摘要:

Longitudinal results of a5 to 8 year follow‐up study of the double lateral bridging flap for coverage of gingival recessions (GR) are presented. On a total of 75 GR in 18 patients (31 surgical procedures) the majority of the teeth (58%) showed a root denudation reduction of 75% or more. Total coverage was observed on 18 teeth (24%). Examinations did not show a high correlation between the extent of recession and bone dehiscence after surgery, between the degree of root coverage and the initial width of keratinized gingiva, or between the GR before and after surgery. We conclude that neither the quantity of gingival recession nor the quality of the supporting tissues were a prerequisite for the success of this surgical technique.J Periodontol 1993; 64:683–688.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.8.683

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

This study compared the surface characteristicsof periodontally diseased singlerooted human teeth extracted after treatment with either tetracycline HCl or citric acid solutions. The study group was comprised of 30 teeth from 22 patients with advanced periodontal disease extracted before the start of periodontal therapy. Diseased surfaces were identified, outlined, and root planed by hand curet or finishing bur. The teeth were sectioned and solutions of tetracycline HCl or citric acid (pH 1) were applied to the surfaces with cotton pellets for 5 minutes. Extracted teeth were processed and root surface samples then examined by scanning electron microscope. The surfaces of both acidtreated sets of specimens differed considerably from specimens treated with root planing alone, regardless of root planing method. Acid‐treated specimens exhibited dentinal tubules exposed by the removal of the smear layer, surfaces devoid of the debris normally present in root planed‐only specimens, and the dense network of collagen fibers that make up the dentin structure. Although differences were seen in surface depressions and fiber‐like structures among some specimens, the tetracycline HCl and citric acid solutions produced comparable morphologic characteristics.J Periodontol 1993; 64:689–693.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.8.689

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

The goal of this studywas to determine whether an ultrasonic scaler with a modified tip is as effective as a curet in providing supportive periodontal treatment for patients, based on clinical parameters of periodontal disease. Nine patients with 10 sites exhibiting probing pocket depth ≥ 3 mm were treated at 0, 90, and 180 days in a single‐blind, split‐mouth design for supportive periodontal treatment with either Gracey curets (GC) or an ultrasonic scaler with a modified tip (MU). Clinical parameters included plaque index, gingival index, bleeding on probing, darkfield microscopy, and clastase presence. Probing pocket depths and attachment levels were measured using an electronic probe. Measurements of clinical parameters were taken at 0, 14, 45, 90, 135, and 180 days. The results showed that treatment with MU was as effective as treatment with GC in all clinical parameters measured. Both treatment modalities were effective in reducing the elastase levels. Instrumentation time was significantly reduced with the MU (3.9 minutes vs. 5.9 minutes,P<0.05). The MU instrument effectively reduced the microbial environment in a significantly shorter time as compared to GC.J Periodontol 1993;64:694– 700.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.8.694

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Four hundred and fifty‐five teeththat were judged clinically to have a questionable prognosis were observed over a 40‐year span in 166 patients in a private practice. Therapy initially was debridement with oral hygiene instruction, followed by flap curettage procedures and preventive maintenance recall therapy. An assessment of compliance based on oral hygiene and recall attendance was also performed. A total of 55 (12%) teeth were lost with an average survival rate of 8.8 years prior to extraction. No teeth were lost during the first 2 years of observation. The majority of extracted teeth were maxillary second molars (38.2%), followed by maxillary first molars (25.5%), and mandibular second molars (16.4%). Tooth loss patterns appeared to be bilaterally symmetrical, with 51% of teeth lost in the right quadrants and 49% lost in the left quadrants. Indications for extraction were primarily periodontal abscesses. Teeth that were considered to have a very questionable prognosis have been retained for many years after therapy, supportive treatment, and patient compliance with recall attendance.J Periodontol 1993;64:701– 705.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.8.701

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Arecent development inguided tissue regeneration procedures is the use of resorbable membranes, which eliminate the need for subsequent surgical removal. In this study we performed flap surgery in rats with (experimental) or without (control) implantation of one of the newer materials, atelocollagen. We observed the gingival epithelial cell kinetics using 3H‐thymidine and examined the extent of gingival epithelium migration. Histological observations at day 1 on the experimental side demonstrated regenerated epithelium apposed to the collagen membrane with an intervening layer of necrotic tissues and/or fibrinous exudate. There was no observable proliferation of regenerated epithelium toward the root apex. On day 14, the regenerated epithelium migrated apically along the treated root surface in the control group. By contrast, on day 14 in the experimental group, the regenerated epithelium contacted the root surface at the cemento‐enamel junction (CEJ). Apical to the CEJ, there was new cementum formation with inserting connective tissue fibers. Autoradiographs from day 1 experimental sides demonstrated labeled cells in the basal cell layers from oral, crevicular, and junctional epithelium. From day 1 to day 5, labeling indices of oral epithelium and regenerating crevicular epithelium on experimental sides were lower than on control sides. These histological and autoradiographic findings suggest that atelocollagen membrane inhibits apical migration of regenerating epithelium and accelerates connective tissue reattachment in part by inhibiting the mitotic function of basal epithelial cells in early stages of wound healing.J Periodontol 1993;64:706–712.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.8.706

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Astepwise approach to determine attachment levelchanges was utilized to assess the nature of progression of periodontal disease. Following initial screening, 51 subjects with established Periodontitis were monitored quarterly for 9 more months. Probing depth (PD) and relative attachment level (RAL) were recorded using an automated, pressure sensitive probe system. To establish intra‐examiner error, repeated measurements were performed for all sites at the final visit. An overall standard deviation (SD) for RAL repeated measurements was initially calculated (0.76 mm) using all 6,935 double measurements. Sites were sorted by factors which contribute to the error of attachment level measurements; i.e., pocket depth (shallow, moderate, deep), tooth type (molar, nonmolar) and location (buccal, lingual). Data were sorted by the above 12 groups, and SD for repeated measurements was calculated separately for them. The ratio between these SD and the overall SD served as the corrective factor. Each patient's initial threshold (2 SD) was multiplied by these corrective factors thus resulting in 12 thresholds for each subject. Next, linear, exponential and logarithmic regression models were tested for each site, and the regression model showing the highest R value was chosen for that site. AL changes were tested against the patient's threshold for that site. Sites with attachment loss exceeding the threshold were deemed active. Five hundred eighty‐one sites (8.3%) exhibited attachment loss exceeding the various thresholds. Of these, linear progression occurred in 195, logarithmic in 224, and exponential in 162 sites. Individual patient's attachment loss ranged from 0.6 to 19.4% of all sites. Mean AL change was 0.2 mm; however, deep sites had significantly (P<0.001) greater mean loss (1.03 mm) compared to moderate (0.34 mm) and shallow (0.1 mm) sites. Twenty‐two subjects exhibited a small percentage of losing sites (11%). Sites with deep pockets had experienced greater percentages of losing sites (16.3%) compared to 7.7% and 8.8% for the shallow and moderate sites respectively (P≤0.001). Patients with a small percentages of losing sites experienced an overall net attachment gain (0.078 mm) compared to mean AL loss of 0.357 mm and 0.581 mm for the moderate and massive groups respectively (P<0.05). These results suggest that regression models and individualized thresholds can be utilized to produce site‐based data analysis to determine AL changes. Furthermore, the rapid AL changes in approximately 20% of the subjects suggest that they may represent different phases or possibly different forms of periodontal disease. Various risk factors or pathogenic microorganisms may be associated with these different patterns which, whenever found, could help to better understand the variability of periodontal disease.J Periodontol 1993; 64:713–718.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.8.713

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Chlorhexidine in an alcohol vehiclewith flavoring agents has been used as a mouthrinse to reduce plaque accumulation in periodontal surgery patients. The purpose of this study was to evaluate the effects of a chlorhexidine‐containing mouthrinse on the early tensile wound strength of healing surgical wounds in the rat. Standardized transdermal incisions were made on each lateral abdominal wall of 40 Sprague‐Dawley rats. Wounds were irrigated with 10 ml of 0.12% Chlorhexidine or 10 ml of normal saline prior to closure. Animals were sacrificed at 48 hours and 96 hours, and the wound area was excised by a standardized protocol. Wound strength was measured using constant speed tensiometry to determine the tensile strength of the healing incision. Results revealed a significantly reduced tensile wound strength at 48 hours for the chlorhexidinetreated group (127 ± 18.5 gm) compared to the saline irrigation group (150 ± 32.3 gm) (P<0.001). However, by 96 hours a significantly increased tensile wound strength was demonstrated by the Chlorhexidine treated group (202.1 ± 21.7 gm) compared to the saline irrigation group (183.2 ± 37.3 gm) (P<0.05). These data suggest that chlorhexidine‐containing mouthrinse irrigation of wounds produced a reduced early tensile wound strength, but ultimately resulted in shorter healing time.J Periodontol 1993; 64:719–722.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.8.719

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

The maintenance of172patientswho were treated and then attended a periodontal practice in Sydney, Australia for periods of at least 10 years has been surveyed. The results, expressed as loss of teeth over the maintenance period, have been compared with a 1978 study. Results of the two surveys have been compared for total tooth loss over the maintenance period, loss of individual tooth types, loss of teeth with furca lesions, and tooth loss relative to surgical experience. The comparative analysis is limited by the difference in total number of patients and by the duration of the studies. The proportionate division of patients into three groups according to tooth retention (well maintained, downhill, and extreme downhill) was statistically similar in both surveys. There were very few statistically valid differences in numbers of individual teeth lost between the two studies. Despite these comparable end results of long‐term maintenance, the surgical experience was quite different, with the patients in our practice undergoing much more surgical treatment than those in the earlier report. The results appear to support the hypothesis that long‐term maintenance is attainable for most periodontal patients, and is consistent with a variety of treatment approaches.J Periodontol 1993; 64:723–729.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.8.723

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Twenty‐six proximal, intrabony periodontal defectswith probing depths equal to or exceeding 6 mm in 23 patients were treated with gingival flap surgery supported by an expanded polytetrafluoroethylene barrier membrane. The material included 1, 2, and 3‐wall defects with crestal involvement relative to the root circumference ranging between 90° and 270°. Healing was evaluated clinically 12 months after surgery. Deep defects exhibited greater probing depth reduction and attachment gain than shallower defects. Probing depth reduction, attachment gain, and bone fill were positively correlated to the depth of the 3‐wall intrabony component of the defect. The extent of crestal involvement, and wall form in the fundus of the defect did not appear to influence the healing response. The treatment also affected the proximal surface of the defect‐adjacent tooth, which showed some reduction in bone level as well as gingival recession. Thus, the overall healing pattern following barrier membrane‐supported flap surgery appears similar to that generally observed for conventional reconstructive flap surgery in intrabony periodontal defects.J Periodontol 1993; 64:730–733.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.8.730

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Subepithelial palatal connective tissue grafts, separated from the epithelium either chemically (n = 5) or surgically (n = 2) were inserted in patients presenting with gingival recession. Biopsies at the grafted tissue and a portion of non‐keratinized mucosa were taken 12 months later. Histology showed keratinization of the newly formed epithelium, and interestingly a deep projection of epithelium into the connective tissue in almost all biopsies, sometimes with an enlargement and a cyst‐like space. We conclude that chemical separation of epithelium and connective tissue is clinically feasible for connective tissue grafts and that the subepithelial connective tissue grafting technique should be modified to avoid this projection of epithelium.J Periodontol 1993; 64:734– 738.

ISSN:1049-8885    

DOI:10.1902/jop.1993.64.8.734

出版商:Wiley    

年代:1993

数据来源: WILEY