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PubMed2002

Vibrational and thermal study on the in vitro and in vivo degradation of a bioabsorbable periodontal membrane: Vicryl Periodontal Mesh (Polyglactin 910).

Fourier transform Raman (FT-Raman), attenuated total reflection/Fourier transform infrared (ATR/FT-IR) spectra and differential scanning calorimetry (DSC) measurements were performed on a biodegradable periodontal membrane, the Vicryl periodontal mesh, in order to study its in vitro and in vivo degradation mechanism and kinetics. The hydrolitic in vitro degradation was investigated in two aqueous media: a saline phosphate buffer (SPB, pH=7.4) and a 0.01 M NaOH solution. Moreover, a membrane implanted in vivo for 4 weeks for treatment of contiguous vertical bony defects, was examined. Vibrational and thermal measurements show that the Vicryl membrane presents a semicrystalline structure. It degrades faster in the NaOH solution than in the SPB and degradation occurs heterogeneously with a progressive increase in the percentage of crystallinity and shortening of the polymeric chains both in vitro and in vivo. The trends of % weight loss and IR I627/I1415 intensity ratio (identified as a marker of crystallinity) are discussed in comparison with the DSC results. The IR I627/I1415 intensity ratio and Xc% allow to determine the % weight loss undergone by the membrane degraded in vivo. The result obtained shows that the Vicryl membrane degrades faster in vivo than in vitro with the formation of oligomers which are more easily absorbed by the surrounding tissues than they are soluble in the degradation media examined.

Journal Article↗
PubMed1989

Measurements of probing velocity with an automated periodontal probe and the relationship with experimental periodontitis in the Cynomolgus monkey (Macaca fascicularis).

The Toronto Automated Periodontal Probe allows simultaneous measurements of gingival attachment level and probing velocity. The efficacy of probing velocity in measuring the integrity of the dento-gingival junction was studied and compared with loss of gingival attachment level, gingival inflammation, tooth mobility and gingival crevicular fluid collagenolytic activity. The gingiva around the maxillary and mandibular incisor teeth of 2 monkeys were first brought to clinical health by daily prophylaxis. Baseline measurements were made and inflammation was then induced around the maxillary incisors by withdrawing plaque control and by placing silk ligatures subgingivally. The mandibular incisors served as controls. After 10 weeks, the ligatures were removed and the teeth scaled and polished daily for 1 week. The plaque index and gingival index reached maximum values within 1 week; crevicular fluid flow was significantly increased at 1 and 3 weeks but mobility did not change significantly. There was progressive loss of the gingival attachment level, which peaked at 10 weeks on experimental teeth; there was no significant loss on control teeth. Probing velocity around experimental teeth exhibited large and significant increases above controls between 1 and 3 weeks, coinciding with the largest weekly losses of the gingival attachment level. Thus probing velocity may be a useful clinical method for the ancillary measurement of early loss of the gingival attachment level. It can also detect biophysical changes in the dento-gingival junction of progressive inflammatory lesions.

Animals↗
PubMed1999

Changes in the periodontal membrane due to apical periodontitis.

Teeth with an apical inflammatory lesion were studied by light microscopic morphometrical procedures to estimate the volumetric density of periodontal ligament tissues by point counting. Sixty-four root surfaces were investigated from coronal to apical. The observed tissue changes were similar in groups with and without bacteria, except for an elevated volumetric density of inflammatory cells in the first group. The attachment was lost apically. Principal fibers running to the root surface and extensions in the cementum decreased from coronal to apical, but were replaced by fibers running parallel to cementum and fibers oriented in a network. We suggest that acellular extrinsic fiber cementum was lost, whereas cellular mixed stratified cementum was built. The cellular mixed stratified cementum synthesis was by inclusion of the remaining fibers from the acellular extrinsic fiber cementum. We suspect that the changes were the result of the anti-inflammatory reaction caused by the periapical lesion.

Adult↗
PubMed1999

Antibiotic susceptibility of putative periodontal pathogens in advanced periodontitis patients.

In the present study, the antibiotic susceptibility of most prevalent micro-organisms in advanced periodontitis patients was evaluated. In 56 patients, pooled subgingival plaque samples were taken from the deepest site of each quadrant and were cultivated anaerobically. From each patient, the 4 most frequently encountered types of bacterial colonies were subcultured and identified (Rapid ID 32 A). From all bacterial species identified in the 224 subcultures, the 4 most prevalent were used for susceptibility testing to tetracycline, metronidazole and amoxicillin/clavulanate using the E Test. The most prevalent microorganisms were Fusobacterium nucleatum (38/214), Peptostreptococcus micros (33/214), Prevotella oralis (33/214) and Porphyromonas gingivalis (32/214). Regarding antibiotic susceptibility it could be shown that minimal inhibitory concentration (MIC) in all cases was below antibiotic concentrations achievable in gingival crevicular fluid. However, antibiotic resistance was seen in 3 to 29% of the investigated microorganisms.

Adult↗
PubMed1990

On the inability of root debridement and periodontal surgery to eliminate Actinobacillus actinomycetemcomitans from periodontal pockets.

In a previous study, we observed that root debridement was inefficient in eliminating Actinobacillus actinomycetemcomitans from adult periodontitis lesions. The present report describes the effects on A. actinomycetemcomitans of subsequent treatments of 6 patients that had at least 2 separate sites still harboring A. actinomycetemcomitans 6 months following debridement. 1 site or more in each individual was treated with renewed root debridement and at least 1 other site was treated by surgical excision of the gingival tissue. The results indicated that retreatment with either repeated root debridement or with surgical excision of the gingival tissue was not more effective in eliminating A. actinomycetemcomitans than initial debridement. The possible reasons for this limited therapeutic effect on the subgingival presence of A. actinomycetemcomitans are discussed.

Actinobacillus↗
PubMed1999

A six-month comparison of three periodontal local antimicrobial therapies in persistent periodontal pockets.

BACKGROUND: Currently, several local antimicrobial delivery systems are available to periodontists. The aim of this 6-month follow-up parallel study was to evaluate the efficacy of three commercially available local delivery systems as adjuncts to scaling and root planing in the treatment of sites with persistent periodontal lesions. METHODS: Seventy-nine patients with 4 pockets > or = 5 mm and bleeding on probing and/or suppuration were randomized into 4 treatment groups which included: scaling and root planing alone (S) (20 patients), or in conjunction with the application of 25% tetracycline fibers (S+Tet) (19 patients), or 2% minocycline gel (S+Min) (21 patients), or 25% metronidazole gel (S+Met) (19 patients). Clinical measurements were taken at baseline, 6 weeks, 3 months, and 6 months after antimicrobial application. Treatments were applied using the distributors' recommended protocols. RESULTS: All 4 therapies resulted in significant improvements from baseline in probing depth, attachment level, bleeding on probing, and the Modified Gingival Index (MGI) scores. The improvements in clinical parameters were greater in all 3 adjunctive treatment groups than scaling and root planing alone. The mean probing depth reductions at 6 months were: scaling + tetracycline = 1.38 mm; scaling + metronidazole = 0.93 mm; scaling + minocycline = 1.10 mm; and scaling alone = 0.71 mm. The probing depth reduction at all time points was significantly greater in the scaling plus tetracycline fiber group than the scaling and root planing alone group (P<0.01). There was also a significant improvement for scaling plus tetracycline fiber application over scaling and metronidazole at both 6 weeks and 3 months, although this did not remain significant at the 6-month visit. While the frequency of sites with suppuration was markedly reduced following all antimicrobial treatments, the most effective reductions were seen in the scaling plus tetracycline fiber group, followed by the minocycline group. CONCLUSIONS: Although all 3 locally applied antimicrobial systems seem to offer some benefit over scaling and root planing alone, a treatment regimen of scaling and root planing plus tetracycline fiber placement gave the greatest reduction in probing depth over the 6 months after treatment.

Adult↗
PubMed1991

[An epidemiological study on dental-periodontal pathology in a sample of the school-age population of the city of Naples. I. Periodontal pathology].

The paper reports the results of a study of the prevalence of periodontal diseases found in a sample group, aged between 6 and 18, resident in Naples. The structure of the survey, the clinical methods of collecting data and the statistical processing of data were carried out according to WHO directives regarding the study of oral pathologies.

Adolescent↗
PubMed1995

[Cariologic and periodontal screening of children aged 7, 12 and 14 years in the city of Debrecen. II. Periodontal status and need for treatment].

The aim of present survey was to gain epidemiological data on periodontal condition of 7, 12 and 14 yrs old (40 children in 7, 92 children in 12 and 84 children in 14 yrs old groups) schoolchildren as assessed by the CPITN. The peridontal health of children proved to be very poor. Only 33.3% of 7 yrs old, 20.9% of 12 yrs and 13.1% of 14 yrs old children showed healthy gingiva. Bleeding on probing was observed in 66.7% of 7 yrs old group, in 19.8% of 12 and in 16.7% of 14 yrs old groups. The calculus prevalence was 0.0% of 7 yrs old children, 56.0% in 12 and 44.7% in 14 yrs old groups. Oral hygiene instruction was needed by 66.7% of 7, 79.1% of 12 and 86.9% of 14 yrs old children. Scaling was necessary in 11.1% of 7, 59.3% of 12 and 70.2% of 14 yrs old groups. Complex treatment was needed in none of the groups examined.

Adolescent↗
PubMed2002

Stress and the periodontal diseases: effects of catecholamines on the growth of periodontal bacteria in vitro.

Microorganisms possess the ability to recognize hormones within the host and utilize them to adapt to their surroundings. Noradrenaline and adrenaline, which are released during human stress responses, may act as environmental cues to alter the growth of individual organisms within subgingival biofilms. The aims of this study were to modify, for anaerobic culture, existing methodology used in determining microorganism catecholamine responses and to investigate the growth responses to noradrenaline and adrenaline of 43 microorganisms found within subgingival microbial complexes. We established initial inocula for each strain using anaerobic culture, re-inoculated into a minimal serum-based medium and grown anaerobically at 35 degrees C. We assessed organism growth by optical density (OD(600nm)) readings, with test and control cultures performed in triplicate. Test cultures were supplemented with 50 microm noradrenaline or 100 microm adrenaline. We observed significant growth effects for supplementation with noradrenaline (20 species responding positively) and adrenaline (27 species responding positively), with differences in growth response observed within bacterial species and within and between microbial complexes. The most pronounced positive growth effects of noradrenaline were demonstrated in Actinomyces naeslundii (+ 49.4%), Actinomyces gerenscseriae (+ 57.2%), Eikenella corrodens (+ 143.3%) and Campylobacter gracilis (+ 79.9%). We also observed inhibitory effects of noradrenaline supplementation for Porphyromonas gingivalis (- 11.9%) and Bacteroides forsythus (- 22.2%). Responses to adrenaline tended to mirror the responses seen with noradrenaline. Individual organisms from different microbial complexes vary in their in vitro growth responses to noradrenaline and adrenaline. Such variation may influence the in vivo composition of the subgingival biofilm in response to stress-induced changes in local catecholamine levels and play a significant role in the aetiology and pathogenesis of the periodontal diseases.

Actinomyces↗
PubMed2003

C-1 esterase inhibitor dysfunction localised to the periodontal tissues: clues to the role of stress in the pathogenesis of chronic periodontitis?

BACKGROUND: C1-esterase inhibitor (C1eIn) is an important modulator of complement activation via the classical pathway. Deficiencies or dysfunction involving this inhibitor underlie the condition of angioneurotic oedema. AIM: The purpose of this report is to describe a female patient who presented at the age of 24 years with an apparently aggressive form of periodontitis and severe oedema, localised to the free gingival tissues. After 21 years of repeated surgical reduction of the gingiva, a diagnosis of C1eIn dysfunction was made. METHODS: Exhaustive serological investigations were performed along with histopathology. RESULTS: All investigations were unremarkable, until the function of the C1eIn molecule was investigated. These demonstrated a functional activity of only 29% and a raised C1q at 157 mg/l. Subsequent repeated investigation with careful specimen handling demonstrated undetectable levels of C1eIn and normal C1q. A diagnosis of C1eIn dysfunction was made, although at present it is unclear whether this represents an unusual variant of hereditary dysfunctional C1eIn deficiency. The patient was managed by various means, including steriodal and non-steroidal drugs, the latter forming part of her maintenance regime. CONCLUSIONS: To our knowledge, this is the first case of angio-oedema localised to the free gingiva. The role of stress in the acute exacerbations of oedema and bone loss is discussed along with the diagnostic pitfalls associated with this case.

Adult↗
PubMed1983

Effects of nonsurgical periodontal therapy on periodontitis in humans. A review.

Root planing is an effective method of treating both moderate and severe periodontitis. Predictable and significant improvement in bleeding scores, probing pocket depths and probing attachment levels have been demonstrated by a number of different research groups. Significant positive changes in the subgingival microflora are induced. These improvements can be sustained for longer periods of time if adequate supragingival plaque control is achieved. It is important to realize that the research to date excludes the effects of therapy on furcation pockets. Results of conservative therapy in this critical area remain to be studied.

Dental Scaling↗
PubMed1986

Serum antibody levels to 4 periodontal pathogens remain unaltered after mechanical therapy of juvenile periodontitis.

Serum antibody titers to Actinobacillus actinomycetemcomitans (A.a.) Y4, Bacteroides gingivalis, Capnocytophaga ochracea and Eubacterium saburreum were determined with an enzyme immunoassay in 12 patients with juvenile periodontitis (JP) at the beginning of treatment and 16 to 32 months later after clinically successful mechanical therapy without antibiotics. The values were compared to corresponding data obtained from 26 age- and sex-matched individuals with a healthy periodontium. 6 JP patients had significantly increased levels of IgG and IgA antibodies to A.a. and 2 patients had increased IgG and IgA antibodies to C.ochracea. About 75% of the JP patients had a level of IgG antibody to B.gingivalis and E.saburreum which was more than one SD lower than the mean of the healthy controls, and in the IgA class 80-100% had such decreased levels of antibodies to these bacteria. In the IgM class, the JP patients by and large had normal levels of antibodies to the 4 bacteria. After treatment, antibodies to A.a. had decreased in only 3 patients, but the levels were still significantly higher than in healthy controls. Minimal alterations were observed in the levels of antibodies to B.gingivalis, C.ochracea and E.saburreum after treatment.

Actinobacillus↗
PubMed1992

Periotest for measuring periodontal characteristics--correlation with periodontal bone loss.

The Periotest measures the reaction of the periodontium to a defined percussive force. The percussion is applied to the tooth by an electronically controlled tapping head. Information on structural change is obtained by measurement of both the elastic and viscous characteristics of the periodontium. The latter prevent oscillations of the tooth in the alveolar bone. A value is calculated and is displayed as a "Periotest value". The following research report shows the relation of Periotest values to bone loss. Bone loss was quantitatively determined for 2312 teeth from orthopantomographic radiographs and for 900 teeth exposed to intra-oral films using the standard paralleling technique. A differentiation was made between vertical and horizontal bone loss. Clinical mobility index, pocket depth, gingival recession and papillary hemorrhagic index were also measured. There was a strong association between the Periotest value and bone loss. These results suggest that Periotest evaluation provides an objective indication of the extent of periodontal bone loss.

Adult↗
PubMed1984

An osteonectinlike protein in porcine periodontal ligament and its synthesis by periodontal ligament fibroblasts.

Periodontal ligament, a soft connective tissue that lies between cementum and alveolar bone in the periodontium, has been shown to contain an osteonectinlike protein. The similarity between porcine ligament osteonectin and bovine bone osteonectin was evident from immunochemical studies, from migration characteristics on sodium dodecyl sulfate - polyacrylamide gel electrophoresis (SDS-PAGE) and from binding studies on hydroxyapatite. Using immunotransfer and immunodot analyses, ligament osteonectin was found to be extractable from tissues with 4 M guanidine-HCl (GuHCl) and 4 M GuHCl - 0.5 M EDTA and to comigrate with authentic bovine osteonectin on SDS-PAGE with a relative mass approximately 38 000. Furthermore, osteonectin from guanidine extracts of ligament was bound to hydroxyapatite in the presence of 4 M GuHCl. Immunofluorescence studies showed the osteonectin to be distributed throughout the extracellular matrix of the ligament and to be present within the ligament fibroblasts in a perinuclear, punctate distribution. Biosynthesis of osteonectin by ligament fibroblasts was studied following pulse-chase labelling with [35S]methionine and immunoprecipitation. The labelled osteonectin in the chased culture medium represented approximately 0.5% of the total labelled proteins secreted. It comigrated on SDS-PAGE with the corresponding labelled protein from pulsed cells and with the protein extracted from the tissue.

Animals↗
PubMed1979

Importance of combined periodontal and acid-etch composite treatment in restoration of anterior teeth and periodontal health.

Severely fractured, hypoplastic, and carious mandibular anterior teeth in a 17-year-old patient precluded the ability to use adequate methods of control of plaque. With simple, inexpensive techniques, periodontal health was restored and a functional and esthetic occlusion was provided. This treatment plan was accomplished with minimal risk of injuring the pulps of the teeth.

Acid Etching, Dental↗
PubMed1987

Periodontal wound healing in the absence of periodontal ligament cells.

This experiment was designed to study the ability of mucoperiosteal flap connective tissue to form new attachment on partially demineralized roots as well as nondemineralized roots in a wound-model where periodontal ligament (PDL) cells are absent, and ingrowth of bone granulation tissue is controlled. After reflecting mucoperiosteal flaps, bone was removed circumferentially around the distal root of mandibular second premolars and the mesial root of mandibular third premolars in five beagle dogs. The roots were completely denuded from the cementoenamel junction to the apex and curetted to remove PDL and cementum. Following root canal filling, the denuded roots on one side were conditioned with citric acid while the contralateral roots served as controls. To prevent bone-derived granulation tissue from contacting denuded roots, sheets of Nuclepore membrane were placed over the exposed bone margins and secured in place with steel ligatures. The flaps were coronally positioned and sutured. Histologic examination was made after three months of healing accompanied by regular plaque control. Both the experimental (acid conditioned) and control roots showed epithelium extending into the apical third of denuded roots and root resorption confined to the root apices. Some experimental specimens showed connective tissue adhesion in the apical third of roots without any new cementum or oriented fibers. Inflammatory cell infiltrate was seen extending to the apical third of denuded roots in both groups. In this model, the flap connective tissue cells failed to form new cementum and inserting fibers. Whether this was the result of inflammation and epithelial downgrowth or the inability of flap connective tissues to form new attachment could not be concluded from the study.

Alveolar Process↗
PubMed1990

Periodontal disease morbidity quantification. I. Optimal selection of teeth for periodontal bone loss surveys.

The assessment of alveolar bone loss with bite-wing radiographs is attractive because bite wings are relatively convenient, inexpensive, and available. The choice of teeth used influences the validity of global bone loss assessments based on partial mouth measurements. The objective of this study was to validate periodontal bone loss indices based on a few teeth. The mandibular posterior teeth were considered as a basis for abbreviated indices. The optimum number of teeth included was evaluated, and the utility of abbreviated indices was determined experimentally. The teeth from 75 skulls were measured from the cemento-enamel junction (CEJ) to the alveolar bone at six locations per tooth. The subsets of teeth which best represent the average whole mouth bone loss were found with all-possible-subsets regression analysis. Bone loss data from 179 prehistoric skulls were used to test the validity of selected teeth indices. Bone loss measurements from the mandibular posterior areas were representative of full-mouth bone loss measurements. Mandibular second premolars plus any other mandibular posterior teeth were the optimal combination of tooth for an abbreviated index. This subset is suitable for use with bite-wing radiographs.

Adult↗