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Biomedical subjects

L Flores-de-Jacoby

Publications and source records attributed to L Flores-de-Jacoby.

At least 19 recordsLinked to original sources

Humoral antibody responses in periodontal disease.

Several forms of periodontal disease are considered to be infectious diseases with associated specific bacteria. This study examined the humoral antibody levels as assayed by ELISA to Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia in adult periodontitis (AP), localized juvenile periodontitis (LJP), rapidly progressive periodontitis (RPP), and in periodontally healthy subjects (HS). Sixty-two of the 64 (96.9%) patients had significantly elevated antibody levels to at least one of the three organisms. Elevated levels of antibodies to P. gingivalis occurred in 82.8% of the RPP, LJP, and AP patients with all 3 disease groups showing greater responses than HS controls. Antibodies to A. actinomycetemcomitans were found in 59.4% of the RPP, LJP, and AP patients and were significantly higher in both LJP and RPP patients. Only 21.9% of the RPP, LJP, and AP patients showed elevated levels to P. intermedia with only significantly higher levels in the RPP and LJP groups. Antibodies to A. actinomycetemcomitans and P. intermedia were rarely found alone (only 5.1% and 2.6% of the patients respectively) but were usually accompanied by P. gingivalis. These results suggest that one or more combinations of these 3 bacteria may play a role in the pathogenesis of these forms of periodontal disease.

Adolescent

CPITN application in regular dental practice.

The periodontal status of 8862 dentulous and partially dentulous inhabitants of the Federal Republic of Germany was investigated in various dental practices, using the CPITN, developed by the World Health Organization. The results show that a total of only 4.3% of those examined have a healthy periodontal apparatus and thus require no periodontal treatment. At least detailed oral hygiene instruction needs to be given to 95.7% of all subjects. Furthermore, 80% patients with periodontal disease require scaling or root planing, and 10% of them require periodontal surgery. The treatment of shallow gingival pocketing (CPITN 3) is predominant in every age group, and every fifth patient aged 35 years or more is need of periodontal surgery. This high frequency rate of periodontal disease illustrates the urgent necessity in regular dental practice for each and every patient to undergo periodontal screening. Such screening, based on the time saving CPITN, is to be recommended as it ensures fast, reliable determination of the periodontal status of each individual patient and the treatment needs involved.

Age Factors

Polymorphonuclear neutrophil chemiluminescence in periodontal disease.

The oxidative metabolism of polymorphonuclear leukocytes (PMNs) in rapidly progressive periodontitis (RPP, n = 19), localized juvenile periodontitis (LJP, n = 10), adults periodontitis (AP, n = 10) and healthy control subjects (HS, n = 39) was compared using the luminol chemiluminescence (CL) method. Possible influences of the isolation procedure on CL were circumvented by replacing starch with Haemaccell 35 as the sedimentation agent. In all groups, CL was significantly higher with autologous serum than with normal pooled serum (NPS) and there was a significant linear relationship between the two values. Comparisons of both pooled and autologous serum between patient groups and their matched controls were not statistically significant. There was a suggestion of serum-induced defects in 2 patients and 1 control. The range of individual values within each group was very heterogeneous, probably because of the many factors that are able to influence both the production of CL and the basal levels of CL observed.

Adolescent

Gingival crevicular fluid elastase-inhibitor complex: correlation with clinical indices and subgingival flora.

This investigation analyzed, in a cross-sectional study, the possible relationship between gingival crevicular fluid (GCF) elastase-like protease (ELP) levels and the periodontal clinical parameters or the presence of specific bacteria in subgingival plaque. A total of 388 periodontal sites from 8 adult periodontitis patients were examined for plaque index (PII), gingival index (GI), pocket depth (PD) and alveolar bone loss (ABL). GCF ELP levels were determined as ELP alpha-1 protease inhibitor (ELP-alpha 1-PI) complex levels with a commercially available ELISA. Subgingival plaque samples were tested for the presence of Bacteroides gingivalis, B. intermedius and Actinobacillus actinomycetemcomitans by indirect immunofluorescence (IF) microscopy. GCF ELP-alpha 1-PI levels were then correlated with clinical periodontal indices and proportions of IF-positive bacteria per site. Statistically significant positive correlations were found between GCF ELP-alpha 1-PI concentrations and subgingival Bacteroides proportions. When the sites examined were analyzed depending on the level of each clinical parameter, the levels of these correlations changed. A. actinomycetemcomitans correlated highly (r = 0.716) with ABL for sites with low GI score. The correlations between GCF ELP-alpha 1-PI and B. gingivalis (r = 0.642) or B. intermedius (r = 0.774) were the highest for ABL less than or equal to 20% and PD less than or equal to 3 mm, respectively. The strong association between GCF ELP-alpha 1-PI concentrations and subgingival bacteria previously associated with advancing periodontitis indicates that measurement of GCF ELP-alpha 1-PI concentrations may be useful in the evaluation of periodontal sites, especially those with very little or no tissue destruction.

Actinobacillus

[Gingivectomy].

The gingivectomy is the oldest surgical approach in periodontal therapy. During the centuries, the technique has been modified. Just at the middle of our century, gingivectomy was the most important surgical method in periodontal treatment. Indication for performance of the gingivectomy is the complete elimination of the periodontal pocket (gingival overgrowth/e.g. hyperplasia, subgingival caries, subgingivally located crown margins. The physiologic design of the free gingival margin by surgical means, gingivoplasty, must be taken under consideration. Depending on the long and painful healing for the patient, gingivectomy should be preserved for the indications above. Wherever possible, is recommended a flap procedure like the apically repositioned flap.

Anesthesia, Dental

[Periodontal treatment after the method of guided periodontal tissue regeneration].

Results of studies on animal models have shown that only guided periodontal tissue regeneration (GTR) will induce growth of new connective tissue fibers attached to new zement and bone tissue when the root surface had been exposed to plaque or pocket organisms. Studies of various authors suggest that it is exclusively the progenitor cells in the still existing periodontal ligament that permit regeneration. The development of GTR is based on biological principles. In the beginning its application was limited to periodontal surgery and has meanwhile expanded to include other areas such as implantology and oral surgery. Best results can be achieved in the periodontological treatment of three-walled bone defects and class II furcation involvements according to the data of several studies.

Animals

[Preliminary results in periodontal treatment with guided tissue regeneration].

The objective of the present clinical study was to evaluate the predictability of a treatment procedure (GTR) aimed at regenerating periodontal tissue. 34 patients and 103 teeth were selected for the investigation. All teeth included in the study exhibited advanced loss of periodontal attachment. The periodontal defects were associated with even and/or angular bone defects or, in the case of multirooted teeth, advanced loss of periodontal tissue support in the furcation area. The probing bone level (PBL) and the probing tissue level (PTL) of the diseased sites were recorded using a standardized procedure. Treatment included placement of a barrier membrane (e-PTFE, Gore-Tex) according to the GTR method. After a healing period of 4-6 weeks the membrane was removed in a second surgical procedure. The result of healing was evaluated immediately after membrane removal. A further measurement was carried out during a re-entry operation 9 months later. The measurements of the treated sites revealed that GTR therapy had resulted in a marked tissue gain of more than 60% (p less than 0.001). In 33 of a total of 34 furcation-involved molars treatment had resulted in complete closure of the furcation defect. In the light of the findings of the present clinical trial it may be suggested that GTR therapy is an effective and predictable means of improving prognosis for both single- and multirooted teeth. A definite evaluation, of course, will be possible with the results of the re-entry procedure.

Adult

[Periodontal diagnosis based on an immunohistochemical-morphometric analysis].

What is the correlation between immunoreactive blood cells, clinical parameters and the presence of special subclasses of bacteria in the subgingival microflora? To answer this question, patients suffering from juvenile and rapid progressive periodontitis were examined and compared with a control group without any periodontal disease. Cryostat sections from gingiva biopsies were marked immunohistochemically. Using the Kruskall-Wallis test, highly significant differences could be shown between the groups of disease in terms of immunoreactive cells such as leukocytes and monocytes, as well as in terms of the clinical parameters pocket depth, plaque index, gingival index and sulcus fluid and in terms of the microbiological subclasses coccoid cells, curved and motile rods and spirochetes. The results showed that immunohistochemical and morphometric methods of characterizing immunoreactive white blood cells might be used as an aid in diagnosis and understanding of periodontal diseases.

Aggressive Periodontitis

[Changes in the physical properties of Gingivamoll flexible gingival epithesis].

It was the purpose of this study to investigate variations in weight, volume, hardness, material density, adjustment and colour of Gingivamoll flexible gingival masks during a period of twelve months. Additionally, patients were inspected for potential infections of Candida albicans. Thirty-three gingival masks of nine patients were selected for the study. One third was placed into patients' mouths, one third was placed on stone models under room conditions and a third group was submerged under water. At baseline all gingival masks were examined and measured. For the first half of the year, measurements were recorded monthly and in the second half of the year at two months' intervals. Results showed a constant Shore-A hardness, volume and density. Gingival masks submerged under water kept their weight. The other masks, i. e. those placed into patients' mouths and those placed on plaster models, lost weight. Adjustment deteriorated at distal sites. Colour stability was not satisfactory. Tests for Candida albicans remained negative. It can be concluded that Gingivamoll flexible gingival masks can be used without serious problems for a period of twelve months.

Adult

[The etiopathogenesis of periodontal diseases: the role of microorganisms. A review].

The microbiology of periodontal diseases as well as associations between certain microorganisms and types/stages of periodontal diseases are discussed and the ecology and the composition of the subgingival plaque are included in this discussion, too. Furthermore, the possible role of microorganisms associated with periodontal diseases, their pathogenic mechanisms and their virulence factors are treated in the present article. Periodic upsets of the host-parasite equilibrium seem to be responsible for the bursts of disease progression. Several plaque hypotheses (specific, non-specific, opportunistic) have been proposed as likely models to explain the nature of periodontal infections and diseases. However, none of these theories is widely accepted at the moment. Therefore, we suggest that further investigations concerning the complex bacterial interactions and the manner in which the host responds to the mass and the composition of the dental plaque must be carried out in the future.

Adolescent

[Clinical indices in periodontal diagnosis. A review].

In this review, are described the most common clinical indices. Further, is discussed and criticized their application as well as usefulness in the clinical diagnosis and patient management. Although, there exists a variety of clinical indices, only a few of them could be sufficient for monitoring diagnosis and treatment in the general practice.

Dental Health Surveys

[Sulcus fluid in periodontal diagnosis. A review].

In the present review, the composition of the gingival crevicular fluid (GCF) as well as its important role in the diagnosis of periodontal disease have been discussed. Furthermore, the different sampling methods and the subsequent analytical procedures have been described. Some of the GCF-components, such as elastase, prostaglandin, arylsulphatase and beta-glucuronidase, are examined for their use as suitable markers of future disease activity. At the present time, the interest of research is focussing on the host-parasite interaction, the prediction of disease activity, and the identification of risk groups of patients. Therefore, GCF is considered a valuable research subject and a possible diagnostic marker.

Gingival Crevicular Fluid

[Periodontal status in Rio de Janeiro city (Brazil)].

The periodontal status and the treatment needs were investigated in 1854 residents of Rio de Janeiro City (Brazil) by means of the CPITN. The results of the study showed that 2.5% of the examined individuals were healthy (CPITN 0), 8.1% displayed an increased tendency towards bleeding on probing (CPITN 1) and 23.2% presented with calculus and bleeding on probing (CPITN 2). Shallow pocketing (CPITN 3) was observed in 51.4% and deep pocketing (CPITN 4) in 14.7% of the examined subjects. Since 97.5% of the examined population were in need of periodontal therapy, the necessity for organizing an oral health program with emphasis on prevention and treatment of periodontal disease is strongly indicated.

Age Factors

[Modified Widman flap--a standard method].

The modified Widman flap offers such clinical advantages over root planing as root visualization. Treating periodontal pockets, which after preliminary treatment show a depth of 4 mm and more and remaining sulcus bleeding upon probing we obtained with this procedure a reduction of pocket depths and of gingival inflammation and gain of clinical attachment. The maintenance of these results as well as the further loss of attachment are directly related to the frequency of the maintenance recall appointments. The success of this procedure does not depend on the age of the patients. The healing following this procedure is normally achieved after 21 days and is by a long junctional epithelium, which may be seen as a stable treatment success.

Epithelial Attachment

Flow-cytometric analysis of lymphocyte subsets in patients with advanced periodontitis.

Peripheral blood lymphocytes from 36 patients with advanced periodontitis and from 34 healthy subjects were examined using a panel of monoclonal antibodies and fluorescence flow cytometry. The absolute and relative counts of B-cells, T-cells, T-helper (TH), T-suppressor/cytotoxic (TS) cells, activated T-cells and natural killer cells were assessed and the TH/S ratio was calculated. In the periodontitis patients, the TH/S ratio was 1.56 +/- 0.62 and in the controls 1.35 +/- 0.55. This was not statistically significant. A classification on the basis of sex also did not show significant differences in the TH/S ratio. B-cells and activated T-cells were slightly increased in the periodontitis group. However, all determined lymphocyte subpopulations revealed no significant differences between the groups. These results indicate that local inflammatory reactions and immunoregulatory dysfunction are limited to the periodontium in the patients with advanced periodontitis, with no significant quantitative effects on the peripheral lymphocyte subpopulations.

Adult

Periodontal conditions in Hesse, Federal Republic of Germany, measured by CPITN.

The periodontal status and the need for treatment were investigated among 3140 inhabitants of the Federal German state of Hesse, using the CPITN index. The male and female subjects forming the case material were divided into 6 age categories (I up to 19 yr, II 20-24 yr, III 25-29 yr, IV 30-34 yr, V 35-44 yr, VI 45 yr or more). The dentitions of 1.3% of those examined were healthy from the periodontal aspects (CPITN 0). 3.3% of examined persons displayed an increased tendency towards bleeding on probing as the sole pathologic manifestation (CPITN 1); calculus and bleeding on probing (CPITN 2) were recorded in 35.5% of patients. Shallow pocketing (CPITN 3) was observed in 49.3, and deep pocketing (CPITN 4) in 10.6% of the examined subjects. There was a marked increase in scores 3 and 4 among patients from age group V. In addition, the posterior teeth were more susceptible to disease than those in the anterior segments, with slightly higher figures being recorded among female than among male individuals. 98.7% of the patients were in need of periodontal treatment. Application of the PTNS index yielded a treatment requirement of 6841.0 hours for the examined population. 2323 hours of this time were allocated to oral hygiene instruction, 4148 hours to scaling and 370 hours to surgical intervention.

Adolescent