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PubMed1992

Longitudinal monitoring for disease progression of localized juvenile periodontitis.

The present study was performed to investigate the factors associated with disease progression in localized juvenile periodontitis (LJP) patients by longitudinal monitoring of microbiological changes. Following a 9-month period, 9 LJP patients were divided into 2 groups based upon attachment loss, progressing and non-progressing. Both groups received scaling, root planing, and modified Widman flaps. Clinical and microbiological data were obtained at baseline, following the observation period, and at 6 and 12 months post-treatment. At 6 and 12 months post-treatment significantly more cocci were persistent in the non-progressing group than in the progressing group. Actinobacillus actinomycetemcomitans was also more frequently isolated in the progressing group than in the non-progressing group initially and following the 9-month observation period. Also after treatment, A. actinomycetemcomitans recolonized earlier in the progressing group than in the non-progressing group. These studies suggest that A. actinomycetemcomitans may play a role in disease progression in LJP; however, they do not eliminate the possibility that other organisms may also play a role, since A. actinomycetemcomitans was not detected in all of the patients in whom disease progressed.

Adolescent↗
PubMed1992

Tissue concentration and localization of tetracycline following site-specific tetracycline fiber therapy.

The primary objective of this study was to evaluate the concentration and location of tetracycline hydrochloride in tissue adjacent to periodontal pockets treated with a tetracycline impregnated fiber. A secondary objective was to determine if the presurgical placement of fibers had any adverse effects on healing following periodontal surgery. The study population consisted of 10 patients with at least 2 pockets in both maxillary quadrants of > or = 5 mm in depth and exhibiting bleeding on probing. After an initial scaling and root planing, placebo or tetracycline fibers were randomly assigned by quadrant to 2 non-adjacent pockets. Fibers were removed at the time of surgery; i.e., day 8, and periodontal surgery was performed utilizing a flap incision that allowed biopsy of 1 interdental papilla from each of the 2 test sites in each quadrant. One biopsy was analyzed for tetracycline concentrations by high performance liquid chromatography (HPLC). The second biopsy was examined by both light and ultraviolet fluorescence microscopy to determine the location of residual tetracycline and the intensity of inflammatory cell infiltrates. Results showed that the tissue concentration of the antibiotic in tetracycline treated sites was 64.4 +/- 7.01 ng/mg (ng of tetracycline/mg tissue weight) which corresponds to 43 micrograms of tetracycline and was below levels of accurate measurement in placebo treated sites. Tetracycline tissue concentrations corresponded to the ultraviolet fluorescence microscopy with a Pearson correlation coefficient of r = 0.92. Tetracycline fluorescence was noted in the soft tissue wall ranging from 1 to 20 microns.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

The host response in gingival crevicular fluid: potential applications in periodontitis clinical trials.

Traditional clinical variables of periodontal pathology have only limited value as indicators for future disease progression in patients with adult periodontitis. Consequently, other aspects of the periodontal lesion are being examined for their diagnostic utility. Analysis of the host response in gingival crevicular fluid (GCF) is among the most intensely studied of these new diagnostic approaches. Specific indicators of the humoral immune response, cellular immune response, and acute inflammatory response have been identified in GCF. The relationship of indicators of the humoral immune response to active periodontal disease is equivocal. Specific indicators of the cellular immune response in GCF may ultimately prove to be important diagnostically, but the relationship of any specific marker to active periodontal disease has not been reported. In contrast, the acute inflammatory response in GCF has been extensively studied and a number of factors appear to be associated with an increased risk for future disease progression. Indicators of enhanced polymorphonuclear leukocyte activity, (lysosomal beta-glucuronidase, lysosomal collagenase), prostaglandin E2, and an indicator of acute tissue destruction (the cytoplasmic enzymes aspartate aminotransferase) have been associated with the occurrence of clinical attachment loss. An example of the application of a GCF marker in a periodontitis clinical trial is provided by describing the relationship of lysosomal beta-glucuronidase in GCF at baseline and 2 weeks following root planing and scaling to the occurrence of disease activity during the following 6 months. Persistently elevated levels of this enzyme were related to clinical attachment loss. The positive, negative, and total predictive values for beta-glucuronidase as an identifier of clinical attachment loss were 86%, 71%, and 76%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Aggressive Periodontitis↗
PubMed1992

Clinical, laboratory, and immunological studies of a family with a high prevalence of generalized prepubertal and juvenile periodontitis.

A study of a consanguineous family with a high prevalence of localized juvenile periodontitis (LJP) and generalized prepubertal periodontitis (GPP) was done over a 7-and-a-half year period. The parents had adult periodontitis, while 2 daughters, aged 13 and 15, had LJP. Furthermore, 2 other daughters, ages 14 and 10, and a son, aged 9, were affected by GPP. Two remaining siblings were not affected. Clinical and radiographic examinations on all family members were done, and chemotaxis for blood neutrophils was assessed. Laboratory tests, immunological examinations, and evaluation for neutrophil functions were done on the GPP patients. Microbiological cultures were performed on 2 of the GPP patients, as well as in the mother. The mother, the 2 LJP patients, and 1 of the unaffected siblings had depressed PMN chemotaxis. The other family members, including the 3 GPP patients, had normal PMN chemotaxis. GPP patients did not have any systemic disease, and evidence of major defects in the immunological functions was not detected. LJP patients were successfully treated with root planing, subgingival curettage, and tetracycline therapy. Intensive periodontal therapy, combined with systemic administration of antibiotics, was not effective in halting periodontal tissue destruction in the 3 GPP patients. Results indicate that the underlying cause of GPP is not always related to leukocyte dysfunction. Since Actinobacillus actinomycetemcomitans was the most frequent pathogen found in subgingival microflora of 2 of the GPP patients, it is assumed that it may play a key role in the etiology of GPP.

Adolescent↗
PubMed1992

Early effects of periodontal therapy on the detection frequency of four putative periodontal pathogens in adults.

This study aimed to examine early posttreatment changes in the periodontal microflora. Paper point sampling and conventional bacterial cultivation were used to monitor the effects of surgical and non-surgical periodontal therapy on the detection frequency of Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans, and Capnocytophaga species in deep periodontal pockets. Ten patients, 5 men and 5 women (mean age 44 years), with advanced periodontal disease were selected from the dental school patient population for the study. A total of 245 teeth in 10 defined areas of the dentition were treated by oral hygiene instruction followed by scaling and root planing alone (121 sites) or with surgical interventions (124 sites). Ninety sites, 47 surgical and 43 non-surgical, with initial pocket depth greater than or equal to 6 mm were sampled at baseline and 3 months after completion of therapy. Treatment by both procedures resulted in significant clinical improvements as assessed by all clinical parameters used. Baseline results may indicate that the level of P. gingivalis was reduced in the presence of P. intermedia, while A. actinomycetemcomitans seemed to be reduced in the presence of P. gingivalis and/or P. intermedia. Three months after therapy, the detection frequency of P. gingivalis was significantly reduced (P less than 0.05) in surgical and non-surgical sites while the reduction for P. intermedia was significant only for surgical sites (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Retained "hopeless" teeth: lack of effect periodontally-treated teeth have on the proximal periodontium of adjacent teeth 8-years later.

We previously reported the lack of effect periodontally-treated teeth prognosed "hopeless" and retained for 3.4 +/- 1.5 years have on the proximal periodontium of adjacent teeth. We now report our findings for the same group of subjects following 8.4 +/- 0.7 years of "hopeless" tooth retention. Of the 17 "hopeless" and adjacent teeth originally measured in 17 subjects, 14 of the subjects were still available for re-evaluation. Measures used to assess the periodontium of proximal surfaces of adjacent teeth included pocket depths (PD), radiographic alveolar bone level (R-BL), and periodontal ligament space width (W-PL). Treatment for the subjects consisted of surgical therapy (N = 15) and scaling and root planing (N = 2). Of the 14 subjects re-examined, 2 were eliminated due to loss of adjacent tooth reference points and 2 due to extraction of the "hopeless" tooth (N = 10). Differences in measurements (i.e., nonadjacent to "hopeless" tooth value minus adjacent to "hopeless" tooth value) were analyzed using a repeated measures ANOVA. There were no significant differences for PD (P = 0.20), R-BL (P = 0.29), or W-PL (P = 0.16). These data confirm our original findings that retained periodontally "hopeless" teeth do not significantly affect the proximal periodontium of adjacent teeth following therapy.

