摘要:

The prevalence and genotype distributionofActinobacillus actinomycetemcomitansstrains in families where at least one adult family member (proband) suffered from periodontal disease was investigated to better understand how this periodontal organism is acquired or transmitted. Fifteen probands with severe (established) periodontal disease (EPD) and their 46 immediate family members were sampled forA. actinomycetemcomitans. Among the 15 families, 10 contained at least one additional family member colonized with oralA. actinomycetemcomitans. Genomic DNA from 3 subgingivalA. actinomycetemcomitansstrains from each of the 10 probands and their 17 family members were amplified and characterized by the polymerase chain reaction (PCR) using a single arbitrary primer known to distinguishA. actinomycetemcomitansstrains. The PCR products from each strain were separated by electrophoresis on a 1% submarine agarose gel containing ethidium bromide and visualized by UV light transillumination. The amplification products migrated to form readily distinguishable bands and, since the banding patterns were characteristic of strains ofA. actinomycetemcomitans, these patterns were called “amplitypes.” The culture studies showed that 51% of all patients suffering from EPD carried oralA. actinomycetemcomitans. Moreover, 50% of their spouses and 30% of their children harbored the bacterium. Comparison of the PCR‐generated amplitypes showed that 26 out of 27 individuals had strains exhibiting a single amplitype ofA. actinomycetemcomitans, the 27th being colonized by 2 different amplitypes. They also showed that in 6 out of 7 families, the husband and wife did not harbor the sameA. actinomycetemcomitansamplitype. Furthermore, most often children carried an amplitype identical to one of the parents. However, one of the 10 children harbored two amplitypes each of which was identical to the parents. We propose thatA. actinomycetemcomitansis acquired through contact with one of the parents at some time during childhood.J Periodontol 1994;65:2–7.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.1.2

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Although patients with refractory periodontitishave been widely reported, no clear biologic profile of these patients has been noted. The purpose of the present study was to evaluate host responsiveness of a well‐defined group of refractory periodontitis patients by determining the effect of a lipopolysaccharide (LPS) challenge on monocyte surface receptor density and on the release of inflammatory mediators. Venous blood was obtained from 7 refractory periodontitis, 8 stable periodontal maintenance, and 8 gingivitis patients with no evidence of periodontitis. Mononuclear cells were cultured in either control media or media treated withActinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), orSalmonella typhimurium(S. typh) LPS. At 0 and 24 hours supernatants were assayed for prostaglandin‐E2(PGE2) and interleukin‐1β (Il‐1β) release by ELISA. Using flow cytometry the density of specific monocyte surface receptors were assayed with Mo3e and LeuM3 monoclonal antibodies (mAb); T‐cell CD4/CD8 ratios were assayed with OKT‐3, OKT‐4, and OKT‐8 mAb. After 24 hours incubation withPgorS. typhLPS, the upregulation of the Mo3e receptor was significantly decreased for refractory periodontitis patients (P<0.05) when compared to gingivitis and to stable maintenance patients. In refractory periodontitis patients the T‐cell CD4/CD8 ratio was decreased. Upon stimulation withPgorS. typhLPS, monocytes from stable maintenance and refractory periodontitis patients released more Il‐1β (P<0.05) and PGE2(P= 0.13 and 0.15) than monocytes from gingivitis subjects. The current data suggest that, as assessed by the inflammatory mediator release of Il‐1β and PGE2, monocytes from both stable maintenance and refractory periodontitis patients may have the potential for a more vigorous inflammatory response to a given bacterial challenge, when compared to monocytes from individuals without a previous history of periodontitis. However, only refractory periodontitis patients had a decreased CD4/CD8 ratio and decreased Mo3e expression, representing some alteration in the mononuclear cell‐cytokine system, that distinguished them from patients who responded predictably to treatment.J Periodontol 1994;65:8–16.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.1.8

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Healing of extraction socketswhere the buccal plate of bone has been destroyed often results in localized ridge deformities. This is most likely due to the ingrowth of extraskeletal connective tissue into the space originally occupied by the tooth which then fills with a combination of bone and soft tissue. Techniques for managing these defects have been described, but it would be preferable to prevent them from occuring at all. Using the principles of guided tissue regeneration, a surgical technique is described that can be applied to post‐extraction sites that are deficient in alveolar bone thereby preventing localized ridge deformities. Representative cases are presented illustrating the technique.J Periodontol 1994;65:17–24.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.1.17

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The purpose of this studywas to determine the influence of furcation involvement (FI) and mobility (MO) on change in probing periodontal attachment level (AL) on molar teeth. Twenty‐four patients were selected from The University of Michigan longitudinal periodontal clinical trial. The patients who met the entry criteria received a baseline examination and were treated by periodontal scaling and root planing followed by different periodontal surgical approaches in a split‐mouth design. Patients were placed on a 3‐month interval for maintenance prophylaxis and had yearly periodontal scorings for a period of 8 years. The scorings included determination of AL, FI, MO, and tooth loss (TL). Data for molar teeth from three different time periods (at entry (A) and at 1 (B) and 8 (C) years) were analyzed. The results demonstrated that teeth with FI were 2.54 times more likely to be lost when compared to teeth without FI during the maintenance period. By using pairedttest approach to the probing attachment level data, molars with FI had significantly more loss between times B and C but not between A and B or A and C. Teeth with increased MO demonstrated significantly more AL between times A and C and B and C. When the interaction between MO and FI was analyzed, teeth with both FI and MO had significantly more attachment loss during the maintenance period (B to C). No statistically significant difference was found among the three different therapeutic approaches (pocket elimination, curettage, and modified Widman flap) during any of the time periods. From these limited data it was concluded that during periodontal treatment and maintenance, molars with FI had a higher tendency to lose periodontal attachment and be extracted as compared to molars without furcation involvement. The inclusion of MO in the analysis suggests mobile teeth and mobile teeth with FI are at greater risk of AL when compared to teeth without these characteristics.J Periodontol 1994;65:25–29.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.1.25

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Fifty chronic adult periodontitis patientscompleted a 6‐week controlled, doubleblind, split mouth clinical study to determine the effects of subgingival irrigation with an antimicrobial mouthrinse on periodontal microflora, supragingival plaque, and gingivitis when used as an adjunct to normal oral hygiene. Qualifying subjects had at least four sites, two on each side of the mouth, with probing depths between 4 and 6 mm, which bled on gentle probing. Following baseline examinations, subjects received a half mouth scaling and prophylaxis and full mouth subgingival irrigation with either the antimicrobial mouthrinse or sterile colored water control professionally delivered. Subjects continued irrigation at home once daily for 42 days with their assigned rinse delivered via a subgingival delivery system. All sites in the mouth were scored at baseline and at day 42 for supragingival plaque, bleeding on probing, and redness. For the four selected periodontitis sites, probing depth and attachment level were measured at baseline and on day 42; additionally, supragingival plaque and gingival redness were scored on days 7 and 21. Subgingival plaque samples for microbiological analysis were harvested from the selected periodontal sites at baseline and on days 7, 21, and 42. Microbiologically, irrigation with the antimicrobial mouthrinse resulted in statistically significant reductions compared to control in putative periodontopathogens, including black pigmenting species, which persisted at 42 days. Clinically, subgingival irrigation with the antimicrobial mouthrinse produced a significant reduction in supragingival plaque (P0.05); this finding was not surprising in view of the small number of periodontitis sites and relatively short study duration. The findings indicate that subgingival delivery of the antimicrobial mouthrinse by means of an oral irrigation device can play a potential role in the management of chronic periodontitis by virtue of its significant effects on the subgingival periodontopathic microflora and supragingival plaque and gingivitis.J Periodontol 1994;65:30–36.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.1.30

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Associations between oral malodor, measures of periodontal disease, and trypsinlike activity of periodontal pathogens on tongue and teeth were examined in 127 subjects. Volatile sulphur compound (VSC) measurements were made with a portable sulphide monitor; oral malodor was also estimated by organoleptic methods. Measurements repeated one week apart indicated that steady‐state VSC levels (r = 0.72;P= 0.0001) and peak VSC levels (r = 0.63;P= 0.0001) were reproducible but these r values were not significantly different (P>0.1). There was a significant correlation between tongue odor and peak VSC levels (r = 0.40;P= 0.0001) and between tongue odor and whole mouth organoleptic measures (r = 0.55;P= 0.0001). To study the effect of reducing microbial colonization on oral malodor, chlorhexidine gluconate (0.2%) rinsing was prescribed for 7 days. Reductions of VSC levels were significant for both peak (37%) and steady‐state (41%) data (P= 0.0001). Anaerobic periodontal pathogens on the tongue estimated by the proportions of positive BANA tests were reduced 19% (P= 0.001) and this was concomitant with a 40% (P= 0.0001) decrease in organoleptic measurement of the tongue dorsum. Mean pH measurements of the tongue dorsum showed large reductions from 6.9 initially to 6.3 post‐treatment (P= 0.0001). Subjects were divided into periodontitis/no periodontitis based on periodontal inflammation and probing depth (≥5 mm). Of the 37 subjects with periodontitis, 23 had oral malodor whereas 52 out of 90 periodontally healthy subjects exhibited malodor. Chi square analysis comparing halitosis in subjects with and without periodontitis showed no statistically significant association (X2= 0.208;P0.65) between these two factors although the intensity of malodor as based on VSC concentration in periodontally healthy subjects was 19% less (mean = 111 ppb) than in subjects with periodontitis (mean = 136 ppb). The odds ratio was 1.2, indicating that oral malodor was not associated with periodontitis. These data indicate that a large proportion of individuals with oral malodor are periodontally healthy and that the mucosal surface of the tongue is a major site of oral malodor production.J Periodontol 1994;65:37–46.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.1.37

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Porphyromonas gingivalisin subgingival plaqueis an important risk factor for future periodontal attachment loss in susceptible adults. The elimination ofP. gingivalisis usually concomitant with a healing process. Therefore, it should be valuable to have an easy chairside method to follow the effect of periodontal treatment onP. gingivalisdetection as well as on its eventual reappearance during the maintenance period. We have previously reported the stimulation of amidolytic activity ofP. gingivalisby the addition of glycyl‐glycine to the assay buffer. In this study we determined the proportions ofP. gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Capnocytophagaspp,Camphylobacter rectus, andEikenella corrodensby cultivation technique and the amidolytic activity, using N‐benzoyl‐L‐argininep‐nitroanilide (BAPNA) as substrate, in gingival exudate before and during a 3‐year treatment and maintenance period.P. gingivaliswas the only species yielding a high and persistent correlation to stimulated amidolytic activity (Pvalues ≤0.0001) on both site (r = 0.5) and subject (r = 0.8) level. Testing pure cultures of suggested periodontal pathogens for effect of glycyl‐glycine on amidolytic activity, we found that ofP. gingivalisto be 5.9‐fold increased. The amidolytic activity ofTreponema denticolawas only slightly stimulated (ratio with/without glycyl‐glycine = 1.2) and that ofCapnocytophagaslightly inhibited (ratio with/without glycyl‐glycine = 0.8). The outcome of this study has the potential to be used for the development of a simple, rapid, and inexpensive assay for a qualitative and quantitative determination ofP. gingivalisin gingival crevicular fluid.J Periodontol 1994;65:47–55.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.1.47

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

The occurrence and surface propertiesofPrevotella intermediaandP. nigrescensin healthy sites and in periodontic and endodontic infections were studied among 73 strains, tentatively identified asP. intermedia. Fifteen strains were from necrotic root canal infections, 41 were from periodontal samples, and 17 isolates were obtained from healthy gingival sites. Identification of isolates as eitherP. intermediaorP. nigrescenswas based on differences in malate and glutamate dehydrogenase electrophoretic mobilities which allowed unambiguous separation ofP. intermediaandP. nigrescens. The majority of strains from periodontal samples wereP. intermedia(29 of 41 strains). In endodontic samples only 4 out of 15 isolates wereP. intermedia, while all except 1 of 17 strains from healthy gingival sites were identified asP. nigrescens. SDS‐PAGE of whole cell proteins revealed 31 and 38 kDa proteins inP. nigrescenswhich were not detected inP. intermedia. Surface biotinylation of cells, followed by Western blotting and detection by alkaline phosphatase conjugated extravidin, showed strong staining of the 31 kDa protein inP. nigrescensindicating that this protein is located on the surface of the cell. Corresponding staining was not seen inP. intermedia. Fimbria‐like projections were observed using electron microscopy of negatively‐stained cells ofP. nigrescens. The results show thatP. intermediaandP. nigrescensmay have different site specificities and surface properties and thus emphasize the need for accurate identification of these two species for the evaluation of their role in the pathogenesis of oral infections.J Periodontol 1994;65:56–61.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.1.56

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Radiographic frames used for longitudinal studiesmay be in part unreadable for measuring crestal bone change. Sites may not be present on the film, or the measurement reliability may be compromised because of dissimilar geometry. Several techniques used to address this problem are expensive, time‐consuming, and require great skill. For the present study a commercially‐available alignment system was simply modified by addition of a reference pin in the bite block, facilitating the repositioning of the film holder for a second exposure. This study determined the ability of the modified instrument to: 1) improve the geometrical correspondence between serial radiographs; and 2) reduce the frequency of missed sites in the film. Two pairs of x‐rays were taken for each of 40 subjects, 1 pair with the standard alignment instrument of an assigned site and 1 pair with the modified instrument of the contralateral site. Measurements of alveolar bone height were performed using the “side by side” technique. The modified instrument yielded significantly smaller measurement differences and a significantly better geometrical correpondence than the conventional system (P<0.05). Also, the modified instrument yielded significantly greater (P<0.01) readable sites (86%) as compared to the conventional instrument (62%). The simply‐modified instrument facilitates the correct interpretation of serial radiographs.J Periodontol 1994;65:62–67.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.1.62

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Across‐sectional periodontal studyof 74 subjects aged 65 to 75 years was performed. Clinical data were collected and related to microbiological and immunological data. A statistical model (step‐wise multiple regression) of factors related to bone loss was created initially using clinical data only; then by adding either the microbiologic or immunologic data; and then by using clinical, microbiologic, and immunologic data together. When only clinical data were considered, three factors were found to have significant positive correlations with bone loss. Tooth mobility accounted for 17% of the variability in the alveolar bone level measurements, probing depth for 12%(r2), and plaque index for 3%, for a total of 32% of the variability explained by these clinical factors. Tooth mobility and probing depth were clinical factors which remained significant in the model when the microbiological data were also considered. As percentages of the total cultivable microbiota,E. corrodens(r2= 14%) and black‐pigmentingPrevotella intermedia(r2= 4%) correlated positively with alveolar bone loss. The addition of the microbiologic data only increased the r2to 33%. When immunological data were considered with the clinical data, pocket depth and tooth mobility were the clinical parameters which remained in the model. IgG antibody levels toP. gingivalisW83 and/or 381 (r2= 24%)A actinomycetemcomitans627 (r2= 2%) were the significant immunologic measures having a positive correlation with bone loss. Anti‐F. nucleatumlevels had a significant negative correlation. A total of 50% of the variability in alveolar bone level was accounted for in the model by the addition of specific serum antibody levels to subgingival plaque microorganisms. When clinical, microbiological, and immunological measurements were all considered together, antibody toP. gingivalisW83 and/or 381 (r2= 42%), percentage of B‐lymphocytes (r2= 3%), probing depth (r2= 4%), anti‐E. corrodenslevels (r2= 2%), and anti‐P. gingivalis33277 levels (r2= 4%) all had significant positive correlation with loss of alveolar bone. The number of enteric bacteria, anti‐F. nucleatumlevels, and anti‐P. intermedialevels each had a significant negative correlation with alveolar bone heights. The r2for this model was 75%. These results indicated that antibody levels to subgingival plaque microorganisms and tooth mobility were the best predictors of bone loss in the elderly patients tested in this study.J Periodontol 1994;65:68–78.

ISSN:1049-8885    

DOI:10.1902/jop.1994.65.1.68

出版商:Wiley    

年代:1994

数据来源: WILEY