摘要:

AbstractThis investigation developed an experimental design that (1) detailed the distribution ofA. actinomycetemcomitansin Subgingival plaque related to the level of serum antibody to this pathogen; (2) used broad based subgingival plaque sampling to allow a definition of the distribution ofA. actinomycetemcomitansinfection in periodontitis patients; (3) described the distribution ofA. actinomycetemcomitansserotypes in patients and within sites; and, (4) assessed how this infection impacted upon local clinical symptoms of disease. We noted a significant positive relationship between the level of IgG anti‐A. actinomycetemcomitansantibody and the frequency of teeth infected until nearly 13 teeth demonstrated an infection. Furthermore, the results showed a generally negative relationship between the antibody level and the burden ofA. actinomycetemcomitansin the infected sites. Interproximal sites associated with first molar teeth were the predominant sites for subgingival colonization; incisors were also frequently infected in this population. The first molar teeth also exhibited the greatest level ofA. actinomycetemcomitanswhile the incisors demonstrated a high level ofA. actinomycetemcomitansin individual sites. The results clearly indicated the majority of the sites sampled were colonized by a single serotype ofA. actinomycetemcomitans.We detectedA. actinomycetemcomitansnearly 2 × times more frequently and a significant increase in the proportion ofA. actinomycetemcomitanswas found in samples obtained from teeth with bleeding on probing. The results also showed a significant trend for both pocket depth and attachment levels to be related to the presence and proportion ofA. actinomycetemcomitansin the subgingival plaque. These findings detail the microbiological, immunological and clinical characteristics of a unique subset of periodontitis patients that appear to exhibit disease associated (caused?) withA. actinomycetemcomitansinfection irrespective of clinical categorization. The results support a unique distribution of this microorganism in the subgingival ecology that is related to active host immune responses and clinical presentation of the too

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1994.tb00282.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThe aim of the present study was to investigate the prevalence of periodontopathic microorganisms and periodontal destruction in the spouses and children of adult periodontitis patients. For this study, 24 families were selected on the basis of one parent with severe periodontal breakdown and the presence ofActinobacillus actinomycetemcomitansand/orPorphyromonas gingivalisand/or more than 30%Prevotella intermediasubgingivally. The clinical examination of both parents and children included pocket depth and clinical attachment loss (CAL) measurements. Samples for bacterial examination were obtained from the mucous membranes, the saliva and pockets. Pocket selection was based on the most advanced periodontitis situation found in a subject. The samples were cultured for the detection ofA. actinomycetemcomitans, P. gingivalisandP. intermedia.By phase‐contrast microscopy, the % of spirochetes and motile microorganisms was assessed. The number of children within each family varied between 1 and 3. In total 49 children were investigated with a range in age of 3 months to 15 years. Results showed that under the age of 5 years, none of the children had CAL. whereas in the age group of 5–15 years, 26.5% had 1–5 sites in the primary and/or permanent dentition with 1–3 mm CAL. 3 of the spouses had no interproximal CAL. 16 of the 24 spouses had a light to moderate form of periodontitis, with at least one site with 1 to 4 mm CAL and 5 spouses had severe periodontal breakdown with sites showing at least 8 mm CAL. Spirochetes, motile microorganisms andP. intermediawere frequently present in all family members. 18 out of the 24 probands were positive forP. gingivalis.This organism was found once only in a 5‐year‐old boy and in 11 of the spouses.A. actinomycetemcomitanswas detected in 13 probands; 5 children and 5 of the spouses were also positive for this bacterium. If a child harboured one of the periodontopathogens, at least 1 of the parents was also positive for that bacterium. This phenomenon may be due to transmission of microorganisms between family members. Comparison of the clinical data reported in the present study with similar clinical parameters from epidemiological studies of the Dutch population suggest that the spouses and children of adult periodontitis patients might be at relatively high risk of developing periodonta

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1994.tb00283.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractIn the present clinical trial, the effect on existing plaque and gingivitis of a new electric toothbrush (ET) was compared to that of a manual toothbrush (MT). 40 medical students, age 18–30 years, participated. Plaque index (PlI) and gingival index (GI) were recorded at 6 sites at all teeth. At baseline, a PlI and GI>1 were required. The participants were at random allocated to a group using either ET or MT and were instructed only to use the assigned toothbrush, brushing each morning and evening for 2 min. No oral hygiene instruction was given. Reexamination was done after 1, 2 and 6 weeks. In the MT group, a minor decrease in mean PlI was found after 6 weeks (all sites: from 1.2 to 1.1, approximal sites: from 1.4 to 1.2). The corresponding figures in the ET group were: 1.2 to 0.6 and 1.4 to 0.8. After 6 weeks, the % of sites with visible plaque with MT was: 24% (all sites) and 30% (approximal sites) and with ET 8% and 9%, respectively. With MT, mean GI was unchanged after 6 weeks compared to baseline, whereas with ET, the changes were from 1.1 to 0.9 (all sites) and from 1.1 to 1.0 (approximal sites). The % of sites with GI score 2 had not changed after 6 weeks with MT (all sites: 11%, approximal sites: 13%). With ET, these results were 3% and 4%, respectivel

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1994.tb00284.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThis study evaluated the effect of smoking on the clinical response to non‐surgical and surgical periodontal therapy. 74 adult subjects with moderate to advanced periodontitis were treated according to a split‐mouth design involving the following treatment modalities: coronal scaling, root planing, modified Widman surgery, and flap with osseous resectional surgery. Clinical parameters assessed included probing depth, probing attachment level, horizontal attachment level in furcation sites, recession, presence of supragingival plaque and bleeding on probing. Data were collected: initially, 4 weeks following phase‐I therapy, 10 weeks following phase‐II therapy and on a yearly basis during 6 years of maintenance care. Data analysis demonstrated that smokers exhibited significantly less reduction of probing depth and less gain of probing attachment level when compared to non‐smokers immediately following active therapy and during each of the 6 years of maintenance (p<0.05). A greater loss of horizontal attachment level was evident in smokers at each yearly exam during maintenance therapy (p<0.05). There were no differences between groups in recession changes. In general, these findings were true for the outcomes following all 4 modalities of therapy and were most pronounced in the deepest probing depth category (≥ 7 mm). Statistical analysis showed a tendency for smokers to have slightly more supragingival plaque and bleeding on probing. In summary, smokers responded less favorably than non‐smokers to periodontal therapy which included 3‐month mainte

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1994.tb00285.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThe importance of microbial surveillance is illustrated in 3 clinical cases. Each case demonstrated a continued lack of response to conventional periodontal treatment. Repeated bouts of periodontal abscess formation and bone Joss occurred over a 3‐ to 4‐ year period, despite numerous surgeries supplemented with antibiotics. As a result, patients were termed refractory to treatment and extensive microbiological analysis and sensitivity testing was performed. Following institution of the appropriate antibiotic and conservative therapy consisting of several sessions of scaling and root planing, each of these cases demonstrated a dramatic remission of disease progression. No further breakdown has been seen for a minimum of 21/2, years. While anecdotal in nature, these cases support the usefulness of microbial identification coupled with antibiotic sensitivity as an adjunct to conventional conservative periodontal ther

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1994.tb00286.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractIn this study, we evaluated the microbiological and clinical effects of mechanical debridement in combination with metronidazole and amoxicillin therapy in 48 patients withActinobacillus actinomycetemcomitans‐associated periodontitis, 3 months and at least 24 months after active treatment. The results of this study showed that 47 out of 48 patients were still negative forA. actinomycetemcomitanssubgingivally, at the mucous membranes, the tonsillar area and in the saliva, 2 years after therapy. The clinical results showed that a reduction of probing pocket depth, probing attachment level, bleeding index and plaque index was not only seen in the time between baseline and 3 months after therapy, but further clinical improvement was observed between 3 and 24 months after active treatment. We conclude that combined mechanical debridement and metronidazole plus amoxicillin therapy is very effective in suppressingA. actinomycetemcomitansbelow cultivable levels over a long period of time, suggesting elimination of this organism, and that recolonization ofA. actinomycetemcomitansseems to be a rare event. The elimination ofA. actinomycetemcomitansis paralleled by a further improvement of the periodontal status of the patients, even up to 24 months after active treatmen

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1994.tb00287.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThe aim of this study was to evaluate the predictability of guided tissue regeneration (GTR), using ePTFE‐membranes (Gore‐Tex®) in the treatment of advanced periodontal disease. The study presents long‐term results for 88 teeth in 23 patients at least 9 months after membrane surgery. The periodontal lesions included severe horizontal and/or vertical bone loss. The bone level (BL and BL) and the tissue level (TL), a new parameter between cemento‐enamel junction and coronal margin of the tissue in the defect, were recorded during surgery: immediately before application of the membrane (BL), after membrane removal (TL) and during a re‐entry procedure (BL') 9 to 12 months later. The average tissue gain in the periodontal defect (BL‐Tl) at membrane removal was 65.7% (p<0.001) and the average gain in mineralized tissue at re‐entry (BL‐BL'), 30.4%, meaning more than 46% of the gained tissue at removal was mineralized at reentry. The decreased amount of mineralized tissue at re‐entry in relation to the tissue gain at membrane removal might be due to formation of a so‐called long connective tissue attachment or to mineralization‐induced shrinkage of the new tissue and some surgical difficulties in coverage of the newly formed tissue. Nevertheless, an absolute gain of 31% mineralized tissue after GTR can provide a marked improvement in the prognosis of a periodontally

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1994.tb00288.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractPrevious reports have suggested that persistently elevated levels of the acidic glycohydrolase β‐glucuronidase (βG) in gingival crevicular fluid (GCF) can identify patients with chronic adult periodontitis who are at risk for future probing attachment loss (PAL). To comprehensively study βG activity in GCF, a multicenter trial examining the relationship of the enzyme in GCF to traditional clinical parameters of periodontal disease and PAL was conducted. In this report, the baseline data was used to evaluate the relationship of βG activity in GCF to traditional parameters of periodontal disease. The study group included 130 patients who had been treated for periodontal disease and were on a regular recall schedule, and 10 patients with chronic adult periodontitis who had never received treatment. Upon entering the longitudinal trial, the patients were examined, and a standardized 30‐s GCF sample was collected from the mesiobuccal crevice of all study teeth. As a control, GCF samples and clinical data were collected from 62 patients with a healthy periodontium or mild inflammatory gingivitis without loss of probing attachment. At baseline, βG activity for the periodontitis patients ranged from 0 to 1704 Units (U), with a median of 32 U. βG could not be detected in 0.2% of samples (activity ≤2.0 U). The 90% cumulative relative frequency was 139 U. For the healthy/gingivitis subjects βG activity ranged from 0 to 504 U, with a median of 22 U. Enzyme was not detectable in 0.4% of samples. Only 0.9% of samples contained greater than 139 U. βG activity in GCF was not related to gender or age. For the periodontitis patients, elevated enzyme activity (140 U) was most often associated with molar teeth, followed by maxillary bicuspids. Maxillary central incisors, and mandibular central and lateral incisors displayed the lowest frequency of elevated enzyme activity. The relationship of βG activity to the traditional parameters of probing depth and bleeding on probing was assessed. For shallow sites (1.0–1.5 mm, 2.0–2.5 mm probing depth), the large majority of GCF samples contained low enzyme activity (90% of sampies ≤U). Descriptive indicators demonstrated a trend of increased βG activity with increased probing depth. The median βG activity shifted from 15 U for the shallowest sites (1.0–1.5 mm) to 127 U for the deepest sites (5–8 mm). However, this was due to a broadening of the distribution rather than representing a shift in the distribution profile. The relationship of bleeding on probing to βG activity was assessed on a tooth basis (bleeding at 0 to 6 sites). Teeth with no bleeding sites demonstrated a median βG activity of 22 U, while teeth with 5–6 bleeding sites had a median βG activity of 86 U. Again, this was the result of a broadening and flattening of the distribution observed with increased occurrence of bleeding on probing. These data suggest that while sites and teeth with increased severity of periodontal disease demonstrate greater βG activity, quantitative assessment of this enzyme in GCF provides a different measure of periodontal pathology than traditiona

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1994.tb00289.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThe aim of this investigation was to determine the relationship between loss of radiographic crestal bone height and probing attachment loss. As part of this aim, we are introducing a new method for determination of a threshold for significant probing attachment loss which takes into account the error contributed by alteration in tissue tone. 57 adults with established periodontitis were selected. Radiographs were taken using the Rinn alignment system. Crestal change was determined from bone height measurements on digitized images of pairs of radiographs using the “side‐by‐side” technique of analysis developed recently by us. Probing attachment loss was measured using the Florida electronic probe system. Radiographic and probing measurements were made at baseline and after 1 year. No treatment was given during this period. A direct and significant relationship was observed between radiographic bone loss and probing attachment loss on a site basis (p= 0.0001,r2= 0.018) and between subject means (p= 0.0014,r2= 0.16). Radiographic and probing attachment change at all categories of sites, dichotomously classified as to not changing or loosing indicated 13% of sites were loosing by measurement of radiographic change and 9.6% were Loosing by measurement of attachment change. Concordance in radiographic and attachment level change was found in 82% of sites examined. The relative diagnostic import of change in probing attachment or change in radiographic bone height requires treatment outcome studies based on use of diagnostic information of the 2 measuring techniques used singly and in comb

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1994.tb00290.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThe aim of the present study was to assess the changes in prevalence of early radiographic alveolar bone loss in a birth cohort (all subjects born 1970) over a period of 8 years as related to sex, ethnic origin, orthodontic treatment and socio‐economic status. In 1984, the target population consisted of 2767 subjects. In 1986, 1988 and 1992, sets of bite–wing radiographs were obtained from samples of the same population. Alveolar bone loss was recorded if the distance from the cemento‐enamel junction to the alveolar crest exceeded 2 mm measured on posterior bite‐wing radiographs. The frequency of subjects with radiographic alveolar bone loss increased significantly with age (p≤ 0.05). The number of subjects with 3 or more lesions also increased with age. The demographic variables studied did not seem to influence the prevalence of bone loss significantly in the present coh

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1994.tb00291.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY