摘要:

Gingival bleeding is an objective, easily assessed sign of inflammation that is associated with several periodontal diseases. Many bleeding indices have been devised; some assess bleeding as simply present or absent, whereas others use grading in an attempt to assess severity of bleeding. The choice of which index to use depends on whether the purpose is an epidemiological survey, a clinical study, diagnosis and treatment, or patient motivation. Bleeding may be elicited manually with toothpicks, dental floss, or a periodontal probe, but a controlled‐force probe, although more expensive, causes less trauma and less false‐positive bleeding from healthy tissues. As a predictor of periodontal disease progression, bleeding on probing has low sensitivity owing to a high frequency of false‐positive responses, but has high specificity in that failure to bleed indicates health. There is evidence that smokers have less, or delayed, gingival bleeding when compared with non‐smokers; therefore smoking needs to be controlled for in studies of gingival bleeding. Measurement of gingival bleeding tendency should be an integral part of a comprehensive oral examination. In clinical practice, the use of a graded bleeding index is more likely to identify sites that are at risk of further destructive activity. For monitoring individual patients, both for response to initial therapy and during maintenance, a modified Sulcus Bleeding Index (mSBI) with three bleeding scores is recommended in preference to dichotomous scoring of bleeding.J Periodontol 1996;67:555–561.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.6.555

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The purpose of this studywas to assess the clinical effect of treatment aimed to suppressActinobacillus actinomycetemcomitansandPorphyromonas gingivalisbelow detection level andPrevotella intermediabelow 5% of the cultivable periodontal pocket flora. Sixteen patients and a total of 111 periodontal pockets with probing depth ≥ 6 mm were included in the study. Twelve patients and a total of 77 sites completed the 5‐year study. The results demonstrated clinical improvement of probing depth and gain of clinical attachment level of 3.4 mm and 1.2 mm, respectively. Treatment to eliminate indicator bacteria continued for 3 years before the aim was fulfilled. In order to eliminateA. actinomycetemcomitansfrom a majority of the sites, a combination of surgery and generalized tetracycline treatment was performed. A recolonization or regrowth of the indicator bacteria exceeding detection levels took place in several sites. The presence ofA. actinomycetemcomitans, P. gingivalis, andP. intermedia, alone or in combination, correlated with attachment level change on the individual level. No such correlation was obtained by using presence of plaque, bleeding on probing, or three other bacteria (Campylobacter rectus, Eikenella corrodens, andFusobacterium nucleatum) not used as treatment goal markers.J Periodontol 1996;67:562–571.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.6.562

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The persistence of action, or substantivity, of antimicrobial agents in the mouth appears to be a major variable influencing plaque inhibition. Such substantivity can be assessed by measuring the duration and magnitude of suppression of salivary bacterial numbers produced by antimicrobial agents. Although this has been determined for some agents, there is little information on the substantivity of the numerous products which contain these and other antimicrobial agents. This study was commissioned on the basis that efficacy cannot be assumed merely because a product contains a known active agent. Nine formulations or products were chosen: 2 rinses containing Chlorhexidine or C31G, 4 rinses containing cetylpyridinium chloride (CPC) (with and without fluoride and/or alcohol), a minus‐CPC control rinse, and 2 toothpastes with and without stannous fluoride. Additionally, water was used as a placebo control. Twenty health dentate volunteers took part in this blind, 10 cell, randomized, single rinse, cross‐over study, which was balanced for carryover. Mouthrinses were 15 ml volumes and toothpastes 3 gm in 10 ml water slurries rinsed for 60 seconds. On the day of each study volunteers suspended oral hygiene habits and at approximately 9:00 a.m. rinsed with the allocated formulation. Unstimulated saliva samples were obtained immediately before and 30, 60, 180, 300, and 420 minutes after rinsing. The samples were immediately processed for total anaerobic bacterial counts. All rinses except water and the minus CPC control rinse produced significant falls in counts to 30 minutes. Of more relevance in this inter‐treatment comparison‐designed study, the C31G rinse showed significant substantivity compared to water only for 60 minutes. C31G was highly significantly less substantive than Chlorhexidine from 30 minutes to 420 minutes. The CPC rinses were similar and significantly more substantive than their control rinse to between 180 and 300 minutes. The stannous fluoride and control pastes were similarly substantive to 300 minutes, with the stannous fluoride paste remaining substantive compared to water to 430 minutes. Based on antimicrobial action these formulations varied considerably in substantivity and this is likely to reflect their comparative plaque inhibitory properties.J Periodontol 1996;67:572–576.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.6.572

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The purpose of the study was to examine the anti‐malodor, anti‐gingivitis, and plaque reducing properties of a 2 phase oil:water mouthrinse compared with a control mouthrinse. Fifty subjects rinsed with one of the two rinses for 30 seconds twice a day over 6 weeks, while continuing their normal oral hygiene habits. Measurements were made at time zero (prior to beginning the rinsing regimen), and ≥ 9 hours following rinsing, at intervals of 1, 3, and 6 weeks. Malodor of whole mouth, as well as tongue dorsum anterior and posterior, was assessed on a 0 to 5 semi‐integer scale by two odor judges. Volatile sulphide compounds (VSC) were determined using a sulphide monitor. Gingival, plaque, and bleeding indices were recorded for Ramfjord teeth. Oral microbial levels were assessed using the oratest. Salivary levels of diamines (putrescine and cadaverine) were analyzed by HPLC. Results were analyzed by 2tailed covariant ANOVA, with the time zero value as covariant. Dramatic improvements were observed in parameters associated with malodor, periodontal health, plaque accumulation, and microbial levels in both groups. As compared to time zero scores, whole mouth odor, tongue dorsum anterior and posterior odors decreased continuously over time, attaining 80%, 79% and 70%, reductions, respectively following 6 weeks, in the 2‐phase mouthrinse group, versus 70%, 77% and 59% for the control group. For whole mouth and tongue dorsum posterior, the reductions observed in the 2‐phase mouthrinse group were significantly greater than those obtained with the control mouthrinse (P= 0.026 andP= 0.025, respectively), suggesting that the 2‐phase mouthrinse is superior to the control mouthrinse in long‐term reduction of oral malodor. For bleeding index, gingival index, oral microbial levels, and VSC, differences between the groups were not significant. Diamine levels were not significantly reduced in either group. The control mouthrinse reduced plaque index more significantly than the 2‐phase mouthrinse (P<0.005). The results of this randomized clinical trial suggest that the 2‐phase oikwater mouthrinse formulation is superior to the control mouthrinse in long‐term reduction of oral malodor.J Periodontol 1996;67:577–582.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.6.577

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The objective of this retrospective studywas to evaluate the influence of cemental tear as a risk factor in periodontal attachment loss. Seventeen extracted, singlerooted teeth showing loss of attachment and having one cemental tear surface and one opposite intact surface were examined. The teeth were stained in 0.1% toluidine blue to visualize attached periodontal ligament remnants and examined in a light microscope under incident light. On each tooth, loss of attachment was measured along the long axis of the root from the cemento‐enamel junction to the most coronal level of the periodontal ligament on intact as well as on defect surfaces. Cemental tear surfaces demonstrated a significantly greater loss of attachment than opposite intact surfaces (P<0.0001). In one specimen, the cemental tear fragment was partially attached to the root after the extraction procedure. This specimen was processed for light microscopy to determine the location of the cemental tear fracture. Histological examination clearly revealed that the split between the root and the fragment had occurred along the cemento‐dentinal border. The results indicate that cemental tear should be considered as a possible etiologic entity in localized rapid periodontal breakdown.J Periodontol 1996;67:583–588.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.6.583

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The aim of the present study was to evaluatethe association between the outcome of a chairside test measuring gingival crevicular fluid (GCF) levels of the enzyme aspartate aminotransferase (AST) and other clinical measures of disease including probing depth, severity of inflammation, and GCF flow before and after therapy. We studied 91 patients with moderate to severe periodontitis. Eight sites with probing depths between 5 mm and 8 mm and obvious signs of inflammation were selected and designated diseased sites. Four sites with probing depth ≤ 3 mm with no or minimal signs of inflammation were selected and designated non‐diseased sites in patients. Thirty healthy individuals were enrolled and four sites in each were selected and designated healthy controls. Patients were treated with scaling and root planing and control subjects with supragingival prophylaxis. Measurements including GCF volume, gingival inflammation, and probing depth were performed at screening baseline, 1 week later at pretreatment baseline, and at weeks 2 and 4 after treatment. AST content of GCF was measured using a chairside colorometric test. It was concluded that the outcome of the test is an effective objective measure distinguishing between diseased sites and non‐diseased sites in patients and control subjects when evaluated both prior to and following application of therapy. Use of this simple chairside test, when combined with other standard diagnostic procedures, provides an objective measurement permitting improved capacity to distinguish between diseased and non‐diseased periodontal sites, and to better assess and monitor the outcome of therapy.J Periodontol 1996;67:589–596.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.6.589

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

This study examined the relationships betweenplasma and saliva concentrations of phenytoin and 5‐(4‐hydroxyphenyl)‐5‐phenylhydantoin (HPPH), the major metabolite of phenytoin in man, and the prevalence and severity of gingival overgrowth. Thirty‐six adult epileptic patients who had been receiving phenytoin for greater than 6 months without a recent change in dosage were assessed for signs of periodontal disease and gingival overgrowth. Plasma and saliva samples were analyzed by high performance liquid chromatography for the determination of phenytoin and HPPH concentrations. Seventeen patients demonstrated clinically significant gingival overgrowth (responders; overgrowth index ≥ 30%). There were significant correlations between the gingival overgrowth index and both the papillary bleeding index (r = 0.495;P<0.005) and probing depth (r = 0.632;P<0.005). The plaque index correlated with the papillary bleeding index (r = 0.420;P<0.05) and the probing depth (r = 0.301;P<0.005), but not with the gingival overgrowth index. The extent of gingival overgrowth did not correlate significantly with either plasma or saliva concentrations of phenytoin or HPPH. Mean plasma and saliva concentrations of phenytoin and HPPH did not differ significantly between non‐responders and responders, nor did the mean plaque index. The mean papillary bleeding index (32.5 ± 21.2 vs. 63.8 ± 37.7;P<0.01) and mean probing depth (12.4 ± 14.4% vs. 35.9 ± 25.3%;P<0.02) were significantly greater in the responders. This study found no evidence of a relationship between phenytoin or HPPH concentrations in plasma or saliva and the extent, or prevalence of phenytoin‐induced gingival overgrowth. Further studies with larger populations may be necessary to establish the relationship, if any, between phenytoin or HPPH levels and gingival overgrowth.J Periodontol 1996;67:597–602.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.6.597

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

The objective of this studywas to compare guided tissue regeneration (GTR) and osseous surgery (OS) in treatment of early‐onset periodontitis. Six patients participated in this research, presenting 15 paired defects randomly assigned to 1 of the surgical groups. Pre‐operative clinical parameters (probing depth and attachment loss) between the two groups were not significantly different. Results 1 year following surgery showed probing depth reduction (2.60±1.30 mm) and clinical attachment gain (2.20±1.42 mm) were significantly greater in the GTR group than in the osseous surgery group (P0.05). The base of the GTR‐treated defects showed significant increase in bone fill (1.67±0.68; 1.97±0.74 mm;P<0.05). At a follow‐up reexamination 1 year following surgery, oral hygiene and gingival conditions in both groups were at satisfactory levels and gingiva was clinically healthy throughout the entire study period, except the first 4 to 6 weeks following surgery.J Periodontol 1996;67:603–607.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.6.603

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Aspirate of pus from5periapical abscessesof the upper jaw and their corresponding maxillary sinusitis were studied for aerobic and anaerobic bacteria. Polymicrobial flora were found in all instances, where the number of isolates varied from 2 to 5. Anaerobes were recovered from all specimens. The predominant isolates werePrevotellasp.,Porphyromonassp.,Fusobacterium nucleatum, andPeptostreptococcussp. Concordance in the microbiological findings between periapical abscess and the maxillary sinus flora was found in all instances. However, certain organisms were only present at one site and not the other. Five beta‐lactamase‐producing. organisms were present in the five specimens. These data confirm the importance of anaerobic bacteria in periapical abscesses.and demonstrate their predominance in maxillary sinusitis that is associated with them.J Periodontol 1996;67:608–610.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.6.608

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

This report describes9casespresenting exostosis at mandibular and maxillary sites where autogenous gingival grafts have been used to increase the amount of attached gingiva. The exostoses were recognized during routine dental examinations and identified by palpation, horizontal sounding, occlusal radiographs, and in one case by histologic examination. Only in three cases was there a surgical removal of exostosis and recurrence was not observed during a follow‐up evaluation. The remainder of the cases were not treated and the exostoses appeared to have limited growth. Apparently, a correlation between the presence of tori and the development of exostosis could not be established in these series of case reports, but a possible explanation with respect to the mechanism of bone formation is discussed along with the clinical implications of this interesting clinical finding.J Periodontol 1996;67:611–616.

ISSN:1049-8885    

DOI:10.1902/jop.1996.67.6.611

出版商:Wiley    

年代:1996

数据来源: WILEY