摘要:

AbstractThis investigation compared a traditional periodontal surgical method with a non‐surgical treatment of scaling and root planing by an ultrasonic device (Odontoson M®) using irrigation with an iodised solution. 8 adult patients with periodontal disease were each treated at 2 randomly chosen quadrants by a Widman flap type surgical technique, and the remaining non‐surgically. The patients then attended bi‐monthly oral hygiene sessions over a period of 1 year. At that stage, clinical evaluation revealed that the Odontoson M® plus an ionised irrigant solution achieved a statistically comparable outcome to that of surgical treatment, even in the pockets initially up to 7 mm i

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00583.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThis case report compares the results of placement of HTRTM(Hard Tissue Replacement Synthetic BoneTM) and freeze‐dried bone allograft (FDBA) in the same patient. 2 notches were made in each of 6 teeth, 1 at the gingival margin and the other at the most apical level of calculus. Soft tissue reponses with both materials included probing depth reduction, gingival shrinkage and gain in clinical attachment. Histological sections of block extraction sites 30 months after placement of either material showed no signs of new attachment. Little or no inflammation was present with both materials. There was also an absence of all FDBA particles which assumes complete resorption of this material prior to 30 months. Gingival shrinkage resulted in the exposure of the gingival and calculus notch in all FDBA treated sites. Gingival epithelium was found adjacent to the gingival notch in all HTRTMtreated sites. The calculus notch in HTRTMtreated sites was lined by junctional epithelium with connective tissue and bone opposing the adhesion. HTRTMparticles were present and surrounded by connective tissue or bone. HTRTMappears to serve as a scaffold for new bone formation when in close contact with alveolar bon

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00584.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBetter understanding of the furcation anatomy may serve to decrease the risk of pulpal injury during rotary odontoplasty, a procedure often used in conjunction with guided tissue regeneration. The purpose of this study was to determine (i) the tooth thickness about the furcation entrance of lower molars, and (ii) whether there is a relationship between tooth thickness and patient age. 40 mandibular 1st molars (M1) (mean age = 36.2; range 10–65 years) and 40 mundibular 2nd molars (M2) (mean age=37.9; range 14–70 years) were collected. Age, gender and furcation involvement (if any) were noted for each tooth at the time of extraction. Teeth were sectioned in half, buccal‐lingual. at the furcation entrance with a rotary diamond blade. A standardized linear reference scale was placed on each experimental section and an 8×10 in. photograph generated. The distance from the floor of the pulp chamber to 5 predetermined sites on the root surface was calculated. The data were expressed as (a) the mean of each site and (b) the mean of each tooth (the average of the 5 points of each tooth). Analysis of covariance failed to show a relationship between thickness measurements and gender or furcation involvement. Thus, the data was subjected to simple regression analysis to determine the relationship of age with tooth and cementum thickness. This study revealed that by site, the mean measurements ranged from 2.7–3.0 mm for both M1 and M2. The single least/greatest measurements of the 5 sites were for M1: 1.6/4.7 mm and for M2: 1.8/4.2 mm. By tooth, the average distance from the pulp to the root surface was 2.83 mm (±0.49) for Ml and 2.88 mm (±0.44) for M2. Regression analysis of tooth thickness with age was significant for M1 only. The maximum slope of the 5 sites was approximately 0.3 mm/10 years. No relationship was found between cementum thickness and age for either tooth group. The results of this study indicate that the majority of times the pulp is 1.6–4.2 mm from the root surface in the vicinity of the furcation entrance of lower 1st and 2nd molars. Although tooth thickness in this area may increase with age, the amount is not enough to forego judicious odontoplasty on ol

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00585.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe role of HLA phenotype as a risk factor for drug‐induced gingival overgrowth was investigated in a cohort of 172 transplant recipients. Clinically significant overgrowth warranting surgical correction was observed in 72 patients (42%). Using stepwise regression modelling. 6 clinical parameters were identified as significant risk factors for the severity of gingival overgrowth. These were; age. sex. creatinine plasma level, duration of therapy, papilla bleeding index and concomitant medication with a calcium channel blocking drug. 3 HLA alleles were also identified as risk factors when adjusted for other clinically significant risk factors (HLA ‐DR2, A24, B37). However, when the p‐values for the HLA variables were corrected to compensate for the use of multiple significance testing, only HLA‐B37 remained statistically significant at the 5% level. Organ transplant patients are at risk of developing gingival overgrowth, with approximately 25% medicated with cyclosporin alone requiring corrective gingival surgery. This figure more than doubles in patients concomitantly medicated with a calcium blocking drug. The data at present available would suggest that the severity of gingival overgrowth is also significantly associated with the HLA‐B37

