摘要:

One endpoint of periodontal therapyis to regenerate structure lost to periodontal disease. Periodontal regeneration requires both formation of a new connective tissue attachment to the tooth and formation of alveolar bone. Several procedural advances may support regeneration of the attachment, however, regeneration of alveolar bone does not occur consistently. Therefore, factors which stimulate bone repair are areas for research in periodontal reconstructive therapy. Effects of cytokines or growth factors on bone repair are examples of such areas. Another one is electrical stimulation which naturally occurs in bone, and as‐such bone may be particularly susceptible to electrical therapy. This overview describes the potential of electrical stimulation for bone regeneration and applications in alveolar and periodontal research.J Periodontol 1995;66:2–6.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.1.2

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Mild oxygenating agents generatinglow concentrations of hydrogen peroxide (H2O2) are effective alternatives to heat‐activated 30% H2O2in bleaching discolored, vital teeth. There are concerns about possible pathological effects of long‐term exposure to bleaching agents, and irritation and ulceration of the gingiva and other oral soft tissues can occur. The objective of this study was to determine the effect of one of these agents on gingival fibroblasts in vitro. Microscopic examination revealed that concentrations of 0.05% to 0.025% of the agent appeared to kill most of the cells. At concentrations of 0.025% to 0.017% some morphological changes were noted; the cells appeared normal at concentrations of ≤0.0125%. The agent significantly (P≤0.002) decreased proliferation (measured by incorporation of [3H]‐thymidine into cellular DNA) at concentrations as low as 0.006%. The agent also had a dose‐dependent effect on fibronectin production, measured by ELISA, causing significant (P≤0.03) decreases at concentrations as low as 0.017%. The agent significantly decreased the production of types I (P≤0.01) and III (P≤0.04) collagens (measured by ELISA) at concentrations as low as 0.0125%. Type V collagen was not detected under any conditions. Catalase, which catalizes the breakdown of H2O2, abolished toxic effects of a 0.05% solution. The results show that in vitro, the agent is toxic to human gingival fibroblasts, inhibiting several cellular functions. Taken together, the findings of the study suggest that while the agent is toxic to gingival fibroblasts in vitro, enzymes in the oral environment which destroy H2O2may protect oral tissues and their component cells in vivo from the potential toxic effects of the agent.J Periodontol 1995; 66:7–13.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.1.7

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Twenty‐four(24)deep wide buccal gingivalrecessions were treated with ePTFE membrane according to guided tissue regeneration principles (GTR). Factors affecting the surgical outcome of the regenerative procedure were retrospectively analyzed. In 16 cases, the barrier membrane was used in conjunction with tetracycline root conditioning and fibrin‐fibronectin system application, and 8 cases were treated with the membrane alone. Healing response was evaluated 12 months after surgery. Since no difference was observed between the two treatment protocols, all available data were grouped. Mean recession depth was reduced from 4.6 mm to 1.3 mm postoperatively, which represents an average root coverage of 71.7%. Fifty percent (50%) of the cases showed clinical attachment gain greater than or equal to 4 mm and a mean increase of keratinized tissue of 1.0 mm was observed. Baseline recession depth and extent of membrane exposure at the reentry procedure significantly influenced the amount of newly‐formed tissue under the membrane. Recession reduction positively correlated with the preoperative recession depth and the regenerated tissue gain. Treatment was also affected by tooth location, recession reduction, and attachment gain, being significantly greater in upper than lower archs. Results suggest that GTR technique represents a predictable procedure to improve the soft tissue conditions of deep mucogingival defects. Randomized controlled trials of other forms of management of mucogingival defects as compared to the GTR technique will be necessary to fully evaluate the utility of the GTR technique.J Periodontol 1995; 66:14–22.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.1.14

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

This study examined the risk indicatorsfor alveolar bone loss associated with periodontal infection. A cross‐section of 1,361 subjects aged 25 to 74 years, from Erie County, NY were evaluated for interproximal alveolar bone loss and potential explanatory variables including age, gender, history of systemic diseases, smoking, and presence of 8 subgingival bacteria. Interproximal alveolar bone loss was measured from the alveolar crest to the CEJ and a mean computed for each subject. The mean bone loss per subject (BL) ranged from 0.4 to 8.8 mm, and this outcome variable was grouped into 4 ordered categories. The degree of association between the explanatory variables and BL was examined utilizing an ordinal stepwise logistic regression model. Factors which were positively associated with more severe bone loss included subgingival colonization withB. forsythus(O.R. 2.52; 95% CI: 1.98 to 3.17) orP. gingivalis(O.R. 1.73; 95% CI: 1.27 to 2.37), race (Native American, Asian, or Pacific Islanders) with an O.R. 2.40 (95% CI: 1.21 to 4.79), and gender with males having higher odds than females. Smokers had greater odds for more severe bone loss compared to non‐smokers ranging from 3.25 (95% CI: 2.33 to 4.54) to 7.28 (95% CI: 5.09 to 10.31) for light and heavy smokers, respectively. Individuals at older ages also showed more severe levels of bone loss. History of kidney disease (O.R. 0.55; 95% CI: 0.35 to 0.89) and history of allergies (O.R. 0.76; 95% CI: 0.59 to 0.98) were inversely associated with severity of bone loss. Severity of alveolar bone loss is associated with increasing age, smoking, race, and colonization with subgingivalB. forsythusorP. gingivalis. This and other studies directed to identifying true risk factors associated with periodontal disease may lead to preventive measures directed to reducing the deleterious effects of modifiable risk factors.J Periodonol 1995;66:23–29.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.1.23

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Periodontal status was evaluatedin two cohorts participating in a study of the natural history of human immunodeficiency virus (HIV) infection. One cohort consisted of 77 seropositive and 44 seronegative homosexual men, and the other cohort was comprised of 44 seropositive and 39 seronegative parenteral drug users (PDU). No differences were observed between seropositive and seronegative individuals within a cohort in terms of clinical periodontal” parameters (percent of sites with ≥4 mm probing depth, percent of sites exhibiting bleeding on probing, mean oral hygiene index). The PDU displayed more existing periodontal disease than the homosexual men. Periodontal disease in the seropositive individuals in both cohorts was not strictly related to the number of CD4+ lymphocytes. Linear gingival erythema (LGE), defined as an erythematous band of at least 2 mm extending between adjacent papilla, was observed in all 4 groups. Seropositive homosexual men displayed more LGE than seronegative homosexual men (16.6% vs. 11.4%) and seronegative PDU displayed more LGE than seropositive PDU (38.5% vs. 29.5%), but neither difference was significant. LGE tended to be related to reduced numbers of CD4+ lymphocytes, but this relationship did not reach statistical significance. A statistically‐significant relationship was found between the presence of intraoral candidiasis and LGE in seropositive homosexual men: 42.9% of these subjects with candidiasis had LGE, while only 12.7% of the subjects without candidiasis had LGE (P<.05). For the seropositive PDU, 35.3% of the individuals with candidiasis had LGE and 25.9% of the subjects without candidiasis displayed LGE, but the difference was not statistically significant. Analysis of clinical parameters suggested that the very poor oral hygiene in the seropositive PDU may have obscured the candidiasis‐LGE relationship. Lastly, the incidence of necrotizing ulcerative gingivitis (NUG) and necrotizing ulcerative periodontitis (NUP) was low. For homosexual men 5.2% of seropositive individuals and none of the seronegative individuals displayed NUG. For the PDU, none of the seropositive individuals but 5.1% of the seronegative individuals displayed NUG. NUP was not detected in either cohort. These data indicate that there are differences in non‐HIV associated periodontal disease between homosexual men and PDU, regardless of serostatus. In addition, we observed an association between the presence of intraoral candidiasis and LGE in seropositive homosexual men. Lastly, the prevalence of necrotic gingival/periodontal lesions in seropositive individuals was low.J Periodontol 1995;66:30‐37.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.1.30

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Atotal of1,128sitesin 15 periodontal maintenance patients were examined twice, 7 to 10 days apart, to evaluate reproducibility of periodontal probing by a conventional manual and an automated force‐controlled electronic probe. Probing depths (PD) and relative attachment levels (AL) were recorded to the nearest 0.5 mm with both instruments. At each visit, all sites were probed first with the conventional and then with the electronic probe. Reproducibility of PD at shallow sites (PD ≤3 mm) by the manual probe was 59.1% for exact agreement and 98.6% within ± 1.0 mm variation. For the electronic probe, corresponding values were 41.3% and 91.5%, respectively. Reproducibility of PD measurements at deeper sites (PD>3 mm), was 33.0% for exact match and 96.4% within ± 1.0 mm for the manual and, correspondingly, 31.7% and 85.9% for the electronic probe. Reproducibility of AL followed a similar pattern, but was consistently lower than for PD. Reproducibility was consistently higher for anterior than for posterior sites and, for some comparisons, higher in the maxilla than in the mandible. These differences were smaller for the manual than for the electronic probe. Time required to complete the probing was longer for the conventional probe than for the electronic instrument. Under the prevailing study conditions, the automated force‐controlled electronic probe failed to offer significant advantages over the conventional manual probe.J Periodontol 1995;66:38–46.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.1.38

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Twenty‐six(26)patients, 18female and7male, aged 16 to 25 years (mean age 19.03 ±2.2 years) previously diagnosed as suffering from localized juvenile periodontitis were randomly assigned to one of the following treatment groups: 9 patients acted as controls; 8 received subgingival chlorexidine gel; and 9 had subgingival tetracycline paste application. All treatment modalities resulted in a pronounced improvement in PI, GI, and GI‐S by 12 weeks (P<0.001). The mean probing depths also decreased, but there were no significant‐differences found between the three groups. However, when the interproximal sites of the 3 groups were examined separately from the buccal and lingual sites, it was found that there was a significant (P<0.05) difference between the probing depths, with the control group showing the greatest reduction of 2.58 mm and the Chlorhexidine group showing the least reduction of 1.37 mm. It was concluded that a single application of topical subgingival tetracycline did not result in any short‐term improvement over that achieved by standard non‐surgical therapy in the clinical parameters of these localized juvenile periodontitis patients.J Periodontol 1995;66:47–51.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.1.47