Alveolar Bone Loss↗
PubMed1993

Unusual gingival enlargement with rapidly progressive periodontitis. Report of a case.

A 15-year-old female patients suffered from recurrent unusual enlargement of the gingiva together with rapidly progressive alveolar bone loss. The enlarged gingiva completely covered her anterior teeth and protruded from the mouth. Marked inflammatory edematous tissue, which predominantly contained plasma cells, was observed in the connective tissue. Rapidly progressive alveolar bone loss was observed radiographically. The serum antibody titer to Porphyromonas gingivalis, measured by ELISA, was much higher than that in healthy individuals. The diagnosis was unusual gingival enlargement with rapidly progressive periodontitis. Conventional periodontal therapy, including plaque control, scaling, root planing, and surgical removal of the soft tissue, did not produce complete healing of the gingival lesion, although recurrence of gingival enlargement and further loss of the periodontal attachment level were well controlled. After the periodontal treatments, the serum antibody titer to P. gingivalis decreased to normal levels. This unusual gingival enlargement was considered due to systemic factors that exaggerated the gingival response to local irritation and altered the usual clinical features of chronic gingivitis; local plaque irritation produced the extensive and recurrent enlargement of the gingiva. Under these circumstances, infection or overgrowth of periodontopathic bacteria, including P. gingivalis, might occur and the alveolar bone loss would then advance very rapidly.

Adolescent↗
PubMed1993

Guided tissue regeneration and anti-infective therapy in the treatment of class II furcation defects.

The purpose of the present study was to evaluate the effect of anti-infective therapy on the success of periodontal regeneration in mandibular Class II furcation defects. Eighteen patients with mandibular bilateral Class II furcation defects were enrolled. Following an initial hygienic phase, guided tissue regeneration (GTR) was performed using an expanded polytetrafluoroethylene (e-PTFE) membrane barrier. The area was surgically exposed, thoroughly root planed, and irrigated with either tetracycline (100 mg/ml) or 0.9% saline. Post-operative care included systemic tetracycline (250 mg q.i.d.) and chlorhexidine 0.12% mouthwash twice daily. Patients were maintained on a prophylaxis schedule of every 2 weeks for the first 3 months, and monthly thereafter. Clinical parameters of probing depth (PD), probing attachment level - vertical (PAL-v), probing attachment level - horizontal (PAL-h), and target periodontal pathogens were monitored at baseline and quarterly for one year. An overall improvement in all clinical parameters was observed in both groups: probing reduction (3.1 mm), PAL-h gain (2.3 mm), and PAL-v gain (1.2 mm) were all statistically significant compared to baseline measurements. Vertical measurements were performed parallel to the long axis of the tooth with no attempt to angulate the probe into the furcation. There was no significant difference in sites receiving tetracycline. A strong positive correlation was noted between initial PD and pocket reduction (r = 0.77, P < 0.0001) and between initial PD and PAL-h gain (r = 0.54) and PAL-v gain (r = 0.45) suggesting that initial probing depth might be used to assess the regenerative potential of a given site.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Severe progressive periodontal destruction due to radiation tissue injury.

Cancer radiotherapy to the head and neck region results in short- and long-term radiation tissue injuries. Radiation bone injury is a long-term manifestation which could progress to osteoradionecrosis. A case of radiation tissue injury to the periodontium is presented. The possible pathogenesis of these events is described as they relate to the sequential radiographic changes observed over a period of 6 years until the involved teeth were exfoliated. The post-irradiation management of the teeth with advancing periodontal disease in the path of irradiation was by conservative means, including good personal oral hygiene care, scaling and root planing, periodic chlorhexidine irrigation, and topical fluoride application.

Adult↗
PubMed1993

A role for antibiotics in the treatment of refractory periodontitis.

Refractory periodontitis is considered by many investigators to be a separate disease entity that is descriptive of a particular patient who has multiple sites, rather than a few individual sites, that do not respond to conventional periodontal treatment modalities. Such patients continue to demonstrate loss of attachment and alveolar bone despite frequent periodontal treatment which includes surgical intervention, scaling and root planing, and often systemically-administered tetracycline. Controlled clinical studies have demonstrated that both clindamycin-hydrochloride and amoxicillin/clavulanate potassium (Au) are beneficial when used in conjunction with periodontal scaling. Gordon et al. found improvements in attachment levels, inflammation, suppuration, and a decrease in pocket depths for up to 2 years following a 7-day course of clindamycin given in conjunction with a full-mouth scaling. The incidence of disease activity decreased from an annual rate of 8% of all sites prior to antibiotic treatment to 0.5% after treatment. Magnusson, reporting on a similar group treated with a 14-day course of Au, found an average loss of attachment of 2.2 mm and an increase in pocket depth of 1.5 mm in sites demonstrating disease progression prior to antibiotic treatment. At 3 months post-antibiotic therapy, these sites had regained an average of 2 mm of attachment and pocket depths had decreased an equivalent amount. Both attachment levels and pocket depths remained relatively stable for up to 12 months post-therapy. In an ongoing study, 30 subjects with refractory periodontitis were treated with either clindamycin or Au in conjunction with scaling or scaling plus a placebo. Prior to antibiotic treatment, but while being scaled at 3-month intervals, sites with disease activity lost an average 2.4 mm of attachment. At 3 months post-treatment, the clindamycin-treated group showed an average gain of 2.1 mm, the Au-treated group gained 1.9 mm, and the scaling group gained 1.4 mm in attachment. The clindamycin group remained relatively stable for up to 21 months and the Au group remained stable for about 15 months without additional treatment. Five of the 6 subjects treated with scaling alone required additional treatment within 9 months. Preliminary analyses have indicated that at least two patterns or rates of attachment loss may be associated with refractory periodontitis and that each pattern may be indicative of a different microflora. The pattern associated with a relatively rapid loss of attachment was characterized by a Gram-negative flora which contained spirochetes, P. intermedia, and Fusobacterium species.(ABSTRACT TRUNCATED AT 400 WORDS)

Anti-Bacterial Agents↗
PubMed1994

The influence of molar furcation involvement and mobility on future clinical periodontal attachment loss.

The purpose of this study was to determine the influence of furcation involvement (FI) and mobility (MO) on change in probing periodontal attachment level (AL) on molar teeth. Twenty-four patients were selected from The University of Michigan longitudinal periodontal clinical trial. The patients who met the entry criteria received a baseline examination and were treated by periodontal scaling and root planing followed by different periodontal surgical approaches in a split-mouth design. Patients were placed on a 3-month interval for maintenance prophylaxis and had yearly periodontal scorings for a period of 8 years. The scorings included determination of AL, FI, MO, and tooth loss (TL). Data for molar teeth from three different time periods (at entry (A) and at 1 (B) and 8 (C) years) were analyzed. The results demonstrated that teeth with FI were 2.54 times more likely to be lost when compared to teeth without FI during the maintenance period. By using paired t test approach to the probing attachment level data, molars with FI had significantly more loss between times B and C but not between A and B or A and C. Teeth with increased MO demonstrated significantly more AL between times A and C and B and C. When the interaction between MO and FI was analyzed, teeth with both FI and MO had significantly more attachment loss during the maintenance period (B to C). No statistically significant difference was found among the three different therapeutic approaches (pocket elimination, curettage, and modified Widman flap) during any of the time periods.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Evaluation of an absorbable collagen membrane in treating Class II furcation defects.

Recent research has focused upon the utilization of an absorbable collagen membrane in guided tissue regeneration (GTR). Concern exists as to whether this type of membrane is beneficial in the treatment of periodontal defects. The purpose of this study was to evaluate the effect of a type I bovine collagen membrane on treatment of Class II furcation defects. Twelve systemically healthy patients (six male and six female, ages 32 to 68) were treated. Each had bilateral mandibular furcation defects with attachment loss > or = 6 mm. Prior to surgery all patients completed initial therapy including scaling and root planing. At the time of the surgery, teeth were randomly assigned to either a control (flap debridement alone) or test (flap debridement plus collagen membrane) group. Data were collected on the day of surgery, and 2, 4, and 6 months post-surgery and at the 12 month re-entry surgery. Clinical measurements included probing depth (PD), clinical attachment level (CAL), gingival recession (GR), stent to base of defect (SB), crestal bone to base of defect (CB), width of defect, and mobility. Statistical analysis was performed utilizing the paired t test. Both control and test groups demonstrated significant (P < 0.05) improvement at 12 months re-entry in PD, CAL, SB, and CB when compared to the presurgery status. While there is no significant difference in PD, CAL, GR, width of defect, and mobility between control and test groups, sites treated with the collagen membrane had significantly higher bone fill (SB and CB) at re-entry.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Probing velocity: novel approach for assessment of inflamed periodontal attachment.

