Search PubMed⌕ Search

Biomedical subjects

J M Goodson

Publications and source records attributed to J M Goodson.

At least 55 records · Page 3Linked to original sources
PubMed1985

Intraclass correlations of periodontal measurements.

Components of variance and intraclass correlation coefficients were computed for changes in attachment level, pocket depth, gingival and plaque index scores for 5 groups of treated periodontal disease patients and 1 group of untreated subjects with periodontal disease. The intraclass correlation coefficients for attachment level change ranged from 0.011 to 0.165 (median 0.067), while intraclass correlation coefficients for pocket depth changes ranged from -0.009 to 0.178 (median 0.071). These intraclass correlation coefficients were much lower than those computed for changes in measurements of plaque which ranged from 0.086 to 0.568 (median 0.268) or gingival inflammation which ranged from 0.119 to 0.522 (median 0.264). Intraclass correlation coefficients at baseline for pocket depths ranged from 0.000 to 0.199 (median 0.053), for plaque accumulation from 0.121 to 0.531 (median 0.222) and for gingival inflammation from 0.229 to 0.596 (median 0.391). The differences in the intraclass correlation coefficients between pocket depth and attachment level on the one hand and plaque accumulation or gingival inflammation on the other could not be explained on the basis of differences in the measurement scale employed, since collapsing measurement scales had little effect on the intraclass correlation coefficients. The observed larger intraclass correlation coefficients for changes in plaque and gingival indices suggest a larger rôle for host contribution to these measurements. In contrast, the data suggest that the major but by no means the sole factor determining the variability of attachment level or pocket depth changes is the nature of the local factors.

Chlorhexidine↗
PubMed1985

Clinical responses following periodontal treatment by local drug delivery.

A 4-quadrant, single-blind study was designed to test the efficacy of periodontal disease therapy by local drug delivery. A delivery system made of extruded ethylene vinyl acetate fibers loaded with 25% USP tetracycline hydrochloride was placed and maintained in periodontal pockets for 10 days. The clinical effects of this form of therapy were compared with treatment by periodontal scaling. In addition, the effect of treatment by combined local delivery and scaling was investigated. Untreated quadrants were included as control. Placement of tetracycline-loaded ethylene vinyl acetate fibers into periodontal pockets established a drug concentration of approximately 0.06%. By covering the delivery system with a periodontal dressing, this concentration level was maintained throughout the 10-day therapeutic period. The average tetracycline dose used was 2.4 mg/tooth treated. Following fiber therapy, treated sites improved clinically, as evidenced by a gain in periodontal attachment and a decrease in periodontal pocket depth. The rate of new lesion formation at fiber-treated sites decreased from a pretreatment rate of 26.5% of sites/year to a posttreatment rate of 4.8% of sites/year. Periodontal scaling also produced clinical improvement, as indicated by significant attachment gain, pocket depth reduction and a decreased rate of new lesion formation. However, in no case were clinical results by scaling superior to results by local drug delivery, and by several measures local drug delivery was found to provide a better clinical response. Principal measures by which the clinical response using local drug delivery exceeded that by scaling were in early (3-6 months) attachment gain and in the degree of reduction of new lesion formation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
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↗
PubMed1985

Periodontal disease treatment by local drug delivery.

The subgingival microbiologic composition of diseased periodontal sites was evaluated by darkfield microscopy before and after scaling or local delivery of tetracycline. A standardized sampling and counting method using a crevicular washing technique was developed to determine both numbers and proportions of morphotypes using darkfield microscopy. Tetracycline-loaded hollow fibers established an initial intrasulcular concentration of 200,000 micrograms/ml, which decreased exponentially to 15 micrograms/ml in 24 hours. Repetitive intrasulcular placement of these fibers at periodontitis sites produced an incremental reduction in bacterial counts over a 10-day period. Monolithic fibers made of ethylene vinyl acetate loaded with 25% tetracycline hydrochloride provided sustained release for 10 days under in vitro test conditions. Ten patients were treated in a study comparing the effects of these fibers with scaling. Fibers were placed subgingivally to fill pockets to their probable depth and covered with a periodontal dressing which was maintained for 10 days. The average intrasulcular tetracycline concentration measured at the end of the 10-day period was 643 micrograms/ml. At these sites, total counts, spirochetes, motile rods and nonmotile rods were significantly reduced immediately following treatment. Total counts were depressed to levels near the detection limit of darkfield microscopy. In comparison, scaling produced much smaller alterations of darkfield counts which were not statistically significant.

Adult↗
PubMed1984

New concepts of destructive periodontal disease.

The most common forms of destructive periodontal disease have been thought to slowly and continuously progress until treatment or tooth loss. Recently, data have become available which are inconsistent with this "continuous disease" hypothesis. Data from longitudinal monitoring of periodontal attachment levels and alveolar bone in humans and in animals suggest that periodontal disease progresses by recurrent acute episodes. In addition, rates of attachment loss have been measured in individual sites which are faster than those consistent with the continuous disease hypothesis or slower than those expected from estimates of prior loss rates. To account for these observations, a model of destructive periodontal disease is described in which bursts of activity occur for short periods of time in individual sites. These bursts appear to occur randomly at periodontal sites throughout the mouth. Some sites demonstrate a brief active burst of destructive periodontal disease (which could take a few days to a few months) before going into a period of remission. Other sites appear to be free of destructive periodontal disease throughout the individual's life. The sites which demonstrate destructive periodontal activity may show no further activity or could be subject to one or more bursts of activity at later time periods. Comparison of monitored loss rates for a year with mean loss rates prior to monitoring suggested that there may be relatively short periods in an individual's life in which many sites undergo periodontal destruction followed by periods of extended remission. An extension of the random disease model is also suggested in which bursts of destructive periodontal disease activity occur with higher frequency during certain periods of an individual's life.

Adult↗
PubMed1984

The relationship between attachment level loss and alveolar bone loss.

Standardized radiographs and repeated periodontal probe measurements were made on 22 untreated subjects with destructive periodontal disease monitored for 1 year. Radiographs of selected sites were taken at 0, 6 and 12 months. Measurements of attachment level were made monthly. Radiographic measurements were made on 7X magnified projected images. Alveolar bone height from the CEJ was computed by multiplying the average length of the root times the measured ratio of CEJ to alveolar bone over CEJ to root tip. Each radiograph was measured twice by 2 investigators. Sites were excluded as having indistinct anatomical landmarks in which the standard deviation of the 4 measurements exceeded 0.16 mm, the measurement error for repeat determination of bone height on high quality radiographic images. A 3 sigma critical value for significant bone loss was selected as 0.48 mm. Changes in attachment level were computed for the intervals preceding and during the 6-12 month radiographic measurement period. Based on these critical values, 6.1% of the 231 radiographed sites showed significant bone loss. Similarly, 5.7% of the 1155 probed sites showed significant attachment loss. However, none of the sites with significant bone loss exhibited significant attachment loss over the same time period. In general, significant attachment loss preceded bone loss by 6 to 8 months. At 4 mm, attachment loss was found to predict subsequent bone loss with a true positive ratio of 60% and a false positive ratio of 5%, indicating a high degree of predictive discrimination. These observations indicate that attachment loss precedes radiographic evidence of crestal alveolar bone loss during periods of periodontal disease activity.

Alveolar Process↗
PubMed1983

Comparison of different data analyses for detecting changes in attachment level.

The purpose of the present investigation was to evaluate methods to detect periods of destructive periodontal disease activity in individual sites using pairs of repeated attachment level measurements. Attachment level measurements were made at 6 sites on every tooth in 22 individuals with radiographic evidence of periodontal destruction, and were repeated within 7 days. A total of 3414 sites were monitored at 2-month intervals for approximately 1 year. 3 analytical procedures were used to test for significant changes in attachment level. For regression analysis, a linear least squares fit function of time in days vs attachment level was computed for each site and the slope tested for difference from 0. Running medians of 3 were used to smooth attachment level measurements and changes greater than 2 mm in the smoothed curves were considered significant. By the tolerance method, differences between pairs of attachment level measurements were used to compare the mean change and the site specific variability of that change. The proportion of specific agreement (Ps) for breaking down sites was highest between the tolerance and running median methods (Ps = 0.63). Overall agreement (kappa), which included sites which showed "loss", "gain", and no change was 0.56. By regression analysis (P less than 0.01), 175 sites were identified as having significant attachment loss and 79 sites were identified as improving. By running medians these figures were 90 and 50, and by tolerance 94 and 40, respectively. Each of the 3 methods had certain advantages. Regression analysis was particularly sensitive to gradual changes in slope whereas the running median method detected abrupt changes in attachment level. The tolerance method was well suited to detecting changes over a short period of time. The tolerance and running median methods detected more breaking down sites on the molars and lower incisors and on interproximal surfaces; whereas regression analysis did not show these differences.

Adult↗
PubMed1983

Monolithic tetracycline-containing fibers for controlled delivery to periodontal pockets.

For the purpose of developing controlled delivery devices for periodontal therapy which would release over several days, six fiber types made of tetracycline-loaded biocompatible polymers were manufactured and tested. Polyethylene, polypropylene, polycaprolactone, polyurethane and cellulose acetate propionate all released their drug load within 1 day. Ethylene vinyl acetate fibers, however, provided in vitro sustained release for periods up to 9 days. A bioassay was designed to measure levels of tetracycline achieved by local delivery which used growth inhibition of Bacillus cereus as a measure of the amount of tetracycline in measured volumes of gingival sulcus fluid on filter paper strips. By this assay, fibers made from 25% loaded ethylene vinyl acetate established initial concentrations of approximately 500 micrograms/ml. The measurement of tetracycline concentration resulting from the placement of these fibers into deep periodontal pockets as a packing material provided indication that concentrations of greater than 50 micrograms/ml could be maintained for months by weekly to monthly replacement. These studies indicate that monolithic fibers made of tetracycline-loaded ethylene vinyl acetate have characteristics which could prove useful as the basis of a tetracycline delivery system for the treatment of periodontal disease.

Delayed-Action Preparations↗
PubMed1983

A method for the geometric and densitometric standardization of intraoral radiographs.

The interpretation of dental radiographs for the diagnosis of periodontal disease conditions poses several difficulties. These include the inability to adequately reproduce the projection geometry and optical density of the exposures. In order to improve the ability to extract accurate quantitative information from a radiographic survey of periodontal status, a method was developed which provided for consistent reproduction of both geometric and densitometric exposure parameters. This technique employed vertical bitewing projections in holders customized to individual segments of the dentition. A copper stepwedge was designed to provide densitometric standardization, and wire markers were included to permit measurement of angular variation. In a series of 53 paired radiographs, measurement of alveolar crest heights was found to be reproducible within approximately 0.1 mm. This method provided a full mouth radiographic survey using seven films, each complete with internal standards suitable for computer-based image processing.

Absorptiometry, Photon↗
PubMed1982

An approach to the definition of periodontal disease syndromes by cluster analysis.

Clinical syndromes of 22 untreated patients with advanced destructive periodontal disease were analyzed using cluster analysis. Clinical characteristics coded for each patient included age, sex, measures of gingival inflammation, plaque, suppuration, pocket depth, attachment level, extent and pattern of bone loss, rate of change in pocket depth, and correlation coefficients between certain clinical measurements. Microbiologic features included darkfield enumeration of 10 morphologically distinct forms of organisms which were removed from the three sites showing the most advanced destruction in each patient, as well as viable counts of specific microbial groups from the same teeth using elective and selective media. Serum antibody levels were determined by the ELISA technique to 13 species of subgingival microorganisms. The Gower coefficient was used to estimate similarity between patients and clusters were formed using an average unweighted linkage sort. Three distinct patient clusters were observed with greater than 70% average intra-cluster similarity. One subject did not fall into any of the patient clusters. The features which defined and differentiated the clusters were found to include age of subject, extent and patterns of bone loss, percent of sites showing change in pocket depth and attachment level, percent of small motile rods, intermediate spirochetes and fusiforms and serum IgG levels against Bacteroides gingivalis, Selenomonas sputigena and a Wolinella strain.

Adolescent↗