Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Root Planing”

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 721 records · Page 40Linked to original sources
PubMed1994

The influence of supragingival plaque control on clinical and microbial outcomes following the use of antibiotics for the treatment of periodontitis.

Although supragingival plaque control is essential to successful periodontal therapy, the role of plaque control following systemic antibiotic use in periodontal disease has not been well defined. This study evaluated, following antibiotic use, which clinical and microbial parameters appeared to be influenced primarily by the antibiotics, independent of plaque control, and which outcomes appeared to be dependent on plaque control. Two hundred thirty-six patients (236) with moderate to severe periodontitis were clinically evaluated and microbial samples were taken by their private-practice periodontists. All patients were treated with scaling and root planing and a variety of systemic antibiotics, which were selected based on the microbial and clinical profile of the patient. Three months after therapy, patients were reevaluated and grouped by post-treatment plaque control, as either having very good oral hygiene (LoPl: N = 143; < or = 10% plaque-covered surfaces) or poor oral hygiene (HiPl: N = 93; > or = 25% plaque-covered surfaces). The two groups had different plaque and bleeding scores initially, but similar numbers of pockets probing > 5 mm and similar microbial patterns. Although the LoPl group had a significantly greater reduction in plaque than the HiPl group, bleeding scores and probing depths changed comparably in both groups after antibiotic therapy. Plaque control influenced outcomes significantly, but in a complex manner. The LoPl group exhibited a significantly greater reduction in certain bacteria, for example P. gingivalis. Interactions between plaque control and specific microbial parameters significantly affected clinical outcomes, although neither alone was sufficient to predict outcomes following antibiotic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2003

Meta-analysis of local tetracycline in treating chronic periodontitis.

BACKGROUND: Meta-analysis was used to assess the clinical efficacy of local delivery of tetracycline alone or as an adjunct to conventional mechanical therapy in patients with chronic periodontitis. METHODS: Studies were identified in MEDLINE and others sources. Meta-analyses were performed on the basis of probing depth (PD) at baseline, type of antimicrobial used, and experimental and control regimens (i.e., tetracycline plus scaling and root planing [SRP] versus SRP, tetracycline versus SRP, and tetracycline versus placebo, or no treatment). The effect of local tetracycline was evaluated for follow-up times of 4, 8, 12, 16, 24, and 36 weeks. Sensitivity analysis was performed according to antimicrobial delivery mode (irrigation, fibers, strips). A random effects model was used. RESULTS: The literature search identified 29 studies that met our inclusion criteria and were entered Into the meta-analysis. A significant mean reduction in PD for the combined tetracycline and SRP was observed regardless of initial probing depth and independently to the duration of follow-up. Tetracycline alone did not perform better than SRP, whereas they performed significantly better than placebo. Differences in improvement of attachment level (AL) were substantially similar to those encountered for PD. CONCLUSIONS: Our results documented that local. delivery of tetracycline improves the clinical outcomes of traditional treatment and should be considered particularly as an adjunct to SRP. Considerations regarding the adverse effects of widespread use of tetracycline should be taken into account when choosing a therapeutic strategy of chronic periodontitis.

Administration, Topical↗
PubMed1992

Collagen III aminoterminal propeptide in gingival crevicular fluid before and after periodontal treatment.

The amount of procollagen III aminoterminal propeptide (PIIINP) in crevicular fluid (CF) was measured from three periodontitis patients before treatment (scaling, root planing, and curettage) and 2, 5, 10, 20, and 40 days after treatment. CF was collected by placing two paper strips in each pocket for 5 s, after which the amount of fluid was measured. Control samples were collected from three subjects with minimal gingival inflammation. PIIINP was extracted into saline solution and determined by a radioimmunological method. Plaque Index, Papilla Bleeding Index, and pocket depth were recorded before and 40 days after treatment. Forty days after treatment clinical parameters indicated healing. The CF PIIINP mean concentration was 162 micrograms/l (range 0-430) in the pretreatment samples. Ten days after treatment, PIIINP mean concentration was 1400 micrograms/l (range 1000-9000). After this, the concentration gradually decreased, reaching the pretreatment level 40 days after treatment. Most of the control samples showed undetectable amounts of PIIINP. It was suggested that elevated PIIINP concentrations in CF after periodontal treatment reflected increased type III collagen synthesis in gingiva. PIIINP concentrations before treatment reflected the rate of type III collagen turnover in inflamed periodontal tissues. It was further suggested that CF PIIINP has clinical value as an indicator of the healing process of inflamed gingiva.

Adult↗
PubMed1995

A multicenter clinical trial of PerioGard in distinguishing between diseased and healthy periodontal sites. (I). Study design, methodology and therapeutic outcome.

We designed and performed a multicenter clinical trial to determine the relationship between measurements of the level of the enzyme aspartate aminotransferase (AST) in gingival crevicular fluid (GCF) to other measures used to detect periodontal disease and monitor outcome of treatment, including pocket depth and gingival inflammation. 32 periodontitis patients were enrolled at the University of Washington, Seattle, 30 at the University of Florida, Gainesville, and 34 at the University of Illinois, Chicago. 10 periodontally normal control subjects were enrolled at each location. 8 diseased and 4 healthy sites were designated for study in each patient and 8 healthy sites designated in each control subject. Measures of disease included pocket depth, severity of gingival inflammation, and GCF volume. AST levels were measured using the PerioGard test kit. Clinical measurements were made and GCF samples harvested and tested 2x before and 2x after therapy consisting of scaling and root planing under local anesthetic. Specific design and other issues are discussed, including selection of patients and control subjects, sample size, selection of experimental test sites, methods for assessment of diseased and therapeutic improvement, harvesting of GCF and selection of appropriate biostatistical methods for data analysis. Demographics of the patient populations at the 3 locations are reported. As expected, therapy induced only negligible changes in the measures of disease at healthy sites in control subjects, and relatively minor improvement in healthy sites in patients. In contrast, statistically significant improvement relative to pretreatment baseline status in all 3 measures of disease was observed for diseased sites at all 3 study locations with all p-values less than 0.0002. The magnitude of improvement was comparable to that reported previously by others. The % of PerioGard-positive sites decreased significantly between the screening baseline and both post-treatment visits for patients at all 3 locations, with p values of 0.0001 to <0.0008.

Adult↗
PubMed1998

Histologic evaluation of guided tissue regeneration using 4 barrier membranes: a comparative furcation study in dogs.

This study evaluated and compared four different barrier membrane materials used to treat class II mandibular premolar and molar furcations in seven dogs with naturally occurring periodontitis. Five class II furcation defects in each animal were randomly assigned to one of four experimental groups or to a control group. Each defect was treated by surgical debridement, root planing, and barrier membrane coverage with one of the four test materials or no barrier membrane (control). Thus, each animal served as its own control. Following 6 months of healing, block sections were used to histologically measure the amount of regenerated tissue and stereometrically enumerate the inflammatory cell infiltration observed with each of the treatment modalities. The four barrier membrane materials (polycarbonate filter, silicone rubber, expanded polytetrafluoroethylene, and polycaprolactone) all provided a wound healing environment that promoted new cementum formation, with mean values ranging from 1.96 +/- 0.031 mm to 2.18 +/- 0.015 mm, and facilitated alveolar bone regeneration, with mean values ranging from 1.18 +/- 0.019 mm to 1.44 +/- 0.014 mm. Control-treated sites showed mean values of only 0.24 +/- 0.007 mm new cementum formation and 0.32 +/- 0.017 mm bone fill. Polycarbonate filter and polycaprolactone membrane barriers elicited a significantly greater chronic inflammatory cell response of lymphocyte and plasma cell infiltrates as compared to expanded polytetrafluoroethylene and silicone rubber, which were comparable to control-treated sites.

Alveolar Process↗
PubMed2004

Debridement and local application of tetracycline-loaded fibres in the management of persistent periodontitis: results after 12 months.

BACKGROUNDS/AIMS: The aim of our study was to evaluate the clinical, radiological and microbiological response to the local delivery of tetracycline (TE) of sites with persistent periodontal lesions. MATERIALS AND METHODS: The study was conducted in a split-mouth design. Nineteen patients with at least four bilateral pockets 4-5 mm and bleeding on probing (BOP) were treated with scaling and root planing (SRP) plus TE fibres (test sites) or with SRP alone (control sites). Clinical and radiological measurements were taken at baseline, 6 months and 12 months post-operatively. Subgingival plaque samples were collected at baseline, at fibres removal, 6 and 12 months following treatment and analysed by polymerase chain reaction. RESULTS: Both treatments yielded a statistically significant (p<0.05) reduction of probing depth (2.05 and 1.21 mm), gain of clinical attachment level (1.71 and 0.53 mm) and reduction of BOP scores (23.68% and 57.89%) for TE and SRP groups, respectively, when comparing 12-month data with baseline. The differences between two groups were significant. The prevalence of Treponema denticola and Bacteroides forsythus decreased after therapy in both groups but only in the test sites Actinobacillus actinomycetemcomitans and Prevotella intermedia were not yield detected. The pathogens could be eliminated from five periodontal pockets by SRP alone, while 21 TE sites were not recolonized at 12 months. CONCLUSIONS: SRP plus TE fibres gave the greatest advantage in the treatment of periodontal persistent lesions at least 12 months following treatment.

Aggregatibacter actinomycetemcomitans↗
PubMed1993

Effects of treatment on antibody titer to Porphyromonas gingivalis in gingival crevicular fluid of patients with rapidly progressive periodontitis.

Twenty-eight patients diagnosed as having rapidly progressive periodontitis (RPP) were enrolled in a study in which samples of subgingival microflora were harvested from test teeth and assayed for the presence of Porphyromonas gingivalis, and GCF collected and analyzed by ELISA for specific antibody for P. gingivalis. Clinical conditions were measured and recorded, and treatment by scaling and root planing provided at baseline and at 3, 6, 9, and 12 months. Reduction in pocket depth, stabilization of attachment level, and resolution of inflammation were comparable to previously reported values. By 3 months, mean and median specific antibody concentration had decreased, and continued to decrease through 12 months. The proportion of samples in which specific antibody was not detectable increased from 27% at baseline to 73% at month 12. GCF samples from sites at which P. gingivalis was present had greater than 2-fold higher median specific antibody than samples from P. gingivalis-negative sites. At baseline, specific antibody titer of 30-second GCF samples positively correlated with pocket depth, and GCF volume significantly correlated with antibody titer and concentration, and with pocket depth. In addition, change in specific antibody titer of 30-second samples from baseline to both 6 and 12 months correlated positively with pocket depths. Thus sites infected by P. gingivalis manifested high levels of specific antibody, and levels were related to clinical status. Following treatment, antibody levels decreased significantly as pocket depths decreased, attachment levels stabilized, and inflammation resolved.

Adult↗
PubMed2000

Effects on the clinical indices and gingival crevicular fluid enzyme activities of the cyclical regimen of low-dose doxycycline therapy for adult periodontitis.

The purpose of this study was to determine the effect of cyclic regimen of low dose doxycycline (20 mg) or placebo therapy following scaling and root planing on clinical parameters and crevicular fluid alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase and elastase activities. Fifteen adults (13 males, 2 females) with moderate to advanced adult periodontitis were recruited for the study. The LDD-treated group (n = 8 subjects) self administered low dose doxycycline b.i.d. (20 mg, p.o.) from time (treatment) to 2 months and then no drug from 2 to 4 months and finally low-dose doxycycline b.i.d. from 4 to 6 months (i.e. "cyclical" regimen). The placebo-treated group (n = 7 subjects) was asked to take placebo capsules (containing inactive filler; i.e. starchflour) b.i.d. according to the same "cyclical" regimen. No differences were found between LDD- and placebo-treated groups regarding any of the clinical parameters and gingival crevicular fluid enzyme activities. The relative attachment gain was significantly improved in both groups. The "cyclical" regimen of low-dose doxycycline was not found to reduce alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase and elastase activities in gingival crevicular fluid of the adult periodontitis patients over a 6-month time period.

Adult↗
PubMed2005

Enamel matrix proteins and systemic antibiotics as adjuncts to non-surgical periodontal treatment: clinical effects.

OBJECTIVES: The purpose of the present study was to evaluate the clinical effects of non-surgical periodontal treatment, supplemented with enamel matrix derivative (EMD) and/or systemic antibiotics, in deep periodontal pockets of patients with chronic periodontitis. METHODS: This was a randomized, placebo-controlled longitudinal clinical trial of 12 months duration. Using a split-mouth design, 16 subjects were randomly assigned to scaling and root planing (SRP) with EMD or placebo in contra-lateral dentition areas. One half of the subjects received 250 mg metronidazole and 375 mg amoxicillin three times a day for 7 days and the other half received a placebo. One inter-proximal periodontal lesion was chosen as study site in each of the contra-lateral quadrants. RESULTS: Subjects treated with systemic antibiotics yielded significantly better clinical results than those treated with placebo. In these cases, probing pocket depth was reduced significantly more after 6 months (3.0+/-2.1 mm versus 1.6+/-1.4 mm, p=0.05), and the mean clinical attachment gain was significantly greater after 6 months (2.3+/-1.9 mm versus 0.7+/-1.6 mm, p=0.02) and 12 months (2.3+/-3.5 mm versus 0.4+/-3.8 mm, p=0.02). Sites treated with the antibiotics plus EMD gained the largest amount of clinical attachment. There was no significant benefit of EMD adjunctive to SRP in subjects not treated with antibiotics. CONCLUSIONS: The present study supports the notion that optimal repair and regeneration of the periodontium requires suppression of the microbiota causing periodontal disease.

Adult↗
PubMed2006

Monitoring periodontal disease status in smokers and nonsmokers using a gingival crevicular fluid matrix metalloproteinase-8-specific chair-side test.

BACKGROUND AND OBJECTIVE: With current periodontal diagnostic tools it is difficult to identify susceptible individuals or sites at risk. The aim of this study was to evaluate the efficacy of the matrix metalloproteinase (MMP)-8-specific chair-side dip-stick test in longitudinally monitoring the periodontal status of smoking (S) and nonsmoking (NS) patients with chronic periodontitis, using their gingival crevicular fluid (GCF) MMP-8 concentrations. MATERIAL AND METHODS: Clinical parameters, MMP-8 test results and concentrations were monitored in 16 patients after initial treatment and in 15 patients after scaling and root planing (SRP), every other month, over a 12-mo time period. Progressing and stable sites, and sites with exceptionally high MMP-8 concentrations, were analysed in smokers and nonsmokers. RESULTS: SRP reduced the mean GCF MMP-8 levels, test scores, probing depth (PD), attachment loss (AL) and bleeding on probing (BOP). In sites of periodontal disease progression, the distribution of MMP-8 concentrations was broader than in stable sites, indicating a tendency for elevated concentrations in patients with periodontal disease. The mean MMP-8 concentrations in smokers were lower than in nonsmokers, but in smokers' and nonsmokers' sites with progressive disease, MMP-8 concentrations were similar. Sites with exceptionally elevated MMP-8 concentrations were clustered in smokers who also showed a poor response to SRP. In these sites, the MMP-8 concentration did not decrease with SRP and these sites were easily identified by the MMP-8 test. CONCLUSION: Persistently elevated GCF MMP-8 concentrations may indicate sites at risk, as well as patients with poor response to conventional periodontal treatment (e.g. SRP). MMP-8 testing may be useful as an adjunct to traditional periodontal diagnostic methods during the maintenance phase.

Biomarkers↗
PubMed1996

Topographic distribution of black-pigmenting anaerobes before and after periodontal treatment by local delivery of tetracycline.

The purpose of this study was to determine the distribution of black-pigmenting Gram-negative bacteria in the dentition of 10 adult periodontitis patients before and after treatment by local delivery of tetracycline. The subjects were selected based on a screening for high counts of Porphyromonas gingivalis and multiple deep pockets. Subgingival microbial samples were taken from the mesial and distal aspect of every tooth (44 to 56 sites per patient) before treatment, and after one and two months. Therapy included full mouth scaling and root planing, chlorhexidine mouth rinsing and placement of tetracycline HCl fibers (Actisite) on all teeth. 63.4% of 524 baseline samples yielded total anaerobic viable counts > or = 10(6) CFU/ml; P. gingivalis was found in 59.2% and Prevotella intermedia in 56.9%. One month after treatment, the % of samples with > or = 10(6) CFU/ml was reduced to 9.4%, 5.3% were P. gingivalis- and 5.1% P. intermedia- positive. After 2 months, 9.6% samples yielded > or = 10(6) CFU/ml, 5.2% were P. gingivalis- and 9.4% P. intermedia- positive. 20 of the 39 sites with a persistence of P. gingivalis were located on second molars. Logistic regression models were utilized to explain the persistence of P. gingivalis, using site location and other clinical parameters as independent variables. These analyses indicated a strong association of site location, pocket depth and bleeding on sampling with persistence of P. gingivalis. The study shows that local delivery of tetracycline is highly effective in reducing the prevalence and proportions of black-pigmenting anaerobes within a dentition. Bleeding deep pockets of second molars have an increased risk for persistence of these anaerobes.

Administration, Topical↗
PubMed1996

A double-blind trial of tetracycline in the management of early onset periodontitis.

The aim of the study was to evaluate the adjunctive effect of systemic tetracycline (250 mg qds for 14 days) in sequential root planing and surgical phases of treatment in a randomised, double-blind controlled trial. 38 patients who were under 26 years of age, in good general health and with localised (15 test/15 control) or generalised (4 test/4 control) early onset periodontitis completed the non-surgical phase. Data were analysed by ANOVA using baseline covariates and transformations where appropriate. Improvements in probing depth, probing attachment level and bleeding on probing were significantly better in the group treated with adjunctive tetracycline, at 3 months post-treatment. 26 patients (13 test/13 control) subsequently completed the surgical phase (modified Widman flap surgery with adjunctive tetracycline or placebo as before) and were re-examined at 6 months and 12 months. In the test group, 58% of the originally affected teeth required surgery compared to 75% in the control group. Surgery produced further reductions in mean probing depths but no further gains in probing attachment. There were no further statistically significant differences between test and control groups for any of the clinical measures, although the tetracycline group appeared to maintain an advantage. In conclusion, systemically administered tetracycline is a useful adjunct in the management of early onset periodontitis, particularly in non-surgical treatment.

Administration, Oral↗
PubMed1994

The effect of smoking on the response to periodontal therapy.

This study evaluated the effect of smoking on the clinical response to non-surgical and surgical periodontal therapy. 74 adult subjects with moderate to advanced periodontitis were treated according to a split-mouth design involving the following treatment modalities: coronal scaling, root planing, modified Widman surgery, and flap with osseous resectional surgery. Clinical parameters assessed included probing depth, probing attachment level, horizontal attachment level in furcation sites, recession, presence of supragingival plaque and bleeding on probing. Data were collected: initially, 4 weeks following phase-I therapy, 10 weeks following phase-II therapy and on a yearly basis during 6 years of maintenance care. Data analysis demonstrated that smokers exhibited significantly less reduction of probing depth and less gain of probing attachment level when compared to non-smokers immediately following active therapy and during each of the 6 years of maintenance (p < 0.05). A greater loss of horizontal attachment level was evident in smokers at each yearly exam during maintenance therapy (p < 0.05). There were no differences between groups in recession changes. In general, these findings were true for the outcomes following all 4 modalities of therapy and were most pronounced in the deepest probing depth category (> or = 7 mm). Statistical analysis showed a tendency for smokers to have slightly more supragingival plaque and bleeding on probing. In summary, smokers responded less favorably than non-smokers to periodontal therapy which included 3-month maintenance follow-up.

Adult↗
PubMed2003

Locally delivered minocycline microspheres for the treatment of periodontitis in smokers.

AIM: The aim of the present analysis of a larger phase 3 clinical trial was to evaluate the efficacy of 1 mg minocycline hydrochloride microencapsulated in 3 mg of resorbable polymer, subgingivally administered as an adjunct to scaling and root planing (SRP) in smokers with chronic periodontitis. MATERIAL AND METHODS: Two hundred and seventy-one patients who smoked were randomized to one of three treatment groups: (1) SRP alone, (2) SRP plus vehicle (polymer without minocycline) or (3) SRP plus minocycline microspheres. Full mouth SRP was performed for all groups at baseline, and vehicle or minocycline microspheres were administered to the appropriate patients at all periodontal pockets > or =5 mm at baseline, 3 and 6 months. Efficacy was evaluated over 9 months. RESULTS: Significantly greater pocket depth reductions with SRP plus adjunctive minocycline microsphere treatment were observed at 1, 6 and 9 months (p<0.05) versus control treatments. At 9 months, smokers treated with SRP plus minocycline microspheres exhibited a pocket depth reduction of 1.19 mm from baseline, as compared to 0.90 mm for smokers treated with SRP alone. The efficacy of adjunctive minocycline microspheres was consistent among all tested smoking subcohorts, including those based on gender, age and smoking exposures. CONCLUSION: These data indicate that treatment with SRP plus locally delivered minocycline microspheres is more effective than SRP alone in reducing pocket depths in smokers with periodontitis.

Administration, Topical↗
PubMed2003

Radiographic bone fill following non-surgical therapy--a report of three cases.

PURPOSE: Non-surgical therapy, including scaling, root planing, and personal plaque control continues to be a powerful effective treatment modality for treating chronic periodontal diseases. Reports in the literature have suggested that adjunctive procedures such as systemic antibiotics and topical antiseptics may enhance the clinical outcomes of non-surgical treatment. MATERIAL AND METHODS: Three retrospective case reports spanning an evaluation period of 9-36 months are presented. The patients were treated in a private periodontal practice and had advanced periodontal disease. A significant positive clinical and radiographic response was achieved with non-surgical and adjunctive therapy. RESULTS: The teeth that were treated initially had deep angular bony defects with probing depths ranging 5-8 mm. Following non-surgical and adjunctive therapy, probing depths were considerably reduced and ranged 3-5 mm. As well, a significant degree of radiographic osseous fill of the angular defects was observed. CONCLUSIONS: In light of the dramatic healing responses observed in these cases, the healing potential of deep periodontal defects with non-surgical and adjunctive therapy requires further investigation. Once the critical elements contributing to the positive responses noted can be identified, then perhaps a more predictable outcome may be achieved in future cases.

Alveolar Bone Loss↗
PubMed1996

Use of the polymeric matrix as internal standard for quantitation of in vivo delivery of tetracycline HCl from Actisite tetracycline fiber during periodontal treatment.

Actisite (tetracycline hydrochloride) periodontal fiber is a 23 cm monofilament containing 12.7 mg tetracycline HCl homogeneously dispersed in a polymer. This product is indicated as an adjunct to scaling and root planing to reduce pocket depth and bleeding on probing in patients with adult periodontitis. The sustained-release system, placed in the periodontal pocket for 10 d, releases the antibiotic through mechanisms of diffusion and osmosis. A study was conducted in 13 patients with moderate to severe adult periodontitis to evaluate the amount of tetracycline HCl released during therapy (based on residual drug content). Fibers placed in the pocket remained in place for an average of 9 d. Each patient had 1-4 teeth treated with fiber therapy. At the termination of therapy samples from 29 teeth were retrieved and analyzed. The amount of matrix polymer was used as an internal standard for the quantitation of tetracycline, eliminating any uncertainties with respect to recovery or contamination. An average of 31% (SD 9%) of the tetracycline HCl content was released from the fiber during the treatment period. No single fiber had less than 50% of the original drug remaining. The study demonstrated that a substantial amount of the tetracycline remains in the Actisite fiber at removal (about 70%), which indicates that substantial drug concentrations are maintained in the pocket for the duration of treatment.

Administration, Topical↗
PubMed2002

Treatment of Papillon-Lefèvre syndrome periodontitis.

BACKGROUND, AIMS: Conventional mechanical treatment of Papillon-Lefèvre syndrome periodontitis has a poor prognosis. This report describes an effective antimicrobial treatment of rapidly progressing periodontitis in an 11-year old girl having Papillon-Lefèvre syndrome. METHOD: Clinical examination included conventional periodontal measurements and radiographic analysis. Occurrence of major suspected periodontopathic bacteria was determined by selective and non-selective culture and by polymerase chain reaction (PCR) identification. Presence of cytomegalovirus and Epstein-Barr type 1 virus was determined by a nested-PCR detection method. Therapy included scaling and root planing, oral hygiene instruction, and systemic amoxicillin-metronidazole therapy (250 mg of each/3 times daily/10 days) which, based on follow-up microbiological testing, was repeated after 4 months. Supportive periodontal therapy took place at 2 visits during a 16-month period. RESULTS: At baseline, 10 of 22 available teeth demonstrated severe periodontal breakdown. At 16 months, probing and radiographic measurements revealed no teeth with additional attachment loss, and several teeth exhibited significant reduction in gingivitis and pocket depth, increase in radiographic alveolar bone height and clinical attachment level, and radiographic evidence of crestal lamina dura. Baseline subgingival microbiota included Actinobacillus actinomycetemcomitans (3.4% of total isolates), Prevotella nigrescens (16.4%), Fusobacteriumnucleatum (14.3%) and Peptostreptococcus micros (10.6%), as well as cytomegalovirus and Epstein-Barr type 1 virus. At termination of the study, culture and PCR examinations showed absence of A. actinomycetemcomitans, P. micros and herpesviruses, and P. nigrescens and F.nucleatum each comprised less than 0.1 % of subgingival isolates. CONCLUSION: This study suggests that controlling the periodontopathic microbiota by appropriate antibiotic and conventional periodontal therapy can arrest Papillon-Lefèvre syndrome periodontitis.

Aggregatibacter actinomycetemcomitans↗
PubMed2002

Clinical and radiographic evaluation of periodontal intrabony defects treated with guided tissue regeneration. A pilot study.

BACKGROUND: The aim of this clinical and radiographic study was to evaluate the effect of guided tissue regeneration using a bioabsorbable barrier in the treatment of intrabony defects in humans. METHODS: Intrabony osseous defects (2 or 3 walls) around mandibular canines and premolars were treated in 10 systemically healthy patients with ages ranging from 35 to 56 years. Prior to the surgical phase, patients were enrolled in a strict maintenance program including oral hygiene instructions and scaling and root planing (presurgical Pi and GI < 10%). Patients were seen for professional prophylaxis during the duration of the study. Clinical measurements were performed with an electronic probe at baseline and at reentry 8 months following surgical therapy. Measurements included clinical attachment levels (CAL), gingival margin levels (GML), probing depths (PD), bone defect levels (BDL), and alveolar crest level (ACL). A split mouth design was used. Quadrants were randomly assigned for treatment by GTR (experimental) or open flap debridement alone (control). Standardized radiographs were taken at baseline and at reentry. Digital images were analyzed by subtraction to assess changes in area (A) and optical density (OD). Data were evaluated using paired t test. RESULTS: Statistically significant differences were found in both groups when comparing baseline and post-treatment values for CAL, GML, PD, and BDL (P < 0.0 1). Greater reductions in BDL and gain in A and OD were observed in the GTR group when compared to control (P < 0.01). Both therapies were effective in improving the clinical parameters assessed. CONCLUSION: Clinical and radiographic findings from this study demonstrated more bone fill in sites treated with GTR.

Absorbable Implants↗