe at the same sites. This difference was especially evident in pockets ≥ 6 mm in depth. Based on sites, the mean intra‐examiner standard deviations of differences in repeated relative attachment level measurements using the Florida Disk Probe ranged from 0.55 to 0.82 mm. The mean standard deviations of site measurements for attachment level obtained with the conventional probe ranged from 0.62 to 1.14 mm. Inter‐examiner measurement error was greater than intra‐examiner measurement error for each probing method. It was concluded that use of the Florida Probe and Florida Disk Probe may offer significant advantages in reducing measurement error for some clinical examiners. For other examiners, use of the Florida Probes do not necessarily result in less measurement error than use of conventional probing methods.J Periodontol1992; 63:283–289.

ISSN:1049-8885    

DOI:10.1902/jop.1992.63.4.283

出版商:Wiley    

年代:1992

数据来源: WILEY

摘要:

The disto‐buccal root is the most commonlyresected root in maxillary molars. This root resection procedure results in a unique environment dictated by the contours of the remaining roots and the residual furcation between them. Tooth morphology was evaluated in 50 extracted maxillary first molars after disto‐buccal root resection. The following measurements were studied: 1) The maximum concavity (D) on the distal aspect of the resected molar; 2) the minimum mesio‐distal dimension (d) of tooth structure between the two remaining roots; 3) the width (s) of the residual interradicular septum; and 4) the distance (p) from the pulp chamber floor to the root separation on the distal aspect of the resected molar. The mean measurements were (D) = 2.47 mm, (d) = 3.67 mm, (s) = 3.33 mm and (p) = 2.70 mm. The value of (p) was equal to or less than 3 mm in 86% of the teeth; this means that the distance from the finish line to the interradicular osseous peak is less than 2.04 mm (average biologic width), if the finish line is placed on solid tooth structure about 1 mm below the pulp floor. Six percent of the resected molars had an overall topography easily amenable to periodontal maintenance and restorative procedures with (D)3 mm. Poor root anatomy of the remaining roots after removal of the disto‐buccal root in maxillary first molars may be considered as a contraindication for root resection procedures. Unfortunately, this poor topography can be ascertained only during the surgery and after removal of the disto‐buccal root.J Periodontol 1992; 63:290–296.

ISSN:1049-8885    

DOI:10.1902/jop.1992.63.4.290

出版商:Wiley    

年代:1992

数据来源: WILEY

摘要:

The association between the periodontaldiagnosis and a variety of subject characteristics was studied in a group of 1,783 patients examined at a large military dental clinic. In order of importance, age greater than 30, smoking, male sex, and Filipino racial background were all found to be statistically significant risk indicators for the presence of moderate or advanced periodontitis. A logistic regression equation serving as a predictive model employing these four variables was presented. The strong association found between smoking and advanced periodontitis is consistent with the hypothesis that smoking has cumulative detrimental effects on periodontal health. While these and other risk indicators are neither causative, diagnostic, nor prognostic, they may be helpful in alerting the clinician to more carefully evaluate other clinical signs or laboratory findings of disease.J Periodontol 1992; 63:297‐302.

ISSN:1049-8885    

DOI:10.1902/jop.1992.63.4.297

出版商:Wiley    

年代:1992

数据来源: WILEY