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Biomedical subjects

N Claffey

Publications and source records attributed to N Claffey.

47 records · Page 3Linked to original sources
PubMed1988

Repair of periodontal furcation defects in beagle dogs following reconstructive surgery including root surface demineralization with tetracycline hydrochloride and topical fibronectin application.

This study examines the effects of root surface demineralization and topical fibronectin as adjuncts to reconstructive periodontal surgery. In 14 beagle dogs, horizontal periodontal defects were surgically induced around the mandibular premolars followed by a 6-week period without plaque control. Reconstructive surgery of the defects was subsequently carried out. The root surfaces were debrided and superficially demineralized with citric acid or tetracycline hydrochloride, with or without subsequent application of fibronectin. Mucoperiosteal flaps were raised to cover most of the crowns and sutured. The animals were sacrificed 12 weeks after surgery and block sections of the teeth and surrounding tissues were processed for histology. Analysis included incidence of furcation defects presenting with an epithelial lining, quantification of connective tissue repair relative to the furcation circumference, and regeneration of alveolar bone relative to the furcation defect height. The incidence of root resorption and ankylosis was also analyzed. Within the limitations of this study it was concluded that: (1) citric acid conditioning of the root surface frequently resulted in complete connective tissue repair of the furcation defect; (2) root resorption and ankylosis were prevalent features of the healing response; (3) citric acid and tetracycline treatment had similar potential to induce connective tissue repair and resulted in corresponding incidences of root resorption and ankylosis; (4) application of fibronectin to demineralized root surfaces did not enhance the amount of connective tissue repair and did not alter the pattern of root resorption and ankylosis.

Administration, Topical↗
PubMed1988

The relative effects of therapy and periodontal disease on loss of probing attachment after root debridement.

This study investigated the immediate effects, and the effects during 12 months, of a single episode of root debridement in 1248 sites in 9 periodontitis patients. Single recordings for probing depths and probing attachment levels were made at baseline, and at 3, 6, 9 and 12 months. In addition, triplicate recordings of attachment levels were made for all sites by 3 independent examiners immediately prior to debridement, immediately post debridement, and at 3 and 12 months. It was found that a mean loss of probing attachment of 0.5 to 0.6 mm occurred as a result of instrumentation, irrespective of initial probing depth. Individual sites were identified as having lost probing attachment using a site-specific standard deviation for measurement variability and a greater than or equal to 1.0 mm change. 5% of all sites lost probing attachment from pre-instrumentation to 12 months. Approximately half of these had probing attachment loss inflicted during instrumentation. 23 sites (2% of all sites) were identified as having lost probing attachment from the post-instrumentation time point to 12 months. The majority of these sites seemed to undergo this probing attachment loss as a result of a remodelling process during the healing phase. Over the observation period used in this study, the majority of the attachment loss identified seems to be either directly attributable to instrumentation or to a remodelling process as a result of the therapy rather than to progressive periodontitis.

Adult↗
PubMed1988

Effects of oral hygiene measures on clinical and microbiological parameters of periodontal disease.

The effects of a 12-week period of oral hygiene alone on gingival conditions and subgingival microflora in 15 patients with severe periodontitis were investigated. Clinical measurements and plaque samples from selected sites were taken at week 0 (baseline), week 6, and week 12. Plaque samples were also taken at week 13, that is, 1 week following debridement. At week 0, the patients were instructed in supragingival plaque control and at week 6, the hygiene regimen was supplemented with the subgingival use of a toothpick device. At week 12, the patients received a full mouth supra- and subgingival debridement under local anesthesia. In those patients who complied with oral hygiene instructions (subgroup A), the gingival condition improved moderately while no improvement was found in less compliant patients (subgroup B). No significant changes were noted in the subgingival microflora in either subgroups A or B throughout the 12-week period of oral hygiene alone. However, significant reductions for all microbial parameters were found 1 week after debridement. Therefore, while moderate clinical improvements followed oral hygiene alone, no measurable changes in the subgingival microflora were observed concomitantly.

Adult↗
PubMed1988

Clinical and microbiological effects of root debridement in periodontal furcation pockets.

The aim of the present study was to investigate longitudinally over 52 weeks the clinical and microbiological effects of plaque control and root debridement at molar furcation sites. The results were compared with changes at non-molar sites. 24 non-molar sites and 31 grade II molar furcation sites with probing depth greater than or equal to 5.0 mm were monitored in 11 patients. Clinical measurements consisted of plaque scores, probing depths, and changes in probing attachment level. Microbiological monitoring was carried out with phase-contrast microscopy and anaerobic culturing. The debridement resulted in improvement in probing measurements and microbiological counts for both groups of sites. A slightly less favorable clinical response was noted for molar furcation sites. Higher post-operative microbiological counts were found throughout the 52-week observation period for molar furcation sites. Sites with probing attachment loss showed higher microbial counts and higher proportions of spirochetes, black pigmented colony forming units (CFU), and Bacteroides gingivalis CFU than sites with probing attachment gain. Individual site analysis, however, demonstrated marked variations of the microbiological counts at the different postoperative time points. In the few available sites undergoing probing attachment loss, no apparent association between target micro-organisms and periodontal deterioration was observed.

Adult↗
PubMed1987

Topical application of tetracycline in regenerative periodontal surgery in beagles.

This study was designed to test the effect of tetracycline on healing subsequent to periodontal surgery. Aqueous solutions of tetracyclines are highly acidic and may therefore represent a suitable substitute for citric acid. Furthermore, tetracyclines react with dental hard tissues to from long-lasting antimicrobial compounds, and they have a retarding effect on pellicle and plaque formation and an antienzymatic effect. The alveolar bone around mandibular premolars was surgically reduced up to 6 mm from the cementoenamel junction in two beagles. The denuded root surfaces were exposed to the oral environment during 3 months without plaque control. Regenerative surgery was then carried out, using root surface conditioning with 1% tetracycline and coronally repositioned flaps. Six months later, histologic evaluation showed connective tissue attachment extending to the cementoenamel junction in most of the specimens. Superficial root resorption was prevalent in the cervical region, below which a collar of replacement resorption partly surrounded the roots in a characteristic manner. Morphometric analysis showed that attachment gain was similar to that obtained with citric acid in a preceding series of seven dogs. These preliminary results indicate that connective tissue attachment gain after topical use of tetracycline is similar to that obtained with citric acid. In addition, the antibacterial capacity and biological effects of tetracycline warrant further study of its possible clinical use in periodontal reconstructive surgery.

Administration, Topical↗
PubMed1986

Relationship of gingival thickness and bleeding to loss of probing attachment in shallow sites following nonsurgical periodontal therapy.

Periodontal sites of shallow initial probing depth often seem to lose probing attachment following various types of periodontal therapy, including nonsurgical therapy. The susceptibility to this treatment-associated probing attachment loss may conceivably be related to gingival architecture as well as to the inflammatory status of the tissues. This study was designed to study the relationship of buccolingual gingival thickness and bleeding on probing in shallow buccal sites (less than or equal to 3.5 mm probing depth) to loss of probing attachment following nonsurgical therapy. 3 months following treatment consisting of oral hygiene instruction and supra- and subgingival debridement, thin (less than or equal to 1.5 mm), initially non-bleeding sites displayed a mean loss of probing attachment of 0.3 mm. Thick (greater than or equal to 2.0 mm), non-bleeding sites displayed a less noticeable mean loss of probing attachment, whereas bleeding sites of both categories of gingival thickness showed a tendency towards gains in probing attachment levels. It may be concluded that the mean loss in probing attachment levels, commonly seen for shallow sites post-therapy, may be primarily due to the changes in shallow, thin healthy areas.

Adult↗
PubMed1985

Antimicrobial irrigation of deep pockets to supplement non-surgical periodontal therapy. II. Daily irrigation.

106 sites with probing pocket depths 7 mm or greater from 14 patients were treated with plaque control instruction and 1 episode of root planing. Sites in each patient were either irrigated with 2% chlorhexidine or left as non-irrigated controls. Irrigation immediately followed root planing and was repeated daily, by the patient, for 24 weeks. Clinical measurements were made at 12 and 24 weeks, as were gingival washings for determining the number and % of spirochetes. Results at 24 weeks demonstrated that bleeding scores decreased from 91% to 9%; the % of spirochetes dropped from approximately 9% to less than 1%; probing pocket depths decreased from 7.5 to 4.5 mm, and probing attachment levels gained 1.1 to 1.4 mm. The chlorhexidine irrigated experimental group and the non-irrigated control group did not differ significantly in any of the studied parameters. Thus, daily patient-administered chlorhexidine irrigation of deep pockets did not augment the effects of non-surgical periodontal therapy.

Adult↗
PubMed1985

Subgingival spirochete and leukocyte counts as indicators of response to therapy.

The aim of this study was to determine whether changes in probing attachment levels are related to subgingival spirochete or leukocyte counts in periodontal pockets. Following initial clinical recordings and therapy consisting of oral hygiene instruction and root debridement, the probing attachment levels of proximal sites of 120 single-rooted teeth in 7 patients were measured every 3 months for 12 months. The measurements of each site were subjected to regression analysis, which determined whether the site was deteriorating, improving, or non-changing. Subgingival washings were taken of 19 deteriorating, 22 improving, and 127 non-changing sites to determine the number and % of spirochetes and the number of leukocytes at each site. Improved probing attachment levels were associated with reduced numbers of spirochetes and leukocytes. However, the ranges of individual measurements of subgingival washing variables overlapped considerably between groups. Spirochete and leukocyte counts related better to the 12-month probing depths than to changes in probing attachment levels during the preceding 12 months. These findings suggest that none of the tested subgingival washing parameters are suitable indicators of changes in attachment levels on an individual site basis.

Gingiva↗
PubMed1985

Healing of horizontal circumferential periodontal defects following regenerative surgery in beagle dogs.

Regenerative surgery of dog teeth with reduced periodontal support was undertaken to determine: if new connective tissue attachment could be predictably attained back to the level of the cemento-enamel junction; and to what extent the new attachment would be accompanied by bone regeneration, root resorption, and ankylosis. The alveolar bone around mandibular premolars was surgically reduced up to 6 mm from the cementoenamel junction. The denuded root surfaces were exposed to the oral environment during a period of 3 months without plaque control. Regenerative surgery was then carried out employing citric acid root conditioning and coronally positioned flaps. 6 months later, histologic evaluation of the midbuccal and midlingual areas of mesial and distal roots revealed new attachment over extended portions of the root surfaces. In 91 of 120 available surfaces, there was no epithelial downgrowth apical to the cemento-enamel junction. Bone regeneration varied from negligible amounts to complete reformation. However, root resorption and ankylosis were prevalent features. 2 different types of resorptions could be distinguished: those occurring near the cemento-enamel junction (cervical resorption), and those occurring more apically in areas of newly formed bone (ankylosis-associated resorption). Resorption of either or both types was noted for 92 of the 120 surfaces.

Alveolar Process↗