摘要:

AbstractThe purpose of the present investigation was to determine magnitude and rate of proximal radiographic attachment loss in relation to endodontic infection in periodontally involved teeth. The investigation was conducted as a retrospective longitudinal study on a periodontitis‐prone randomly selected referral population, including 175 single‐rooted, root‐filled teeth in 133 patients. An observation period of at least 3 years was required. Periapical conditions of the selected sample at baseline and re‐examination were evaluated on radiographs, independently by 3 investigators. Each single‐rooted, root‐filled tooth of the sample was given a score according to the combined registrations. Radio‐graphic attachment level was measured as the distance between the most coronal point of the alveolar bone and the apex at the mesial and distal sides of the tooth, and expressed as relative radiographic attachment level (RRAL) (radio‐graphic attachment level at baseline/root length) at proximal sites for every tooth. Multiple regression analysis was used to study change in RRAL over time. Teeth in periodontitis‐prone patients with progressing periapical pathology indicating a continuous root canal infection were found to lose comparatively more radiographic attachment than teeth with no signs of periapical pathology or teeth with an established periapical destruction which subsided during the observation period. An approximate 3‐fold amplification of the rate of marginal proximal radiographic bone loss by endodontic infection in periodontitis‐prone patients was found with an average 0.19 mm/year, while 0.06 mm/year was lost for teeth without endodontic infection or subsiding e

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1995.tb00254.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThe interpretation of studies aimed at understanding the pathophysiology of periodontal breakdown has been hampered by an insufficient understanding of the physiology of host responses in clinically healthy gingiva. This investigation was aimed at the evaluation of the in situ phenotype and topographic distribution of the inflammatory cells in clinically normal gingiva and peri‐implant keratinized mucosa (PIKM). Soft tissue biopsies were obtained from clinically healthy gingiva or PIKM in 14 patients. Acetone fixed, cryostat sections were stained with a panel of monoclonal antibodies with a three stage avidin‐biotin immunoperoxidase technique. Numbers of positive cells/mm2 were determined with a calibrated image analysis system. The major findings of the study were: (i) the presence of significantly higher densities of phenotypically characterized mononuclear cells in the 1CT than in the JE in both gingiva and PIKM; (II) the absence of a significant difference in PMN densities between JE and ICT in both gingiva and PIKM; (iii) the absence of statistically significant differences in densities of phenotypically characterized leukocytes associated with gingiva and PIKM; (iv) the presence of regional differences in the relative proportions of immunocompetent cells in both the gingiva and PIKM. It is concluded that inflammatory cells are selectively distributed in gingiva and PIKM. Unique functional compartments could be identified. The observed compartmentalization requires selective regulatory mechani

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1995.tb00255.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThis study was performed to assess the influence of smoking on periodontal disease severity. Data concerning periodontal status and smoking habits were collected from 889 periodontal patients: 340 male and 549 female. 21 to 76 years of age. 47.4% being non smokers and 52.6% smokers. Periodontal parameters, recorded by the same examiner (PMC), were: gingival recession (GR), Pocket depth (PD), Probing attachment level (PAL), and mobility (M). The influence of age, sex and tobacco consumption on these periodontal parameters was statistically evaluated using an analysis of variance (ANOVA) with covariates. A non‐linear effect model was also fitted by taking the natural logarithms of the response variables (GR. PD, PAL) closer to bio‐medical phenomena. Mobility was analyzed by a x2‐test. The effect of smoking on periodontitis showed no association with age or with sex. Smoking, age and sex were shown to be statistically significant for periodontitis, by performing both univariate (I‐test for equal means) and multivariate tests.p‐values for smoking and periodontitis were: GR (p= 0.000). PD (p= 0.000), PAL (p= 0.000) and M (p= 0.015). Smoking one cigarette per day. up to 10, and up to 20, increased PAL by 0.5%, 5% and 10%. respectively. The impact of tobacco is comparable to the impact resulting from the factor of age in this sample, increasing PAL by 0.7% for each year of life. Comparison between smokers of less than 10 cigarettes per day (PAL mean 3.72 mm±0.86) and non‐smokers (PAL mean 3.84±0.89) showed no differences in PAL (p= 0.216). while comparison for smokers from 11 to 20 cigarettes (PAL mean 4.36±1.23) and for more than 20 cigarettes PAL mean 4.50±1.04) demonstrated significant differences (p = 0.000). These findings suggest that: (i) tobacco increases periodontal disease severity; (2) this effect is clinically evident above consumption of a certain quan

