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Biomedical subjects

J M Goodson

Publications and source records attributed to J M Goodson.

At least 19 recordsLinked to original sources
PubMed1992

Antibiotic resistance of the subgingival microbiota following local tetracycline therapy.

The antibiotic resistance of the subgingival microbiota was studied by 3 approaches. First, we assessed the ability of subgingival isolates taken following therapy to grow on media containing tetracycline (TC). Higher percentages of TC-resistant organisms appeared at TC fiber-treated periodontal sites and within the saliva 1 week after treatment as compared with pre-treatment levels. By 1 month, the percentage of TC-resistant organisms had returned to levels comparable to those seen before treatment. In the second approach, subgingival isolates taken following therapy were grown on media without antibiotics, and isolates were selected for Gram-stain and cell morphology determination. This study indicated that subgingival sites became colonized with gram-positive cocci in the same time period that an increase of TC-resistant isolates was observed in the first study. This may account for the transient increase in TC resistance, because many gram-positive cocci are intrinsically resistant to TC. In the third approach, the antibiotic resistance of subgingival gram-negative species was determined. The predominant cultivable microbiota of 9 sites from 3 subjects were isolated immediately before and 6 months after TC fiber treatment. Gram-negative rods were characterized and tested for sensitivity to TC (minimum inhibitory concentration [MIC] 1-128 micrograms/ml), penicillin at 80 micrograms/ml, and erythromycin at 8 micrograms/ml. None of the gram-negative rods were resistant to TC (MIC greater than or equal to 16 micrograms/ml), either before or after treatment. Before treatment 98% of the gram-negative rods were susceptible to TC at 1-2 micrograms/ml and after therapy 88% were susceptible.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Subgingival temperature (I). Relation to baseline clinical parameters.

44 subjects ranging in age from 14-71 years were measured at 6 sites per tooth for gingival redness, plaque accumulation, suppuration, bleeding on probing, pocket depth and attachment level. Subgingival temperatures were measured at the same 6 sites per tooth using a periodontal temperature probe (Periotemp, Abiodent, Danvers, MA). This instrument was also used to measure each subject's sublingual temperature in order to compute the differences between sublingual and subgingival temperature. Relationships were sought between the baseline clinical parameters and the temperature variables in subjects and at sites. The mean and standard deviation of the sublingual temperatures for the 44 subjects was 36.6 +/- 0.4 degrees C (range 35.8-37.6 degrees C). The mean of each subject's mean whole mouth subgingival temperature was 1.9 degrees C lower, 34.8 +/- 0.6 degrees C (range 33.4-36.1 degrees C). The differences of the mean subgingival temperature from sublingual ranged from -0.8 to -3.2 degrees C (average -1.9 +/- 0.5 degrees C). Mean temperature difference for a subject correlated with % of sites with plaque (rs = 0.45), redness (rs = 0.33), bleeding on probing (rs = 0.44), % of sites with attachment level greater than 3 mm (rs = 0.44), mean pocket depth (rs = 0.44) and mean attachment level (rs = 0.39). There were higher mean temperatures at sites exhibiting or not exhibiting plaque (35.0, 34.5 degrees C), redness (34.9, 34.6), bleeding on probing (35.1, 34.7) and suppuration (35.4, 34.8). Sites with pockets less than 4, 4-6 and greater than 6 mm had mean temperatures of 34.6, 35.2, 35.8 degrees C, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Subgingival temperature (II). Relation to future periodontal attachment loss.

The purpose of the present investigation was to determine whether subgingival temperature was a risk indicator of periodontal attachment loss (detected in the following 2 months) in a subject or at a site. 29 subjects were measured at 6 sites per tooth for clinical parameters as well as subgingival temperature using a periodontal temperature probe (Periotemp, ABIO-DENT, Danvers, MA). The same instrument was used to measure sublingual temperature in order to compute differences between subgingival and sublingual temperature. Clinical and temperature parameters were measured at 2-month intervals. A total of 49 subject visits which had both baseline temperature and subsequent attachment level change measurements were available for analysis. Attachment level loss greater than 2.5 mm occurred at 1 or more sites at 16 of 49 subject visits. Elevated mean subgingival temperature was related to subsequent attachment loss particularly in individuals who exhibited more than 1 progressing site. The odds ratios of a subject exhibiting new attachment loss at 1 or more sites or at 2 or more sites were 14.5 and 64.0 if the subject's mean subgingival temperature exceeded 35.5 degrees C. Subjects with high mean subgingival temperatures and widespread periodontal destruction appeared to be at greatest risk for new attachment loss. Discriminant analysis using % of sites with suppuration, redness and attachment level greater than 3 mm and mean site temperature correctly "predicted" disease activity with a sensitivity, specificity and overall agreement of 0.75, 0.76 and 0.82 respectively. Of 7243 sites, 43 (0.59%) and 160 (2.2%) showed attachment loss of either 2.5 mm or more or 2 mm or more respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Subgingival temperature (III). Relation to microbial counts.

The present investigation examined the relationship of selected bacterial species and subgingival temperature. 35 subjects were measured at 6 sites per tooth for clinical parameters and subgingival temperature. Measurements were repeated for 21 subjects at 2 month intervals providing a total of 66 subjects visits. At each visit, subgingival plaque samples were taken from the mesial aspect of each tooth and anaerobically dispersed, diluted and plated on non-selective media. After anaerobic incubation, colonies were lifted to nylon filters and specific species detected using digoxigenin-labeled whole chromosomal DNA probes. Species enumerated were; A. actinomycetemcomitans serotypes a and b, B. forsythus, B. gingivalis, B. intermedius I and II, C. ochracea, F. nucleatum ss. vincentii, P. micros, S. intermedius, S. sanguis I and II, V. parvula and W. recta. Total viable counts and counts of Capnocytophaga sp. were determined directly from the primary isolation plates. A total of 1581 samples were evaluated. Subject visits with higher mean subgingival temperatures had significantly higher mean %s of B. intermedius I and P. micros, and lower mean %s of Capnocytophaga sp. Sites with higher subgingival temperatures had elevated proportions of B. intermedius I and II, A. actinomycetemcomitans serotype a and B. gingivalis more frequently than sites with lower temperatures, while Capnocytophaga sp. were elevated more often at cooler sites. 43 of the subject visits had follow up attachment level measurements at 2 months. The 1026 microbial samples and the subgingival temperature measurements from these visits were related to longitudinal attachment change.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Conduct of multicenter trials to test agents for treatment of periodontitis.

The conduct of multicenter trials to test agents for treatment of periodontitis is conceptually similar to that of single center trials, but the requirement that centers ultimately be combined into a single result places much more stringent requirements on uniformity and control. Multicenter trials should be considered only if numbers of subjects or the ability to generalize to other treatment settings becomes a driving theme. General guidelines for the conduct of studies of this sort are suggested and problems that occur are discussed. Despite formidable difficulties that may occur, multicenter studies provide a convincing demonstration of an agent's therapeutic efficacy for the treatment of periodontitis.

Clinical Trials as Topic↗
PubMed1992

Diagnosis of periodontitis by physical measurement: interpretation from episodic disease hypothesis.

Physical measurements including the evaluation of probing depth, bleeding on probing, tooth mobility, and inflammation form the basis for most periodontal diagnostics in use today. The interpretation of these observations and the methods available for their measurement, however, have begun to change significantly. The episodic disease activity concept has done much to implement these changes. Observation of episodic attachment loss has been correlated with parallel radiographic changes, alteration in levels of probable pathogens, and changes in inflammatory mediator levels. The failure of pocket depth, suppuration, and bleeding on probing to predict episodic attachment loss has been given plausible explanations and enhanced meanings. Although attachment loss by a continuous process cannot be excluded in some disease conditions, the hypothesis of periodontal disease progression by episodic activity supplements and expands understanding of the disease process. Interest in periodontal diagnostics has accelerated in the last decade. As a parallel development, the technology of small computers has decreased in cost and increased in sophistication. The combination of these factors has created an environment for the development of intelligent diagnostic systems. Four commercially available systems and two systems under development are described. The systems, which measure pocket depth, pocket depth or attachment level, tooth mobility, and pocket temperature, all utilize computer processing of measurements. The result is to provide a simplified and more meaningful presentation of diagnostic information. As intelligent diagnostic systems prove themselves, some of these instruments are likely to become common to dental practice. The promise of more accurate identification of areas of the mouth that are diseased can increase both the efficiency and effectiveness of periodontal therapy.

Humans↗
PubMed1991

A 4-quadrant comparative study of periodontal treatment using tetracycline-containing drug delivery fibers and scaling.

The present study describes results on selected clinical and microbiological parameters obtained by periodontal treatment with ethylene vinyl acetate fibers containing 25% by weight tetracycline hydrochloride placed into the periodontal pocket alone or in combination with scaling. Supragingival plaque control was maintained throughout the study by weekly professional cleaning and 0.2% chlorhexidine mouthrinses. Controls included untreated sites and sites treated by conventional scaling alone in a 4-quadrant split-mouth design. The experiment was conducted on 95 teeth from 10 subjects with periodontal pockets greater than or equal to 6 mm which initially bled on probing. All treatments resulted in changes indicative of effective therapy. Pocket depth was reduced, bleeding on probing decreased and gingival index scores decreased. Parallel to the clinical changes, all treatments reduced total bacterial numbers, % black-pigmented Bacteroides, motile bacteria, non-motile rods, and produced a proportionate increase in cocci. Fiber therapy with or without scaling reduced bacterial counts by approximately 2 orders of magnitude when evaluated at 62 days post-therapy. The combination of fiber therapy with scaling was particularly effective, suggesting a possible synergy between these forms of therapy. The combined therapy eliminated bleeding on probing, and black-pigmented Bacteroides, and produced the greatest mean reduction in pocket depth.

Adult↗
PubMed1991

Multicenter evaluation of tetracycline fiber therapy. III. Microbiological response.

In a multicenter study of the effects of tetracycline (TC) fiber therapy, subgingival plaque samples were tested for 6 probable periodontal pathogens by DNA probe analysis. Levels of Actinobacillus actinomycetemcomitans, Eikenella corrodens, Fusobacterium nucleatum, Porphyromonas (Bacteroides) gingivalis, Prevotella intermedia (Bacteroides intermedius), and Wolinella recta were quantitatively determined in samples taken at baseline, and immediately after TC fiber removal, control fiber removal, and scaling and root planing. At untreated sites, samples were taken at baseline and 10 d later. Specificity of the DNA probe method was evaluated by testing the hybridization to 83 reference cultures. Interaction of the F. nucleatum probe with Fusobacterium periodonticum, and of the W. recta probe with Wolinella curva were the only cross-hybridizations noted. Species were detected at an average sensitivity of 2.9 x 10(4) organisms per sample. Approximately 70% of sites were initially infected with P. gingivalis and F. nucleatum; 50% with P. intermedia and E. corrodens; infections with W. recta and A. actinomycetemcomitans were less common (36% and 11% respectively). The average numbers of organisms found in the plaque samples were highest for F. nucleatum, P. gingivalis, and P. intermedia (ca. 10(6)). E. corrodens, W. recta, and A. actinomycetemcomitans occurred at 10-fold lower levels. Bacterial numbers and proportions of species in subgingival sites from the five centers did not differ appreciably. Both TC fiber therapy and scaling decreased the number of sites infected with all the monitored species. The bacterial composition at untreated sites and at sites where control fibers were placed was not significantly altered. The percentage reduction of the number of sites with detectable infection varied with each species: from 86% with W. recta to approximately 40% with P. gingivalis. Significant reduction of pocket depth and bleeding occurred at TC fiber-treated sites infected with each of the species. Significant attachment level gain occurred only at sites initially infected with P. gingivalis and treated with TC fibers.

Actinobacillus↗
PubMed1991

Tetracycline fiber therapy monitored by DNA probe and cultural methods.

Oligonucleotide DNA probe and selective cultural methods were compared in their ability to monitor 6 putative periodontal pathogens in a study evaluating local tetracycline fiber therapy. Subgingival plaque was sampled from 4 sites in each of 20 subjects. Samples were taken before and after therapy from sites assigned to the following test groups: tetracycline (TC) fiber, scaling and root planing, control fiber, and untreated. Each sample was analyzed by both DNA probe and cultural methods. Total anaerobic cultivable counts, Porphyromonas (Bacteroides) gingivalis and Prevotella intermedia (Bacteroides intermedius) were enumerated on nonselective blood agar. Actinobacillus actinomycetemcomitans, Eikenella corrodens, Fusobacterium nucleatum and Wolinella recta were isolated on selective media. TC fiber therapy and scaling reduced total cultivable counts from an initial value of 1 x 10(7) to approximately 2 x 10(5) following therapy. Total counts at untreated sites and at sites with control fibers did not change from baseline. A. actinomycetemcomitans and E. corrodens were detected more frequently by the cultural method; the other monitored species were detected more frequently by DNA probes than by the cultural methods. Agreements between methods were: 77.2% for A. actinomycetemcomitans; 72.2% for P. intermedia; 75.6% for E. corrodens; 39.4% for F. nucleatum; 35.6% for P. gingivalis; and 68.9% for W. recta. Limitations of the selective cultural methods used probably contributed to the discrepancies for P. gingivalis and F. nucleatum. DNA probe and cultural methods indicated comparable levels of suppression of the monitored species following TC fiber therapy and scaling. The microbiota of control fiber and untreated sites did not appear to be significantly altered by either method.

Actinobacillus↗
PubMed1991

Multicenter evaluation of tetracycline fiber therapy: I. Experimental design, methods, and baseline data.

The study design and baseline characteristics of a multicenter trial to test the effectiveness and safety of locally delivered tetracycline for treatment of adult periodontitis are described. Local delivery was provided by 0.5 mm diameter ethylene vinyl acetate copolymer fibers loaded 25% with tetracycline hydrochloride which were placed into periodontal pockets and maintained by an adhesive for 10 (+/- 2) days. A total of 113 subjects (56 male and 57 female; mean age 49.3 yr) at five centers participated in the study. Subjects were selected who had 4 nonadjacent teeth with 6-10 mm pockets that bled on probing. The selected sites in each subject were randomly assigned to 4 test groups: tetracycline fiber, control fiber, scaling with root planing, or untreated. A balanced experimental design was thereby established in which each subject contributed equally by providing 4 clinically comparable sites for evaluation. To provide a more specific model for testing periodontitis therapy, gingivitis was treated prior to the initiation of the study by prophylaxis with supragingival calculus removal and home care instruction. Clinical response variables measured were pocket depth reduction, attachment level gain and bleeding on controlled-force probing measured at baseline, 30 d, and 60 d. Levels of 6 bacterial species selected as probable periodontal pathogens were measured by DNA probe analysis of plaque samples. The design of this study provided several unique analytical opportunities. Controls included a comparison with conventional treatment, analysis of vehicle effects, and effects at untreated sites. Comparison of the test group with controls permitted evaluation of the principal variables that could effect interpretation of results.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Multicenter evaluation of tetracycline fiber therapy: II. Clinical response.

The safety and efficacy of periodontal disease treatment by intrapocket placement of tetracycline (TC) fibers was investigated in a 60-day multicenter study conducted by selecting 4 sites in each subject with 6-10 mm pockets that bled on probing. Sites were randomly assigned to 1 of 4 test groups: TC fiber therapy, scaling, control fiber (fibers without drug), or untreated. TC fibers and control fibers were placed to fill the pocket and were maintained with a cyanoacrylate adhesive for 10(+/- 2) d. Scaling was performed for a minimum of 5 min under local anesthesia. Following initial tooth cleaning procedures, pocket depth, attachment level and bleeding on controlled-force probing were measured at baseline and at 30 d, and 60 d following therapy. Analysis of data from 107 subjects who had complete clinical data sets indicated that TC fiber therapy significantly decreased pocket depth, increased attachment level, and decreased bleeding on controlled-force probing to a greater extent than observed in all other test groups including scaling. These effects were greater than, and in addition to, effects that occurred due to prophylaxis and improved home care. No serious adverse side-effects attributed to TC fiber therapy were observed. No TC fiber-treated sites abscessed and superinfection was not noted. A transient redness at fiber removal was seen at 21% of the sites. Although fibers were placed without anesthesia, mild pain on initial placement was infrequent (19%) and abated rapidly. The results indicate that TC fiber placement provides a safe and effective means for treatment of periodontal infections.

Adult↗
PubMed1990

Zero-order delivery with periodontal placement of tetracycline-loaded ethylene vinyl acetate fibers.

The concentration of tetracycline in the gingival fluid was measured in the periodontal pocket following placement of controlled drug delivery monolithic fibers and subgingival irrigation. Following subgingival irrigation with 1% and 10% tetracycline HCl solution, concentrations decayed exponentially with half times of 4.2 and 12.2 h, respectively. Tetracycline fibers maintained a constant average concentration of 1590 micrograms/ml in periodontal pockets over a 10-day period. The observed concentrations were in agreement with those expected from a steady-state model based on release rate characteristic of the fibers and gingival fluid flow rate. After removal of the delivery system, tetracycline concentrations decreased exponentially with half time of 4.5 h. These data describe the delivery characteristics of tetracycline-loaded ethylene vinyl acetate fibers as zero-order for 10 d; following removal, an exponential washout was observed.

Adult↗
PubMed1990

Temperature as a periodontal diagnostic.

Elevated temperature, normally a characteristic of inflammation, is a potential indicator of periodontal disease. Conversely, local periodontal site temperatures within normal variation could suggest relative periodontal health. To evaluate this potential, a temperature probe was designed with rapid response (less than 1 s), high accuracy and reproducibility (+/- 0.1 degree C), good transducer thermal isolation and physical dimensions approximating those of a conventional periodontal probe. To compensate for subject-to-subject variations in core temperature, site temperatures were measured and expressed as differences relative to the sublingual temperature. A cross sectional study was conducted using this instrument in which pocket temperatures of 14 subjects with advanced adult periodontitis were measured and compared with the sulcus temperatures of 11 healthy subjects. Overall, the mean site temperature of the diseased subjects was 0.65 degree C higher than that of the healthy subjects. A natural posterior-to-anterior temperature gradient was observed with the posterior sites being hotter than the anterior sites. Tooth-by-tooth analysis showed that diseased teeth have higher temperatures than anatomically equivalent healthy teeth (p less than 0.01). Threshold temperatures for differentiating diseased and healthy teeth were determined to optimize sensitivity and specificity. The results suggest that site temperature is a diagnostic of inflammatory activity associated with periodontal disease. The specifically designed instrument detected significant disease-related departures from normality.

Body Temperature↗
PubMed1986

The effect of treatment on Actinobacillus actinomycetemcomitans in localized juvenile periodontitis.

Three treatment regimens including local tetracycline delivery, systemic doxycycline and surgery plus systemic doxycycline were investigated in a localized juvenile periodontitis (LJP) population. Of the investigated treatments only surgery plus systemic doxycycline for 14 days was effective in eliminating or suppressing Actinobacillus actinomycetemcomitans, an organism strongly associated with LJP lesions. While surgery plus antibiotics was the superior treatment, it appears that the possibility of reinfection or incomplete elimination of the organism exists. Careful long-term follow-up, including clinical and microbiological monitoring, is highly recommended in this periodontal population.

Actinobacillus↗
PubMed1985

Tetracyclines inhibit tissue collagenases. Effects of ingested low-dose and local delivery systems.

In a series of experiments, Golub et al. demonstrated that tetracyclines, but not other antibiotics, can inhibit mammalian collagenases and proposed that this property could be useful in treating diseases, such as periodontal disease (but also included certain medical conditions, e.g., corneal ulcers) characterized by excessive collagen degradation (J Periodont Res 1983, 1984 and 1985; Experientia 1984; Cornea 1984). One effect was the dramatic reduction of tissue collagenase activity within the gingival crevicular fluid (GCF) of periodontal pockets after administering a standard regimen of a tetracycline (e.g., 200 mg minocycline or 1000 mg tetracycline/day). The preliminary studies described below determined the effect of (1) low-dose (LD; 40-80 mg/day) orally administered minocycline on GCF collagenase activity and on the subgingival microflora (Exp. I), and (2) tetracycline-loaded monolithic fibers (TF) on collagenase activity in vitro (Exp. II). In Exp. I, GCF collagenase activity was reduced by 45 to 80% 2 weeks after initiating LD minocycline therapy, an effect that lasted for at least several weeks after stopping drug treatment. No consistent change in the relative proportions of G(+), G(-) and motile subgingival microorganisms was detected as a result of LD treatment suggesting that the reduction in GCF collagenase activity was a direct inhibition of the enzyme by the drug. In Exp. II, 3- and 6-mm lengths of TF in vitro established tetracycline concentrations in 250 microliters of 132 micrograms/ml, from 3-mm lengths, and 265 micrograms/ml, from 6-mm lengths, after an 18-hour incubation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