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PubMedDate not supplied

[The index assessment of periodontal status in the combined treatment of patients with generalized periodontitis].

The authors compare the periodontal status in 94 patients with moderate periodontitis over the course of treatment making use of various splint designs and without splints. The status of the periodontium was assessed basing on the time course of indexes. Administration of various multiple-modality treatment schemes resulted in improvement of the periodontal clinical status in all the patients, though the efficacy of the therapeutic measures was different. The improvement in respect of all the examined parameters was the most manifest only in the group of patients treated with fixed splints with parapulpal fixation or with those pickling-based.

Combined Modality Therapy↗
PubMed1993

Comparison of two pressure-sensitive periodontal probes and a manual periodontal probe in shallow and deep pockets.

Three periodontal probes--a manual probe and two computerized, pressure-sensitive probes--were studied to determine their relative recording accuracy. In the first part of the study, replicate probing measurements were taken with the three probes at shallow (less than 5 mm) and deeper (greater than or equal to 5 mm) periodontal sites. In the second part of the study, probing depths were determined on all teeth except third molars by the three probing techniques at a single appointment. Mean values between replicate probings for each instrument did not differ statistically, except for duplicate measurements with one of the electronic probes in pockets with depths greater than 5 mm. All three probes demonstrated higher standard deviations with increasing depth, which indicates decreased reproducibility of probing depth measurements. Results of this study suggest that an electronic, pressure-sensitive probe yields more reproducible probing depth measurements than a conventional manual periodontal probe.

Adult↗
PubMed2005

Metronidazole concentrations in plasma, saliva and periodontal pockets in patients with periodontitis.

OBJECTIVES: Metronidazole is widely used antibacterial compound in the treatment of some types of periodontal disease. Pharmacokinetics of metronidazole in plasma has been well-described but few data exist about penetration of the drug to the gingival crevice fluid. The aim of the present study was to compare the concentrations of metronidazole in plasma, saliva and gingival crevice fluid in patients with periodontitis after multiple administration. MATERIALS AND METHODS: Eleven patients with severe generalised adult periodontitis participated in the study. Metronidazole, 500 mg, was administered orally two or three times per day for at least 2 days before sample collection. Samples were collected 2 h after last dose. Metronidazole concentrations in all fluids were measured with high-performance liquid chromatography. RESULTS: Mean drug concentrations in plasma, saliva and crevice fluid were 14.33, 15.15 and 12.86 microg/ml, respectively. Difference between plasma and crevice fluid or between plasma and saliva did not reach statistical significance. CONCLUSION: Present study revealed that metronidazole penetrates well into gingival crevice fluid and saliva. Metronidazole concentrations in crevice fluid are about equal to the protein unbound drug concentrations in plasma. Therefore, general pharmacokinetic data of metronidazole can be also applied in the treatment of periodontal disease and in the design of respective treatment regimens.

Administration, Oral↗
PubMed2001

[Experimental study of periodontal tissue regeneration after the application of enamel matrix derivative in rat periodontal defects].

The purpose of this study was to evaluate periodontal wound-healing after the application of enamel matrix derivative (EMD) in rats. Periodontal defects were surgically created on the mesial side of the first maxillary molar of 24 male Long-Evans rats. EMD was applied to cover the denuded root surfaces in the experimental group. The contralateral molar was used for the control group, which received the same treatment without EMD. The rats were sacrificed at 2 weeks (8 rats), 4 weeks (8 rats), and 8 weeks (8 rats) after the surgery. Demineralized paraffin sections were stained with Masson's trichrome. Histological analysis and histomorphometric measurements were performed on the periodontal sections. Using an immunohistochemical technique, the localization of osteocalcin (OC) was also examined. The formation of new cementum was statistically significant in the experimental group, especially new cementum with extrinsic fiber. Both acellular and cellular cementum were also rather strongly observed in the experimental group. Epithelial down growth was also strongly inhibited in the experimental group at 8 weeks after the surgery. OC-positive cells and matrix were limited at the bottom of the defects in the control group, while positive reaction was detected not only at the bottom but also spreading to the coronal portion of the defects in the experimental group. These results suggest that EMD has potential to promote cementum regeneration, especially fiber-inserted cementum, and to create a favorable environment that will promote periodontal regeneration.

Animals↗
PubMed1990

Protease activity in gingival crevicular fluid from discrete periodontal sites in humans with periodontitis or gingivitis.

Sensitive fluorogenic assays were used to compare the protease activities of fluid collected from eight such sites in each of 21 adult patients with gingivitis and 22 with periodontitis. The degradation of N-carbobenzoxy-gly-gly-arginine-AMC, L-arginine-AMC, glyproline-AMC, L-leucine-AMC, N-alpha-benzoyl-L-arginine-AMC, N-[p-toluenesulphonyl]-gly-pro-arginine-AMC, N-tert-butoxycarbonyl-leu-ser-thr-arginine-AMC, N-tert-butoxycarbonyl-ileu-glut-gly-arginine-AMC and N-tert-butoxycarbonyl-val-leu-lysine-AMC was significantly greater by fluid from the periodontitis group. The specific rates of degradation of L-arginine-AMC, gly-proline-AMC, N-alpha-benzoyl-L-arginine-AMC and N-[p-toluene-sulphonyl]gly-pro-arginine-AMC were significantly greater in that group, indicating that the composition of their gingival crevicular fluid was different from that of the gingivitis group. Discriminant analysis of the substrate hydrolysis data alone correctly identified 77.6% of sites with sensitivity and specificity values of 73.3 and 82.1%, respectively. The predictive value of these assays requires further investigation, but it is possible that they will prove useful for monitoring the success of periodontal treatment.

Adult↗
PubMed2000

Diagnostic characteristics of clinical and microbiological tests for monitoring periodontal and peri-implant mucosal tissue conditions during supportive periodontal therapy (SPT).

The aim of this study was to evaluate a clinical and a microbiological test for monitoring tissue condition during supportive periodontal therapy (SPT) and to compare their diagnostic characteristics at implant and tooth sites. Twelve female (age: 37-72 years) and 7 male patients (age: 26-83 years) were evaluated in this study on the basis of availability to follow a rigid SPT program. Patients had received a complete periodontal examination at 1 and 5 years after implant placement. This included standardized radiographs obtained at implants and matching control teeth. One implant site and one tooth site per patient were followed during the last 2 years of the SPT program. At each recall visit microbiological samples were analyzed according to DNA/RNA analysis identifying periodontal pathogens (IAI Pado Test 4.5, Institute for Applied Immunology, Zuchwil, Switzerland). Presence or absence of bleeding on probing at these sites was also noted using a standardized probing force of 0.25 N (Audio Probe, ESRO, Thalwil ZH, Switzerland). The percentage number of recall visits with positive bacteriological test results and positive BOP scores were calculated. Disease progression at the sites was defined if the annual increase in probing depth was > or = 0.5 mm/year (2.5 mm in 5 years) or if the annual decrease in CADIA values (Computer Assisted Densitometric Image Analysis) was more than -0.7 per year (-3.5 in 5 years). Changes below these values were considered as negative test results indicating stability of the sites. The diagnostic characteristics (sensitivity, specificity, positive and negative predictive values) of BOP and microbiological tests alone or in combination were then calculated using two-by-two tables. By application of increasing thresholds of BOP frequencies set for definition of positive test outcome (BOP > or = 10% > or = 20% > or = 25% > or = 50% > or = 75% > or = 90% or the combined BOP > or = 75%, but DNA positive > or = 10%, > or = 25% > or = 34% > or = 50% > or = 67% > or = 90%) receiver operator characteristics curves (ROC) were constructed for teeth and implants. The areas under the ROC curves were calculated and compared by means of chi-square tests. The results indicated statistically significant better diagnostic characteristics of both tests at implants compared to teeth. The inclusion of an additional microbiological test significantly enhanced the diagnostic characteristics of BOP alone at teeth as well as at implants.

Adult↗
PubMed2003

Periodontal attachment loss over 14 years in cleft lip, alveolus and palate (CLAP, CL, CP) subjects not enrolled in a supportive periodontal therapy program.

OBJECTIVES: (i) To assess the overall and (ii) cleft-associated rate of periodontal disease (PD) progression in subjects with cleft lip, alveolus and palate (CLAP) and (iii) to compare these rates with those of subjects with cleft lip (CL) and cleft palate (CP). MATERIAL AND METHODS: Twenty-six subjects not enrolled in a supportive periodontal therapy (SPT) program were examined in 1979, 1987 and 1993. PD progression was assessed as increase in pocket probing depth (PPD in mm) and probing attachment loss (PAL in mm). RESULTS: Extensive plaque accumulation and high frequencies of gingival units bleeding on probing were observed at all three examinations. A statistically significant increase in mean PPD of 0.57+/-0.21 mm (SD) in both groups as well as a statistically significant loss of PAL of 1.85+/-0.23 mm (SD) in the CLAP group and of 1.72+/-0.21 mm (SD) in the CL/CP group occurred over the observation period (p<0.05). In subjects with CLAP, statistically significant increases in PPD and loss of PAL were recorded over time at sites adjacent to the cleft as well as at control sites (p<0.05). Over 14 years, however, PPD increased 1.72+/-1.08 mm (SD) at cleft sites versus 0.72+/-1.14 mm (SD) at control sites (p<0.05), and PAL amounted to 3.19+/-1.35 mm (SD) at cleft sites versus 2.41+/-1.52 mm (SD) at control sites (p<0.05). CONCLUSION: Both the CLAP and the CL/CP subjects are at high risk for PD progression if no SPT program is provided. This also suggests that alveolar cleft sites in subjects with high plaque and gingival inflammation scores underwent more periodontal tissue destruction than control sites over a 14-year period.

Adult↗
PubMed2002

Assessment of periodontal healing by seeding of fibroblast-like cells derived from regenerated periodontal ligament in artificial furcation defects in a dog: a pilot study.

The regeneration of periodontal supporting tissues lost as a result of disease could be accomplished by repopulating the exposed root surfaces with cells originating from periodontal ligament. Thus, we aimed to assess the seeding of cells derived from regenerated periodontal ligament (RPL) to promote the regeneration in artificial furcation defects of a dog. The fibroblast-like cells were obtained by incubating the explants of RPL tissue taken under a teflon (E-PTFE) membrane. Class II furcation defects were induced on the second and fourth mandibular premolars. Control defects were also included on the contralateral side. A suspension of the fourth passage cells (2 x 10(5) cells) in 0.5 mL of autologous blood coagulum was placed over each furcation area. The healing was histomorphometrically evaluated at the 42nd day postoperatively and expressed as percentage. The healing by new connective tissue attachment with cementum formation was found 75% in the cell-seeding defects whereas, it was 71% in controls. Bone formation was found to fill 51% of furcation defects; however, it was 35% of the defects in the control sites. In this pilot study, we suggested that regeneration of furcation defects by cell-seeding technique may be useful, but further studies are needed to determine the outcome of the procedure.

Alveolar Process↗
PubMed1979

Periodontal self-examination. A motivational tool in periodontics.

The institution of proper oral hygiene procedures and habits is a learning process. This paper describes a self-instructing periodontal self-examination program to be used in the initial phase of periodontal treatment. The program was designed in an effort to facilitate learning by taking the teaching conditions into consideration. The program tries to utilize the patient's curiosity and need for activity and to involve the patient himself in an effort to make the patient apprehend the relevance of subject matter. The program also allows for an individualized learning speed of the patient. The self-examination program was tested on 108 periodontal patients (19-75 years of age) and the patients' findings were compared to those made by a dentist. Questionnaires before and after the self-examination were used in the evaluation of opinions of the patient. The present study showed that the patients were able to perform the self-examination without individual professional guidance. A rather close correlation was noted between findings made by the patient and the dentist. Furthermore, the program was well accepted and appreciated by the patients according to their answers on the questionnaires.

Activities of Daily Living↗
PubMed1986

The effect of artificial crown margins at the gingival margin on the periodontal conditions in a group of periodontally supervised patients treated with fixed bridges.

The purpose of this investigation was to study whether or not artificial crown margins at the gingival margin are compatible with periodontal health. Periodontal conditions and the composition of subgingival plaque of 47 crowned teeth, 22 with crown margins at the gingival margin and 25 with a supragingival location of the margin, in 5 patients with extensive fixed bridgework has been examined 1 year after prosthetic treatment. Patients had been treated for periodontal disease and were recalled for prophylaxis sessions once every 2nd or 3rd month. Clinical data indicated little inflammation of the gingival tissues of crowned teeth with margins at the gingiva while a teeth with a supragingival location of the crown margin, gingival tissues showed minor or even no clinical signs of inflammation. In general, the composition of the subgingival plaque was similar to a flora regularly found to be associated with healthy conditions.

Adult↗
PubMed2004

Periodontal repair in dogs: examiner reproducibility in the supraalveolar periodontal defect model.

BACKGROUND: Histometric assessments are routinely used to evaluate biologic events ascertained in histologic sections acquired from animal and human studies. The objective of this study was to evaluate the intra- and inter-examiner reproducibility of histometric assessments in the supraalveolar periodontal defect model. METHODS: Histometric analysis using incandescent and polarized light microscopy, an attached digital camera system, and a PC-based image analysis system including a custom program for the supraalveolar periodontal defect model was performed on histologic sections acquired from one jaw quadrant in each of 12 dogs. The animals had received an experimental protocol including implantation of a coral biomaterial and guided tissue regeneration (GTR) barrier devices, and were evaluated following a 4-week healing interval. Histometric parameters were recorded and repeated within a 3-month interval by two examiners following brief training. Intra- and inter-examiner reproducibility was assessed using the intra-class correlation coefficient (ICC). RESULTS: Most parameters showed high intra-examiner ICCs. Parameters including defect height, connective tissue repair, bone regeneration (height/area), formation of a junctional epithelium, positioning of the GTR device, ankylosis, root resorption, and defect area yielded an ICC> or 0..9. The ICCs for bone density and biomaterial density were somewhat lower (0.8 and 0.7, respectively). The inter-examiner reproducibility was somewhat lower compared to the intra-examiner reproducibility. Nevertheless, the ICCs were generally high (ICC range: 0.6-0.9). CONCLUSIONS: Histometric evaluations in the supraalveolar periodontal defect model yield highly reproducible results, in particular when a single examiner performs the histometric measurements, even when the examiner was exposed to limited training.

Animals↗
PubMed1995

Costs of periodontal and prosthodontic treatment and evaluation of oral health in patients after treatment of advanced periodontal disease.

Retrospective estimations of dental care costs of periodontal and prosthodontic treatment and evaluation of oral health in 37 patients with advanced periodontal disease were carried out. Measures of their subjective evaluation of oral health 7-10 yr after the treatment are presented as a health profile and as indices in single numbers. The relations between oral health as an index and the dimensions in the health profile are analyzed. Dental care costs for treatment in the mandible was SEK 35 550, for the maxilla SEK 45 380 and for both jaws SEK 74 230. After the treatment oral health as well as general health were in excess of 75 on a 0 to 100 scale. Chewing ability, comfort and aesthetics were the variables found to significantly affect the subjective oral health. Oral health in terms of periodontal and prosthodontic conditions was maintained over the observation period.

Adult↗
PubMed1997

Periodontal and prosthetic therapy in severely advanced periodontitis by the use of the crown sleeve coping telescope denture. A longitudinal case report.

The crown and sleeve-coping (CSC) telescope denture is a removable prosthesis that is supported by both selectively retained teeth and the residual ridge or mucosa. Limited information regarding longitudinal studies of the CSC telescope denture has been reported as to the response of the abutments and their surrounding periodontal tissues to this type of design. The authors have documented a longitudinal ten-year follow-up of a case which was considered 'hopeless' for oral rehabilitation because of advanced periodontitis. The CSC telescope denture used in this case resulted in a significant improvement to the remaining dentition. The beneficial results of this form of treatment can be considered for a wide variety of clinical applications for the severely advanced periodontitis case.

Alveolar Bone Loss↗
PubMed1990

Natural history of periodontal disease in adults: findings from the Tecumseh Periodontal Disease Study, 1959-87.

The purpose of this epidemiological study was to estimate the degree of change in periodontal attachment level in a sample of adults examined in 1959 and 1987 in Tecumseh, Michigan. Out of 526 individuals between the ages of five and 60 years in 1959, a sample of 325 resided within an 80-km-radius area in 1987. Of those, 167 were re-examined. Loss of periodontal attachment (LPA) was determined with a Michigan #0 probe on four tooth sites (disto-buccal, mid-buccal, mesio-buccal, mid-lingual) for all teeth present. Of the individuals contacted, 28 had lost all their teeth during the 28 years. Of the 167 adults examined, two refused periodontal probing. Out of the 165 adults with LPA measurements in 1987, only 22 (13.3%) had an average increased loss of 2 mm or more per person between 1959 and 1987; five adults (3.0%) had an average LPA increase of 3 mm or more, and only two adults (1.2%) had an average LPA increase of 4 mm or more. The attachment level in 59.3% of all the tooth sites examined in 1959 in the 165 individuals either did not change or changed within +/- 1.0 mm. On the basis of bivariate analyses, the individuals with high LPA increase (greater than or equal to 2 mm) had the following characteristics significantly different from those with low LPA increase: They were older, smoked, had tooth mobility at baseline, higher gingivitis, plaque, calculus, and tooth mobility scores at follow-up, lower education level, and irregular dental attendance.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1997

Evidence-based periodontal treatment. Highlights from the 1996 World Workshop in Periodontics.

State-of-the-art periodontal therapy involves a wide range of diagnostic and treatment options. The 1996 World Workshop in Periodontics used an evidence-based approach to assess the efficacy of many of these options. This article describes the evidence-based approach and summarizes the findings of the workshop in the areas of diagnosis and nonsurgical and surgical periodontal therapy as well as dental implants.

Alveolar Bone Loss↗
PubMed1982

The lateral periodontal cyst and isolated periodontal defects.

Over a period of 4 years, 41 isolated, advanced periodontal defects were selected for histologic examination. The objective of this study was to establish the presence of cystic epithelium. Twenty of the biopsies fulfilled the criteria for lateral periodontal cyst (LPC). These results indicate that there is a distinct possibility that proliferation of epithelial elements other than crevicular could be implicated in isolated periodontal defects.

Epithelium↗
PubMed1989

Effect of periodontal status of rotary electric toothbrushes vs. manual toothbrushes during periodontal maintenance. II. Microbiological results.

We compared the use of a rotary electric toothbrush with conventional toothbrushing for their effectiveness in modulating the subgingival microbiota. Forty subjects who had received periodontal treatment for moderate to advanced periodontitis and were on 3-month periodontal maintenance were divided into two equal groups matched for age and sex. One group used only the rotary tooth cleaner and the other group used conventional toothbrushing, dental floss, and toothpicks for 12 months. Subgingival plaque samples (two sites per patient) were taken from 10 subjects per group at baseline, 6 months, and 12 months and analyzed for percentage of obligate anaerobes and colony-forming units of black-pigmented Bacteroides, Fusobacterium, Actinomyces, Streptococcus, and Veillonella spp. The percentage of spirochetes and motile rods was determined by darkfield microscopy. Results showed that levels of obligate anaerobes, Fusobacterium, and Actinomyces and percentage of spirochetes and motile rods decreased significantly (P less than 0.05), while levels of Streptococcus spp. increased (P less than 0.05) for both groups. However, there was no significant difference between the two groups, indicating that the rotary tooth cleaner and conventional toothbrushing are equally effective in controlling gingivitis and fostering a less pathogenic microflora.

Adult↗
PubMed1994

Microbial associations of 4 putative periodontal pathogens in Sudanese adult periodontitis patients determined by DNA probe analysis.

The few previous cultivation studies on the in vivo associations between various periodontal microbial species have shown several positive and negative associations. The present investigation utilized DNA probe analysis to examine possible in vivo associations between the periodontal pathogens Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, and Bacteroides forsythus in subgingival plaque samples obtained from 25 Sudanese untreated adult periodontitis patients. The standard paper point technique was used to sample 99 sites with a mean probing depth of 6.8 mm (range 6.0 to 10.0). Microbial associations were determined by detecting the effect of the presence or absence of one species (effector) on the occurrence of the other 3 species (target). The Wilcoxon signed rank test was used to examine variations in occurrence of each target bacteria in the presence or absence of the effector. In addition, the Spearman's rank correlation test was used to assess the relationship between the level of each bacteria to that of the other 3. Results showed bacterial associations with the following effector-on-target effects: F. nucleatum (P < 0.01 Wilcoxon; P < 0.001 Spearman) >> P. gingivalis (P < 0.01 Wilcoxon; P < 0.001 Spearman), and B. forsythus (P < 0.05 Wilcoxon; P < 0.001 Spearman) > P. intermedia (P < 0.01 Spearman). The study demonstrated positive associations between the 4 species investigated, while no neutral or negative associations were revealed. The most striking finding was the effect exerted by F. nucleatum on the colonization of P. intermedia; P. intermedia was never detected in a site unless F. nucleatum was also present.

Adult↗