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Biomedical subjects

F P Ashley

Publications and source records attributed to F P Ashley.

At least 19 recordsLinked to original sources
PubMed2006

Novel subgingival bacterial phylotypes detected using multiple universal polymerase chain reaction primer sets.

INTRODUCTION: Molecular ecological analysis based on 16S rRNA gene sequence analysis is well established for the characterisation of complex bacterial communities. However, 'universal' PCR primers can introduce biases into the analysis of the species composition of clone libraries because of mismatches between the primer and target organism sequences. In this study, three universal primer sets were compared for the analysis of the microflora in subgingival plaque. METHODS: Three subgingival plaque samples were collected from two subjects with localised severe chronic periodontitis. Half of each sample was cultured while DNA was extracted from the remaining half and 16S rDNA amplified with universal primer pairs 27F, 1525R (A); 27F, 1492R (B) and 530F, 1525R (C). Amplified genes were cloned, sequenced and identified by comparison with 16S rRNA databases. RESULTS: 137 taxa were identified among 177 isolates and 417 clones sequenced. Of these, 86 were detected only by the molecular technique whereas 26 were found only by culture. Sequences from 81 taxa did not correspond to those of named species and of these, 38 were not represented in the nucleotide databases. 16S RNA genes for these 38 taxa were sequenced and deposited with GenBank. CONCLUSION: The use of three sets of universal primers allowed the identification of 38 novel bacterial phylotypes. There were marked differences in the composition of the libraries generated by the different primer sets. A combination of molecular and cultural techniques is recommended to maximise the coverage of detection of bacterial taxa in oral samples.

Bacteria↗
PubMed2001

Periodontal health of London women during early pregnancy.

OBJECTIVES: A descriptive cross-sectional study to determine the severity of periodontal disease in early pregnancy and its relation to demographic variables in a South East London population. METHODS: 2,027 pregnant women attending Guy's Hospital for an ultrasound scan at 10 to 14 weeks gestation were assessed. Data were collected via questionnaire and periodontal examination, including plaque and bleeding scores, pocket probing depth and loss of attachment. RESULTS: Mean age was 29.8 years (sd 5.5). Of these, 61.8% were white, 28.5% black, and 9.7% of other ethnic group. A total of 15% reported smoking during pregnancy. The mean number of teeth present was 28 (sd 2) per subject, mean percentage of sites with plaque present was 60.5% (sd 22.6), mean pocket depth was 2.0 mm (sd 0.4), mean loss of attachment was 0.4 mm (sd 0.3), and the mean percentage of sites bleeding on probing was 20.2% (sd 16.3). Linear regression demonstrated that probing depth was related to age, ethnicity, socioeconomic status and plaque score but not to smoking whereas loss of attachment demonstrated relationships with age, smoking status and plaque score but not ethnicity or socioeconomic status. CONCLUSION: There was a relatively high proportion of subjects with deep periodontal pockets in this pregnant population compared to the Adult Dental Health Survey 1998 but with similar levels of loss of attachment and percentage of sites with plaque present. Several demographic factors were associated with the level of periodontal disease in this population.

Adult↗
PubMed2001

The reproducibility of methods of assessment for cervical dentine hypersensitivity.

BACKGROUND: Many agents and toothpaste formulations have been proposed for treatment of dentine hypersensitivity. However, studies have reported equivocal or contradictory results, potentially related to a lack of clinical efficacy for agents being tested, poor study design or the use of assessment techniques which are unable to distinguish longitudinal changes in dentine hypersensitivity. AIM: To investigate the reproducibility of commonly used measurement protocols for dentine hypersensitivity on single or multiple teeth. In addition, newly-developed controlled air and cold fluid stimuli were investigated. METHODS AND MATERIALS: Standardised pain stimulation techniques were used in 2 investigations with 63 and 42 subjects, respectively. The reproducibility of perceived hypersensitivity before and following stimulation was recorded over time periods of 14 and 2 days, respectively, using visual analogue scales and threshold techniques. RESULTS: Subject demographics resembled those reported in other hypersensitivity investigations. Analysis using several measures of reproducibility indicated that subject-based reproducibility was limited, even when the stimuli were standardised. However, the data are consistent with the findings of investigations on pain assessment in other fields. CONCLUSIONS: The reproducibility of subjects in clinical trials of dentine hypersensitivity may therefore contribute to difficulties in establishing treatment efficacy of agents in clinical trials.

Adolescent↗
PubMed1998

Reported dental attendance and perceived barriers to care in frail and functionally dependent older adults.

OBJECTIVES: This study was designed to investigate the reported dental attendance and the perceived barriers to dental care for frail and functionally dependent older adults. DESIGN: A single centre study of a housebound group of more than 60 years of age and their personal carers. SETTING: The study was carried out from a general dental practice in Ware, Hertfordshire, a market town 20 miles north of London. SUBJECTS AND METHODS: A group of 263 housebound adults more than 60 years old were identified. The subjects were living in 5 residential homes, 3 sheltered housing complexes and in private accommodation. The subjects and 115 of their personal carers were interviewed. RESULTS: 93% only attended a dentist when they had problems. The presence of natural teeth, residential status and age were all statistically significant independent explanatory variables for the time since the previous reported dental visit. Lack of perceived need was found to be a barrier to care for 86% of subjects. Cost and lack of suitable transport were also commonly identified. However, the true cost implication to a patient was poorly appreciated especially by those 34% of subjects who cited cost as a barrier. 52% of the whole group, rising with age to 75% of those more than 90 years old, expressed a preference for treatment to be carried out in their own homes. 93% of carers had found difficulty in arranging dental care for their clients but the difficulties were not always the same as the subjects' perceived barriers. Among the carers, younger, regular dental attendees who were paid to care were more likely to see benefit in obtaining dental care for their clients. CONCLUSION: The mechanisms by which these barriers to care may be lowered should be investigated in order to meet the unmet need identified by this study.

Adult↗
PubMed1998

Can a workplace preventive programme affect periodontal health?

AIM: To evaluate an oral health awareness campaign in an adult population. DESIGN/SETTING: Four workplaces in north-east London were selected, matched in two pairs and randomly allocated to test and control groups. Completion occurred in 1995. SUBJECTS: 98 volunteer employees in good general health. INTERVENTIONS: Two oral examinations were carried out, six weeks apart. The test group received the programme immediately after baseline examination and the controls after the second visit. MAIN OUTCOME MEASURES: Gingival bleeding on probing (BOP) and probing depths (PD) were measured on each occasion using a controlled pressure probe. RESULTS: The mean percentage of sites with BOP per subject reduced from 56% to 25% in the test group, while remaining static in the control group at 46% to 48%. The mean percentage of sites probing 4 mm and above per subject reduced from 38% to 25% in the test group and from 28% to 25% in the control group. These differences between groups were statistically significant when submitted to analysis of covariance (P < 0.001). CONCLUSIONS: The study showed the clinical effectiveness of a workplace-based oral health awareness campaign, which is ideally suited to the skills and resources of the primary care dental team.

Adult↗
PubMed1998

The relationship between irregularity of the incisor teeth, plaque, and gingivitis: a study in a group of schoolchildren aged 11-14 years.

The relationship between irregularity of teeth and periodontal disease was investigated in 201 children aged 11-14 years. The upper and lower incisor teeth were assessed for spacing, labio-lingual displacement, and mesiodistal overlap at each of the six contact areas. Plaque and gingivitis were assessed at six sites on each of the four upper and four lower incisor teeth. There was evidence for a direct relationship between the number of contact areas with tooth displacement combined with overlap and the number of sites with gingival redness (R = 0.25, P < 0.001), bleeding (R = 0.18, P < 0.01), and profuse bleeding (R = 0.25, P < 0.001). There was no evidence for a relationship between labio-lingual displacement alone and gingivitis. One-hundred-and-twenty-eight subjects without tooth displacement combined with incisor overlap had, respectively, 34, 15, and 35 per cent fewer sites with redness (P < 0.01), bleeding (P < 0.05), or profuse bleeding (P < 0.01) than the 73 subjects with overlap. The statistical significance of these differences was unaffected by covariate adjustment to take account of the effect on gingivitis of variation in the number of sites with plaque. There was no evidence of a relationship between incisor overlap and amount of plaque in these subjects. The results indicate that overlapping of incisor teeth is directly related to gingivitis and this relationship cannot be explained simply by an effect on oral hygiene.

Adolescent↗
PubMed1998

The rôle of a dentine-bonding agent in reducing cervical dentine sensitivity.

This double-blind split-mouth trial with 16 adult patients investigated the ability of a dentine bonding agent (DBA) to reduce cervical dentine sensitivity. Following stimulation of pairs of teeth by conventional tactile and air blast stimuli, together with controlled evaporative and cold fluid stimuli, sensitivity was recorded using tactile threshold, visual-analogue scale (VAS) and short-form McGill pain questionnaire (SFMPQ), prior to and 1 week following treatment with DBA. Prior to assessment, subjects recorded their perceived overall sensitivity using VAS and SFMPQ. Application of each stimulus was separated by 10 min. Sensitivity was recorded by a clinician blinded to the treatment status of each tooth. The control tooth was treated by applying DBA to coronal enamel. Dietary information was collected after the post-treatment assessment. There was a significant (p<0.05) improvement in tactile threshold and air flow and air blast VAS scores, together with reductions in sensitivity to evaporative stimuli when assessed by SFMPQ. Treatment response was not influenced by the subjects' age, gender, diet, use of fluoride-containing or silica-based toothpastes or fluoride mouthwashes, or a history of previous sensitivity treatment. It is concluded that topical application of DBA is an effective way to reduce cervical dentine sensitivity.

Adult↗
PubMed1998

Contribution of individual drugs to gingival overgrowth in adult and juvenile renal transplant patients treated with multiple therapy.

Drug regimens for transplantation often consist of multiple therapeutic agents and may result in drug-induced gingival overgrowth (DIGO). The aim of this study was to investigate the contribution of individual drugs in renal transplant patients. 147 adults (19-84 years) and 60 juveniles (3-18 years) were scored for DIGO and other clinical variables. Duration of treatment, dosage of drugs per kg body weight and serum cyclosporin levels were recorded. 44% of adults and 27% of children had DIGO. All patients were receiving prednisolone. More adults than children were administered cyclosporin, the reverse was true of azathioprine (p<0.01). Explanatory models were evaluated by stepwise ordinal polynomial logistic regression. Statistically significant explanation (p<0.05) of DIGO was afforded by prednisolone, nifedipine and azathioprine concentrations in adults and by cyclosporin, nifedipine and azathioprine concentrations in juveniles. Prednisolone and azathioprine were inversely related to the degree of DIGO. Plaque and irregularity scores, lip coverage and mouthbreathing status showed significant additional explanation in adults, replacing nifedipine and azathioprine in the final model. Irregularity was additionally explanatory in children, but no other clinical variables. A larger proportion of the variance of DIGO was explained by the available variables in children than in adults (pseudo r2=0.50 versus 0.25). The degree of DIGO in renal transplant patients is influenced by the dosage of a number of individual components of multiple drug therapy independently of the presence of local clinical factors.

Adolescent↗
PubMed1998

The relationship between socio-dental indices of handicap, felt need for dental treatment and dental state in a group of frail and functionally dependent older adults.

The present study was designed to investigate the relationship between self-reported oral handicap as measured by socio-dental indicators and both dental state and felt need for dental treatment in a group of frail and functionally dependent older adults. A total of 263 housebound adults over the age of 60 years were investigated with regard to their self-reported dental handicap using the socio-dental indices derived by Locker (Community Dent Health 1992;9:109-24). Of these, 117 were in long-stay residential facilities, 67 in sheltered housing and 79 in private housing. The majority were female (76%) and the largest age group comprised 81-90-year-olds (44%), while only 8% were in the youngest group of 60-70-year-olds. A high level of handicap was recorded. In the previous 4 weeks, 74% of the group experienced difficulty in chewing, 54% some other functional handicap, 22% oral pain, 72% some incident of discomfort and 30% some social problem related to their oral condition. The socio-dental indices related more to the number of teeth than to age or gender. Ability to chew five index foods was related directly to the number of teeth present (P<0.001) but unless there were more than 20 teeth present, subjects with natural teeth were more dissatisfied with their appearance than those with complete dentures (P=0.002). The 57 subjects (29%) who expressed a desire for treatment had significantly higher handicap scores (P<0.001). Thus the results indicate that there are high levels of oral handicap in frail and functionally dependent older adults that are related to both the number of natural teeth retained and desire for treatment.

Age Factors↗
PubMed1996

Clinical assessment of periodontitis in young adults--evaluation of probing depth and partial recording methods.

The present study was carried out to compare the ability of different methods of periodontal assessment to identify those subjects in a population who had suffered the worst periodontal breakdown. Comparisons were made between full mouth approximal attachment loss (CAL) assessment and methods relying on pocket probing depth (PPD) evaluation or on partial recording of CAL or PPD. Both of the latter types of assessment are commonly used in epidemiological surveys. 202 workers at an electronics factory aged between 20 and 40 yr were examined for approximal PPD and CAL, excluding third molars. The data were used to determine which individuals had the worst periodontitis based on CAL at several thresholds. Further analysis was carried out to determine which of these subjects would have been identified on the basis of the presence of deep (> or = 6 mm) pocketing, or by using one of a battery of partial recording subsets. CAL was frequently present in the absence of deep pocketing. A subset made up of four approximal sites around each of the 10 index teeth recommended by the WHO for partial recording (two molars in each quadrant and maxillary right and mandibular left central incisors) and a subset comprising maxillary buccal and mandibular lingual sites ("Pritchard" sites) performed best of the subsets considered in identifying the subjects who had been found by full mouth assessment to have at least one or at least two approximal sites with CAL at thresholds of 2, 3 or 4 mm. It was concluded that measurements of CAL using either of these subsets should reduce problems of under-recording of the prevalence of periodontitis associated with the use of PPDs alone or on CAL assessment at other partial recording subsets.

Adult↗
PubMed1996

Passive immunization with monoclonal antibodies against Porphyromonas gingivalis in patients with periodontitis.

Selective inhibition of recolonization of Porphyromonas gingivalis was investigated by topical application of monoclonal antibody (MAb). To select a MAb to P. gingivalis with the potential for recognizing most strains of P. gingivalis, we examined seven MAbs, one of which (MAb 61BG 1.3) recognized all 22 laboratory strains and serotypes of P. gingivalis tested as well as 105 human clinical isolates. A comparative study of the number of P. gingivalis bacteria identified by conventional culture and immunofluorescence with MAb 61BG 1.3 showed a very significant correlation between the two methods (Spearman r = 0.85, P < 0.001). Fourteen patients with periodontitis, who harbored P. gingivalis in their subgingival plaque, were treated by root planing and with metronidazole to suppress any detectable P. gingivalis. In this double-blind study, the patients were then divided randomly into two groups; one was treated with MAb to P. gingivalis, and the other was treated with saline. Each patient had four subgingival applications of 3 micrograms of MAb (or saline) per tooth at 1, 3, 7, and 10 days after P. gingivalis was suppressed. The number of P. gingivalis bacteria was then monitored, and significantly less recolonization of the sites with the most severe periodontitis was found in the MAb-treated patients than in the control patients (P < 0.01). This was evident at 6 and 9 months after the application of MAb, but by 12 months, P. gingivalis, was also found to recolonize these sites in two of the MAb-treated patients. The effect of MAb was specific to P. gingivalis, since the numbers of spirochetes were not significantly different between the two groups. However, no significant difference in any clinical periodontal indices between the immunized and control patients at 6 and 12 months was observed. This is the first demonstration that a putative periodontal pathogen can be selectively prevented from recolonization for up to 9 months in sites with the most severe periodontitis. This strategy could be used to establish directly in humans whether a microorganism is involved in the pathogenesis of periodontitis, by repeated application of the corresponding MAb at about 6-month intervals and by comparing the clinical indices between the MAb-treated and control patients.

Adult↗
PubMed1994

Effectiveness of oral hygiene with and without root planing in treating subjects with chronic periodontitis.

The extent to which patients with chronic periodontitis could improve their condition by oral hygiene without instrumentation was investigated. Ten subjects were assessed, instructed in a subgingivally-directed oral hygiene technique (OH) twice a week until plaque was present at less than 20% of sites on two occasions and reassessed after 6 weeks when half the mouth was root planed. A final assessment took place after a further 6 weeks. At six weeks the mean number of sites with bleeding on probing (BOP) was significantly reduced (P < 0.001), the percentage of sites with BOP falling from 59% to 34%. In addition, an increase in gingival recession (P < 0.001) was accompanied by a reduction in mean probing depths (PD) (P < 0.05). The mean percentage reduction in sites with BOP was greatest for sites with probing depths less than 4 mm at baseline but even at sites with PD of 6 mm or more the mean BOP reduced from 81% to 57% of sites. Root planing at 6 weeks resulted in further significant reductions at 12 weeks in both BOP (to 10% of all sites) and in PD (P < 0.001), but there was little further change for the sites receiving OH alone. There was some evidence that this adjunctive effect of root planing was also present at sites with a PD less than 4 mm at baseline and at sites without retention factors at or below the gingival margin. The results indicate that patients with chronic periodontitis can improve their periodontal condition by OH alone even in deep pockets.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Preliminary characterisation of antigens recognised by monoclonal antibodies raised to Porphyromonas gingivalis and by sera from patients with periodontitis.

A panel of 15 monoclonal antibodies (MAbs) was raised to Porphyromonas gingivalis and used to characterise the antigens which they recognise by ELISA, immunofluorescence (IF), Western blotting and patient serum inhibition studies. All the MAbs were specific for P. gingivalis and did not recognise 24 other species. Eight MAbs gave bright ring-like staining patterns against the majority of serotypes of P. gingivalis tested by IF. The antibodies could be grouped into 5 different antigen recognition profiles on Western blotting, and ELISA indicated that 8 of them bound to a capsular extract. Five antibodies bound to antigenic determinants recognised by sera from patients with periodonitis and 4 of these (1A1, 2B/H9, 3B1, 7D5) bound to a P. gingivalis 47kDa protease preparation on Western blotting. These antibodies are potentially useful for the purification and characterisation of biologically active components of P. gingivalis that are recognised by sera from patients with periodontitis.

Adult↗
PubMed1993

Concentrations of thiocyanate, hypothiocyanite, 'free' and 'total' lysozyme, lactoferrin and secretory IgA in resting and stimulated whole saliva of children aged 12-14 years and the relationship with plaque accumulation and gingivitis.

Resting and stimulated whole saliva was collected from 94 children aged 12-14 years and analyzed for thiocyanate, hypothiocyanite, 'free' and 'total' lysozyme, lactoferrin and secretory IgA. Clinical assessments of the amounts of plaque and gingival inflammation were made, and plaque was collected for determination of dry weight. An inverse relationship was observed between salivary thiocyanate concentrations in both resting and stimulated saliva and the amounts of plaque and gingival inflammation in these subjects (p < 0.05). Lactoferrin concentration in stimulated saliva was directly related to the amounts of plaque and gingivitis (p < 0.05). 'Total' lysozyme concentration in stimulated saliva was directly related to the amount of plaque (p < 0.05), and the 'free' lysozyme concentration in the same saliva was directly related to the amount of gingivitis (p < 0.05). The direct relationship observed between clinical measurements and both lysozyme and lactoferrin concentrations in saliva may have been due to contributions from gingival crevicular fluid. Cluster analysis identified three groups of subjects with different profiles in resting whole saliva, and in particular with different levels of secretory IgA. A statistically significant difference was observed in the quantity of plaque collected from subjects in two of these groups (p < 0.05). These results from cluster analysis using resting whole saliva from children confirmed the findings of a previous study with young adults.

Adolescent↗
PubMed1992

The relationship between 48-h dental plaque accumulation in young human adults and the concentrations of hypothiocyanite, 'free' and 'total' lysozyme, lactoferrin and secretory immunoglobulin A in saliva.

Samples of resting and stimulated whole saliva and stimulated parotid saliva were collected from 40 young adults. One week later, after 48 h on a standardized diet without oral hygiene, all available plaque was collected for dry weighing. An inverse relationship was found between the 'free' lysozyme concentration in stimulated parotid saliva and plaque dry weight (r = -0.46, p less than 0.01). There were no other statistically significant correlation coefficients between concentrations of individual salivary constituents and plaque dry weight. However, cluster analysis of constituents in resting whole saliva revealed three groups of subjects with different salivary profiles, and in particular with different concentrations of both IgA and hypothiocyanite. Subsequent analysis revealed differences in plaque dry weight between the groups, demonstrating the potential biological significance of cluster membership based on salivary factors.

Adult↗
PubMed1991

Relationship between calcium and inorganic phosphorus concentrations of both resting and stimulated saliva and dental plaque in children and young adults.

Calcium and inorganic phosphorus concentrations of both resting and paraffin-wax stimulated whole saliva and dental plaque were estimated in 39 young adults and 98 children aged 12-14 yr. Plaque was collected from the adults after 48 h without tooth-brushing and consumption of a standardized diet. Plaque was collected from the children without any dietary or oral hygiene restrictions. The results from the study with children provided consistent evidence for a statistically significant relationship between salivary and plaque concentrations of both calcium and inorganic phosphorus. However, multiple regression indicated that only the concentrations in the stimulated secretion were directly associated with concentrations in plaque. The apparent relationship between concentrations in resting saliva and plaque was due to correlation between resting and stimulated saliva. These relationships were less apparent in the young adults, in whom the controlled conditions resulted in a narrower range of mineral concentrations in dental plaque.

Adolescent↗
PubMed1991

Mouthbreathing, lip seal and upper lip coverage and their relationship with gingival inflammation in 11-14 year-old schoolchildren.

The gingival health of 201 schoolchildren aged 11-14 years was assessed at 6 sites on all the incisor and first molar teeth by recording separately the presence or absence of redness and bleeding on probing. Crowding of the incisor teeth was recorded as labio-lingual displacement and mesio-distal overlap. A 2nd examiner recorded the presence or absence of plaque at these sites and assessed mouthbreathing, lipseal and upper lip coverage of the maxillary incisors. Mouthbreathing, increased lip separation and decreased upper lip coverage at rest were all associated with higher levels of plaque and gingival inflammation. Multivariate analysis indicated that this association was statistically significant for mouthbreathing and lip coverage but increased lip separation was not independently related to plaque and gingivitis. The relationship of mouthbreathing and decreased upper lip coverage with gingivitis was most evident in the upper anterior segment and was still evident after covariate analysis to take account of variations due to gender, overcrowding and amount of plaque. However, allowance for these factors also suggested that the influence of mouthbreathing was restricted to palatal sites, whereas lip coverage influenced gingival inflammation at both palatal and labial sites.

Adolescent↗