摘要:

AbstractThe objectives of the present study were to establish in a long‐term investigation the safety as well as the clinical and microbiological efficacy of scaling and rootplaning combined with local application of 2% minocycline hydro‐chloride‐gel versus placebo‐gel in patients with moderate to severe chronic adult periodontitis. This was an 18 months, randomized, double‐blind, parallel, comparative study, in which 20 healthy patients with moderate to severe chronic periodontitis participated. At baseline, all patients received professional oral hygiene instruction and supra‐and subgingival scaling and root planing. The minocycline‐gel was applied subgingivally baseline, 2 weeks. 1, 3, 6, 9 and 12 months. Microbiological evaluation was carried out using DMDx to identify the following bacteria:Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans. Campylobacter rectus. Fusobacterium nucleatumandTreponema denticola.In addition standard microbiological techniques were used for the detection ofP. gingivalis, P intermedia, P. micros, A. actinomycetemcomitans. C. rectus, F. nucleatum, C. albicansandEnterobacteriaceae.Results showed a statistically significant improvement for all clinical parameters irrespective of the treatment modality. No differences were observed between test and control with regard to probing depth and attachment level. The DMDx data showed a significant reduction in both the numbers and the prevalence over the 15 months period, but no significant difference between groups. Culture data showed that at baseline two–third were positive forP. gingivalisandP intermedia.Analysis over the 18 month period showed no significant difference between the two treatment modalities. CalbicansandEnterobacteriaceaewere detected only in small proportions at each time interval in a limited number of patients. No adverse reactions were observed during the trial period. The present patient group responded favourably to scaling and rootplaning, but did not benefit from an effect of local of minocycline. Subgingival debridement in combination with oral hygiene instruction by itself has been shown to be effective. It remains to be studied whether local application of minocycline can be effective as an adjunct to mechanical therapy in sites that respond poorly to convent

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00599.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractOral bacteria play an important role in the causation of oro‐facial abscesses. However, they can also be involved in brain, liver and lung abscesses. To persist, it is essential that these bacteria can grow on those sites. The main source of nutrients for growth in abscesses is likely to be tissue exudate, which is rich in serum‐derived proteins, and relatively poor in free amino acids and carbohydrates. Degradation of intact proteins seems a crucial step in providing the pep‐tides necessary for energy generation. The aim of this study was to investigate the capacity of microorganisms from asscesses to degrade serum proteins, in particular immunoglobulins. To this end, samples were taken by aspiration from 16 odontogenic abscesses. It was found that pus from abscesses differed strongly in the concentration of viable bacterial cells. The ability of the abscess microflora to degrade serum proteins was investigated after growth of the sample in heat–inactivated human serum. The microflora from abscesses with a high concentration (n= 10) of bacteria strongly degraded immunoglobulins, whereas breakdown of immunoglobulins was virtually absent after growth of the microflora from low–bacterial concentration (n= 6) abscesses. Bacteriological analyses revealed the presence of at least one proteinase‐producing species, likePorphyromonas, black‐pigmentedPrevotellaspecies, orActinomyces meyeri, in abscesses with a high density of bacteria, but not in those with low bacterial density. The results indicate that the capacity lo degrade intact proteins, in particular immunoglobulins, is a major determinant of bacterial growth

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00600.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThis was a 2‐part study. The purpose of the 1st part was to examine the relationship between brushing force and plaque removal efficacy comparing a regular manual toothbrush (M) with an electric toothbrush the Braun Oral‐B Plak Control* (B). The study consisted of a single oral prophylaxis followed by 5 experiments which differed solely in respect to toothbrushing force. At baseline (after 24‐h plaque accumulation), the amount of dental plaque was evaluated and subsequently, the subject's mouth was brushed by a dental hygienist. Brushing was carried out in a random split‐mouth order. Either the 1st and 3rd quadrants or the 2nd and 4th quadrants were brushed with 1 toothbrush and the 2 remaining quadrants with the other. The available time for the brushing procedure was 2 min. After brushing, the amount of remaining dental plaque was assessed. The force used in experiment 1 through 5 was 100, 150, 200, 250, 300 g, respectively. The results show that when brushing force is increased, more plaque is removed with either of the two brushes. Except for the high brushing force (300 g), the electric toothbrush removed more plaque than the manual brush. The purpose of the 2nd part was to evaluate the habitual brushing force which individuals use with various toothbrushes. Besides a manual toothbrush (M), 3 electric toothbrushes were examined, the Rotadent® (R). Interplak® (I) and Braun® (B). 20 subjects were selected on the basis of being ‘good brushers” (plaque score at screening<25%). At baseline, each subject randomly received 1 of the 4 brushes. They were allowed a training period of 3 weeks at the end of which they were asked to abstain from brushing for at least 24 h. The plaque (Turesky modification of the Quigley&Hein) was scored, after which the subjects brushed their teeth (2 min) with the assigned toothbrush equipped with a strain gauge. A computer set–up measured (100 Hz) and calculated the mean brushing force. After brushing, the amount of remaining plaque was assessed. The design of the study was a 4‐way cross‐over. The results show that with a manual brush, considerably more force is used than with the electric brushes (R=96. 1 = 119. B= 146, M=273). No significant relation between brushing force and plaque removal was demonstrated fo

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00601.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractGingival dimensions and histopathologic alterations in periodontium were examined in rats continuously exposed to cyclosporin‐A (CSA). 60 male Sprague‐Dawley rats were divided into 2 groups. Rats in the test group daily received CSA in mineral oil by gastric feeding at a dosage of 30 mg/kg body weight for 6 weeks. Rats in the control group received mineral oil only. 10 rats from each group were sacrified at 2‐week intervals, Gingival dimensions were assessed from stone models obtained from the maxillary and mandibular incisal regions. Horizontal, sagittal and frontal tissue sections were obtained from these regions as well. Gingival dimensions in the mandibular and maxillary incisal regions were significantly increased in rats exposed to CSA. Light‐microscopic observations revealed a granulation tissue formation at tooth‐gingiva interface and an irregular bony surface on dental alveoli in experimental animals. Because both soft and hard tissue of periodontium in experimental rats being significantly effected by CSA compared to control animals, we hypothesized that the periodontium is a target tissu

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00602.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThis study has been designed to investigate the immunogenetic susceptibility of Cyclosporine‐A (CsA) immunosuppressed renal transplant patients to development of gingival overgrowth, and the amplifying effect of calcium channel blockers on the severity of this clinical entity. 52 renal transplant recipients were selected and initially grouped as follows: group (Gp)1: CsA (n= 7);Gp2: CsA + verapamil (n= 26);Gp3: CsA + diltiazem (n=6);Gp4: CsA + nifedipine (n=13). These groups were not found to be significantly different in age, sex. plaque index (PII). gingival index (GI). calculus index, periodontal probing depth, serum CsA level, or duration of CsA therapy (p>0.05). No significant (p>0.051 additive effect of the calcium channel blockers on the gingival overgrowth (GO) was assessed. The main group (n=52) was evaluated for the correlations between the clinical and the pharmacological variables and the GO. GI (rs=0.60) and the periodontal probing depth (rs = 0.71) were found to be moderately correlated with the GO. The patients were regrouped based on the severity of overgrowth and recognized as responders (n=26) and nonresponders (n=26). Age, sex, calculus index, serum CsA level, duration of the CsA therapy, were not statistically different among these groups (p>0.05). PII, GI, periodontal probing depth, and GO were significantly higher in the responder group (p>0.05). Analysis of HLA distribution of the responders and the nonresponders and comparison with the controls (n= 3731) revealed that a statistically significant (p<0.001) % of the nonresponders were positive for HLA‐DR1. These data would indicate that an immunogenetic predisposition should be suspected in the pathogenesis of the entity, and that HLA‐DR1 would have a protective rôle against gingival overgrowth induced

