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PubMed1988

Relationship between lactate dehydrogenase and myeloperoxidase levels in human gingival crevicular fluid and clinical and microbial measurements.

The present study was designed to determine, in a cross-sectional study, whether there was any relationship between levels of lactate dehydrogenase (LDH) and myeloperoxidase (MPO) in gingival crevicular fluid (GCF) and clinical periodontal status or microbial parameters. Another objective was to determine, in a longitudinal study, the effect of a single session of root planning on GCF levels of LDH and MPO and the relation to changes in clinical and microbial measurements. 15 and 12 test subjects with moderate to severe periodontal disease were seen in the cross-sectional and longitudinal study, respectively. 1 healthy and 2 diseased sites were evaluated in each subject. Higher LDH and MPO levels in GCF were closely associated with higher clinical and microbial signs of periodontal disease. Root planing was effective in reducing these enzymes in GCF, with an accompanying decrease in clinical and microbial signs associated with disease. The return of LDH to baseline levels at 3 months after instrumentation, without a corresponding return of clinical signs of disease, may serve as a marker for subclinical periodontal pathology.

Adult↗
PubMed1982

Longitudinal evaluation of free autogenous gingival grafts. A four year report.

This ongoing study was designed to determine the necessity for and effectiveness of the free autogenous graft in maintaining periodontal attachment. Four-year data are presented for 42 patients who initially had bilateral surfaces with inadequate attached keratinized gingiva including 22 patients who began with bilateral areas of recession and no attached gingiva. In both populations a free autogenous gingival graft was placed on one side and the contralateral side was treated by scaling and root planing to serve as the control. The results indicate that plaque and gingival indices significantly decreased over 4 years on both experimental (grafted) and control (nongrafted) sides. Neither side had further attachment loss but the grafted side showed "creeping" attachment with a concomitant decrease in recession. This study would indicate that facial gingival units with minimal or no attached keratinized gingiva can maintain attachment levels when inflammation is controlled.

Dental Scaling↗
PubMed1990

Crevicular fluid iron changes in treated and untreated periodontally diseased sites.

Previous investigations have shown that crevicular fluid iron concentration (CFIC) is higher in periodontally diseased sites. The present study was conducted to determine whether periodontal treatment changes the CFIC to levels found in healthy sites in the same persons. To test the significance of iron content in gingival fluid as an indicator of periodontal disease severity or activity, CFIC was determined for healthy sites and diseased sites treated with scaling and root planing alone or in conjunction with surgery both before and after treatment. CFIC was increased in diseased sites, but the iron concentration in crevicular fluid was not a good indicator of changes in disease severity resulting from periodontal treatment. Treatments produced an increase in the CFIC that may be more related to the status of the microcirculation than to the disease process itself.

Adult↗
PubMed2006

"Burnishing" demineralization of root surfaces: ultrastructural surface characteristics.

PURPOSE: The purpose of this study was to compare the surface topography of roots treated with a resin bonding demineralizing agent using either a "placed" or "burnished" application technique. MATERIALS AND METHODS: Fifteen roots of human teeth were sectioned in half and a treatment area prepared on the coronal portion of each proximal section. This area was root planed to expose dentin. Treatment areas were demineralized with (1) a commercially available demineralizing agent (10% citric acid with 3% ferric chloride) (Amalgambond; Parkell) or (2) 30% citric acid solution. Cotton pellets saturated in either solution were placed or burnished (vigorously rubbed) on the treatment area for 3 min. Sections were prepared for SEM analysis using liquid CO2 dehydration. RESULTS: Areas of cementum and dentin were evident on most treatment areas. Specimens of both placed groups lacked a smear layer and exhibited a cracked-eroded, flat surface of matted or ridged fibrous material. Specimens in both burnished groups also lacked a smear layer, yet in stark contrast, exhibited an abundant array of deeply tufted fibril material similar to that of a "shag carpet". Two types of tufted fibril patterns were present: a lace-like array of shorter fibrils seen on dentin, and a voluminous mass of longer fibrils seen on cementum. CONCLUSION: Root cementum and dentin, treated with either demineralizing agent using the burnishing application technique, were ultrastructurally similar in that both displayed an abundant array of deeply tufted fibril material. This differed from the flat/matted fibril material seen using the placed application technique.

Acid Etching, Dental↗
PubMed2004

Effect of recombinant human bone morphogenetic protein-12 (rhBMP-12) on regeneration of periodontal attachment following tooth replantation in dogs.

OBJECTIVES: Subcutaneous and intramuscular implants of bone morphogenetic protein-12 (BMP-12) have been shown to induce formation of tendon and ligament tissue. BMP-12 induced a new attachment with a distinct fibrocartilaginous zone at the tendon-bone interface in the rat tendon-bone attachment model. Surgical controls showed poor healing and failure to reform the appropriate tendon-bone attachment morphologically. Application of recombinant human BMP-12 (rhBMP-12) to periodontal defects suggests that rhBMP-12 has the potential to support regeneration of the periodontal ligament (PDL). The objective of this pilot study was to evaluate this effect of rhBMP-12 in a tooth replantation model. METHODS: Six, young adult, male Hound Labrador mongrel dogs were used. Maxillary and/or mandibular incisor and premolar teeth were extracted and the PDL was either left "intact" or removed by root planing. rhBMP-12 (1.0 mg/ml) or a buffer control was topically applied to teeth with "intact" PDL in contralateral jaw quadrants in each of 3 animals. The teeth were immersed in 1.0 ml of the rhBMP-12 or the buffer solution for 10 min and then replanted. The remaining three animals received rhBMP-12 (1.0 mg/ml) and the buffer control in a similar fashion applied to teeth instrumented to remove the PDL and cementum, and surface demineralized with citric acid. The animals were euthanized at 8 weeks postsurgery and block sections were collected and processed for histopathologic analysis. RESULTS: No dramatic differences were found between teeth receiving topical rhBMP-12 and the buffer control. Application of rhBMP-12 did not have an apparent effect on new cementum and PDL formation in the tooth replantation model. Moreover, application of rhBMP-12 did not increase nor did it decrease the apparent presence and extent of ankylosis along the root surface compared to the control. CONCLUSIONS: The observations from this study do not support the use of topical rhBMP-12 to support the reestablishment of the PDL including regeneration of cementum and functionally oriented fibers, and to prevent ankylosis and root resorption following replantation of teeth.

Animals↗
PubMed1987

Periodontics in general practice: perspectives on nonsurgical therapy.

Clinical studies have shown that nonsurgical treatment is a highly effective method of periodontal therapy. It can be instituted in both shallow and deep pockets; however, an objective evaluation of post-scaling soft tissue changes should be recorded to determine the response to therapy. Closed scaling and root planing has limitations as a definitive procedure for the removal of calculus from deep pockets and surgical treatment may be indicated for nonresponding sites. The condition of the tissue, not the probing depth, should dictate the course of action. During maintenance therapy all practitioners should recognize unsuccessfully treated or recurrent periodontitis and provide interceptive treatment to avoid a case of "supervised neglect." Periodontal treatments should be provided by the general practitioner. This can result in improved oral health for the patients and constitute a professionally rewarding part of dental practice.

Dental Scaling↗
PubMed1986

The effect of different treatment modalities on connective tissue attachment.

This study compared the effect of four treatment modalities on connective tissue attachment. Ligature-induced periodontitis was established around the mandibular premolars of five young beagle dogs over 8 weeks. Following a 2-week period without ligatures, a reference dog was sacrificed to estimate the extent and nature of the disease. Three dogs received flap procedures in one mandibular posterior segment, and the six experimental roots were treated with citric acid (pH 1) for 3 minutes; the contralateral mandibular segments received flap procedures and the roots were treated with 4% chlorhexidine gluconate in the Hibiclens preparation for 3 minutes. One segment of the control dog received flap procedures, and the roots were treated with sterile normal saline; the contralateral segment received closed root planning. The experimental dogs were sacrificed 1, 2 and 3 months after treatment. The control dog was sacrificed 3 months postoperatively. One week before sacrifice each dog received a Procion dye injection. At sacrifice the study segments of all four treated dogs were clinically healthy, with no observable differences between the different treatment modalities. Histologically, the 1, and 3-month chlorhexidine, the 3-month saline and 3-month root planed specimens had long junctional epithelial adhesions with little connective tissue attachment. The 2-month chlorhexidine and all citric acid-treated sections showed appreciable amounts of new connective tissue attachment. Some 2-month and 3-month citric acid and 2-month chlorhexidine sections showed cementum over the apical portion of the long junctional epithelium. The frequency of occurrence and the length of cementum overlapping epithelium increased appreciably over time.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
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↗
PubMed1989

[Effectiveness of local delivery of ofloxacin using controlled-release strips (PT-01) in periodontal patients. Part 1. PT-01 application among treatment plans for periodontal disease].

Three different sites which have more than 5 mm pocket were randomly selected in each periodontal patient and were divided into three groups: PT-01 treated site, placebo treated site and control site. After application of either PT-01 or placebo twice for two weeks, subgingval scaling and root planing were performed. Then PT-01 and the placebo were applied weekly to the periodontal pocket for four weeks and clinical and microbiological evaluations were made. The results obtained were as follows: 1. On clinical evaluation, significant improvement was found in the PT-01 treated site in comparison with the placebo treated and/or control site. 2. On microbiological evaluation, slight improvement was found in the PT-01 treated site, whereas there was no significant difference among the three sites.

Delayed-Action Preparations↗
PubMed1987

Longevity: a critical factor in evaluating the effectiveness of periodontal therapy.

A 47-year-old male patient with an advanced form of adult periodontitis presented for evaluation and treatment in 1963. There were several angular bony lesions and 3 molar teeth had an extremely questionable prognosis. The patient was treated by scaling, root planing and gingivectomy, with no attempt to alter the existing morphology of the effected alveolar bone. 23 years following periodontal therapy, there were marked changes of the contour of the marginal bone crest throughout, minimal pocket depth and acceptable gingival form. The patient was seen at regular 5-6 months intervals for maintenance therapy and his home care regimen was exemplary. Advanced cases of periodontitis can be treated successfully by simplistic methods if the "repair potential" of the patient is good and if regular maintenance visits and meticulous plaque control are carried out.

Dental Scaling↗
PubMed1993

Retention of antimicrobial activity by human root surfaces after in situ subgingival irrigation with tetracycline HCl or chlorhexidine.

Substantivity of tetracycline HCl and chlorhexidine digluconate was assessed in extracted teeth. Fifty periodontally compromised teeth scheduled for extraction with probing depths ranging between 6 and 12 mm were root planed and then irrigated in situ with 1 of 4 solutions: tetracycline HCl at concentrations of 10 or 50 mg/ml, 0.12% chlorhexidine digluconate, or 0.9% sterile saline. Each tooth was exposed to 150 ml of the respective irrigation solution. Following extractions, the teeth were transferred to tris buffered saline and incubated at room temperature for 22 days. Incubation solutions were replaced at 24-hour intervals. Removed solutions were examined for desorbed antimicrobial activity using a microtiter assay in which bacterial growth was evaluated by optical density readings. Tetracycline HCl 50 mg/ml exhibited significantly greater antimicrobial activity than chlorhexidine digluconate for 12 days and greater than saline for 16 days. Tetracycline HCl 10 mg/ml exhibited significantly greater antimicrobial activity than chlorhexidine digluconate and saline for 4 days. Chlorhexidine digluconate did not exhibit any significant antimicrobial activity at any time point. Our findings demonstrate long-lasting substantivity of tetracycline HCl, but not chlorhexidine digluconate, by teeth exposed to a single episode of pocket irrigation of their periodontally-exposed roots. The amount of antimicrobial activity retained is proportional to the concentration of tetracycline HCl used for irrigation.

Adsorption↗
PubMed1984

Relationship of ascorbic acid levels of blood and gingival tissue with response to periodontal therapy.

The effect of ascorbic acid megadoses on gingival clinical parameters and vitamin content of blood and gingival tissue was studied. 10 nondeficient individuals, carefully matched according to age, periodontal status, and oral hygiene level, were divided into 2 groups: one received 250 mg q.i.d. of ascorbic acid and the other a placebo. After 1 week on the tablet all patients were scaled and root planed and received oral hygiene instructions. Blood samples and clinical parameters were obtained at baseline and 2, 6, and 7 weeks after. A gingival biopsy was taken at week 6. Correlations between the clinical parameters and the ascorbic acid levels at the different time periods revealed no significant differences between the vitamin and the placebo groups, therefore suggesting that the use of megadoses of vitamin C in normal human subjects does not have a predictable or strong effect on the gingival response to initial therapy.

Adult↗
PubMed1990

Digital subtraction of radiograph in evaluating alveolar bone changes after initial periodontal therapy.

The purpose of this study was to determine the effect of initial periodontal therapy on crestal bone remineralization with the use of a digital subtraction method for quantitative analysis. Fifteen crestal sites randomly selected from five patients were examined at the initial visit, after completion of oral hygiene instruction, and 1, 3, and 6 months after scaling and root planing with standardized radiographs. The radiographs were digitized by means of a drum-scanning microdensitometer with a sampling aperture of 50 microns producing 256 gray levels and corrected for difference of contrast between image pairs. Results were as follows: (1) statistically significant changes were observed even 1 month after the therapy and (2) the extent of changes was quantitatively expressed and monotonically increased with time. These results indicate that subtraction radiography may be a reproducible and quantitative method for the evaluation of periodontal therapy.

Alveolar Process↗
PubMed1990

The long-term efficacy of systemic doxycycline medication in the treatment of localized juvenile periodontitis.

The presence of Actinobacillus actinomycetemcomitans in the deep periodontal pockets of patients with localized juvenile periodontitis has been causally associated with active periodontal destruction. Thus, eradication of this microorganism has become the goal of treatment. It has been postulated that such eradication cannot be achieved without systemic antimicrobial treatment. The efficacy of a semisynthetic tetracycline (doxycycline) in a double-blind follow-up study of 14 patients with localized juvenile periodontitis was evaluated. For assessment of the periodontal status, probing depth and bleeding after probing at 4 sites of all teeth were recorded. The treatment consisted of instruction in oral hygiene, scaling and root planing, periodontal surgery and systemic medication for 2 weeks with either doxycycline (Doximycin) or placebo. A. actinomycetemcomitans was cultivated from subgingival samples taken from 4 sites. The periodontal condition and the prevalence of A. actinomycetemcomitans were monitored at the baseline and at 2, 8 and 20 months. The periodontal condition improved in both groups; the only significant difference was a greater reduction in the prevalence of A. actinomycetemcomitans 8 months after treatment with doxycycline as compared with the placebo.

Actinobacillus↗
PubMed1988

Effect of periodontal therapy on alveolar bone as measured by subtraction radiography.

Changes in the periodontal alveolar bone are often evaluated by comparing a series of radiographs taken over time. This investigation used a technique that allowed the image registration to be geometrically standardized each time a radiograph was taken. Radiographs of 24 patients from an ongoing double-blind, clinical study using metronidazole were obtained: (1) before any treatment, (2) at the completion of scaling and root planing and surgery (when performed) and (3) during the maintenance phase. One hundred six (106) paired comparisons were analyzed by subtraction radiography using a computerized system. Of these, 95 (89%) exhibited a minimal degree of geometric distortion and could be successfully substracted. Most areas (67%) showed no change in bone structure following periodontal treatment. Bone gain was noted in 12% of the sites examined, while bone loss was seen in 21% of the sites. This bone loss was statistically associated with sites that had received some form of surgical treatment.

Alveolar Process↗
PubMed1996

The radicular dentine temperature during laser irradiation: an experimental study.

The detoxification and sterilization radicular surfaces that have been produced by periodontal diseases could be accomplished after polishing (root planing) using the thermal elevation resulting from CO2 laser on continuous emission. In vitro experiments reveal that thermal elevations reached on the surfaces or in the depth are proportional to the dispersed energy. The thermal elevation in the depth (0.5-1 mm from the impact point) remained moderate because of the water absorption potentials of the radiations. Energies from 2 to 4.5 J can help obtain the combination of surface temperature elevation, which allows detoxification, and of a thermal elevation in the depth, compatible with vital tissues. This energy has to be delivered at an application time under 0.6 sec in continuous mode.

Body Temperature↗
PubMed1989

Computer-assisted densitometric image analysis (CADIA) for the assessment of alveolar bone density changes in furcations.

The purpose of this study was to test the applicability of computer-assisted densitometric image analysis (CADIA) for the quantitative assessment of alveolar bone density changes in furcations of multirooted teeth. In 21 patients, standardized radiographs were obtained immediately after and at 1, 6 and 12 months after periodontal flap procedures. Digitized images were obtained by means of a video-camera combined with an image processor that was linked to a computer. Quantitative information regarding density changes within windows covering furcation areas was obtained after superimposition and grey-level correction of images to be compared. 1 month after flap reflection, significantly more density loss was obtained in test furcations exposed to periodontal surgery, compared to the density changes in control furcation exposed to scaling and root planing. At 12 months, however, significantly greater increase in density was measured in test furcations compared to the 1-month results. The radiographic data were compared to the clinical parameters. In test furcations, there was a negative correlation of r = -0.52 between the GI and the loss in density at 1 month, and a negative correlation of r = -0.61 between the loss in density at 6 months and the probing attachment level at 12 months. These results indicate that CADIA may give valuable additional diagnostic information regarding alveolar bone density changes in furcations in studies on periodontal therapy.

Alveolar Process↗
PubMed2002

Effect of a controlled-release chlorhexidine chip on clinical and microbiological parameters of periodontal syndrome.

AIM: The aim of this study was to evaluate the effectiveness of a controlled-released chlorhexidine chip (CHX) as adjunctive therapy to scaling and root planing (SRP) in the treatment of chronic periodontitis. MATERIAL AND METHODS: Twenty patients with at least four sites with probing depth >or= 5 mm and bleeding on probing were selected. This randomized single-blind study was carried out in parallel design. The control group received SRP alone, while the test group received SRP plus CHX chip. The clinical parameters, Plaque Index (PlI), Papillary Bleeding Score (PBS), Bleeding on Probing (BOP), Gingival Recession (GR), Probing Depth (PD) and Relative Attachment Level (RAL), and the microbiological parameter BANA test were recorded at baseline and after 3, 6 and 9 months. RESULTS: Both groups presented significant improvements in all parameters analyzed over the study period. There were no statistically significant differences between the two groups for any parameter analyzed after 9 months, except for BOP, which was significantly reduced in the control group. The mean reductions on PD and RAL were 2.4 mm and 1.0 mm for the control group and 2.2 mm and 0.6 mm for the test group, respectively. CONCLUSION: The CHX chip did not provide any clinical or microbiological benefit beyond that achieved with conventional scaling and root planning, after a 9-month period.

Adult↗