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1995.tb00256.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractFor various clinical indications, oxidising agents have been used in dentistry for many years. Little is known, however, of their antibacterial activity and their ability to inhibit plaque formation. In this study, 2 mouthrinses containing peroxyborate (Bocasan) and peroxycarbonate (Kavosan) were compared alongside a negative control saline rinse and a positive control chlorhexidine rinse (Corsodyl) for their ability to inhibit plaque reformation. Employing a randomised four replicate 4x4 latin square cross over design and, whilst omitting all other oral hygiene, plaque was measured by area and index after rinsing for 4 days. In a second study, in vivo antibacterial effects of the rinses were assessed by measuring salivary bacterial counts following single rinses with the preparations at various time intervals over 7 h, Plaque inhibition by chlorhexidine was significantly greater than the other rinses. All rinses were significantly better than the saline rinse at inhibiting plaque. For plaque area, the peroxycarbonate rinse was significantly better than the peroxyborate rinse at inhibiting plaque. Salivary bacterial count reductions were significantly greater compared to saline with chlorhexidine at all time intervals up to 7 h. Whilst both peroxyborate and peroxycarbonate rinses produced greater reductions in bacterial counts than saline up to 3 h, at no time interval were the differences significant. The findings of these studies would suggest oxidising mouthrinses may inhibit plaque formation not by a direct antibacterial effect, but by some other mechanism. The magnitude of plaque reductions obtained with the peroxyborate and more so peroxycarbonate rinses would suggst a need for further study of these preparations when used as adjuncts to normal toothbrushing.

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1995.tb00257.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThe present clinical trial was designed to evaluate the clinical effect of GTR in the treatment of degree II furcation defects in maxillary molars. 28 patients, 21 to 59 years of age, referred for treatment of advanced periodontal disease were included. They presented with similar periodontal lesions in the right and the left maxillary molar regions, but had only one surface which exhibited furcation involvement. A total of 28 pairs of contralateral furcation defects of degree II including 18 interproximal pairs (10 mesial, 8 distal) and 10 buccal pairs, were available for the study. After the completion of basic therapy, the furcation involved molars in the right and left quadrants in each patient were randomly assigned to either a test or a control treatment procedure. Following flap elevation, scaling, root planing and granulation tissue removal, an e‐PTFE membrane at the test site was adjusted to cover the entrance to the furcation defect and adjacent bone and was retained in this position with sling sutures. The mucoperiostal flaps were subsequently adjusted and positioned to cover the entire surface of the membrane and were secured in this position. An identical surgical procedure was performed in the control tooth regions with the exception of the placement of a teflon membrane. No periodontal dressing was used. Starting the day before surgery and continuing for 7 days, the patients received 1 + 1 g of Amoxicillin per day; morning and evening. The sutures were removed after 10 days. At the test sites, the membranes were removed after 6 weeks of healing. The treated sites were examined and re‐entry procedures performed 6 months after reconstructive surgery. Open flap debridement at maxillary furcations of degree II resulted in some gingival recession and probing depth reduction, but no change occurred in parameters describing probing attachment or bone levels. The addition of GTR at buccal furcations enhanced the treatment result by promoting probing attachment and bone gain and reduced the amount of soft tissue recession above what was accomplished by flap debridement alone. No such benefit of membrane therapy was observed at mesial and distal furcati

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1995.tb00258.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractClarification of the reliability associated with probing attachment level measurements and with diagnostic rules derived from them is necessary to examine the potential of these measurements as reliable markers of the disease process and as an outcome measure in clinical treatment studies. The purpose of the present study was to describe and compare the longitudinal reliability of single and double probing attachment level measurable by estimating false positive and false negative rates. In 20 systemically healthy adults with untreated advanced adult periodontitis, probing attachment levels and probing depth were measured at 6 sites in all teeth at the start of the study, and every 30 days thereafter for 11 months. Attachment levels were double measured, using acrylic onlays providing reference points and an electronic pressure sensitive probe, Attachment loss from baseline of 2.5 mm or more was used to accept dynamic attachment loss. The statistical methods for the cross‐sectional analysis included mean absolute differences between double measurements and cross‐correlations. Longitudinal analyses, expressing estimates of diagnostic error rates were made using maximum likelihood methods. 5 measurement protocols were compared. The results showed that the mean absolute difference between replicate measurements was 0.095 mm in bicuspids and 0.107 mm in molars. The mean absolute differences decreased over time from 0.128 mm in visit 3 to 0.08 mm in visit 7. Correlation coefficients for replicate measurements were higher than 0.98. In general, false positive rates were markedly lower (≤0.02) than false negative rates (≤31). The relative sample size required to obtain comparable statistical power, was minimized in premolars when using the first of 2 measurements or the mean of 2 measurements, and in molars when using the first of 2 measurements. The methodology used in the present study provides guidelines for designing clinical studies which maintain statistical power by balancing off examiner reliability and samp

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1995.tb00259.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThe aims of the present study were to analyze (i) which tissue changes may occur in the zone of co‐destruction to better understand why trauma from occlusion may induce additional attachment loss, and (ii) whether changes occur in the periodontal ligament tissue when an inflammatory lesion (ICT) approaches the periodontal ligament space. 16, 1‐year‐old beagle dogs, were selected and divided into 2 groups, group A and group B, consisting of 6 and 10 dogs, respectively. In group A, on day 0. a bucco‐lingual jiggling type movement was induced resulting inincreasing tooth mobilityat P3(test tooth) by the application of an orthodontic elastic which traversed the buccal surface of the crown of the test tooth. The elastic was exchanged either in a buccal or in a lingual position 2x a week during a 3‐month period.3P served as non‐jiggled control tooth. Tooth mobility measurements were recorded on days 0, 30, 60, 90. A plaque control regimen was maintained until the end of the experiment (day 90). On day 90, biopsies including P3and3P were harvested. The dogs representing group B, were divided into 2 subgroups of 5 each, group BI and group BII. On day 0, a 4‐month period of experimental periodontal tissue breakdown was initiated by placing cotton floss ligatures submarginally around the mandibular fourth premolars (4P4) in group BI and around the mandibular third premolars (3P3) in group BII. All ligatures were exchanged, replaced 1X every month, and on day 120 permanently removed. On the same day, biopsies included4P4were harvested. Following supragingival debridement3P3were allowed to accumulate plaque until the end of the study (day 225). On this occasion, biopsies including3P3were harvested. The results of the histological measurements revealed that in the most coronal portion of the periodontal ligament of teeth exhibitingincreasing mobility, there was an increased width, a reduced % tissue volume of collagen, and an increased volume of vascular structures and leukocytes. Furthermore, the number of osteoclasts bordering this portion of the alveolar bone was increased and the number of collagen fibers inserting into the root cementum and into the alveolar bone was reduced. It was also demonstrated that in teeth with normal mobility, the position of the gingival ICT failed to influence the composition of the tissue within the coronal portion of the periodo

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1995.tb00260.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThe purpose of the present investigation was to study the effect of an altered subgingival environment, induced by changing the local soft tissue morphology, i.e., pocket depth reduction, on the subgingival microbiota and the clinical conditions. 7 patients aged 30–60 years with generalized marginal periodontitis were selected. Patients were instructed in proper oral hygiene and all teeth were cleaned supragingivally. Mucoperiosteal flaps were raised and the bone re‐contoured to eliminate angular bony defects. While the control teeth were carefully debrided and thoroughly root planed, no root instrumentation was performed on the test teeth. Calculus deposits visible to the naked eye were only chipped‐off with the tip of a sealer. The flaps were apically repositioned and sutured at the level of the bone crest. Clinical parameters showed a similar pattern of response in the test and control sites over a one year observation period post therapy. Probing depths and probing attachment levels were significantly reduced one month after surgery and remained at a lower level. A significant decrease was also noted for total anaerobic viable bacterial counts. The proportion of the Gram‐negative anaerobic rods decreased significantly in both groups.P. gingivalis, Fusobacteriumsp.,C. rectuswere detected significantly less often after treatment in both groups.CapnocytophagaandA, odontolyticus, on the other hand, were more frequently isolated after therapy. These findings corroborate the concept that the reduction of selected subgingival microorganisms is the key element for the success of periodontal therapy, rather than the removal of tooth substance and mineralized deposits by root instrume

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1995.tb00261.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract3S skulls, belonging to inhabitants of various age groups of the Neolithic settlement of Khirokitia in Cyprus (5800–3000 BC) were studied and the alveolar bone loss was evaluated in areas where teeth still existed. It was found that the alveolar bone loss increased with age. The differences deriving from the comparison of skulls belonging to older people (the mean life‐span of the inhabitants was 35.2 years), with skulls belonging to younger people suggest that our findings are not due to post‐mortem weathering of bones through the centuries but represent a real fact. The results of this study indicate that periodontal disease has accompanied human beings since prehistoric time without being affected by civiliz

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1995.tb00262.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractWe designed and performed a multicenter clinical trial to determine the relationship between measurements of the level of the enzyme aspartate amino‐transferase (AST) in gingival crevicular fluid (GCF) to other measures used to detect periodontal disease and monitor outcome of treatment, including pocket depth and gingival inflammation. 32 periodontitis patients were enrolled at the University of Washington, Seattle, 30 at the University of Florida, Gainesville, and 34 at the University of Illinois, Chicago. 10 periodontally normal control subjects were enrolled at each location. 8 diseased and 4 healthy sites were designated for study in each patient and 8 healthy sites designated in each control subject. Measures of disease included pocket depth, severity of gingival inflammation, and GCF volume. AST levels were measured using the PerioGardTMtest kit. Clinical measurements were made and GCF samples harvested and tested 2X before and 2X after therapy consisting of scaling and root planing under local anesthetic. Specific design and other issues are discussed, including selection of patients and control subjects, sample size, selection of experimental test sites, methods for assessment of diseased and therapeutic improvement, harvesting of GCF, and selection of appropriate biostatistical methods for data analysis. Demographics of the patient populations at the 3 locations are reported. As expected, therapy induced only negligible changes in the measures of disease at healthy sites in control subjects, and relatively minor improvement in healthy sites in patients. In contrast, statistically significant improvement relative to pre‐treatment baseline status in all 3 measures of disease was observed for diseased sites at all 3 study locations with allp‐values less than 0.0002. The magnitude of improvement was comparable to that reported previously by others. The % of PerioGard‐positive sites decreased significantly between the screening baseline and both post‐treatment visits for patients at all 3 locations, withpvalues of 0.0001

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1995.tb00263.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY