Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PERIODONTICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed1993

HLA-D and T lymphocyte reactivity to specific periodontal pathogens in type 1 diabetic periodontitis.

Bacterial antigen fragments complexed with class II major histocompatibility molecules (HLA-D) on antigen presenting cells (APCs) stimulate CD4+ T lymphocyte proliferation, presumably to protect the host. This study examined these responses to antigens of two periodontal pathogens in four groups (n = 15) of age- (young adult) and sex-matched Caucasian subjects with or without type 1 diabetes and moderate to severe periodontitis: Group DP = diabetics with periodontitis; Group DnP = diabetics without periodontitis; Group nDP = nondiabetics with periodontitis; and Group nDnP = nondiabetics without periodontitis. HLA-D phenotypes for each subject were determined by lymphocytotoxicity assays. T lymphocytes purified from peripheral blood were stimulated in cell culture with APC pulsed with various concentrations of tetanus toxoid, Porphyromonas gingivalis, and Capnocytophaga sputigena antigens. T lymphocyte reactivity (3H thymidine incorporation) was numerically lower in cultures from diabetics stimulated with unpulsed APC (not significant), and antigen-pulsed cultures showed low proliferation and no significant differences among groups. Stimulation indices in cultures from diabetic patients stimulated with P. gingivalis or C. sputigena, however, were significantly elevated at all antigen concentrations compared to nondiabetic cultures. The occurrence of HLA-DR4 was moderately associated with diabetes (P < 0.05) and highly associated with periodontitis (P < 0.001, log-linear model for categorical variables); and HLA-DR53 and HLA-DQ3 were significantly associated with periodontitis (P < or = 0.02). HLA-DR was crucial to lymphocyte stimulation (anti-HLA-DR blocking experiments), but the low peripheral blood T cell reactivity to antigens of periodontal pathogens could not be linked with HLA-D type or periodontitis susceptibility.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2003

Zone between plaque and attached periodontal tissues on chronic periodontitis-affected teeth: an SEM study.

The zone between plaque and attached periodontal tissues on chronic periodontitis-affected teeth was examined by a combined macroscopic and scanning electron microscopy (SEM) approach. Examined were 27 teeth with chronic periodontitis (chronic periodontitis-affected group) and three healthy teeth with no evidence of periodontal disease (control group). Both groups were collected immediately after extraction, fixed in 2% glutaraldehyde, and post-fixed in 1% osmium tetroxide. Then, teeth were macroscopically examined to identify their stained zones. Teeth were dehydrated, critical-point dried, gold coated, and examined in an SEM. Both healthy and chronic periodontitis-affected teeth showed a very similar staining pattern on their surfaces. An unstained band with a belt-like appearance was observed around the teeth, delimited by two osmium-stained zones. Some weakly stained areas were frequently observed inside the unstained band. The SEM examination showed four different regions in both groups. These regions appeared in the following coronoapical sequence: dental plaque, plaque-free zone, junctional epithelium, and attached periodontal tissues. A dental cuticle covering the cementum surface from the plaque border to the junctional epithelium was detected on chronic periodontitis-affected teeth. Some aspects of this particular zone may be involved in the pathogenesis of inflammatory periodontal disease and therefore may have some influence on treatment for chronic periodontitis-affected teeth.

Chronic Disease↗
PubMed2006

[Distribution of fimA genotype of Porphyromonas gingivalis in Chinese periodontitis patients and its relationship with chronic periodontitis].

OBJECTIVE: To investigate the distribution of fimA genotype of Porphyromonas gingivalis in Chinese periodontitis patients and try to find the relationship between fimA genotype and chronic periodontitis. METHODS: Subgingival plaque samples were collected from 101 periodontitis patients. P. gingivalis 16S rRNA primer and fimA type-specific primer were designed. The distribution of fimA genotype in periodontitis patients was detected by PCR. Clinical periodontal indices (PPD, CAL and BOP) were measured at the sample tooth's six points; namely, the mesio-, mid-, distobuccal and mesio-, mid-, distolingual points. RESULTS: P. gingivalis was detected in 89 periodontitis patients (88.1%). Among them, a single fimA genotype was detected in most subgingival plaque samples (65.1%), and the most prevalent fimA genotype was type II (43.8%), followed by type IV (40.4%); Type II fimA and IV fimA were more frequently detected in mild/moderate periodontitis group and severe periodontitis group. CONCLUSION: The findings indicate that P. gingivalis with type II fimA and IV fimA are more predominant in Chinese periodontitis, and the organisms are involved in the destructive progression of periodontitis in Chinese.

Adult↗
PubMed2000

Community periodontal index of treatment needs and prevalence of periodontal conditions.

BACKGROUND/AIMS: In 1977, the World Health Organization (WHO) proposed a new index, the community periodontal index of treatment needs (CPITN) to evaluate the periodontal treatment needs of populations. The aim of this study is to compare different approaches of recording and presenting the CPITN. METHODS: A sample of 2110 subjects aged 35-44 years were examined between September 1994 and July 1995, throughout the province of Quebec, Canada. For each tooth (3rd molars excluded), the presence of bleeding and calculus, the level of epithelial attachment, and the depth of periodontal pockets were measured. Periodontal pocket depths were measured from the edge of the free gingiva, at 2 sites (mesiovestibular and vestibular), as well as all around the tooth. RESULTS: Only 8.5% of adults had at least one tooth with a 6 mm or deeper periodontal pocket when probing on 2 sites, whereas if probing is done all around the tooth, this percentage is 2.5x higher (21.4%). The partial recording of pocket depths (10 index teeth recommended by WHO, or 2 quadrants chosen at random) resulted in an underestimation of the prevalence of subjects with at least one tooth with a periodontal pocket (CPITN score 3 and 4). Among subjects with at least one tooth with a 6 mm or deeper periodontal pocket, 12% were not detected with the 10 index teeth recording, and 25% go undetected with the measure on 2 quadrants. Finally, using the % of subjects with periodontal pockets overestimates the prevalence of deep pockets compared with using sextants. Indeed, close to 30.0% of sextants have no treatment needs, whereas only 5.2% of subjects are in this category. Similarly, 7.7% of sextants have at least one tooth with a 6 mm or deeper periodontal pocket, yet there are 3x more subjects in this category (21.4%).

Adult↗
PubMed1994

Differential periodontal temperature measurements in the assessment of periodontal disease activity: an experimental and clinical study.

The difference in surface temperatures between the bottom of periodontal pockets and the attached gingiva adjacent to the openings of the pockets were determined both in monkeys with experimental marginal periodontitis, and clinically in patients with marginal periodontitis. For this purpose a custom-made, temperature-measuring device was developed which enabled immediate recording of temperature differences as well as periodontal pocket depths, bleeding, and attachment levels. The measurements were performed periodically. The differential temperature measurements were correlated to change in periodontal attachment over time. It was shown that differential periodontal temperatures are well correlated to change in periodontal attachment over time. It was furthermore concluded that differential periodontal temperature measurements have the potential of serving as a predictor of activity of marginal periodontitis. However, more extensive data are required to assess the sensitivity and specificity of the method.

Animals↗
PubMed2001

Osseointegrated implants in patients treated for generalized chronic periodontitis and generalized aggressive periodontitis: 3- and 5-year results of a prospective long-term study.

BACKGROUND: The successful use of osseointegrated implants in periodontally healthy patients has been documented in numerous longitudinal studies in recent years. However, the extent to which these positive results apply to periodontally diseased patients remains unclear. The aim of the present prospective longitudinal study of partially edentulous patients treated for generalized chronic periodontitis and generalized aggressive periodontitis was a clinical, microbiological, and radiographic comparison of teeth and implants and assessment of the implant success rate. METHODS: Five partially edentulous patients treated for generalized aggressive periodontitis (GAgP) and 5 treated for generalized chronic periodontitis (GCP) were enrolled in this study. The GAgP patients received 36 implants, and the GCP patients 12 implants. The teeth were examined 2 to 4 weeks before extraction of the non-retainable teeth (baseline), and 3 weeks after insertion of the final abutments (second examination). All further examinations were performed during a 3-month recall schedule over a 5-year period for the GAgP patients and over a 3-year period for the GCP patients. At each session clinical parameters were recorded at teeth and implants and the composition of the subgingival microflora was determined by dark-field microscopy and DNA analysis. Intraoral radiographs of the teeth and implants were taken for control purposes at baseline; after insertion of the superstructure; and 1, 3, and 5 years later. RESULTS: The clinical findings indicated healthy periodontal and peri-implant conditions in both patient groups throughout the study. However, an increased probing depth and an attachment loss were recorded in the GAgP patients after the third year (P<0.001). The distribution of the microorganisms revealed no significant differences between the patient groups or between implants and teeth. Moderate bone loss at teeth and implants was registered in both groups. The success rates recorded were 100% in the GCP patients and 88.8% (maxilla: 85.7%; mandible: 93.3%) in the GAgP patients. CONCLUSIONS: The 3-year and 5-year follow-ups show that osseointegrated implants may be successful in oral rehabilitation of partially edentulous patients treated for generalized aggressive periodontitis and generalized chronic periodontitis. However, as no significant differences were recorded between conditions at teeth and at implants, progression of the disease cannot be ruled out.

Adult↗
PubMed2003

Distribution of periodontal pathogens in Korean aggressive periodontitis.

BACKGROUND: Microbial associations in aggressive periodontitis versus different ethnic origins are substantially unknown. We undertook this study to determine the prevalence of seven putative periodontopathogens in Korean patients and to evaluate microbial differences in localized and generalized aggressive periodontitis patients. METHODS: Thirty-nine aggressive periodontitis patients between 20 and 35 years old (24 males and 15 females; mean age 29.6 years) were selected according to clinical criteria. The patients were subclassified into 17 localized and 22 generalized aggressive periodontitis patients. In each of the 39 individuals, subgingival plaque samples were collected from four diseased teeth (> or = 6 mm probing depth, 156 sites) and one healthy site (< or = 3 mm probing depth, 39 sites). Polymerase chain reaction (PCR) of the 16S ribosomal RNA gene fragments (about 530 bp) of plaque bacteria and their subsequent detection by dot-blot hybridization using specific oligonucleotide probes were performed to determine the presence of seven periodontopathogens. RESULTS: The prevalences were 75% for Actinobacillus actinomycetemcomitans, 94.2% for Tannerella forsythensis (formerly Bacteroides forsythus), 99.4% for Fusobacterium sp., 85.9% for Micromonas micros (formerly Peptostreptococcus micros), 96.8% for Porphyromonas gingivalis, 78.8% for Prevotella intermedia, and 96.8% for Treponema sp. The prevalences of these bacteria were significantly higher in diseased sites than in healthy sites. Logistic regression analysis showed that P. intermedia was more significantly associated with generalized aggressive periodontitis than the localized form, with an odds ratio of 3.28 (95% confidence interval 1.26-8.56, P = 0.015). CONCLUSIONS: Our results demonstrate that the seven periodontal pathogens analyzed are strongly associated with Korean aggressive periodontitis. In particular, P. intermedia are more significantly associated with generalized aggressive periodontitis, a more severe and progressive form, than with localized aggressive periodontitis.

Adult↗
PubMed1986

Periodontal health and periodontal disease in young people: global epidemiology.

A review of epidemiological surveys of the periodontal conditions of young people has shown that chronic marginal gingivitis associated primarily with plaque, is global, very common and even endemic in some population groups. Data on the prevalence of transient gingival conditions associated with tooth eruption, puberty and systemic factors are lacking and therefore their contribution to the prevalence of periodontal disease is unknown. Reports of periodontitis in young people are relatively uncommon except in a few populations where it appears as an adult-type of chronic marginal periodontitis. Juvenile periodontitis and other more destructive forms of periodontitis are not common. However, problems in epidemiological methodology and clinical differential diagnosis make comparative evaluation of survey data difficult and subjective. Two epidemiological indices, the Periodontal Index and the Community Periodontal Index of Treatment Needs (CPITN) have been used for many surveys in varied population groups. They provide data which agree on the ubiquity of gingivitis, whether identified visually or by bleeding-on-probing, and the low frequency of periodontitis. Data from CPITN surveys reveal a higher prevalence of calculus (sub-gingival) associated with gingivitis in young people than previously reported. All the epidemiological data reviewed point to plaque as the primary aetiological agent in gingivitis. There is little evidence of the involvement of other factors except that host resistance/susceptibility in this age group may modify the microbial effect.

Adolescent↗
PubMed2004

The role of cathepsin C in Papillon-Lefèvre syndrome, prepubertal periodontitis, and aggressive periodontitis.

We have previously reported that loss-of-function mutations in the cathepsin C gene (CTSC) result in Papillon-Lefèvre syndrome, an autosomal recessive condition characterized by palmoplantar keratosis and early-onset, severe periodontitis. Others have also reported CTSC mutations in patients with severe prepubertal periodontitis, but without any skin manifestations. The possible role of CTSC variants in more common types of non-mendelian, early-onset, severe periodontitis ("aggressive periodontitis") has not been investigated. In this study, we have investigated the role of CTSC in all three conditions. We demonstrate that PLS is genetically homogeneous and the mutation spectrum that includes three novel mutations (c.386T>A/p.V129E, c.935A>G/p.Q312R, and c.1235A>G/p.Y412C) in 21 PLS families (including eight from our previous study) provides an insight into structure-function relationships of CTSC. Our data also suggest that a complete loss-of-function appears to be necessary for the manifestation of the phenotype, making it unlikely that weak CTSC mutations are a cause of aggressive periodontitis. This was confirmed by analyses of the CTSC activity in 30 subjects with aggressive periodontitis and age-sex matched controls, which demonstrated that there was no significant difference between these two groups (1,728.7 +/- SD 576.8 micro moles/mg/min vs. 1,678.7 +/- SD 527.2 micro moles/mg/min, respectively, p = 0.73). CTSC mutations were detected in only one of two families with prepubertal periodontitis; these did not form a separate functional class with respect to those observed in classical PLS. The affected individuals in the other prepubertal periodontitis family not only lacked CTSC mutations, but in addition did not share the haplotypes at the CTSC locus. These data suggest that prepubertal periodontitis is a genetically heterogeneous disease that, in some families, just represents a partially penetrant PLS.

Adult↗
PubMed1990

The microbial flora from root canals and periodontal pockets of non-vital teeth associated with advanced periodontitis.

Microflora from root canals and periodontal pockets of periodontally affected teeth were compared in order to elucidate the as yet unknown relationship between pulpal and periodontal disease. Caries-free teeth affected with advanced periodontitis and diagnosed as clinically dead by electric pulp testing were selected. The root canals and periodontal pockets were sampled, and the bacterial flora examined by both culture and interference microscopy. The results indicated that the aerobe/anaerobe ratio in the periodontal pocket was 0.23, while it was 0.0022 in the root canal, the large predominance of obligate anaerobes reflecting the anaerobic environment found in the root canal. Morphological classification obtained from interference microscopy showed similar proportions of morphotypes in the two sites. Results of anaerobic culture demonstrated a significantly higher rate of detection of facultative Streptococcus bacteria in the periodontal pocket than in the root canal. The predominant bacterial species common to both regions were Streptococcus, Peptostreptococcus, Eubacterium, Bacteroides, and Fusobacterium for obligate anaerobes. As for facultative anaerobes, Actinomyces and Streptococcus were detected predominantly in the periodontal pocket. The occurrence of micro-organisms common to both sites in this study suggests that the periodontal pocket may be a possible source of root canal infections.

Actinomyces↗
PubMed1994

The gingival immune response to periodontal pathogens in juvenile periodontitis.

A gingival explant culture system was utilized to evaluate the reactivity of local immunoglobulins produced by juvenile periodontitis tissue. Gingival explant culture supernatant fluids were screened, via a standardized dot-immunobinding assay, for antibodies reactive to: Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Campylobacter rectus, Eikenella corrodens, Peptostreptococcus micros, Peptostreptococcus anaerobius, Capnocytophaga ochracea, Eubacterium nodatum and Fusobacterium nucleatum and one nonoral microorganism, Porphyromonas asaccharolytica. Of the 75 juvenile periodontitis supernatant fluids tested, the organisms that reacted with the highest numbers of supernatant fluids were E. nodatum (72%) and A. actinomycetemcomitans (49%). More juvenile periodontitis than healthy tissue samples showed supernatant fluid reactivity to P. intermedia, C. ochracea, E. nodatum and P. micros. No significant difference was observed between the juvenile periodontitis group supernatant fluids reactivity and the supernatant fluids of the other periodontal disease groups tested. Cluster analysis revealed the association, as determined by supernatant fluid reactivity, of P. micros and C. ochracea in the juvenile periodontitis group. The data from this investigation are consistent with a hypothesis of multiple possible etiologies of periodontal destruction in juvenile periodontitis and other forms of periodontal diseases.

Adolescent↗
PubMed2005

Marker of cemento-periodontal ligament junction associated with periodontal regeneration.

OBJECTIVE: The purpose of this study was to identify factors promoting formation of the cemento-periodontal ligament junction. BACKGROUND: Regeneration of the cemento-periodontal ligament junction is an important factor in recovery of the connective tissue attachment to the cementum and it is important to identify all specific substances that promote its formation. To clarify the substances involved in cemento-periodontal ligament junction formation, we produced a monoclonal antibody (mAb) to human cemento-periodontal ligament junction (designated as the anti-TAP mAb) and examined its immunostaining properties and reactive antigen. METHODS: Hybridomas producing monoclonal antibody against human cemento-periodontal ligament junction antigens were established by fusing P3U1 mouse myeloma cells with spleen cells from BALB/c mice immunized with homogenized human cemento-periodontal ligament junction. The mAb, the anti-TAP mAb for cemento-periodontal ligament junction, was then isolated. The immunoglobulin class and light chain of the mAb were examined using an isotyping kit. Before immunostaining, antigen determination using an enzymatic method or heating was conducted. Human teeth, hard tissue-forming lesions, and animal tissues were immunostained by the anti-TAP mAb. RESULTS: The anti-TAP mAb was positive in human cemento-periodontal ligament junction and predentin but negative in all other human and animal tissues examined. In the cemento-osseous lesions, the anti-TAP mAb was positive in the peripheral area of the cementum and cementum-like hard tissues and not in the bone and bone-like tissues. The anti-TAP mAb showed IgM (kappa) and recognized phosphoprotein. CONCLUSION: The anti-TAP mAb is potentially useful for developing new agents promoting cementogenesis and periodontal regeneration.

Animals↗
PubMed2003

Periodontal health among recent immigrants from Quara, rural Ethiopia and indications for periodontal health care.

OBJECTIVES: To investigate periodontal status and oral hygiene practices among recent new immigrants from Quara, Ethiopia, with the aim to maintain and promote their periodontal health. METHODS: Periodontal status was recorded for a total of 487 participants using the Community Periodontal Index (CPI). Age was grouped into 13-17, 18-24, 25-34, 35-44, and 45-65 years, and its association with 'worst CPI' was tested. Information on oral hygiene behaviour was collected by interview. RESULTS: The percentage of subjects with calculus is most common in all age groups. Low levels of periodontal pockets in the presence of calculus and very low levels of deep pockets were detected. Differences in CPI scores among the various age groups were statistically significant (p<0.0001). Oral hygiene practice is rare among children in Ethiopia, but a considerable proportion (53%) immediately adopted the local common custom and started brushing their teeth in Israel. Among the adults, oral hygiene practice with chewing sticks was common. CONCLUSIONS: Periodontal health promotion of this population should be targeted towards the entire population by enhancement of self-care oral hygiene measures. Periodontal treatment of this population, especially scaling and root planing remains controversial. The presence of inferior oral hygiene and high levels of calculus, together with low levels of periodontal pathology, raises important thoughts regarding the natural history of periodontal disease development.

Adolescent↗
PubMed1979

Periodontal therapy in humans. I. Microbiological and clinical effects of a single course of periodontal scaling and root planing, and of adjunctive tetracycline therapy.

The present results showed that maarked and long-lasting changes in the subgingival microflora associated with periodontal disease could be achieved by a single course of periodontal treatment. Immediately following therapy, the total number of subgingival organisms decreased 10- to 100-fold and the proportions of cultivable Gram negative organisms and anaerobic organisms generally decreased 3- to 4-fold or more. After treatment, most periodontal pockets were populated by a scant microflora predominated by facultative Actinomyces and Streptococcus species. The kinetics of the subgingival bacterial recolonization revealed that the total cell counts and the proportions of spirochetes and Capnocytophaga species did not reach their pretreatment levels even after 6 months. Other Gram negative anaerobic species returned to pretreatment proportions after 3 to 6 months. Several Gram positive species exhibited higher posttreatment than pretreatment proportions throughout the 6 months study. The microbiological shifts paralleled significant changes in the clinical status of the periodontal tissues. Following therapy, the periodontal pocket depths decreased generally 1 to 4 mm, the gingival inflammatory index, the gingival fluid flow, and the suppurative index were generally lower, and nine of 33 test pockets examined showed apposition of alveolar bone. The microbiological and clinical changes described were exhibited by two patients treated with periodontal scaling and root planing alone and by two patients treated with the adjunctive use of systemic tetracycline therapy. In two other patients, mechanical periodontal therapy only slightly reduced the total number of subgingival organisms and the proportions of spirochetes and other Gram negative anaerobic rods. A shift in the subgingival microbial composition was achieved in these two patients after tetracycline therapy. The following model for treatment of periodontal disease is proposed: (1) Conventional therapy including thorough periodontal scaling and root planing; (2) Monitoring the subgingival flora and the clinical course; and (3) Use of antimicrobial therapy in refractory cases. Further studies are needed to develop means for rapid identification of refractory patients, and to determine the optimal antimicrobial agent, the optimal route of administration, and the optimal dosage regime.

Actinomyces↗
PubMed2006

Risk of Porphyromonas gingivalis recolonization during the early period of periodontal maintenance in initially severe periodontitis sites.

BACKGROUND: Porphyromonas gingivalis is considered a critical pathogen of periodontal diseases including recurrent periodontitis. The profound effects of active periodontal treatment (APT) on P. gingivalis elimination were previously demonstrated and revealed that the subsequent P. gingivalis-free or -suppressed status seems to be maintained during early periodontal maintenance (PMT). The aim of the present study was to show the occurrence of microbial recolonization during this early PMT period. METHODS: In total, 128 sites from 11 generalized chronic periodontitis patients and one generalized aggressive periodontitis patient underwent clinical and microbiologic examination at baseline (Exam-I), after APT (Exam-II), and in PMT (Exam-III). Exam-III was carried out an average of 4.5 +/- 3.5 months after Exam-II. Detection and quantification of putative pathogens were performed using a polymerase chain reaction-based method. RESULTS: The PMT used was effective in maintaining the clinical conditions improved by APT. However, in microbiological examinations, Exam-III showed higher detection frequency and levels of P. gingivalis than Exam-II. This suggests that a P. gingivalis recolonization started in the early PMT period. P. gingivalis-increased sites then showed significantly more severe signs of periodontitis in Exam-I than P. gingivalis-stable sites (bleeding on probing frequency: 76.7% versus 56.5%; suppuration frequency: 41.9% versus 12.9%). On the other hand, in Exam-II, no significant differences of clinical parameters were noted between P. gingivalis-increased and -stable sites. CONCLUSION: Severe periodontitis sites before APT seemed to place them at risk of P. gingivalis recolonization in the early PMT period, and this microbial restoration could be a cause of recurrent periodontitis.

Acute Disease↗
PubMed2006

Relationship between prereferral periodontal care and periodontal status at time of referral.

BACKGROUND: According to a recent study, the severity of periodontal disease of individuals referred for periodontal care is greater now than in 1980. Variability in the standard of periodontal care in general dental practices may result in less than desirable outcomes and consequences of poorer periodontal health. METHODS: A sample of 100 newly referred dental patients from three separate periodontal practices in the greater Kansas City, Missouri area participated in this study. Data were collected from three sources: 1) a clinical chart audit, 2) current periodontal disease status as determined by clinical examination, and 3) a patient response questionnaire on past professional care and personal oral care habits. Bivariate analyses were performed using a statistical package. RESULTS: Of the 100 subjects, 74 were diagnosed as periodontal case type IV at the point of referral, of which 29.8% were treatment planned by the periodontist for two or more extractions. Teeth treatment planned for extraction were significant as a function of disease severity (P = 0.0001). Periodontal treatment provided in general dental practices did not vary because of disease severity. The incidence of deep cleanings (scaling and root planing) was reported slightly higher (32.4%) for case type IV than for case type III (26.9%), but this difference was not statistically significant. The average number of cleanings received in the general dental office was less than the standard of care according to the severity of the disease. CONCLUSION: If one assumes that the data obtained in the Kansas City practices are representative of a larger geographic area, it indicates that dentistry may be failing to address issues of the timely diagnosis of periodontal disease, appropriate treatment, and/or timely referral for treatment.

Dental Audit↗
PubMed1989

Study of Chinese periodontal patients at National Taiwan University Hospital. Part I: Basic periodontal information and oral hygiene status.

A cross-sectional study of 288 subjects with complete periodontal documentation was evaluated to determine the clinical status of periodontal disease. The patients were divided into age group intervals of ten years. The conditions of oral hygiene and their association with the clinical status of periodontal disease were compared and analyzed. Chronological features of the disease and its background development among Chinese patients is also explored. Our results indicated that in the mind of Chinese patients the loss of teeth was considered to be a natural fate of aging, and dental and periodontal problems were viewed merely as a symptom of pain, but not as disease entity. Most patients were completely ignorant of both the importance of oral hygiene care and prevention of periodontal diseases. A high incidence of ill-fitted restorations, lack of motivations, and insufficient knowledge on prevention were common in our subjects. In this study, the oral hygiene index (OHI) in females was found to be lower than that of males. The OHI dropped abruptly after 20 years of age in females and after 30 years of age in males. The lowest gingival index (GI) was found in the 31-40 age group in both sexes. During the later periods of life, the OHI again rose, and this increase appeared earlier in females than in males. The GI corresponded to chronological changes in OHI. There was no statistical difference in GI between the corresponding age groups of males and females. The periodontal disease index (PDI) increased progressively with age in both sexes. However, no significant difference was noted between males and females. The progression of the PDI appeared stationary in the 31-40 age group, which corresponded to the period of lowest GI. In conclusion, our Chinese subjects exhibited poor oral hygiene and had an associated high incidence of periodontal disease. Irrespective of sex, OHI showed a positive correlation with GI. However, there was no obvious correlation between OHI and PDI. In contrast, GI was highly correlated to PDI in the 21-30 and 31-40 age groups in the present study. In addition, the paroxysmal nature of clinical periodontal parameters supports the recently held concept that the onset and progression of periodontal disease is intermittent.

Adolescent↗
PubMed1999

A "case control" study on the rôle of HLA DR4 in severe periodontitis and rapidly progressive periodontitis. Identification of types and subtypes using molecular biology (PCR.SSO).

HLA DR4 antigens have been considered as a risk factor in periodontal disease. The aim of this "case control" study was to verify and to provide fuller clarification of such data. "Cases" or patients had to be aged between 20 and 48 years. They presented at least 5 sites spread over several teeth with an attachment loss equal or greater than 6 mm, and 10 sites spread over several teeth with periodontal pockets equal to or greater than 5 mm. Verification with a WHO probe showed an individual CPITN score of 4. Moreover, subjects whose average CPITN score for the 6 sextants was less than 3 were excluded from the study. Among these "severe periodontitis" patients, a subgroup was distinguished composed of subjects aged 20-35 years who presented, in accordance with the cases by Katz and co-workers, 5 or more teeth showing pocket depths of 6 mm or more. The dental chartings of these subjects showed an attachment loss of more than 3 mm on certain teeth over an inter-exam period of 1-3 years. They all displayed obvious loss of bony support in the affected sites. This constituted the "rapidly progressive periodontitis" subgroup. The "controls" were all over 20 years of age, and it was clinically verified that they were free of periodontal disease. There were 48 "cases" and 55 "controls". HLA typing of patients and controls was performed using "sequence oligoprobe hybridization after polymerase chain reaction" in accordance with the 11th International Workshop. This method allowed the detection of DR4 alleles as well as DR4 subtypes. The ethno-geographic origin of the subjects, considered as a confounding variable, was neutralized by stratified analysis. Subtypes 0401, 0404, 0405 and 0408 tended to be more frequent (p=0.08) in the cases (Severe Periodontitis). Focusing on analysis of "rapidly progressive periodontitis" in subjects aged 20-35 years, a very significant Mantel-Haenszel chi2 was obtained (p=0.0058) which led to a Mantel-Haenszel standardized odds ratio (OR) equal to 17. The 95% confidence interval was 1.03<0.R.<180.10. In conclusion, this supports previous reports and gives further clarification: in particular subtypes 0401, 0404, 0405 and 0408 can be considered as a risk factor for "rapidly progressive periodontitis". It should be noted that these determinants have been implicated in rheumatoid arthritis.

Adult↗