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00586.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractIncreased levels of cytokines and prostanoids have been detected in inflamed gingival tissue and may play an important role in periodontal pathogenesis. Recent studies suggest that monocytic products, such as interleukin (IL)‐1β, could stimulate IL‐6 production by human gingival fibroblasts (HGF). In this context, the production of local cytokines and inflammatory mediators could regulate the secretory capacity of resident gingival fibroblasts. Therefore, the purpose of this study was to determine if PGE2induced by IL‐1β could potentiate the IL‐6 response by HGF. Utilizing an ELISA, it was determined that maximal IL‐6 occurred when HGF were stimulated with 0.10–10 nM IL‐1β. These concentrations of IL‐1β also induced a small, but significant increase in PGE2production by HGF. Interestingly, the combination of ILγβ and PGE2induced a synergistic rise in IL‐6 production by HGF. Moreover, inclusion of indomethacin caused a 20% reduction in IL‐6 production and totally eliminated PGE2production. These findings provide additional rationale for the clinical use of NSAIDs in the management of periodontal disease due to their ability to attenuate production of both PGE2, and IL‐6. These results suggest the endogenous PGE2induced by IL‐1β plays an important regulatory role in IL 6 production by HGF. Moreover, they support the concept that elevated PGE2induced during inflammation can r

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00587.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractA new sonic electric toothbrush (Sonicare®) and a traditional manual toothbrush were compared for efficacy in removing supragingival plaque and reducing gingival inflammation in a 12‐week, single‐blind clinical trial. 60 subjects with a gingival index (GI) of>1.5 and no probing depths>5 mm were randomly assigned to use either the manual or sonic brush, instructed in its use, and asked to brush each morning and evening for 2 minutes. Plaque scores were taken at baseline and at 1.2, 4. and 12 weeks using the Turesky modification of the Quigley‐Hein plaque index. Gingival inflammation was assessed by the GI. bleeding tendency score, presence or absence of bleeding on probing, volumetric measurements of gingival crevicular fluid (GCF). and aspartate aminotransferase (AST) levels in GCF. Repeated measures multivariate analyses of variance were used to delect time‐ and device‐dependent differences for all clinical assessments between the 2 groups over the 5 visits. Both types of brush were effective in removing supragingival plaque. The sonic brush was statistically superior, on a percentage reduction basis, in removing supragingival plaque from the dentition taken as a whole (F‐statistic;p=0.012) and was particularly better in hard‐to‐reach areas such as posterior teeth (F‐statistic;p=0.003) and interproximal sites (F‐statistic;p=0.004). Both devices were equally effective in reducing gingival inflammation. The sonic brush exhibited less tendency to cause gingival abrasion than the manual brush (1 incident with sonic, 5 incidents with manual), confirming the safely of this product as an

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00588.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractIt is established that phenytoin, cyclosporin and some calcium antagonists produce gingival overgrowth, but it is not known how this condition may respond to causal periodontal treatment. In order to find out, a longitudinal study was carried out, over a year, comparing a group of patients who were given nifedipine (NG, n= 18) and another group who were given diltiazem (DG.n= 13) with 2 others: one comprised cardiopathic patients who took no calcium antagonists (CG,n= 12) and the other contained patients who were medically healthy. with moderate periodontitis (HG,n= 12). On their basal visit, they were examined and instructed in oral hygiene, and then given causal periodontal treatment, being seen again at 4 and 8 months, when hygiene instructions were reinforced. They were seen for the last time at 12 months, when they were again examined. Groups NG and DG, on their basal visit, showed larger gum size than groups HG and CG. which was statistically significant; on their final visit, these differences remained only at the interproximal level. The number of patients with gingival overgrowth‐taking the average of group HG as a minimal value‐was much higher in groups CG (92%). DG (100%) and NG (89%) on the basal visit; on the final visit, the differences remained only in groups DG (85%) and NG (83%). The probing pocket depth reduction was much greater in groups HG and CG than in DG and NG. basically due to a greater gaining on clinical attachment level. The % of sites in which the pocket depth improved by more than 2 mm was 39.8% in HG, 54.5% in CG, 23.7% in DG and 28.7% in NG. The % of sites where the attachment gain by more than 2 mm was 46.2% in HG, 55.5% in CG, 22.8% in DG and 21.4% in NG. The amount of plaque and bleeding on probing, which was similar in all groups on the basal visit, decreased throughout the study, especially between the basal and 2nd visit in groups HG and CG. We have demonstrated that patients that take nifedipine and diltiazem show a larger gum size and their response to causal periodontal treatment is poorer than in the healthy and the cardiac gro