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00603.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractShort‐chain carboxylic acids (SCCA; C≤5: e.g., lactic acid, propionic acid, butyric acid) are metabolic by‐products of bacterial metabolism which accumulate in the gingival crevice, and exhibit significant biological activity, including the ability to alter gene expression. It has been hypothesized that among the activities of SCCAs are their ability to contribute to gingival inflammation. This concept complements the notion that specific periodontal pathogens are the causative agents of gingival inflammation. To begin testing these 2 hypotheses, we examined the relationship between SCCA concentrations, specific putative periodontal pathogens, and gingival inflammation in medically healthy periodontally diseased subjects. We reasoned that if SCCAs and/or specific periodontal pathogens were causative gingival inflammatory agents, gingival inflammation should increase with increasing concentration of the inflammatory mediator. We also recognized that other clinical variables needed to be controlled for, and an objective quantitative assessment of gingival inflammation used. To accomplish these tasks, sites within subjects were stratified by location and pocket depth, and the following quantified: bacteria] presence; SCCA concentration: and gingival inflammation. The results indicated that gingival inflammation directly and significantly correlated with SCCA concentrations in the maxillary and mandibular molars, incisors and canines (allr≥0.47; allp≤ 0.015; too few bicuspids were available for complete analysis). The relationship between gingival inflammation and SCCA concentration was best described by a natural log relationship. Gingival inflammation did not, however, correlate positively with either the total number of specific putative periodontal pathogens, or the sum of subsets of these pathogens (−0.31 ≤r≤ 0.39; 0.08 ≤p0.75) for any of the locations. Finally, the SCCA concentration did not correlate with the level of individual or groups of pathogens. These data, together with historical work and other preliminary data, support the hypothesis that SCCA, rather than specific putative periodontal pathogens, may be a causative agent in gingival inflammation. This work may, in part, begin to explain the apparent lack of a direct relationship between current gingival inflammation and the prediction of bacterially mediated periodonta

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00604.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe development of chronic inflammatory periodontal diseases is strongly correlated with the growth and maturation of subgingival bacterial colonies. Consequently a major preventive goal should be the control of plaque formation. We conducted a randomized, controlled trial to examine the short‐term effect of an intensive instructional program without professional prophylaxis on the gingival health of 240. 11‐14 year old school children. Plaque index (P1I), gingival index (GI), bleeding index (BI) and probing pocket depth (PD) were examined 4 × by 1 examiner blinded to the instruction. During the period of instruction, subjects in the experimental groups were involved in a plaque and gingivitis prevention program provided in separate educational sessions. One of the experimental groups (E‐l:n=80) was provided with a new toothbrush, toothpaste and instruction while the second experimental group (E‐2:n=80) was provided with toothbrush, toothpaste, dental floss and instruction. In the control group (C;n=80) only dental examinations were provided: no preventive program or oral health measures were conducted. Examinations were conducted every 3 months during the instructional period and at 6 months following the completion of the active preventive programme. During the experimental period there was a significant decrease (p0.05) reductions of PD. Experimental group 1 showed similar PH. GI. BI and PD scores as experimental group 2 during the study. After the instructional program was completed and a period of 6 months had passed, there was a large and significant (p<0.001) increase of mean P1I. GI and BI scores in both experimental groups back to the baseline levels. We conclude that a short‐term preventative program without professional instrumentation induces a transient improvement of gingival health of schoolchildren but only during the instructional period. The maintenance of improved gingival health over longer time periods requires prolonged, repeated instruction by professionals. These measures may be difficult to institute and are of questionable cost‐

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00605.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe present study used full‐mouth clinical assessments of plaque, calculus, bleeding on probing, probing pocket depth and probing attachment level to evaluate the periodontal conditions in a rural (A) and an urban (B) sample of 25–64 year old Greek adults, comprising 190 and 373 subjects, respectively. 13% of the subjects in sample (A) and 8% in sample (B) were edentulous, while mean values of teeth present in the four age cohorts ranged between 19.8—12.6 and 23.3—18.3. respectively. A poor level of oral hygiene was recorded in both samples with high plaque, calculus and bleeding scores. Deep pocketing was more pronounced in the rural than in the urban sample: between 1.7 and 8.0% of all sites probed showed a PPD of ≥6 mm and between 20 and 51.2% of the subjects in each age cohort had at least one deep pocket. Corresponding figures for the urban sample was 0.6‐4.7% and 15.1‐49.2%. However, the prevalence of severe attachment loss was of comparable magnitude in both samples: between 2.8–25.7% of the sites in sample (A) and 2.8–20.6% in sample (B) displayed a PAL of ≥6 mm, while 32.5‐72.1% and 31.8‐73.8% of the subjects, respectively, had at least one severely affected site. It was further found that the distribution of advanced disease in the samples was skewed; 14.4% of the subjects in sample (A) and 9.5% in sample (B) accounted for 75%, of all deep pockets, while 21.8 and 19.4% of the subjects, respectively, accounted for 75% of all sites with PAL of ≥6 mm. Multiple regression revealed that male sex and high plaque and bleeding scores had a significant, positive influence to the amount of attachmen

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00606.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe Papillon‐Lefèvre syndrome (PLS) is a rare, autosomal recessive trait that is characterized by palmar plantar keratosis (PPK) and severe, early onset periodontitis. affecting both deciduous and permanent dentitions. The clinical presentation of PLS is variable: the disease occurs so infrequently as to limit clinical cases for study. The exception is a few families with extensive consanguinity in which numerous cases occur. Of particular interest to mapping the genetic origin of the syndrome is the co‐expression of the major traits of hyperkeratosis and periodontitis, and their severity. In this paper, we report 2 families with multiple affected individuals from geographically remote areas. A large extended family, from the Cochin region of India, currently residing in Israel, in which there is documented consanguinity and a family from the southwest region of Germany. In each family, 1 individual presents with hyperkeratotic lesions with the complete absence of periodontal lesions. Further, the difference in severity of the hyperkeratotic lesions between families is marked, and one sibling in the German family expressed rapid, early onset periodontitis in the absence of PPK. The genetic nature and penetrance of the genetic defect are discu

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00607.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe aim of this study was to evaluate whether an increased thickness of the gingiva through the use of a free connective tissue graft, in conjunction with a coronally advanced flap procedure, may positively influence the treatment outcome with respect to (i) root coverage and (ii) long‐term stability of the position of the soft tissue margin following treatment of recession type defects. 67 consecutive patients having a total of 103 buccally located recession type defects of at least 3 mm were included in the study. After an initial phase of prophylaxis including instructions in a tooth brushing technique giving minimal apically directed forces to the gingival margin, the recession sites were surgically covered with a coronally advanced flap alone (control sites), or coronally advanced flap combined with a free connective tissue graft taken from the palate (test sites). Clinical examinations, including assessments of oral hygiene, gingival conditions, recession depth, gingival height, probing pocket depth and probing attachment loss, were performed before and 6. 12 and 24 months after surgical treatment. The mean initial recession depth for both treatment groups was about 4.0 mm (SD 1.0) with a gingival height apical to the recession of 1.0 mm (0.5). At the re‐examination performed 6 months after surgical treatment, the mean recession depth had decreased to 0.2 mm in both the test and control groups. Complete root coverage was observed at 72% of the test sites and 74% of the control teeth. At teeth treated with the combined surgical procedure, the mean gain in probing attachment amounted to 3.7 mm and the mean gingival height had increased to 3.5 mm (0.6). The corresponding figures for control teeth were 3.6 mm and 1.5 mm (0.5), respectively. At the 24‐month follow‐up examination, the mean root coverage amounted to 98.9% (test) and 97.1% (control). 88% of the teeth in the test group showed complete root coverage compared to 80% for teeth in the control group. It was concluded that the 2 surgical procedures resulted in similar degree of root coverage and that changes of tooth brushing habits may be of greater importance than increased gingival thickness for long‐term maintenance of the surgically established position of the soft tiss

ISSN:0303-6979    

DOI:10.1111/j.1600-051X.1996.tb00608.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY