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Biomedical subjects

I D Mandel

Publications and source records attributed to I D Mandel.

At least 73 records · Page 4Linked to original sources
PubMed1988

Chemotherapeutic agents for controlling plaque and gingivitis.

There has been a vigorous search for many years for chemical agents that could supplement or even supplant patient-dependent mechanical plaque control and thus reduce or prevent oral disease. 5 categories of agents or approaches have been considered: (1) broad spectrum antiseptics, (2) antibiotics aimed at specific bacteria, (3) single or combinations of enzymes that could modify plaque structure or activity, (4) non-enzymatic dispersing or modifying agents and (5) agents that could affect bacterial attachment. The success of these approaches can be evaluated clinically by the use of standard scoring methods for measuring plaque and gingivitis and their safety established by soft tissue and microbiologic examination. Antiseptic agents have received the bulk of the attention over the years. At present, only 2 antiseptics, the bis-biguanide, chlorhexidine gluconate (Peridex) and a combination of phenol related essential oils (Listerine), have developed sufficient supporting data in 6-month (or longer) studies to gain the approval of the Council On Dental Therapeutics of the American Dental Association. On the basis of short-term studies, cetylpyridinium chloride, zinc and copper salts, sanguinarine and octenidine warrant continued study as does stannous fluoride at an appropriate concentration. On the basis of current research, a new generation of more specific antibacterial agents that interfere with attachment to pellicle can be developed. It is hard to predict, however, that they will affect gingivitis, at least until there is more information on what specific organisms should be targeted.

Anti-Bacterial Agents↗
PubMed1988

Salivary gland dysfunction and swallowing disorders.

We have reviewed the functions of salivary secretions and the major role that saliva plays in maintaining oral homeostasis by protection, repair, and lubrication as well as in the initial phase of digestion. Diseases affecting the salivary glands per se as well as systemic diseases that may alter salivary function were discussed, as were treatments of diseases that may disrupt normal salivary function. Simple yet reliable methods of evaluating salivary function to validate subjective complaints were presented.

Deglutition Disorders↗
PubMed1987

Secretion of antimicrobial proteins from the parotid glands of different aged healthy persons.

The secretion of three antimicrobial proteins from the parotid glands of 82 generally healthy men and women, 22 to 81 years in age, was examined. No change was observed in the levels of secretory IgA, but statistically significant, modest elevations (approximately 50 to 100%) of lactoferrin, in both unstimulated and stimulated secretions, and lysozyme, in unstimulated secretions, were detected when results were expressed as mg antimicrobial protein/100 ml saliva. However, these alterations were not observed if data were expressed as mg antimicrobial protein/g total protein. Also, no change was detected in an acinar cell exocrine product, the anionic proline-rich proteins, as reported previously by our laboratory. The data are consistent with a maintenance of protective functions in parotid saliva during aging.

Adult↗
PubMed1987

Neutrophil chemotaxis in refractory cases of periodontitis.

Refractory cases of periodontitis were assayed for chemotaxis of polymorphonuclear neutrophilic leukocytes using an in vivo assay. 9 refractory patients and 9 normal patients were studied. When cell counts were plotted against time, normal patients showed a single peak at 25-30 min after casein (chemo-attractant) challenge, whereas refractory patients showed 2 and 3 peaks of PMN's at varying time intervals. 5 of the refractory patients showed this pattern in tests of normal sulci as well as deep periodontal pockets. 4 of the refractory cases showed a double peak in tests of deep periodontal pockets. This suggests that some refractory cases have an intrinsic chemotactic defect of polymorphonuclear neutrophils while in others the defect may be a secondary phenomenon. It appears that patients with refractory periodontitis have the characteristic cell response that was reported for LJP.

Adult↗
PubMed1987

Sialochemistry of whole, parotid, and labial minor gland saliva in patients with oral lichen planus.

This study was undertaken to determine whether oral lichen planus in otherwise healthy patients is associated with sialochemical abnormalities. Unstimulated and stimulated whole saliva, stimulated parotid saliva, and stimulated labial minor gland saliva were collected from 25 patients with oral lichen planus and from 25 age- and sex-matched controls. Flow rate and salivary concentrations of immunoglobulins A and G, albumin, amylase, lysozyme, lactoferrin, and total protein were determined by standard analytical techniques. Concentrations of inorganic components including sodium, potassium, calcium, chloride, and phosphate were also measured. No significant differences were found between the lichen planus patients and the controls. These findings do not support an association between oral lichen planus and salivary dysfunction in otherwise healthy patients.

Adult↗
PubMed1987

The functions of saliva.

Nature's demands on salivary glands are extensive and diverse and range from the reptilian need for a venomous drop to incapacitate its prey to the 100 quarts that ruminants require to digest a day's grazing. Other species depend on saliva not for survival, but for improving the quality of life, using the fluid for functions varying from grooming and cleansing to nest-building. Humans can manage without saliva; its loss is not life-threatening in any immediate sense, but it results in a variety of difficulties and miseries. Oral digestion per se is only of marginal importance in humans, but saliva is important in preparing food for mastication, for swallowing, and for normal taste perception. Without saliva, mealtimes are difficult, uncomfortable, and embarrassing. The complex mix of salivary constituents provides an effective set of systems for lubricating and protecting the soft and hard tissues. Protection of soft tissues is afforded against desiccation, penetration, ulceration, and potential carcinogens by mucin and anti-proteases. Saliva can encourage soft tissue repair by reducing clotting time and accelerating wound contraction. A major protective function results from the salivary role in maintenance of the ecological balance in the oral cavity via: (1) debridement/lavage; (2) aggregation and reduced adherence by both immunological and non-immunological means; and (3) direct antibacterial activity. Saliva also possesses anti-fungal and anti-viral systems. Saliva is effective in maintaining pH in the oral cavity, contributes to the regulation of plaque pH, and helps neutralize reflux acids in the esophagus. Salivary maintenance of tooth integrity is dependent on: (1) mechanical cleansing and carbohydrate clearance; (2) post-eruptive maturation of enamel.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Mucus glycoprotein of human saliva: differences in the associated and covalently bound lipids with caries.

A high molecular weight mucus glycoprotein has been isolated from submandibular saliva of caries-resistant and caries-susceptible individuals by a procedure involving fractionation on Bio-Gel P-100 and A-50 columns followed by equilibrium density-gradient centrifugation in CsCl. The purified caries-resistant mucus glycoprotein displayed a buoyant density of 1.50 and accounted for 9.5% of the dry weight of caries-resistant saliva. The caries-susceptible mucus glycoprotein represented 14.1% of the dry weight of caries-susceptible saliva and gave a buoyant density of 1.43. Both glycoproteins exhibited similar protein and carbohydrate content, but the caries-resistant mucus glycoprotein contained 28.7% less associated lipids and 3-times less covalently bound fatty acids than the caries-susceptible mucus glycoprotein. The associated lipids were represented by neutral lipids, glycolipids and phospholipids, whereas the covalently bound fatty acids consisted mainly of hexadecanoate, octadecanoate and docosanoate. Extraction of associated lipids caused the caries-resistant glycoprotein to band in CsCl gradient at the density of 1.54 and caused the caries-susceptible glycoprotein to band at the density of 1.52. A further shift in the buoyant densities occurred following removal of the covalently bound fatty acids, and both glycoproteins banded at the density of 1.57. While the intact caries-resistant and caries-susceptible glycoproteins were susceptible to proteolysis by pronase, the lipid-rich caries-susceptible glycoprotein was degraded to a lesser extent. Extraction of associated lipids increased the degradation of both glycoproteins, but the caries-susceptible glycoprotein still remained 25% less susceptible. However, the susceptibility to pronase of the delipidated and deacylated caries-resistant and caries-susceptible glycoproteins was essentially identical. The caries-resistant and caries-susceptible mucus glycoproteins also differed in susceptibility to peptic degradation. The apparent Km values for intact caries-resistant and caries-susceptible glycoproteins were 10.5 X 10(-7) M and 8.1 X 10(-7) M, while the values for the delipidated and deacylated caries-resistant and caries-susceptible glycoproteins were 13.0 X 10(-7) M and 12.4 X 10(-7) M. The results suggest that the differences in the content of associated lipids and covalently bound fatty acids are responsible for the different physiochemical characteristics of caries-resistant and caries-susceptible salivary mucus glycoproteins, which may be determining factors in the resistance to caries.

Chromatography, Gel↗
PubMed1986

Quantitative immunochemistry of salivary proteins adsorbed in vitro to enamel and cementum from caries-resistant and caries-susceptible human adults.

Salivary proteins adsorbed to powdered enamel and cementum from parotid and submandibular saliva (1:1) of caries-resistant (CR) and caries-susceptible (CS) subjects were examined qualitatively by polyacrylamide disc electrophoresis and quantitatively by immunochemical procedures. The electrophoretic patterns showed no consistent difference between enamel and cementum or between CR and CS samples. Quantitatively, there were no significant differences between CR and CS samples, but significant differences between enamel and cementum. On the basis of ng/mm2, enamel adsorbed five times as much acidic proline-rich protein and cysteine-containing protein as cementum and nearly twice as much lysozyme. There were no significant differences in adsorption of albumin and lactoferrin. The lack of difference in the concentration of pellicle proteins in CR and CS subjects may be related to similar findings with parotid and submandibular saliva. The influence of the major differences in surface pellicle proteins between enamel and cementum on the properties of their respective pellicles is uncertain.

Absorption↗
PubMed1986

Lipid composition and viscosity of parotid saliva in Sjögren syndrome in man.

Extraction of the dialysed and lyophilized saliva of patients with this syndrome by chloroform-methanol yielded 15.9 +/- 2.4 mg of lipid/100 ml of secretion, a level 2-times higher than in normal individuals. The saliva of such patients also had 3-times more glycolipid and 20-times more phospholipid than normal, but differences in the content of neutral lipids were less apparent. The neutral lipids, however, had higher proportions of glycerides, and lower proportions of cholesterol and cholesteryl esters than normal. Viscosity measurements, made with a cone/plate viscometer at shear rates between 1.15 and 230 s-1, revealed similarities between the saliva of normal individuals and Sjögren's syndrome.

Cholesterol↗
PubMed1986

Tooth surface-pellicle lipids and their role in the protection of dental enamel against lactic-acid diffusion in man.

The lipid content and composition of the enamel pellicle from caries-resistant (CR) and caries-susceptible (CS) subjects and their effect on its ability to retard the diffusion of lactic acid were investigated. Lipids accounted for 22.2 per cent of the dry weight of CR pellicle and 23.7 per cent of CS pellicle. The content of glycolipids in both groups was similar but CR pellicle contained 42 per cent less neutral lipids and 31 per cent less phospholipids. CR lipids had a higher content of cholesterol, cholesterol esters and sphingomyelin, whereas CS pellicle was richer in free fatty acids and phosphatidylethanolamine. Retardation of lactic-acid diffusion by CR pellicle was 45 per cent higher than by CS. Removal of lipids caused 50 per cent reduction in retardation by CR pellicle and 35 per cent by CS pellicle.

Adult↗
PubMed1986

Pilocarpine for the treatment of xerostomia associated with salivary gland dysfunction.

A double-blind placebo-controlled study was conducted to evaluate the efficacy of orally administered pilocarpine in treating oral dryness caused by salivary gland hypofunction. At low dosages, pilocarpine increased the production of saliva by parotid and submandibular and/or sublingual glands and relieved the sensation of oral dryness. The quantity and composition of pilocarpine-stimulated secretions were similar to saliva produced in response to gustatory stimulation with citrate. In appropriate patients, pilocarpine is a safe, easily administered, effective therapy to relieve xerostomia by increasing natural salivary function.

Aged↗
PubMed1986

Indicators of periodontal disease activity: an evaluation.

It is becoming increasingly apparent that the traditional clinical criteria are inadequate for: determining active disease sites in periodontitis, monitoring quantitatively the response to therapy or measuring the degree of susceptibility to future breakdown. In an attempt to develop objective measures, a wide variety of studies have been undertaken using saliva, blood, plaque and gingival crevicular fluid (GCF) as the specimen source. Examination has included: specific bacteria and their products; host cells and their products (enzymatic and antibacterial, both immunologic and non-immunologic); products of tissue injury derived from local epithelial and connective tissues and bone. Although most of the work to date has failed to provide reliable aids to the clinician, refinements in techniques for sampling and the availability of more sophisticated analytic techniques give cause for optimism. Methods proposed for detection of disease-associated bacteria in subgingival plaque vary in their sensitivity and specificity. Dark field microscopy shows some correlation with existing disease; however, the limited specificity of this method imposes severe restrictions on its usefulness. Highly specific polyclonal and monoclonal antisera to suspected pathogens Bacteroides gingivalis and Actinobacillus actinomycetemcomitans have been developed and improved methods of identification of these microbes in plaque by ELISA immunofluorescence and flow cytometry are under development. With respect to the host response, a strong correlation between antibody patterns to specific bacteria and periodontal disease categories appears to be emerging. Although most studies have focused on serum antibody derived from peripheral blood, a shift to detection of local antibody response appears to be likely. Techniques of measurement that are exquisitely sensitive have been developed for detection of major immune recognition proteins such as antibody and complement in crevicular fluid. Research efforts attempting to correlate local antibody response to local disease activity are underway. Measurement of GCF flow rate, endotoxin, H2S, butyrate and a variety of enzymes (e.g., collagenase, arylsulfatase, B-glucuronidase) show good correlation with levels of gingivitis. In periodontitis, the most promising markers of tissue breakdown are prostaglandins of the E series, the enzymes collagenase and aspartate aminotransferase, sulfated glycosaminoglycans, osteoclastic activating factor and bone resorptive capacity of crevicular cells. Assay of the migration of crevicular leucocytes in vivo can serve as an indicator of a defect in host resistance.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1986

Calculus revisited. A review.

Although there is no doubt that gingivitis can develop in the absence of supragingival calculus, it is not clear to what extent the presence of mineralized deposit enhances gingival inflammation. Partial inhibition of plaque mineralization can be accomplished by chemical agents, but there has been no demonstration in humans of a reduction in gingivitis. It remains to be established what level of inhibition (if any) is required to have more than a cosmetic effect. Since the accepted scenario is that apical growth of supragingival plaque precedes the formation of subgingival calculus, there is no longer an issue of whether subgingival calculus is the cause or the result of periodontal disease. Subgingival mineralization results from the interaction of subgingival plaque with the influx of mineral salts that is part of the serum transudate and inflammatory exudate. This chronology, however, should not be the basis for relegating calculus to the ash heap. Morphologic and analytical studies point to the porosity of calculus and retention of bacterial antigens and the presence of readily available toxic stimulators of bone resorption. When coupled with the increased build up of plaque on the surface of the calculus, the combination has the potential for extending (beyond that of plaque alone) the radius of destruction and the rate of displacement of the adjacent junctional epithelium. The centrality of thorough scaling and root planing in the successful maintenance of periodontal health supports the view that subgingival calculus contributes significantly to the chronicity and progression of the disease, even if it can no longer be considered as responsible for initiation.

Bacteria↗