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00589.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe aim of this study was to investigate the relationship between cigarette smoking and furcation involvement in molar teeth. A consecutive group of 50 smokers were recruited from referrals to a periodontal clinic and age and gender matched with never smokers. Smokers consumed an average of 18.0 (SD 6.7) cigarettes per day and had smoked for 20.7 (SD 6.5) years. Radiographs of all molar teeth were assessed 2 × by an examiner blinded to the smoking status. Smokers had slightly fewer molar teeth 6.7 (SD 2.6) than the never smokers. 7.3 (SD 2.3),t= 1.2,P=0.22. More smokers (72%) had evidence of furcation involvement than never smokers (36%), χ2=13.0,P=0.0003. The odds ratio for a smoker having 1 molar with furcation involvement was 4.6 (c.i. 2 – 10.6). Smokers had more molars with furcation involvement 1.94 (SD 1.7) compared with never smokers, 0.94 (SD 1.4),t= 3.1.P= 0.003. It is concluded that cigarette smoking is associated with a greater expression of molar furcation involvement in periodontitis affected subje

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00590.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe purpose of this study was to determine the suitability of different scaling instruments for surgical removal of hard and soft bacterial deposits and for the removal of soft accretions only for maintenance treatment within furcations. 12 upper and 12 lower plastic replicated molars, with through‐and‐through furcations, were instrumented 3× with 4 different types of instruments: (1) hand instruments: (2) a conventional sonic sealer insert: (3) a set of 3 modified sonic sealer inserts with budded tips and different angulated shafts; (4) a set of 3 sonic sealer inserts with a plastic‐ coating and different angulated shafts. The plastic replicas were fixed in a dummy head without any replicated soft tissues. In the furcation area, an easily removable surface coating material was applied to the teeth to represent the “plaque” and a second, more stubborn lacquer layer representing “calculus/cementum”. Following instrumentation, the following parameters were recorded to assess efficacy: time required for instrumentation, loss of weight, depth of substance removal at the furcation entrance, % of furcation area instrumented, whereby removal of these 2 layers was judged separately. Only minor differences were observed between hand instruments, conventional and budded sonic sealer inserts as to loss of weight, depth of substance loss and area instrumented. The plastic‐coated sonic sealer inserts were just as effective in surface layer removal representing “plaque” as the 3 other instruments, but resulted in less loss of weight and less depth of substance removal. In conclusion, the more aggressive hand instruments, the conventional and budded sonic sealer insert, are preferably used for the surgical phase to increased ease of entry into the furcation dome. An effective debridement of the furcation roof seems only possible with an odontoplastic, for which a furcation is fitted to the instrument by means of an intensive instrumentation, thus leading to weight loss and pronounced substance removal. The plastic‐coated sonic sealer inserts seems to be a reasonable choice for maintenance treatment within furcation, since this treatment phase is usually restricted to removal of s

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00591.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe aim of the study was to evaluate the adjunctive effect of systemic tetracycline (250 mg qds for 14 days) in sequential root planing and surgical phases of treatment in a randomised, double‐blind controlled trial. 38 patients who were under 26 years of age. in good general health and with localised (15 test/15 control) or generalised (4 test/4 control) early onset periodontitis completed the non‐surgical phase. Data were analysed by ANOVA using baseline covariates and transformations where appropriate. Improvements in probing depth, probing attachment level and bleeding on probing were significantly better in the group treated with adjunctive tetracycline. at 3 months post‐treatment. 26 patients (13 test/13 control) subsequently completed the surgical phase (modified Widman flap surgery with adjunctive tetracycline or placebo as before) and were re‐examined at 6 months and 12 months. In the test group, 58% of the originally affected teeth required surgery compared to 75% in the control group. Surgery produced further reductions in mean probing depths but no further gains in probing attachment. There were no further statistically significant differences between test and control groups for any of the clinical measures, although the tetracycline group appeared to maintain an advantage. In conclusion, systemically administered tetracycline is a useful adjunct in the management of early onset periodontitis. particularly in non‐surgical

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00592.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY