摘要:

AbstractLongitudinal studies with humans indicate that gingivitis is associated with an increased dental plaque mass. Also, prior to the onset of gingivitis, changes in the microflora towards a more complex bacterial composition frequently occur. On the other hand, recent cross sectional cultural studies generally do not reveal clear‐cut differences between the composition of the subgingival microflora associated with healthy or inflamed gingivae. Also, some studies have demonstrated an enhanced cell‐mediated immune response during the course of gingivitis to a variety of subgingival plaque bacteria. It has also been observed that plaques allowed to form on cleaned teeth for 2 or 3 days do not differ substantially in their microbial composition. However, long‐term thorough oral hygiene performed at intervals of 48 h permits maintenance of gingival health, whereas that instituted at intervals of 72 h will lead eventually to gingivitis. Collectively, this evidence supports the concept that the etiology of gingivitis is bacteriologically nonspecific. Thus a large increase in the accumulation of bacteria on the tooth surface per se may have a greater pathogenic effect on the periodontal tissues than the relatively minor and inconsistent shifts in the microbial composition.The transition from gingivitis into periodontitis may be induced by changes in the pathogenic potential ofsubgingivalplaque. Gram‐negative rods appear to be specifically associated with periodontitis. A growing body of evidence implicates especiallyBacteriodes asaccharolyticusas one of the responsible pathogens.Juvenile periodontitis (periodontosis) seems to be a distinct disease entity. Recent findings suggest abnormalities in peripheral blood polymorphonuclear leucocytes (PMNL) of patients with juvenile periodontitis. The subgingival microflora is different from that associated with periodontitis and the findings so far implicateActinobacillus actinomycetemcomitansas an important pathogen.The bacterial etiology of acute necrotizing ulcerative gingivitis (ANUG) is still unclear. Satisfactory cultural studies have yet to be performed. The presence of spirochetes in the ulcerative lesions of the junctional epithelium does not necessarily imply that they play an important role in this disease entity.Future research on the bacteriology of periodontal disease should concentrate on longitudinal studies; particular attention should be paid to the change of gingivitis into periodontitis whereby animals as well as humans can be used. Improvements of sampling methods as well as precise and simple identification techniques of microorganisms are r

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1981.tb02038.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

AbstractThe present investigation was performed to assess the efficacy of a maintenance care program to prevent recurrence of disease in patients subjected to treatment of advanced periodontitis. In addition, the periodontal status was monitored of a group of patients who following the end of active treatment were referred back to genera] practitioners for maintenance care. The material consisted of 90 patients who in 1972 were referred for specialist treatment of advanced periodontal disease. The patients were first subjected to an initial examination including assessment of oral hygiene, gingivitis, probing depths and attachment levels. They were on an individual basis given case presentation, instructed how to practice proper tooth‐cleaning methods, their teeth were scaled and eventually the periodontal pockets were treated using the modified Widman technique. During the first 2 months following surgery the patients were recalled once every 2 weeks for professional tooth cleaning. Two months after the end of surgical treatment, the patients were reexamined to provide baseline data. Every third patientwasthereafter referred back to the general dentist for maintenance care. Two out of three patients were maintained in a carefully designed and controlled maintenance care program at the university clinic. This program involved recalls once every 2–3 months and included instruction and practice in oral hygiene, meticulous scaling and professional tooth cleaning. The patients were reexamined 3 and 6 years after the baseline examination.The results demonstrated that in patients suffering from destructive periodontitis, a treatment program that involved oral hygiene instruction, scaling, root planing and modified Widman flap procedures resulted in the establishment of clinically healthy gingiva and shallow pockets. Patients who were placed on a carefully designed recall program were over a 6‐year period able to maintain excellent oral hygiene standards and unaltered attachment levels. In contrast patients who subsequent to active treatment were not maintained in a supervised program showed obvious signs of recurrent periodontitis at the follow‐up exami

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1981.tb02039.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

AbstractA study was carried out to compare the antibacterial properties of four cationic antiseptics, three of which are available as commercial mouthrinse preparations. Minimum inhibitory concentrations for alexidine, cetyl pyridinium chloride, chlorhexidine gluconate and hexetidine against a range of standard test organisms, were determined by tube dilution, Similar values forOxford staphylococcuswere then obtained in Dubos medium to which protein as yeast, or food extract, or serum was added in doubling dilutions to 16%. Salivary bacterial counts after a single rinse with the antiseptics 01 water throughout the day were measured in 10 subjects together with the duration of any residual antiseptic activity in the saliva. All antiseptics were effective at low concentrations against the organisms tested but the minimum inhibitory concentration values for hexetidine were the highest. Food extract and serum markedly increased the minimum inhibitory concentration values of all antiseptics, although alexidine and hexetidine were the least affected in percentage terms. The activity of a 1% povidone iodine preparation, used for comparison, was almost completely vitiated. An immediate significant fall in salivary bacterial counts was produced by the cationic antiseptics. Return to pre‐rinse levels was seen for hexetidine after 90 min, cetyl pyridinium chloride after 3 hours, alexidine after 5 hours and chlorhexidine gluconate after 7 hours. Residual salivary antibacterial activity remained to 90 min for cetyl pyridinium chloride, to 3 hours for alexidine and alexidine and to 5 hours for chlorhexidine gluconate. The antibacterial properties measured, in particular the duration of effectin vivo, may be relevant to the anti‐plaque activity of cationic antisept

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1981.tb02040.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

AbstractThe present study was carried out in the Beagle dog in order to determine if variations of the width of the zone of keratinized gingiva occur in the canine dentition, if the width alters during the development of destructive periodontitis and if, subsequent to surgical excision of the periodontal lesion, the regenerated gingival margin differs from that of a normal, noninflamed gingiva. Five dogs were used. A baseline examination comprised assessments of dental plaque, gingival conditions and width of the zone of keratinized gingiva. Cotton floss ligatures were placed around the teeth on the right side of the jaws and plaque was allowed to accumulate in order to induce periodontal tissue breakdown. After 150 days the inflamed periodontal tissues around the experimental teeth were removed surgically using a “gingivectomy” or a flap procedure. In the “gingivectomy” procedure the entire zone of the keratinized gingiva was excised whereas the main part of the keratinized tissue was maintained with the flap procedure. During a healing period of 120 days plaque control was carried out daily. On the left side of the jaws (control side) a careful toothcleaning program was performed during the entire observation period of 270 days. Clinical examinations of all control and experimental tooth units were repeated on days 150 and 270. Biopsies were sampled from both sides of the jaws on day 270. In histological sections the free gingival tissue was subjected to histometric assessments and a stereologic analysis based on a standardized morphometric point‐counting procedure. In addition, the number of leukocytes residing within the junctional epithelium was determined.The results showed that in Beagle dogs the width of the keratinized gingiva (WKG), on the facial aspect of premolars and molars, varies between 2 and 6 mm. During a period of 270 days of careful plaque control, the WKG was maintained unaltered. In comparison, a phase of experimental periodontitis resulted in a substantial decrease of the WKG. Subsequent to the excision of the inflamed periodontal tissues, which in some cases included the entire zone of the keratinized gingiva, a new free gingival unit developed. In most respects the structural composition of this regenerated gingival unit was similar to that of a normal control unit. Furthermore, in the absence of plaque, the regenerated soft tissue was free from signs of inflammation independent of presence or absence or width of the keratin

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1981.tb02041.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

AbstractThe aim of the present investigation was to evaluate whether and to what degree discrepancies in tooth alignment can influence plaque accumulation and gingival status, An intra‐individual study was performed on 30 children with unilateral malposition of upper lateral incisors (15 children) and lower second premolars (15 children). Corresponding contralateral teeth were used as controls. The meanage was 14.4 years. The degree of malalignment in individual cases was assessed using a new malposition index (MPI). Plaque and gingival condition were assessed according toSilness&Löe(1964) and Löe&Silness (1963), respectively.The test and control areas were compared with regard to plaque accumulation and gingival status. Correlation analysis was performed to test the connection between these two parameters and tooth malalignment. The frequency of visible plaque (P1I 2+ 3) and gingival bleeding (GI 2 + 3) was generally higher for the test areas compared with the control areas. A comparison between the test and control areas showed the difference in gingival bleeding to be significant and of similar magnitude as regards upper laterals and lower second premolars. The difference in visible plaque was less marked but still significant.The correlation analysis did not show any connection between the degree of plaque accumulation or gingival inflammation and the degree of tooth malalignment.The differences found between normal and malaligned teeth thus showed a difnite trend, namely:–plaque and gingivitis were more widespread around malaligned upper lateral incisors and lower second premolars than around contralateral teeth well positioned within the dental arches.–the degree of malalignment was of secondary imp

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1981.tb02042.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

AbstractA relatively high incidence of infection byActinobacillus actinomycetemcomitanscan be shown in subgingival plaque samples obtained from patients with juvenile periodontitis. These organisms possess a potent leukotoxin(s) which rapidly destroys isolated human polymorphonuclear leukocytes (PMNs) and monocytes. If such leukotoxins operatein vivo, they could deprive the gingival crevice area of an essential antibacterial defense mechanism. We have found that sera from juvenile periodontitis patients consistently (>90%) contain antibodies which neutralizeActinobacillus actinomycetemcomitansleukotoxin(s). On the other hand, sera from normal individuals or patients with other types of periodontal disease usually amplified rather than inhibited the leukotoxic reaction. Many patients with juvenile periodontitis have demonstrable defects in PMN or monocyte chemotaxis and this may place them at risk to gingival infection byActinobacillus actinomycetemcomitans.The immune response against these organisms could be a crucial determinant in the course of juvenile periodontitis. While this disease is relatively rare, it does cause immeasurable emotional, physical and economic hardship for patients and their families. The identification ofActinobacillus actinomycetemcomitansas a potential pathogen in this disorder may eventually lead to specific forms of therapy to prevent and eliminate infection by this organism in these patients.

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1981.tb02043.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

AbstractThe studies currently reported farmed part of an enquiry whose overall objective was to identify a suitable animal model upon which initial screening of compounds and formulations with prophylactic and/or therapeutic potential in periodontitis could be carried out, An earlier study (Rovin et al. 1966) reported that periodontal inflammation could be produced in the conventional laboratory rat by application of a ligature to the molar teeth. The present paper describes the pathological and histopathological changes in the periodontium following application of ligatures to the molar teeth of young rats, and the tissue responses observed after topical application of chlorhexidine digluconate. Plaque formed rapidly and an acute periodontitis was induced; application of increasing concentrations of chlorhexidine digluconate gave a progressive diminution in the severity of the lesions. The major bacterial components of the plaque were actinomycetes and streptococci.

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1981.tb02044.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

AbstractA method for the detection of prostaglandin E (PGE) in crevicular fluid has been developed which provides a sensitive, noninvasive technique for measurement of local concentrations of this mediator of inflammation. Assay sensitivity sufficient for the detection of 4 picograms of PGE2; was achieved by utilizing a high‐affinity anti‐PGE2antibody, a solid‐state second antibody and low isotope concentrations. The method permits detection of concentrations equivalent to 108M PGE2in μl of crevicular fluid. Crevicular fluid PGE (CFPGE) concentrations were determined in samples from 12 patients with periodontal disease. Patients with periodontitis had significantly higher mean CFPGE concentrations than patients with gingivitis (179.5±51.4 pg/μl vs 32.1 ± 15.5 Pg/μl, mean ± SEM). Periodontitis sites were selected on the basis of clinical and radiographic evidence of periodontal destruction. Some sites displayed low CFPGE levels, while others had CFPGE concentrations which were elevated tenfold, suggesting the presence of both inactive and active periodontal lesions. CFPGE levels greater than 100 pg/μl were positively associated with gingival erythema and pai

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1981.tb02045.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY