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PubMed2000

The influence of nicotine on the bone loss rate in ligature-induced periodontitis. A histometric study in rats.

BACKGROUND: The present study investigated the possible influence of nicotine on the bone loss rate in the furcation region due to ligature-induced periodontitis in rats. METHODS: Twenty adult male Wistar rats were included. After anesthesia, the tooth was randomly assigned to receive the cotton ligature in the sulcular area, while the contralateral tooth was left unligated. The animals were randomly assigned to one of the following treatments, including daily intraperitoneal injections: group A, 2 microl/g body weight of saline solution; group B, 2 microl/g body weight of a nicotine solution with 0.13 microl of nicotine/ml of saline solution; group C, 2 microl/g body weight of a nicotine solution with 0.19 microl of nicotine/ml of saline solution; and group D, 2 microl/g body weight of a nicotine solution with 0.26 microl of nicotine/ml of saline solution. Thirty days later, the animals were sacrificed and the specimens routinely processed for serial decalcified sections. RESULTS: Intergroup analysis revealed greater bone loss in the ligated teeth of group B (1.01 +/- 0.61 mm2), group C (1.14 +/- 0.72 mm2), and group D (1.36 +/- 0.60 mm2) when compared with group A (0.64 +/- 0.62 mm2) (P <0.01). However, no statistically significant differences in bone loss were found among groups B, C, and D. In addition, no bone loss was observed for unligated teeth (P>0.01). CONCLUSIONS: Within the limits of the present study, nicotine enhanced the effects of the local components of periodontal disease in a non-dose-dependent way; nevertheless, the administration of nicotine did not produce periodontal bone loss by itself.

Alveolar Bone Loss↗
PubMed2001

Longitudinal comparison of the periodontal status of patients with moderate to severe periodontal disease receiving no treatment, non-surgical treatment, and surgical treatment utilizing individual sites for analysis.

BACKGROUND: The progression of periodontal disease without treatment and the response of existing periodontal disease to various types of treatment have been studied extensively. Many past studies have used the mean of the patient's probing depths or attachment levels to evaluate disease progression as opposed to following changes in individual sites or teeth. The purpose of the current study was to evaluate the response of individual teeth to treatment or non-treatment. METHODS: The records from a private periodontal practice were reviewed to find patients with complete periodontal examinations that were recorded at least 1 year apart. Patients who fit these criteria were divided into those who had none of the recommended treatment (untreated, n = 30); those who had only non-surgical treatment (partially treated, n = 20); and a control group who had completed all recommended treatment (surgically treated, n = 41). The data for each tooth of each patient were placed in a database and analyzed using the method of generalized estimating equations (GEE) to test for associations between increase or decrease in probing depths and various initial clinical parameters while adjusting for significant confounders. RESULTS: Teeth that received no treatment or non-surgical treatment showed significant increases in probing depths, worsening of prognosis, worsening of furcation involvement, and increases in mobility when compared to surgically treated teeth. Teeth that received surgical treatment showed significant decreases in probing depths. No significant difference was noted between teeth that had no treatment and teeth that had non-surgical treatment. CONCLUSIONS: When individual teeth are used as the basis for analysis, teeth that receive no treatment or non-surgical treatment show a significant worsening of probing depths, furcations, mobility, and prognosis when compared to teeth that receive surgical treatment, while surgically treated teeth show significant improvement in probing depths.

Adult↗
PubMed2001

The effect of occlusal discrepancies on periodontitis. I. Relationship of initial occlusal discrepancies to initial clinical parameters.

BACKGROUND: A causal relationship between occlusal discrepancies and periodontal disease has been postulated in the past. However, animal studies and clinical studies have not been able to clearly demonstrate or rule out this potential relationship. METHODS: The records from a private practice limited to periodontics were reviewed to find patients who had complete periodontal examination records, including occlusal analysis, that were recorded at least 1 year apart. Patients who fit these criteria were divided into a group who had none of the recommended treatment (untreated n = 30), those that had only nonsurgical treatment (partially treated n = 18), and a control group that had complete all recommended treatment (surgically treated n = 41). The data for each tooth of each patient, including occlusal status, were placed in a database and analyzed using the generalized estimating equations (GEE) method to test for associations between initial occlusal discrepancies and various initial clinical parameters while adjusting for significant confounders. RESULTS: Teeth with initial occlusal discrepancies were found to have significantly deeper initial probing depths (P < 0.0001), significantly worse prognoses (P < 0.0001), and significantly worse mobility than teeth without initial occlusal discrepancies. In addition, this association between initial occlusal discrepancies and initial periodontal condition was found to hold for various subsets considered as well, including posterior teeth only and when only patients with good oral hygiene were considered. CONCLUSIONS: This study indicates that there is a strong association between initial occlusal discrepancies and various clinical parameters indicative of periodontal disease. Based on adjustments made for other known risk factors for periodontal disease, such as smoking, poor oral hygiene, etc., this study provides some evidence that occlusal discrepancy is an independent risk factor contributing to periodontal disease.

Adult↗
PubMed2001

The effect of occlusal discrepancies on periodontitis. II. Relationship of occlusal treatment to the progression of periodontal disease.

BACKGROUND: A causal relationship between occlusal discrepancies and periodontal disease has been postulated in the past. However, minimal data are available concerning the effect of treatment of occlusal discrepancies on periodontitis. METHODS: The records from a private practice limited to periodontics were reviewed to find patients who had complete periodontal examination records, including occlusal analysis, that were recorded at least 1 year apart. Patients who fit these criteria were divided into a group that had none of the recommended treatment (untreated n = 30), those who had only non-surgical treatment (partially treated n = 18), and a control group that had completed all recommended treatment (surgically treated n = 41). The data for each tooth of each patient, including occlusal status, were placed in a database and analyzed using the generalized estimating equations method. RESULTS: Worsening in overall clinical condition, as measured by worsening in prognosis, indicated that teeth with no initial occlusal discrepancies and teeth with treated initial occlusal discrepancies were only about 60% as likely to worsen in overall clinical condition over time compared to teeth with untreated occlusal discrepancies. Teeth with untreated occlusal discrepancies were also shown to have a significantly greater increase in probing depth per year than either teeth without initial occlusal discrepancies or teeth with treated initial occlusal discrepancies (P < 0.001). In addition, teeth with untreated occlusal discrepancies had a significant increase in probing depth per year (P < 0.001), whereas teeth without initial occlusal discrepancies and teeth with treated initial occlusal discrepancies had no significant increase in probing depth per year (P > 0.05). CONCLUSIONS: This study provides strong evidence of an association between untreated occlusal discrepancies and the progression of periodontal disease. In addition, this study shows that occlusal treatment significantly reduces the progression of periodontal disease over time and can be an important adjunct therapy in the comprehensive treatment of periodontal disease.

Adult↗
PubMed2001

Root trunk concavities as a risk factor for regenerative procedures of class II furcation lesions in dogs.

BACKGROUND: The purpose of this study was to evaluate the influence of root trunk concavities on guided tissue regeneration. METHODS: The second, third, and fourth mandibular bicuspids of 4 healthy mongrel dogs were used. Full flaps were elevated and furcation lesions (5 mm in height and 2 mm in depth) were surgically created. One mm deep concavities were prepared on the root trunks and part of the crown of all teeth. The second bicuspids remained as controls (C); the left third and fourth bicuspids received normal expanded polytetrafluoroethylene (ePTFE) membranes (NM) and the right bicuspids received modified ePTFE membranes (MM). The MM were made by removing the collar from an NM, cutting it into 2 mm segments, and suturing each of the segments to the collar of each MM. Normal and modified membranes were sutured to their corresponding teeth and the flaps sutured. After the healing period, the mandibles were removed and the teeth processed for histomorphometry. RESULTS: The results showed that the junctional epithelium measured a mean of 0.71 mm for C, 0.64 mm for NM, and 0.14 mm for MM. The differences between C and MM and between NM and MM were both statistically significant at the 5% level (Kruskal-Wallis test). Mean bone height measurements for the buccal surfaces from the furcation roofs were 2.79 mm for C, 2.60 mm for NM, and 1.06 mm for MM and for the mid-portion 1.10 mm for C, 1.23 mm for NM, and 0.30 mm for MM. Differences were statistically significant at the 1% level between C and MM and between NM and MM for the buccal measurements, and at the 5% level between NM and MM for the mid-portion measurements. CONCLUSIONS: Root trunk concavities are important risk factors for regenerative procedures. The collars of the membranes should be modified to improve results when concavities are present.

Alveolar Process↗
PubMed2001

Effects of furcation involvements on periodontal status and healing in adjacent proximal sites.

BACKGROUND: In a recent study it was found that following non-surgical treatment, probing depth (PD) reduction in proximal sites is significantly less in the presence of a vertical destruction in the adjacent site of the neighboring tooth. The present investigation was undertaken to study whether the presence of a proximal furcation involvement also influences the periodontal conditions in the adjacent site of the neighboring tooth. METHODS: The investigation was conducted as a retrospective study on a consecutive referral population based on full-mouth oral radiographic examinations and PD and plaque score registrations. The statistical analyses were performed on a final sample of 136 patients, with 153 (periodontal status) and 123 (periodontal healing) second maxillary premolars with an adjacent first maxillary molar. RESULTS: Baseline pockets were significantly deeper, relative radiographic attachment levels significantly reduced, and periodontal PD significantly less reduced after non-surgical treatment in the distal sites of second maxillary premolars adjacent to first maxillary molars with a mesial furcation involvement of degree > or = 2, compared to distal sites adjacent to first maxillary molars with a mesial furcation involvement of degree < or = 1. CONCLUSIONS: Periodontal status and healing after non-surgical treatment in proximal sites are negatively influenced by the presence of a deep furcation involvement in the adjacent site in the same proximal space. The presence of a deep proximal furcation involvement should consequently be considered a risk factor for the adjacent site of the neighboring tooth.

Adult↗
PubMed2001

Failure of resin ionomers in the retention of multi-rooted teeth with Class III furcation involvement: a rebuttal case report.

BACKGROUND: Severe periodontal furcation invasion has long been a treatment dilemma for the clinician. Many techniques have been advocated in the treatment of multi-rooted posterior teeth ranging from conventional scaling and root planing (SRP), apically positioned flaps, root amputations, root resections, tunnel procedures, guided tissue regeneration, and restorations. The keys to success depend on the clinician's ability to access the furcation to remove local factors and create an environment that enhances the patient's own hygiene efforts. Long-term success in treating teeth with furcation invasion depends upon tooth retention and arresting the destructive processes within the furcation area. METHODS: A Class III furcation invasion in a mandibular molar was treated by surgical access for SRP along with obliterating the furcation utilizing a resin ionomer restoration. RESULTS: Initially, the patient was asymptomatic. Within 3 months of treatment, the patient presented with suppuration that was refractory to local efforts. Radiographs taken only 5 months postsurgery demonstrated advanced bone loss apical to the restoration. The tooth ultimately was extracted because mobility increased and the tooth became symptomatic. CONCLUSIONS: The clinician must consider the multi-factorial etiology of periodontal breakdown within a furcation. For this patient, the technique of sealing off the exposed furcation with restorative material appeared to have resulted in progressive bone loss and accelerate tooth loss. This single case report is presented as a rebuttal to recently published articles, which have demonstrated excellent results when treating furcations with ionomer restorations.

Adult↗
PubMed2001

A comparison of the success of root resected molars and molar position implants in function in a private practice: results of up to 15-plus years.

BACKGROUND: When faced with a furcated molar, today's clinician must decide between a number of treatment options, including root resection, tooth removal, and implant placement. This paper assesses the results in one private clinical practice of root resection and subsequent restoration or molar implant placement and subsequent restoration. Clinical considerations in treatment selection are discussed. METHODS: A retrospective analysis of treated patients was carried out by examining active and inactive patient charts. When patients had discontinued therapy, every effort was made to determine the reason for leaving the private practice, so as to assess the impact of previously undocumented treatment failure on the statistics in question. RESULTS: A total 701 root resected molars and 1,472 molar implants were evaluated after > or = 15 and 13 years in function, respectively. Resection of the distal root of a mandibular molar demonstrated the lowest success rate (75%). All other success rates for various root resected molars in function ranged from 95.2% to 100%. Lone standing implants in second molar positions demonstrated the lowest success rate (85%). All other implant use in molar positions demonstrated a success rate ranging from 97.0% to 98.6%. Root resected molars and molar implants demonstrated the highest degree of failure when they were lone standing terminal abutments. Seven out of 23 (30.4%) root resected molar failures, and 17 of 45 (37.8%) of the molar implant failures were associated with untreated parafunction. Cumulative success rates were 96.8% for root resected molars and 97.0% for molar implants. Success and failure are discussed by tooth and/or implant position, and resected root, where applicable. Possible ramifications of these findings upon treatment planning are also reviewed. CONCLUSIONS: Both molar root resection and appropriate restoration and molar implant placement and restoration demonstrated a high degree of success in function. However, this success rate is markedly affected when either the root resected molar or molar implant is a lone standing terminal abutment. Care must be taken to choose the appropriate treatment modality for a given patient scenario.

Adult↗
PubMed2002

Systemic release of endotoxins induced by gentle mastication: association with periodontitis severity.

BACKGROUND: Periodontitis has recently been identified as a potential risk factor for systemic pathologies such as cardiovascular disease, the hypothesis being that periodontal pockets could release pro-inflammatory bacterial components, for instance endotoxins, into the bloodstream. It is known that the oral cavity can be a source of circulating bacteria, but this has never been shown for bacterial endotoxins, and no evidence exists so far that the risk of systemic injury is related to the severity of periodontitis. The aim of the present study was to test the influence of gentle mastication on the occurrence of endotoxemia in patients with or without periodontal disease. METHODS: A total of 67 subjects were periodontally examined and grouped according to their periodontal status. This classification was based on an original index of severity of periodontal disease (periodontal index for risk of infectiousness, PIRI) aimed at reflecting the individual risk of systemic injury from the periodontal niches. Thus, the patients were classified into 3 risk groups: low, PIRI = 0; n = 25; moderate, 1 < or = PIRI < or = 5, n = 27; and high 6 < or = PIRI < or = 10, n = 15. Blood samples were collected before and 5 to 10 minutes after a standardized session of gentle mastication for detection of circulating endotoxins. Blood samples were tested with a chromogenic limulus amoebocyte lysate assay. RESULTS: Overall, blood levels of endotoxin after mastication were found to be significantly higher than before mastication (0.89 +/- 3.3 pg/ml versus 3.0 +/- 5.8 pg/ml; P= 0.0002). Likewise, the incidence of positive endotoxemia rose from 6% before mastication to 24% after mastication (P = 0.001). When accounting for the PIRI index, endotoxin levels and positive endotoxemia proved to be significantly higher in patients with severe periodontal disease than in the subjects with low or moderate periodontitis. CONCLUSIONS: Gentle mastication is able to induce the release of bacterial endotoxins from oral origin into the bloodstream, especially when patients have severe periodontal disease. This finding suggests that a diseased periodontium can be a major and underestimated source of chronic, or even permanent, release of bacterial pro-inflammatory components into the bloodstream.

Adult↗
PubMed2002

Endoscopic visualization of the submarginal gingiva dental sulcus and tooth root surfaces.

BACKGROUND: Direct, real-time visualization of the hard and soft tissues within the gingival sulcus may aid the clinician in diagnosis and therapy of periodontal disease. This report describes an endoscope specifically designed for this purpose and the interpretation of dental endoscopic images. METHODS: Medical endoscope technology was modified for application in the dental environment. A fixed, fused fiber optic bundle, less than 1 millimeter in diameter, was coupled to an active matrix LCD-TFT flat panel video monitor for viewing by the clinician. A bilumen sheath was designed to provide irrigation of the sulcus and a sterile barrier between the patient and the fiber bundle. Standard dental curets and ultrasonic scalers were adapted for instrumentation aided by the endoscope. RESULTS: Endoscope technology has been successfully adapted for use in periodontal diagnosis and therapy. Techniques for identification and interpretation of the hard and soft tissue images, as well as the location of root deposits and caries, have been developed. CONCLUSIONS: The dental endoscope gives the clinician direct, real-time visualization and magnification of the subgingival tooth root surface, aiding in the location of deposits on the tooth root. The subgingival soft tissue, including the gingival attachment, sulcus wall, and sulcus contents, can be assessed. Identification and location of subgingival caries, root fractures, tooth root deposits, post perforations, and open restoration margins may aid the clinician in diagnosis and therapy.

Computer Terminals↗
PubMed2003

Oral Kaposi sarcoma associated with severe alveolar bone loss: case report and review of the literature.

BACKGROUND: In AIDS patients who present with an oral neoplasm, Kaposi sarcoma is the tumor most frequently encountered, comprising 50% to 80% of all tumor occurrences. However, oral Kaposi sarcoma associated with erosion of underlying bone is a relatively rare finding. This report and review of the literature documents a case of AIDS-related oral Kaposi sarcoma exhibiting severe bilateral erosion of the maxillary alveolar ridges. METHODS: An HIV-seropositive male with extensive maxillary Kaposi sarcoma and associated bilateral alveolar bone erosion presented for dental evaluation subsequent to radiation therapy. Clinical and radiographic examinations were performed. Medical and dental histories were procured and supplemented with consultations from the patient's primary physician and radiation oncologist. Maxillary edentulation with surgical revision for primary closure was the treatment of choice for management of the dentoalveolar pathology. A maxillary immediate treatment denture was designed to obturate anticipated antral communications with the maxillary sinus. RESULTS: Surgical and prosthetic treatments were completed, but complicated by an oral-antral perforation that subsequently healed without complication. Soft tissue biopsies obtained during surgery revealed no evidence of residual Kaposi sarcoma. CONCLUSIONS: Although AIDS-related oral Kaposi sarcoma is a relatively common finding, erosion of subjacent alveolar bone is uncommon. Treatment of the tumor with subsequent dental reconstruction can be complicated by the severe lack of bone, surgical perforation of the maxillary sinus, and lack of stable teeth to serve as abutments. Significant advances in understanding the pathogenesis of AIDS-related Kaposi sarcoma have occurred in the last decade. HHV-8 and various inflammatory cytokines have been implicated in the pathogenesis and are likely to become the primary targets for therapeutic intervention.

AIDS-Related Opportunistic Infections↗
PubMed2003

Efficacy of controlled-release subgingival chlorhexidine to enhance periodontal regeneration.

BACKGROUND: Periodontal regeneration success may be limited by placing bone grafts and membranes in infected sites. The objective of this study was to test the hypothesis that adjunctive subgingival administration of chlorhexidine gelatin bioresorbable chips enhances bone gain when used in conjunction with guided tissue regeneration. METHODS: This was a single center, blinded, 2-arm parallel design study of 44 subjects with one or more sites with probing depth and clinical attachment loss > or = 5 mm following initial therapy and radiographic evidence of bone loss. The patients were randomly assigned to receive either chlorhexidine (CHX) chip or sham chip placement one week prior to regenerative therapy that included graft placement and site coverage with guided tissue membranes. Patients also received CHX or sham chip placement, per their randomization, adjunctively to scaling and root planing or maintenance procedures. Periodontal examinations were completed at baseline (8 weeks prior to surgery); 1 week prior to surgery; and at 3, 6, and 9 months postsurgery. The major outcomes for the study were changes in bone height and bone mass as measured from standardized radiographs used for quantitative digital subtraction radiography over the 11-month study period. RESULTS: Subjects receiving sham chip placement gained a mean bone height of 1.49 +/- 0.22 mm, while patients receiving the CHX chips gained significantly more bone height (3.54 +/- 0.45 mm; P<0.001). Similarly, subjects receiving CHX chips as an adjunct gained significantly more bone mass (5.57 +/- 0.69 mg; P<0.001) than the standard therapy (2.59 +/- 0.34 mg). CONCLUSIONS: These pilot results indicate that locally delivered, controlled-release antimicrobial treatment may improve the amount of bone gain during guided tissue regeneration procedures. These data support the evidence that infection control is an important variable in successful regeneration.

Adult↗
PubMed2003

Untreated periodontal disease: a follow-up on 30 cases.

BACKGROUND: Many studies have shown that periodontal disease can be successfully treated. However, there is limited documentation as to what happens when periodontal disease is left untreated. This study examined patients in a private practice who were diagnosed with periodontal disease and did not complete any treatment. The goal was to see what happened to this group of untreated patients. METHODS: Thirty patients with periodontal disease were included in this study. After a mean period of 2.1 years without periodontal treatment, the patients were re-examined and the changes which occurred evaluated. RESULTS: There was a statistically significant increase in probing depth (3.43 mm to 3.95 mm) and attachment loss (4.19 mm to 4.77 mm) and a statistically significant decrease in the number of teeth present (23.37 to 22.67). Twenty-one teeth were lost, which was 3.0% of the teeth present at the time of initial diagnosis. The rate of tooth loss was 0.32 teeth/patient/year. The teeth that were lost had deeper recession, probing depths, and attachment loss than the teeth that were retained. Patient factors evaluated could not be associated with statistically significant changes in the clinical parameters, except that smokers had a greater number of sites gaining > or = 2 mm of attachment and patients with the poorest oral hygiene had a greater percent of sites breaking down. However, certain site specific variables could be associated with statistically significant changes in the clinical parameters. These included sites: with bleeding on probing, associated with molar furcations, on interproximal surfaces, at posterior teeth, with probing depths > or = 3.43 mm, with probing depths > or = 7 mm, attachment loss > or = 7 mm, and teeth with increased mobility. CONCLUSIONS: This group of patients with untreated periodontal disease had greater breakdown and tooth loss than one would expect to see in a group of patients if their periodontal disease was treated.

Adult↗
PubMed2003

Crown lengthening in mandibular molars: a 5-year retrospective radiographic analysis.

BACKGROUND: Crown lengthening procedures are a significant part of the periodontist's armamentarium. In order to recreate the clinical space lost to caries or trauma necessary for prosthetic restoration, osseous surgery is often required. If the procedure is not carefully planned, it may result in furcation involvement of multirooted teeth. METHODS: Twenty-six subjects with 26 mandibular molar teeth requiring crown lengthening procedures prior to prosthetic crown placement were evaluated. Nineteen subjects with 24 prosthetic crowns on lower molars which had not undergone crown lengthening were included as control teeth. Bite-wing radiographs prior to surgery (for the test group) or placement of the crown (control group) and 5 years after completion of the prosthesis were compared and analyzed. RESULTS: Of the 26 test teeth, 10 teeth (38.5%) were found to have radiographic evidence of furcation involvement, whereas none of the control teeth developed furcation invasions. CONCLUSION: A critical distance from the furcation (CDF) of 4 mm was established as a landmark under which, if surgery was performed on mandibular molars, chances of furcation involvement in the future were very high.

Adult↗
PubMed2004

Effect of restraint stress on the progression of experimental periodontitis in rats.

BACKGROUND: A hypothesis of an increased risk for destructive periodontal diseases due to psychological stress has long been promoted. However, the research on stress and periodontal disease is still in its infancy. One of the reasons is thought to be that there is no suitable animal model for investigating the relationship. METHODS: One hundred male Wistar rats were included. A nylon ligature was placed around the second right maxillary molars. The animals were then divided into group S, exposed to a restraint stress for 12 hours/day for up to 10 days, and group N, controls. Ten animals were sacrificed on days 2, 4, 6, 8, and 10. Blood samples were taken, and the blood glucose level and the concentrations of adrenocorticotropic hormone, corticosterone, and adrenaline were measured as the markers of stress. The atrophies of the thymus and the spleen were measured. The furcation area of the second maxillary molars was examined histologically and histometrically. RESULTS: In group S, all values of stress markers were increased, and the thymus and the spleen were atrophied. Whereas group N showed only slight alveolar bone resorption, a marked alveolar bone resorption occurred in group S between days 8 and 10. An increase in beaded nerve terminals occurred around the vessels in the furcation area of group S. CONCLUSION: The results of the present study suggest that the restraint stress modulates the progression of periodontal inflammation and that this rat model is suitable for investigating the association between stress and periodontal disease.

Adrenocorticotropic Hormone↗
PubMed2004

Clinical evaluation of a composite bone graft with a calcium sulfate barrier.

BACKGROUND: The goal of this study was to evaluate the effectiveness of a composite bone graft (demineralized freeze-dried bone allograft, calcium sulfate, tetracycline, and porous hydroxyapatite) and calcium sulfate barrier to treat non-furcation osseous defects. METHODS: One hundred patients were treated with the technique. The preoperative measurements were compared to the postoperative measurements (mean 5.2 months) to determine whether the technique had a statistically significant effect. Various factors were evaluated to determine whether they could be related to improved or diminished results. RESULTS: The surgical procedure produced a statistically significant change in the clinical measurements. The mean recession increased from 0.8 to 1.8 mm; the mean probing depth decreased from 8.5 to 3.8 mm; and the attachment level improved from 9.3 to 5.5 mm. Non-smokers, defects in the mandibular arch, defects with deeper probing depths, or defects with greater attachment loss had statistically significant changes in one or more of the clinical parameters evaluated. CONCLUSION: The technique examined in this study (composite bone graft + calcium sulfate barrier) was an effective method to improve the clinical measurements.

Adult↗
PubMed2004

Alendronate may protect against increased periodontitis-related bone loss in estrogen-deficient rats.

BACKGROUND: The aim of this study was to evaluate the impact of alendronate (ALD) and estrogen (EST) therapies and their withdrawal on bone loss in experimental periodontitis in ovariectomized rats. METHODS: Eighty-seven Wistar rats were divided into six groups: group 1 (N = 15): sham surgery; group 2 (N = 15): ovariectomy (OVX); group 3 (N = 15): OVX plus alendronate administration for 80 days (AT); group 4 (N = 14): OVX plus alendronate administration for 40 days (AW); group 5 (N = 14): OVX plus 17beta estradiol administration for 80 days (ET); and group 6 (N = 14): OVX plus 17beta estradiol administration for 40 days (EW). Twenty-one days after ovariectomy or sham surgery, one mandibular molar was randomly assigned to receive a ligature, while the contralateral tooth was left unligated. Sixty days later, the animals were sacrificed and the specimens processed. RESULTS: OVX presented a direct impact on alveolar bone, regardless of plaque accumulation and significantly increased bone loss resulting from periodontitis (P < 0.05). The effect of OVX on unligated sites was significantly reduced by AT, AW, and ET (P < 0.05), but not by EW (P > 0.05). In addition, alendronate administration (AT/AW) significantly reduced the impact of OVX on periodontitis-related bone loss (P < 0.05), while estradiol did not (P > 0.05). CONCLUSION: Within the limits of this study, alendronate administration, but not estrogen replacement, may protect against the impact of estrogen deficiency on alveolar bone presenting a significant residual effect after its withdrawal.

Alendronate↗
PubMed2004

TT virus infection of periodontal tissues: a controlled clinical and laboratory pilot study.

BACKGROUND: A novel single-strand, circular DNA virus has been recently isolated and named TT virus (TTV). It has been demonstrated that peripheral blood cells harbor TTV DNA, suggesting that the virus might replicate in lymphoid cells and contribute to lymphocyte imbalances with consequent immunosuppressive effects. The purpose of this study was to investigate the prevalence of TTV DNA in healthy and periodontally compromised subjects, evaluating the presence of the virus in the gingiva and saliva, and comparing virological results with clinical data. METHODS: Twenty-one patients (seven males and 14 females, aged 25 to 76 years) were enrolled in the study. Eleven subjects were diagnosed with moderate periodontitis, while 10 were periodontally healthy. A sample of saliva was taken from each patient before recording the periodontal data; subsequently, a gingival biopsy was performed. A real-time polymerase chain reaction was used to quantify the presence of TTV DNA in saliva and gingival specimens. RESULTS: A statistically significant association was found between TTV in gingival tissue and the presence of periodontitis (P = 0.0351), while no association was observed between TTV in saliva and the presence of periodontitis (P = 0.4762). CONCLUSIONS: A new DNA virus (TTV) was first identified in the gingival tissue and was found to be significantly associated with the presence of periodontitis. These findings need to be investigated in further studies.

Adult↗