摘要:

The reproducibility of an electronic devicefor the assessment of periodontal tissues damping characteristics was judged by evaluating the inter‐examiner, inter‐device and day to day variations of the measurements (PTVs). Nine young periodontally healthy volunteers were examined by two examiners (EX‐1 and EX‐2) and two devices (D‐1 and D‐2) in the following sequence: EX‐1 D‐1, EX‐2 D‐1, EX‐1 D‐2, and EX‐2 D‐2. PTVs were obtained at 5 different occasions during the same day. In some instances examiner 2 measured higher scores than examiner 1 with both devices. This difference was statistically significant (P= 0.05), if the total of 900 measurements was considered. The measurements of device 2 were approximately 0.5 PTV units higher, also reaching a statistical significance (P= 0.05). This difference is of limited clinical significance. The day to day variation was evaluated by comparing the scores obtained at 8 a.m. with the ones at the four other periods. The lowest scores were measured at 8 a.m. Only the 11 a.m. and the 2 p.m. measurements differed significantly. The effect of hormonal changes during the menstrual cycle and of smoking habits on PTVs were also evaluated. Ten female periodontally healthy volunteers were examined three times a week, during a period of two menstrual cycles. No significant PTV changes were found during the menstrual cycle. The effect of the smoking habit on PTVs was tested on 23 periodontally healthy patients. Scores obtained from all teeth, which did not present marginal bone loss in the vicinity, were related to smoking habits (non‐smoker, former smoker, current smoker). Statistically significant lower PTVs for non‐smokers (P= 0.03) were only found for the inferior molar teeth. Nevertheless a propensity of non‐smokers for lower PTVs was noted.J Periodontol 1995; 66:165–170.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.3.165

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Asmall laser doppler probewith an outside diameter comparable to a conventional periodontal probe (0.5 mm) was developed. The objectives of this investigation were to determine if intrasulcular laser doppler readings (LDR): 1) are reproducible; 2) can detect vascular changes associated with trauma from probe placement; 3) were reproducible when obtained with a stabilizing stent or without a stent; and 4) could detect vascular changes following the injection of a local anesthetic with vasoconstrictor. Nine adult volunteers with clinically healthy gingiva were evaluated for 30 second intervals at 5 sites. Baseline LDR were obtained twice at each site utilizing an acrylic stent to stabilize the probe and once without the stent (trial 1). All LDR were repeated at one month (trial 2) and again two months (trial 3) after baseline. One additional reading per subject was obtained following the administration of a local anesthetic with a vasoconstrictor during the second trial. Inter‐trial comparisons found no significant difference in mean LDR between any of the three observation times. However, intra‐trial comparison between the first and second LDR revealed an increase of approximately 50% in mean LDR. A 3fold reduction in mean LDR (P<0.001) was noted following the administration of a local anesthetic with vasoconstrictor. Intra‐class correlation coefficients for stent stabilized LDR were 0.51 (P<0.01) and 0.63 (P<0.01) while intra‐class correlation for hand held LDR was 0.40 (P<0.01). Results from this study demonstrate: 1) intrasulcular LDR are reproducible at one and two month intervals; 2) trauma associated with probe placement results in increased LDR; 3) statistically significant intra‐class coefficients exist for both stent stabilized and non‐stent‐stabilized LDR, however, higher correlation coefficients were found for stent‐stabilized LDR; and 4) a highly significant reduction in LDR was noted following the administration of local anesthetic with vasoconstrictor.J Periodontol 1995; 66:171–176.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.3.171

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The purpose of this studywas to examine the effect of smokeless tobacco (ST) on gingival inflammation as assessed clinically and biochemically by gingival crevicular fluid (GCF) levels of PGE2, IL‐1α, and IL‐1β. These parameters were compared in ST users (n = 12) and control, non‐tobacco using subjects (n = 8) matched for plaque and probing depth levels: Both GI and GCF PGE2concentration were significantly (P<0.05) elevated at ST placement sites compared to sites in control subjects. A short‐term longitudinal trial spanning 7 days also was undertaken within ST users (n = 18) to study the dynamics of gingival inflammation when ST is moved to a new site. At day 0 habitual ST placement sites exhibited a significantly (P<0.05) higher GI compared to nontobacco placement sites. Following transfer of ST to a new placement site, 48 hour GI scores were increased (P<0.05) at this region. Although GCF parameters were not significantly altered, over 80% of the subjects developed dramatic inflammatory reactions in the alveolar mucosa, ranging from erythema to ulceration, at the new site of placement. This observation of a more severe response in alveolar mucosa compared to gingiva may be related to the physical location of ST or differences in tissue characteristics.J Periodontol 1995;66:177–183.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.3.177

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The purpose of this studywas to locate the position of the periodontal probe tip using a pressure of 126 N/cm2(force of 0.30N using a round periodontal probe tip with a diameter of 0.55 mm). The influence of gingival inflammation on this position was also studied. Subjects with three levels of periodontal health and disease were entered into the study and each contributed one experimental tooth. At each site a standardized probing system was used to place a probe into a clinical pocket. The probe tip was luted to the test tooth surface. The tooth with its gingival tissue and probe tip was extracted, fixed, and processed for histological measurements. Distances in mm were obtained from the cemento‐enamel junction (CEJ) to the probe tip, to the base of the crevice/pocket, and to the most coronal connective tissue attachment. Analysis of the data indicated that clinical inflammation was not a factor in the placement of the probe tip at crevice/pocket's landmarks relative to the CEJ; however variability of probing may have caused the nonsignificance. The probing system placed the probe tip 0.66 mm apical to the base of the crevice/pocket and 0.06 mm coronal to the most coronal connective tissue attachment. These conclusions corroborated the results of the previous study in dogs which predicted probe placement of 0.44 mm apical to the base of the crevice using the standardized pressure of this probing system.J Periodontol 1995; 66:184–190.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.3.184

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Subgingival plaque removal at interproximal sitesby automatic and hand toothbrashes was compared with control sites at which cleansing was not performed. There were 58 patients, 35 to 63 years of age, each with one hopeless tooth requiring extraction. Each patient was randomly assigned to. one of four test groups: hand brash; automatic toothbrush 1; automatic toothbrush 2; and no brushing. The brushing instructions as stated by the manufacturers were demonstrated and the patient brushed the sextant containing the test tooth for 20 seconds. The level of the gingival margin was marked at each interproximal test site. The teeth were extracted and processed for SEM, and subgingival plaque was viewed at X100 and X2000 magnifications. A montage of photomicrographs of the gingival groove to the occlusal margin of the bacterial plaque at XI00 magnification was made and the distance from the groove to the margin was measured. An ANOVA was performed usingP= 0.05 level for significance. Due to processing difficulties, only 33 specimens were available for analysis. The average distances from the groove to the subgingival plaque front for the four test groups were 0.514, 0.132, 0.163, and 0.111 mm respectively. The maximum distance (1.5 mm) of plaque removal was greatest for the hand toothbrush. Due to the large standard deviation (0.636 compared to 0.146, 0.250, and 0.124 respectively), the hand brushing group was excluded from ANOVA. There were no statistically significant differences among the automatic toothbrashes and the no brushing control (P= 0.8393). It was concluded that a single session of oral hygiene instruction with an automatic toothbrush did not result in subgingival inteiproximal plaque cleansing.J Periodontol 1995; 66:191–196.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.3.191

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Predictable regeneration of tooth‐supportingtissues lost to periodontal disease is the aim of periodontal therapy. Often the result of conventional treatment is healing with a long junctional epithelium along the root surface and little regeneration of the complete attachment apparatus. The purpose of this pilot study was to evaluate whether de‐epithelialization with a CO2laser at the time of flap surgery and at 10‐day intervals over the first 30 days of healing has the potential to enhance the formation of a connective tissue attachment. Six mandibular incisors in two patients were selected for the study. Each patient received oral hygiene instruction and initial therapy prior to surgery. The teeth were splinted together, open flap debridement was performed on all teeth, a notch was placed on the roots at the height of the crest of the alveolar bone, and the flaps were sutured in place. The test side received controlled de‐epithelialization of the outer (oral) gingiva with the carbon dioxide laser, and the inner gingival flap. The de‐epithelialization was repeated on the test side at 10, 20, and 30 days postsurgically. Controls received open debridement only. Block sections were taken at 90 days and processed for histologic analysis. The results showed that for both patients, junctional epithelium (JE) was formed on both test and control teeth. In all control teeth, the JE extended the entire length of the root to the base of the reference notch. On the test side (laser treated) in one patient, the notch was filled with connective tissue and limited repair cementum. This finding was not seen in any control teeth. This is the first reported observation of human histologic evaluation utilizing the CO2 laser for de‐epithelialization and may warrant further study.J Periodontol 1995;66:197–204.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.3.197

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

This study was undertaken to determinethe vascular changes which occur following mucoperiosteal flap surgery where two different suturing techniques were employed. In four healthy adult mongrel dogs, buccal and lingual full‐thickness envelope flaps were reflected in the mandibular quadrants following intracrevicular incisions from the first premolar to the first molar. The flaps were immediately readapted and primary closure was achieved by the horizontal mattress suturing technique in one quadrant and the direct interrupted suturing technique in the contralateral quadrant of each dog. A simple photographic system was developed for recording the in vivo gingival circulation depicted by fluorescein angiography just prior to surgery and then after surgery on days 1, 3, 7, 10, 14, and 21. The flaps were divided into three interproximal and two mid‐buccal sites for analysis and the intracapillary and diffusion extent of dye fluorescence was accurately quantified by computerized planimetry. As healing progressed, longitudinal changes relative to presurgical baseline were analyzed by pairedt‐test. Cross‐sectional comparisons utilizing Studentt‐test allowed for evaluating differences between the two suturing techniques as well as differences between interproximal versus mid‐buccal sites at each postsurgical day. It was found that the simple act of raising a mucoperiosteal envelope flap initiates significant vascular trauma. Statistically significant reductions in flap circulation relative to presurgical baseline lasted for at least 3 days but persisted for 7 days at the interproximal sites. Flap diffusion (extravascular leakage) recovered sooner and extended over a significantly greater area of the flap than did intracapillary flap circulation during the early period of healing. No significant differences appeared between the two suturing techniques compared, although both may have exerted a local negative influence on the circulation until they were removed.J Periodontol 1995; 66:205–210.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.3.205

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The treatment of periodontal disease has been largely directed at the microbiological etiology. The prevention of bone loss by modulating the host response to the bacteria may be a useful adjunctive method in the management of periodontitis. Alendronate, an amino bisphosphonate, may inhibit bone loss in osteolytic diseases by altering osteoclast activity. The objective of this double‐blind study was to evaluate alendronate inhibition of alveolar bone loss in the naturally occurring beagle dog model of periodontitis. Sixteen 7 to 9 year old beagles with moderate‐to‐severe periodontitis were studied for 6 months. The dogs were stratified into two groups based on initial periodontal severity. One group received 3.0 mg/kg alendronate weekly orally and the other group received a placebo. Silk ligatures were placed on the study teeth for the first 3 months of the study to exacerbate the periodontal destruction. Clinical data were collected for attachment level, gingival index, plaque index, and mobility at baseline and one‐month intervals. Intraoral radiographs were made at baseline and at 3 and 6 months. The mandibles were processed for histolology at month 6. The radiographs were analyzed by digital image analysis of the subtracted images. A statistically significant difference in bone mass (P<0.001) was observed between the alendronate and placebo groups. The bisphosphonate had no effect on the clinical parameters of gingival inflammation or plaque. A trend toward decreased attachment loss and mobility was observed in favor of the alendronate group. A significant difference in bone density (P<0.05) was found by histomorphometric analysis. Bisphosphonate treatment may be beneficial in the management of alveolar bone destruction associated with periodontal destruction.J Periodontol 1995; 66:211–217.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.3.211

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Adisposable polyester foam spongeon a stick, impregnated with a non‐foaming dentifrice, has been widely dispensed to hospitalized and nursing home patients for intraoral cleansing and refreshing. Since no information was found relative to tooth cleansing capabilities, we have evaluated its effectiveness in the removal of accumulated plaque and also in prevention of plaque accumulation. Removal of 72 hours of accumulated plaque was assessed in a cross‐over design study comparing the device with a commercially‐available toothbrush by two different groups of 13 and 29 adult, healthy subjects who used each instrument for 1 and 3 minutes respectively. No significant differences were found between mean scores assessed by Turesky's modification of the Quigley‐Hein plaque index by either group using either instrument at either time period (P>0.05). Prevention of plaque accumulation was assessed in a third group of 25 subjects who used each instrument an average of 3 times a day for 1 week in a cross‐over study. While the toothbrush was found significantly more effective in retarding the accumulation of plaque from a plaque‐free baseline on both facial and lingual surfaces (P<0.02), the tooth cleansing device still retained plaque‐preventive capabilities by maintaining plaque formation below 2 mm at the cervical margin of the tooth. Results of this study indicate the tooth cleansing device may be a viable alternative to conventional toothbrushes.J Periodontol 1995; 66:218–221.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.3.218

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Histological studies have revealedelevated levels of T and B lymphocytes in inflamed gingival tissue. Functional analysis of these B cells has determined that they are spontaneously secreting large amounts of Immunoglobulin. Several components of bacterial plaque which accumulate during the onset of periodontal disease induce polyclonal B cell activation, and are most likely responsible for the “hyperactive” state of these gingival B lymphocytes. In addition to this exaggerated humoral response, increased levels of inflammatory mediators, such as Prostaglandin (PG) E2, have been implicated in the pathogenesis of disease. Therefore, the purpose of this study was to determine if PGE2could regulate Immunoglobulin production within inflamed gingival tissue. Specimens were harvested during routine surgery of patients with chronic adult periodontitis. Utilizing an ELISA, elevated levels of IgG were detected in the supernatant of cultured gingival mononuclear cells. Inclusion of indomethacin, which inhibits arachidonic acid metabolites such as PGE2, caused a decrease in IgG levels. PGE2exerted a biphasic effect upon IgG production, with high doses diminishing and low doses increasing IgG levels. From a clinical perspective, these results suggest that elevated levels of PGE2associated with inflammation will attenuate an IgG response and, as PGE2production wanes, the local humoral response will rebound. Interestingly, the combination of low dose PGE2and IL‐4 induced a synergistic rise in IgG production. These findings support the theory that local PGE2levels can regulate Immunoglobulin production and potentiate cytokine induced class switching within gingival tissue.J Periodontol 1995; 66:222–227.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.3.222

出版商:Wiley    

年代:1995

数据来源: WILEY