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PubMed2006

[Alveolar bone resorption in animal models of periodontitis].

Periodontitis is a chronic inflammatory disease caused by infection of periodontopathic bacteriae, which induces alveolar bone resorption, tooth mobility, and finally tooth loss. In order to clarify the pathogenesis and to develop prevention and treatment of periodontitis, it is important to establish animal models of periodontitis. In this article, we showed several types of experimental models previously reported, and also showed a rat model using ligature and a hamster model using periodontopathic bacteria, both we used in our laboratory. Micro computed tomography (CT) analysis and histological observation revealed the inflammatory localization and osteoclast appearance in periodontal tissues. The usefulness of animal models of periodontitis is demonstrated by exhibiting an inhibitory effect of bisphosphonate and prostaglandin E(2) on alveolar bone resorption in our experimental systems.

Alveolar Bone Loss↗
PubMed2006

Studies on periodontitis and analyses of individuals at risk for periodontal diseases.

Periodontal disease is an infectious disease initiated by microbial plaque, which accumulates on the tooth surface at the gingival margin and induces an inflammatory reaction. The function of the inflammatory process is to protect the host, however the process may also contribute to tissue destruction. Most individuals show gingival inflammation, but only a limited number suffer from periodontitis i.e. loss of attachment. Without treatment, periodontitis will result in tooth mobility and subsequent tooth mortality. Independent of ethnicity, 10%-15% of an adult population will develop severe periodontitis The aim of this thesis has been to analyse individuals at risk for periodontal disease. Four studies have been conducted in 2 different groups of individuals with: Recurrent periodontitis kept in a maintenance care program--studies I-III. Type 2 diabetes (T2D)--study IV. In study I, the clinicaleffect of local periodontitis treatment with an antibiotic gel was investigated. In study II, the microbiologicaleffect of periodontitis treatment with the same antibiotic gel as in study I was investigated. In study III, it was investigated whether the interleukin-l (IL-1alpha and beta) and interleukin-6 (IL-6) gene polymorphisms were associated with the susceptibility of chronic periodontitis. In study IV, the prevalence of periodontitis in individuals with T2D was investigated, together with the prevalence of diabetic complications in relation to periodontal disease. We also studied whether there was a difference in dental care habits and knowledge of oral health between T2D subjects with and without periodontal disease. In conclusion, this thesis did not find any significant clinical and microbiological differences between subjects with recurrent periodontal disease treated with a locally delivered metronidazole gel compared to a placebo gel. Neither could we find an association between genetic variants in the IL-lalpha, IL-beta and IL-6 genes in individuals with or without periodontal disease. The prevalence of severe periodontitis, according to radiographic criteria, was almost 20% in subjects with T2D. This was further confirmed by clinical parameters. T2D individuals with periodontal disease demonstrated a higher HbAlc level, a higher prevalence of cardiovascular complications and a higher proportion of smokers compared to periodontally healthy T2D subjects. Finally, T2D individuals seem to lack sufficient knowledge about oral health.

Adult↗
PubMed1994

Periodontal status of teeth in contact with denture in removable partial denture wearers.

The aims of the study were to determine the periodontal status of the teeth in contact with removable partial dentures (RPDs) and to compare them with other teeth in the opposing arch not related to any prosthesis. The periodontal status was also assessed in relation to the age of the dentures. Four hundred and twenty-seven patients treated with RPDs from 1981 to 1986 were recalled for examination. Prior to prosthetic treatment they were given periodontal treatment and fillings when required. Initially all were given oral hygiene instructions and motivation. They were reviewed regularly only on a short-term basis. Eighteen patients were suitable for the present study comprising of eight males and 10 females whose mean age was 41 years. The RPDs were in use from 1.5 to 8 years (mean 4.6 years). The following parameters were assessed: Plaque index (P1I), Gingival index (GI), loss of attachment (LA) and tooth mobility. The wearing of RPDs resulted in higher P1I, GI and LA compared to the controls and these differences were statistically significant. There was an increased frequency of higher P1I, GI and LA with the increase in denture age. Minor changes in tooth mobility were observed. It was concluded that the wearing of RPDs was detrimental to periodontal health in patients whose oral hygiene was less than adequate.

Adult↗
PubMed1976

Osseous surgery--how much need we compromise?

It is essential that the execution and results of osseous surgery be carefully analyzed. Perhaps the two most compelling reasons are (1) that we should understand the effects on tooth mobility and their implications for complex restorative dentistry, and (2) to facilitate the accurate assessment of postoperative "success," bearing in mind not only improvement of the environment, but also increased chances of survival for the operated teeth. We have discussed the effects of osseous surgery on tooth mobility. In the light of recent information, a more accurate assessment of the need for splinting can be made. There has always been some controversy about osseous recontouring. Of late, there has been a particular resurgence of scepticism as to the efficacy of osseous resective procedures compared with more conservative forms of therapy. Scientific investigation demands the doubting mind and the analytical approach in order to establish the truth or fallacy of current ideas. This approach is essential to the continued existence of periodontics as a clinical science. These investigations should be based on a full understanding of the therapeutic measures being investigated, as it is misleading to assess the results of a procedure when that procedure is either not used to its full advantage or inappropriately used. It is hoped that these comments will be helpful in deciding whether definitive osseous correction in a given case is desirable or possible, in terms of both bone removal and permanent splinting. The author also hopes that this article has served to enhance the possibilities of more complete osseous correction when indicated, in order to achieve minimal pocket depths, and to permit proper comparison with other modes of periodontal therapy. It is, however, crucial to realize that whatever modality of therapy utilized, it is merely one phase in the treatment spectrum. Maintaining a stable state for the patient over many years is the ultimate goal, beside which any given technical procedure pales in significance. Periodontal therapy is an ongoing process in which patient recall plays a central role.

Alveolectomy↗
PubMed1980

A 3-month study in monkeys of occlusal dysfunction and stress.

A dysfunctional occlusal relationship was produced in six Macaca irus monkeys by insertion of occlusal splints in the maxilla which raised the vertical dimension of occlusion by 3-4 mm and incorporated interferences into the occlusion (test side). Cortisol levels of plasma and urine were measured by competitive protein binding analysis. At week 1 and week 3 after insertion of the splints there was a significant increase of 24 h urinary cortisol excretion rate and plasma cortisol concentration, indicating emotional stress. Furthermore, there was evidence of acute trauma from occlusion of the mandibular teeth of the test side, including a significant increase of tooth mobility and GI; radiographically there were signs of breakdown of margial and interradicular alveolar bone. One animal developed periodontal pockets of 4-5 mm adjacent to the teeth of the test side. At week 6 and week 12 urinary and plasma cortisol levels had declined to basal values whereas tooth mobility, GI and PI remained elevated. There was no clinical or radiographic evidence of further loss of bone or increase of pocket depth adjacent to the teeth of the test side during the latter part of the experimental period. The results suggest that emotional stress may be involved in periodontal reactions associated with acute trauma from occlusion.

Animals↗
PubMed2006

A comparative study of systemic subantimicrobial and topical treatment of minocycline in experimental periodontitis of rats.

OBJECTIVE: The purpose of this study was to compare the effectiveness of minocycline on treating experimentally induced periodontitis in rats when administered either as a systemic subantimicrobial dose or as a topical ointment. DESIGN: Thirty-two adult male Sprague-Dawley rats in four experimental groups-(1) model group; (2) systemic subantimicrobial dose of minocycline (5mg/kg/day) treatment group; (3) topical subgingival dose of minocycline (2mg/animal/week) treatment group; (4) control group. Experimentally induced periodontitis-silk ligatures were placed around the crevices of the second molar teeth and the animals fed a 10% sucrose drink. Assessment was carried out at days 28 and 56 using a number of different visual, histological and ultrastructure approaches. (1) Visual assessment-tooth mobility, gingival index and alveolar bone loss. (2) Histological examination-monocyte infiltration and resorption lacunae with osteoclasts. (3) Transmission electron microscopy (TEM)-morphological transformation of fibroblasts and osteoclasts. The collected data were analysed for statistical significance using the analysis of variance statistical test. RESULTS: Minocycline significantly reduced tooth mobility, gingival index and alveolar bone loss when administered either systemically or as a topical ointment compared to the model group (P<0.01). However, the alveolar bone loss was significantly less (P<0.01 in the systemic treatment group compared to the local treatment group. Monocyte infiltration and resorption lacunae with osteoclasts were significantly less in the both treatment groups compared to the model group (P<0.01). The osteoclasts failed to form a ruffled border in the systemic treatment group. CONCLUSION: Topical treatment significantly reduces gingivitis while systemic treatment is beneficial in terms of inhibiting alveolar bone loss.

Administration, Oral↗
PubMed1986

Influence of occlusal interferences on the periodontium in patients treated with fixed prosthesis.

Gingival bleeding, pocket depth, and tooth mobility were recorded, and occlusal analyses were made on 147 subjects treated with fixed prostheses placed 4 years earlier. The percent of gingival bleeding was greater in teeth with interferences than in those without interferences. A slight increase in pocket depth was found in connection with interferences. However, the difference was statistically significant only in the group with no preprosthetic treatment. No differences in tooth mobility were found between teeth with and those without interferences, possibly partly because of the splinting influence of the fixed partial dentures on the mobile teeth.

Crowns↗
PubMed1990

Post-orthodontic splinting of periodontally-involved teeth.

Shortcomings of techniques presently available for the stabilization of periodontally-involved teeth following orthodontic therapy are discussed. The rationale for rigid fixation of such teeth is questioned in the light of modern concepts of tooth mobility. An inexpensive technique of tooth stabilization based on wire and composite resin is described. The technique permits fixation allowing for individual periodontal adjustment, yet with minimal interference with tooth structure and the occlusion.

Dental Occlusion↗
PubMed1989

[Effect of the 3/4 crown and porcelain-fused crown restorations on the tooth displacement and the loading force of the supporting tissues].

A mechanical simulation model of tooth and alveolar bone in the application of 3/4 crown and porcelain-fused crown restorations was made and analyzed using three-dimensional finite element technique. The results obtained were as follows. 1. When the physiological tooth mobility was less than 150 microns, the teeth were sufficiently fixed using the splint and the bridge connected with more than two teeth, in the case of 20 percent absorption of the alveolar bone, and more than three teeth in the case of 40 percent absorption. In the case of 60 percent absorption, the teeth were fixed with the splint of six teeth connections, and were fixed with the bridge of five teeth connections. 2. The periodontium supporting force decreased markedly according to the increase of the number of the abutment teeth. 3. The teeth accompanied with the absorption of the alveolar bone were connected, in order to inhibit the tooth mobility and the periodontium supporting force. In this application, it had the inhibitory action when the replacing ratio of metal and ceramics to a crown of the tooth was less than 35 percent. 4. According to the finite element analysis, the design bases of fixed restorations applied in the teeth accompanied with the absorption of the alveolar bone were preferred.

Alveolar Bone Loss↗
PubMed1982

Tissue tolerance to orthodontic banding. A study in carbohydrate metabolism.

Tissue tolerance to orthodontic banding was determined in a group of children in the Department of Orthodontics at the University of Alabama School of Dentistry. Nonfasting blood glucose and three oral parameters--gingival state, clinical tooth mobility and labial debris--were determined before banding a mandibular lateral incisor and again one month later. Each subject received a multivitamin-trace mineral supplement or an indistinguishable placebo during that month. In the placebo group, statistically significant blood glucose variability (variance) was found in those whose periodontal state was made worse by the orthodontic band. However, a very homeostatic pattern of blood glucose values was displayed by those whose gingival state, tooth mobility, and labial debris improved or remained the same in the presence of the band. Thus, blood glucose variability or homeostasis is one possible way to predict or measure the elusive factor that has been called tissue tolerance.

Blood Glucose↗
PubMed1980

A longitudinal study of peridontal status comparing osseous recontouring with flap curettage. I. Results after 6 months.

The purpose this study was to test for short-term clinical differences in periodontal status after treatment with osseous recontouring and flap curettage in humans. Twelve systemically healthy patients with bilaterally similar marginal periodontal destruction received a standardized regime of presurgical therapy. The posterior segments of these patients were then treated with osseous recontouring and flap curettage. The investigators assigned the segments in one jaw at random to osseous recontouring and flap curettage, and then reversed the sides receiving surgical treatment in the opposing jaw. Postsurgical photographs and measurements for supragingival plaque, tooth mobility, gingival inflammation and periodontal attachment levels relative to the cemento-enamel junction were made for 6 months. Statistical analysis revealed that: (1) osseous recontouring and open flap curettage equally reduced plaque and gingival inflammation; (2) each surgical procedure equally increased attached gingiva; (3) pocket reduction achieved with osseous recontouring was maintained over 6 months, pockets recurring after open curettage; (4) open curettage did not induce bone regeneration; (5) osseous recontouring did not result in irreversible tooth mobility; (6) osseous recontouring resulted in a net loss of attachment; open curettage producing a net gain, especially in deeper pockets; and (7) both procedures improved periodontal health.

Alveoloplasty↗
PubMedDate not supplied

North American Burkitt's lymphoma presenting with intraoral symptoms.

A case is presented in which posterior tooth mobility and pain, bilateral intraoral swelling of the mandible, and anterior open bite following an incident of facial trauma were the presenting symptoms of a 4-year-old, white American male with Burkitt-type malignant lymphoma. Radiographic examination revealed multiple osteolytic lesions in the body of the mandible, with loss of osseous trabecular architecture, and generalized loss of lamina dura in both maxillary and mandibular arches. The patient also had bone marrow involvement at the time of diagnosis. Following the initial course of chemotherapy, the patient experienced a significant resolution of the bilateral mandibular swelling, anterior open bite, tooth mobility, and dental pain. Relapse occurred shortly after remission was achieved, with tumor metastasis to the central nervous system and testes. The tumor remained resistant to further chemotherapeutic treatments and radiation strategems. Because of renal and metabolic complications, Burkitt's lymphoma constitutes an oncologic emergency. If untreated, this rapidly growing tumor is fatal. Early interception and referral of these cases by the examining dentist is crucial.

Burkitt Lymphoma↗
PubMed1994

Effects of tetracycline-containing gel and a mixture of tetracycline and citric acid-containing gel on non-surgical periodontal therapy.

The purpose of this study was to assess the clinical and microbiological effects of a newly developed root conditioning gel system containing tetracycline or a mixture of tetracycline and citric acid on non-surgical periodontal therapy. Sixty-four (64) single-rooted teeth with a probing depth of 4 to 6 mm were randomly subjected to one of the following four treatments; 1) root planing alone (RP group); 2) tetracycline-containing gel alone (TCG group); 3) root planing plus tetracycline-containing gel (RP + TCG group); or 4) root planing plus a mixture of tetracycline and citric acid-containing gel (RP + TC-CAG group). Probing depth, attachment level, and tooth mobility were measured and the presence of dental plaque and gingival inflammation was recorded at baseline and after 2, 4, 8, and 12 weeks. Subgingival plaque samples from each site were collected at the same visits and examined with phase contrast microscopy for proportions of motile rods and spirochetes. Plaque index, gingival sulcus bleeding index (SBI), probing depth, and attachment level decreased significantly in all groups compared to the baseline values (P < 0.05). A significant decrease in probing pocket depth was noted after 12 weeks in RP + TC-CAG group compared to the other groups (P < 0.05). Significantly more gain in attachment was detected in the RP + TC-CAG group compared to the TCG group (P < 0.05). Tooth mobility scores also decreased later in the study. A significant decrease in the proportion of motile rods was found primarily in the RP + TC-CAG group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Periodontal aspects in menopausal women undergoing hormone replacement therapy.

AIMS: Currently, an important number of women use HRT to control their hormonal problems during menopause. A large percentage of these have problems at periodontal level. The present study aims at examining the effects that menopause, due to a decline in the synthesis of hormones, mainly of estrogens, can cause on the oral dental health of such women; in particular on the characteristics of the gingiva and periodontium, checking whether characteristics such as gingival recession, pain, tooth mobility and periodontal pocket formation might permit physicians to evaluate the degree of bone loss in menopausal woman. PATIENTS: Menopausal women aged 40 to 58 years of age undergoing hormone replacement therapy that had gingival periodontal disturbances. The total population of the study comprised 210 patients, divided into two groups. One group received HRT administered in patches and the other group did not receive this therapy. METHOD: Gynecologic and odonto-stomatologic protocols were established for data collection. In order to assess the efficacy of the treatment a descriptive statistical study for sociodemographic variables, analysis of variance, McNemar's test and the Stuart-Maxwell test were performed. RESULTS: The mean age of the patients studied was 49.6 years. HRT acts as a protective factor in dental pain and improves tooth mobility and depth of the probing of periodontal pockets. With respect to the variable gingival recession, no significant results were found either for the group not receiving HRT or for the group being treated with patches. CONCLUSIONS: The response to the HR therapy in periodontal disease is probably due to the existence of estrogen receptors localized in the gingiva and in the periodontal ligament.

Adult↗
PubMed1999

A multiparametric analysis of occlusal and periodontal jaw reflex characteristics in adult skeletal mandibular protrusion before and after orthognathic surgery.

Periodontal jaw reflex, duration of percussion sounds, tooth mobility, and time-moment analysis of occlusal contacts by the T-scan system were recorded in seven pre-orthognathic surgery patients and six post-orthognathic surgery patients over a 2-year period. The results showed that: (i) reflex response to the pressure applied to the upper right central incisor in the lingolabial direction varied, depending on the background jaw-clenching force (BCF) of the same-sided first molar. The BCF level required to elicit excitatory reflexes was only 0 kgf, and inhibitory reflexes were clearly elicited with a BCF of 1 kgf and beyond before orthognathic surgery. After orthognathic surgery BCF levels required to elicit excitatory reflexes were 0-4 kgf, and inhibitory reflexes were elicited with a BCF of 6 kgf and above; (ii) duration of percussion sounds determined via an occlusal sound analyser decreased in both the upper right central incisor and upper right first molar while tooth mobility measured by 'Periotest(R)' increased in the upper right central incisor, but did not change in the same-sided first molar after orthognathic surgery; (iii) the time moments of occlusal contacts were symmetrical toward the midsagittal axis of the occlusal plane after orthognathic surgery. The centre of the anterioposterior occlusal contacts did not differ between pre- and post-orthognathic surgery groups.

Adolescent↗
PubMed1998

Autogenous free tooth transplantation by the two-stage operation technique. An analysis of treatment factors.

Teeth were autogenously transplanted by the 2-stage technique in adult patients and examined up to 5 years after surgery for the prevalence of, and correlation between, tooth graft loss, root resorption, ankylosis, periodontal attachment loss, tooth mobility, and pain. The influence on the dependent variables of independent variables related to the patient, the donor tooth, the recipient site, and the transplantation procedure was examined. Pain was correlated to transplanted teeth, later extracted, and teeth with periodontal attachment loss. The expected correlation of root resorption to periodontal attachment loss was not verified owing to incomplete follow-up. The older the patient was, the less root resorption was found. Variables indicative of infection of the recipient bed and of traumatic injuries to the donor tooth at the transplantation were found to be detrimental to the tooth transplant.

Adolescent↗
PubMed1995

Trauma from occlusion. Periodontal concerns.

Application of the chronic disease model to IPD suggests that to be most effective, programs of prevention and treatment include measures to address as many of the identified risk factors as is possible. It remains to be determined if TO is involved in the initiation of IPD, for example, if individuals with TO are at greater risk for the development of IPD. There is evidence that TO is a risk factor in the progression of IPD. Tooth mobility is associated with and is a risk factor for increased attachment loss and increased bone loss in patients with periodontitis. Tooth mobility can be reduced by occlusal treatment. Clinical trials involving patients with periodontitis clearly establish that a better clinical periodontal attachment level response to treatment is obtained when occlusal adjustment is included as part of the treatment plan. Patients with advanced periodontal involvement benefit from occlusal treatment in terms of increased stability for the teeth and also in terms of oral comfort. Finally, There is no evidence that without occlusal treatment, periodontal patients who are in careful maintenance programs are more likely to suffer recurrence of IPD.

Chronic Disease↗