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The purpose of this studywas to evaluate the feasibility and reliability of using a home screening occult blood test to detect the presence of gingival inflammation. Fifty (50) healthy male and female subjects participated in this study. Pre‐ and post‐stimulation saliva samples were obtained and tested for occult blood. Subjects brushed for one minute to stimulate gingival bleeding associated with inflammation. Saliva samples were obtained and tested for occult blood using a commercial screening kit. Following the screening test, a bleeding index (BOP) was determined and used as an indicator of gingival inflammation. Those with a BOP>50% were assigned to the high group. Those with a BOP of 31 to 50% were assigned to the middle group, and those with a BOP of ≤30% were assigned to the low group. Twelve subjects in the high group, 10 subjects in the mid group, and 2 subjects in the low group tested positive for occult blood following stimulation. A chi‐square analysis showed an association between the screening test for occult blood and the groups (P= 0.0001). The test sensitivity was 75.9% and the specificity was 90.5%.J Periodontol 1995; 66:52–54.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.1.52

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

In order to simultaneously assessthe local humoral immune and polymorphonuclear leukocyte (PMN) responses in periodontal disease, IgG, IgM, and IgA, as well as the PMN lysosomal enzyme β‐glucuronidase (βG), were examined in gingival crevicular fluid (GCF) from patients with varying degrees of periodontal pathology. Evaluations were made before and after conservative therapy (scaling and root planing). Thirty patients with varying degrees of periodontal pathology, ranging from mild inflammatory gingivitis to moderate periodontitis, were studied. GCF was collected from the mesial surfaces of all teeth. The presence of the 3 Immunoglobulin isotypes was determined by enzyme linked immunosorbent assays (ELISA), while total βG activity in GCF was determined by a fluorometric assay. Clinical parameters were obtained from 6 sites per tooth. Our data indicate that prior to treatment, total βG activity is strongly related to the severity of periodontal disease as measured by mean probing attachment level (AL; r = 0.89;P<.005), mean probing depth (PD; r = 0.89;P<.0005) and percentage of sites exhibiting bleeding on probing (% BOP; r = 0.49;P<.005). Following treatment, no statistically significant relationship of disease severity and βG is found. The concentrations of IgG and IgM in GCF do not follow a specific pattern when related to disease severity. In contrast, prior to treatment the concentration of IgA is negatively correlated to mean AL (r = ‐0.54;P<.005), mean PD (r = ‐0.59;P<.005), and % BOP (r = ‐0.47,P<.005). Following treatment, the negative correlation of IgA concentration to the clinical parameters is not as strong as seen before treatment, but still reaches significance for AL and PD. We also examined individual sites within patients who were categorized as displaying either gingivitis or periodontitis. We compared sites of comparable probing depth (1 to 3 mm or 4 to 6 mm) in the two groups of patients. With these analyses, the inverse relationship of the concentration of IgA in GCF and clinical measures of periodontal disease is still observed, suggesting that this finding was independent of probing depth of the individual site, and is a characteristic of the patient. In summary, the increased concentration of IgA in GCF from patients with minimal periodontal pathology suggests that IgA may play a protective role in the crevicular environment. Furthermore, this investigation supports the concept that a biochemical profile of GCF can be used to investigate the nature of the host response in periodontal disease.J Periodontol 1995; 66:55–61.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.1.55

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

An automatic scaling apparatusthat simulated the scaling process of hand instrumentation was developed to quantitatively analyze the cutting quality and abrasive resistance of sealers. We first tested 4 synthetic resins as the abraded material. Of the 4 synthetic resins tested, polycarbonate resin proved most similar to dentin. The effects of lateral scaling forces (700, 500, and 300 dyne) and sealer angles (70° to 95°) on the cutting quality and abrasive resistance of sealers were evaluated quantitatively by the amount of the abraded material worn away in 1,000 strokes. Comparison of the 3 scaling forces showed a greater amount of abrasion at higher force than that at lower force. This suggests that the decrease in the amount due to abrasion could be compensated by increasing the lateral scaling force. Regarding the sealer angle, results indicated that the amount of material removed increased with an increase of the sealer angle up to 70°, but then rapidly decreased at an angle of 90° or more. The most effective scaling angle was 87°, and this was not affected by scaling force. These results suggest that a greater amount of removal could be obtained at a scaling angle of 87° and a scaling force of 700 dyne. The present findings suggested the automatic scaling apparatus could be a useful tool for quantitatively evaluating the cutting quality and abrasive resistance of sealers.J Periodontol 1995; 66:62–68.

ISSN:1049-8885    

DOI:10.1902/jop.1995.66.1.62

出版商:Wiley    

年代:1995

数据来源: WILEY