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Biomedical subjects

E E Machtei

Publications and source records attributed to E E Machtei.

At least 55 records · Page 3Linked to original sources
PubMed1994

Lack of evidence for hypophosphatasia as a factor in the pathogenesis of early-onset periodontitis.

Hypophosphatasia, an inheritable metabolic disorder affecting calcification, has been shown to have various oral manifestations. Recently, it was suggested that it may serve as a predisposing factor in the pathogenesis of early-onset periodontitis. The present study was designed to examine the frequency of hypophosphatasia among patients with juvenile periodontitis and rapidly progressive periodontitis. Eighteen patients, nine females and nine males (age 19-37 years, mean 23.2 years), were included in this study. Venous blood and urinary samples were collected and assayed for alkaline phosphatase and urinary phosphoethanolamine. Mean alkaline phosphatase levels (109 +/- 35 IU/L) were within the normal limits for all patients except one who exhibited slightly lower than normal values. Urinary phosphoethanolamine, a typical marker of hypophosphatasia, was absent from all specimens, which rules out the possible diagnosis of such disorder in these patients. Until more information is available, the role of hypophosphatasia as a predisposing factor in early-onset periodontitis is yet to be established.

Adult↗
PubMed1993

Alternative methods for screening periodontal disease in adults.

Clinical measurements of periodontal attachment loss, while not always representing the histological changes, are used to establish the diagnosis of adult periodontitis. Such measurements are difficult to perform accurately and are labor intensive. To counter these problems, index teeth and index sites have been employed in an attempt to estimate the severity of the periodontal condition without the need to resort to elaborate attachment measurements. Unfortunately, such indices usually tend to underestimate prevalence while often overestimating severity. The purpose of the present study was to examine the correlation of alternative clinical, radiographic and microbiological parameters, with periodontal disease using the diagnostic criteria of established periodontitis. 508 adults included in this study received thorough periodontal examination which included probing pocket depth, clinical attachment level, plaque, gingival and calculus scores, together with radiographic analysis and assays of subgingival periopathogenic microorganisms. Radiographic alveolar bone loss and probing pocket depth had the highest correlation with clinical attachment loss (phi = 0.72 and phi = 0.75 respectively). Plaque scores (phi = 0.17), like gingival scores (phi = 0.06) and calculus scores (phi = 0.42) had poor correlation with established periodontitis. Periodontopathogenic species demonstrated high specificity and negative predictive values; but low sensitivity and positive predictive values make for an overall low correlation of these species with established periodontitis. However, when used in a logistic regression model, the presence of P. gingivalis (odds ratio = 6.25) has shown to contribute significantly to the estimate of probability for established periodontitis. The use of these various alternative parameters for screening of periodontal disease is discussed in light of their sensitivity, specificity and predictive value.

Adult↗
PubMed1993

Periodontal status of women taking postmenopausal estrogen supplementation.

The association between supplementary estrogen intake and periodontal and gingival status in a total of 228 women 50 to 64 years of age was examined. Clinical parameters including visible supragingival plaque, subgingival calculus, probing pocket depth, clinical attachment level, alveolar bone height measurements, and number of remaining teeth were measured. Gingival status was recorded as gingival bleeding after gentle manipulation. Selected periopathogens, socio-economic, demographic, smoking habits, and health care variables were assessed. Gingival bleeding was significantly lower in the estrogen supplement group (n = 57) compared to the control group (n = 171) (P = 0.009); the estrogen group also exhibited significantly lower visible plaque levels (P = 0.030) and fewer Capnocytophaga-ssp. (P = 0.032). Dental care was more frequent (P < 0.001), and education levels were higher (P = 0.022) in the estrogen group. To investigate whether differences among the above parameters contributed to the difference in gingival bleeding, an age-adjusted analysis of covariance (ANCOVA) was used. The final ANCOVA indicated non-significant relationships for all parameters examined except estrogen intake (P = 0.044). Women taking estrogen exhibited lower gingival bleeding than the control group after correcting for these factors. The results indicate that estrogen supplementation is associated with less gingival bleeding in women aged 50 to 64, as compared to an age-matched control group.

Aged↗
PubMed1993

Guided tissue regeneration and anti-infective therapy in the treatment of class II furcation defects.

The purpose of the present study was to evaluate the effect of anti-infective therapy on the success of periodontal regeneration in mandibular Class II furcation defects. Eighteen patients with mandibular bilateral Class II furcation defects were enrolled. Following an initial hygienic phase, guided tissue regeneration (GTR) was performed using an expanded polytetrafluoroethylene (e-PTFE) membrane barrier. The area was surgically exposed, thoroughly root planed, and irrigated with either tetracycline (100 mg/ml) or 0.9% saline. Post-operative care included systemic tetracycline (250 mg q.i.d.) and chlorhexidine 0.12% mouthwash twice daily. Patients were maintained on a prophylaxis schedule of every 2 weeks for the first 3 months, and monthly thereafter. Clinical parameters of probing depth (PD), probing attachment level - vertical (PAL-v), probing attachment level - horizontal (PAL-h), and target periodontal pathogens were monitored at baseline and quarterly for one year. An overall improvement in all clinical parameters was observed in both groups: probing reduction (3.1 mm), PAL-h gain (2.3 mm), and PAL-v gain (1.2 mm) were all statistically significant compared to baseline measurements. Vertical measurements were performed parallel to the long axis of the tooth with no attempt to angulate the probe into the furcation. There was no significant difference in sites receiving tetracycline. A strong positive correlation was noted between initial PD and pocket reduction (r = 0.77, P < 0.0001) and between initial PD and PAL-h gain (r = 0.54) and PAL-v gain (r = 0.45) suggesting that initial probing depth might be used to assess the regenerative potential of a given site.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

The rate of periodontal attachment loss in subjects with established periodontitis.

A stepwise approach to determine attachment level changes was utilized to assess the nature of progression of periodontal disease. Following initial screening, 51 subjects with established periodontitis were monitored quarterly for 9 more months. Probing depth (PD) and relative attachment level (RAL) were recorded using an automated, pressure sensitive probe system. To establish intra-examiner error, repeated measurements were performed for all sites at the final visit. An overall standard deviation (SD) for RAL repeated measurements was initially calculated (0.76 mm) using all 6,935 double measurements. Sites were sorted by factors which contribute to the error of attachment level measurements; i.e., pocket depth (shallow, moderate, deep), tooth type (molar, non-molar) and location (buccal, lingual). Data were sorted by the above 12 groups, and SD for repeated measurements was calculated separately for them. The ratio between these SD and the overall SD served as the corrective factor. Each patient's initial threshold (2 SD) was multiplied by these corrective factors thus resulting in 12 thresholds for each subject. Next, linear, exponential and logarithmic regression models were tested for each site, and the regression model showing the highest R value was chosen for that site. AL changes were tested against the patient's threshold for that site. Sites with attachment loss exceeding the threshold were deemed active. Five hundred eighty-one sites (8.3%) exhibited attachment loss exceeding the various thresholds. Of these, linear progression occurred in 195, logarithmic in 224, and exponential in 162 sites. Individual patient's attachment loss ranged from 0.6 to 19.4% of all sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Changes in periodontal status of children and young adolescents: a one year longitudinal study.

The purpose of the present study was to describe longitudinal changes in accumulation of dental plaque and gingival inflammation, and their effect on changes in sulcus depth of children and young adolescents. Forty one boys and 37 girls aged 1-12 years living in a rural community in Israel were included in the study. At baseline and 12 months later, Loe's Plaque Index (PlI) and Gingival Index (GI), and sulcus depth were examined. Boys' mean age was significantly lower than girls' mean age (6.04 + 2.76 years, and 7.68 + 2.84 years respectively). PlI, GI and sulcus depth were higher in the 12-month examination compared to baseline. PlI was slightly higher in boys, while GI was slightly higher in girls. These differences however, were not statistically significant. At baseline, sulcus depth was significantly greater in girls than in boys, while at 12 months the difference was not significant. The children were grouped by age as follows: 1-5 years, 6-9 years and 10-12 years. PlI and GI mean scores were significantly higher among the 6-9-year-old individuals. Mean sulcus depth for the 10-12-year-old children was greater than that of the 6-9-year-olds at baseline and after 12 months. The effect of age, PlI and GI on the outcome variable (sulcus depth) was examined using a correlation matrix. At baseline, age showed the highest correlation (r = 0.659) followed by GI (r = 0.364) and PlI (r = 0.123). The same pattern was also observed at the 12 months examination.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Distribution↗
PubMed1992

Dental plaque and calculus: risk indicators for their formation.

The aim of this study was to determine the levels of plaque and subgingival calculus accumulation and to evaluate their correlations with periodontal disease, as well as to evaluate the correlations with race, age, and gender in an attempt to identify risk indicators for plaque and calculus formation. A total of 508 adults 25-73 years of age was examined, and plaque assessment, gingival bleeding assessment, probing pocket depth, and attachment levels were determined. The mean percent visible plaque was 73.5% (range, 8.3-100%), mean percent of bleeding surfaces 38.5% (range, 0-100%), and the mean percent teeth with subgingival calculus 39.6% (range, 0-100%). The mean probing pocket depth in the group was 2.5 +/- 0.6 mm (SD), and mean clinical attachment loss was 2.1 +/- 1.1 mm. The majority (63%) were classified as having "Moderate" periodontal disease, 7% were "Healthy", and the remaining 30% had "Established" periodontal disease. Plaque and calculus showed statistically significant relationships to the three disease categories (p less than 0.001). Multiple step-wise regression analyses on the correlations between plaque and periodontal disease, race, age, and gender resulted in an overall correlation coefficient of r = 0.25 (p less than 0.001). Disease status ("Established") contributed most (p = 0.003), followed by race (Blacks; p = 0.015), gender (Males; p = 0.022), and age (55-73 yr; p = 0.022), to the correlation with plaque. For subgingival calculus, the overall correlation coefficient was r = 0.44 (p less than 0.001). However, only two of the variables--namely, disease status (p less than 0.001) followed by race (p = 0.017)--showed statistically significant correlations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Clinical criteria for the definition of "established periodontitis".

The objective of The Present study was to define criteria for the diagnosis of "established periodontitis." This term will define subjects who have demonstrated clinical attachment loss, and as such can be considered to have periodontitis. Using these criteria, healthy and established periodontitis subjects were compared with respect to gender, race, and age. Five hundred and eight subjects including 248 females and 260 males between the ages of 25 to 73 (mean 44.6 years), were examined in this study. The clinical examination included: plaque assessment index (PAI); gingival assessment index (GAI); probing pocket depth (PPD); and clinical attachment level (CAL). The mean and frequency distribution of these parameters were analyzed by age and gender. CAL (mean 2.12 mm) showed constant and significant increases with age, ranging from a mean of 1.63 mm in subjects 25 to 34 years of age to a mean of 2.65 mm in subjects 65 to 74 years of age. Males exhibited higher mean values than females for all the measured parameters, which were statistically significant for PAI, PPD, and CAL. The frequency distribution of subjects with PPD and CAL beyond certain threshold levels showed an exponential decline and was correlated to both the severity of the most involved site as well as the number of sites beyond threshold levels. The clinical entity of "established periodontitis" is suggested based on the presence of CAL greater than or equal to 6 mm in 2 or more teeth and one or more sites with PPD greater than or equal to 5 mm. In the present study, 30.5% of the subjects fell into this category.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Sounding depth measurements: a method for evaluating various surgical techniques.

Fourteen patients undergoing periodontal treatment for moderate to severe adult-type periodontitis were included in the study. Seven patients (a total of 210 sites) were treated with modified Widman flap surgery while the other 7 patients (the same number of sites) were treated with apically-positioned flap surgery. The 2 modalities were compared using sounding depth measurements before and immediately after surgery. The mean sounding depth decreased from 4.89 mm to 3.42 mm in the modified Widman flap group, compared to a drop from 4.77 mm to 2.46 mm in the apically-positioned flap group. Neither of these procedures resulted in the total eradication of all periodontal pockets. The final outcome of modified Widman flap surgery may, at times, result in zero sounding depth (placement of the flap at the crest of the bone); on the other hand, very often the flap was placed far supra-crestally in an intended apically-positioned flap procedure. This lack of consistency between intended and actual flap placement would suggest that studies which try to compare different treatment modalities using a flap approach should include sounding depth measurements immediately post-surgery. This is needed to assure that the intended procedure has actually been carried out.

Alveolar Process↗
PubMed1991

Advanced periodontal disease and development of anterior open bite. A case report.

Severe anterior open bite in adults is often both functionally and esthetically unacceptable. The treatment usually consists of a combined orthodontic and surgical correction. The stability of open bite treatment results is often poor. The case presented is of marked anterior open bite in a previously normal bite patient with advanced periodontal disease. An etiology for the development of this condition is suggested and a successful treatment described.

Aged↗
PubMed1991

Multiple therapy approach to juvenile periodontitis: a case report.

Various therapeutic techniques for the treatment of juvenile periodontitis are reported in the literature, with occasional contradictory results. One of the reasons for the contradictory results may be differences in patient selection and/or response to treatment. The following report describes the results of various treatment modalities, in different sites in the same individual, on localized juvenile periodontitis.

Adult↗
PubMed1990

Anterior open bite and gingival recession in children and adolescents.

Gingival recession is a manifestation of periodontal breakdown. Plaque microorganisms are the primary aetiological factor, but other secondary conditions are also associated with its presence. This study examined the hypothesis that localized gingival recession is more prevalent in open-bite cases. The study included 26 children with untreated anterior open bite and a matched control group. Clinical crown length, recession depth, oral habits and periodontal indices were recorded for each individual. Although the plaque index was not significantly different between the two groups, the open-bite group showed significantly greater clinical crown length and gingival inflammation. This may be attributed to increased virulence of dehydrated plaque and it is suggested that open bite may predispose to the development of localized gingival recession in the anterior segments of young individuals.

Adolescent↗