Little is known about the biophysical characteristics of the dento-gingival junction in response to the development or resolution of inflammation. The Toronto automated periodontal probe (TAPP) provides an estimate of the biophysical integrity of the dento-gingival junction by measuring intrapocket probing velocity. Presence or absence of a plateau in displacement versus time plots were used to perform dichotomous analyses as a function of established parameters of inflammation. Plateaus were operationally defined as a 3 standard deviation reduction in the slope of the displacement versus time plot (probing velocity) and hence the plateau represents an increased resistance of the probe tip at the dento-gingival junction. The aim of the study was to measure the relationship between post-treatment reductions of gingival inflammation and the probability of plateau formation as measured by the TAPP. Twenty-nine subjects exhibiting gingival inflammation were provided with periodontal therapy consisting of subgingival scaling and root planing. Over a 2-month sampling period, 6 sites from each subject were monitored and these sites exhibited wide variations of inflammation. Logistic regression revealed a significant relationship between the probability of plateau formation and treatment (P = 0.002), plaque index (P = 0.002), the increased severity levels of gingival index (P > 0.05), or bleeding index (P > 0.05). The probability of plateau formation decreased with higher levels of crevicular fluid flow but there was no dependence of plateau formation on probing depth (P > 0.55). These data indicate a direct relationship between improved measures of clinical health and increased resistance to probe penetration near the base of the pocket.(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies↗
PubMed1994

Guided tissue regeneration with and without decalcified freeze-dried bone in mandibular Class II furcation invasions.

The purpose of this study was to compare periodontal soft and hard tissue repair using expanded polytetrafluoroethylene (ePTFE) membranes with and without decalcified freeze-dried cortical bone allografts (DFDBA). Six patients with 17 mandibular Class II buccal molar furcal invasions received oral hygiene instructions followed by scaling and root planing. Baseline soft tissue measurements with periodontal probes were made to assess probing depths (PD), recession (REC), and probing attachment levels (PAL). After non-surgical therapy, 10 teeth were randomly selected as test sites (ePTFE + DFDBA) and 7 as controls (ePTFE alone). Full-thickness flaps were elevated, and open surgical measurements were made to determine alveolar crestal height (CEJ-AC) and vertical (CEJ-BDF) and horizontal (HPDF) defect depth. The ePTFE membranes were removed at 6 weeks. After 6 months, all sites were reentered and both soft tissue and open surgical measurements recorded. The following mean changes (mm) were found for ePTFE and ePTFE + DFDBA treated sites respectively: decreased PD = 1.5, 2.2; increased REC = 1.3, 1.3; loss(-)/gain PAL = -0.2, 0.8; decreased CEJ-BDF = 3.8, 5.0; increased CEJ-AC = 0.5, 0.4; and decreased HPDF = 2.3, 2.4. None of the changes were statistically significant. The addition of DFDBA to the GTR procedure did not significantly improve any of the mean soft tissue and open surgical measurements between control (ePTFE alone) and test (ePTFE+DFDBA) groups in mandibular Class II buccal furcations. Both treatment procedures resulted in significant decreases in PD, CEJ-BDF, and HPDF and a significant increase in REC. There were no differences for PAL and CEJ-AC within control and test groups seen with this sample. Larger randomized clinical trials are needed to more fully evaluate whether combined graft and GTR procedures offer an advantage over GTR alone.

Adult↗
PubMed1994

Maintenance therapy in young adults with severe generalized periodontitis.

The purpose of this study was to evaluate one year of maintenance therapy in young adults with severe periodontitis (SP) who had previously received periodontal therapy consisting of root planing and scaling followed by open flap debridement. Subjects were evaluated with clinical and microbiological measurements at 3, 6, 9, and 12 months following the completion of active therapy. Subjects were included in the study if they completed a minimum of two evaluation appointments. Monitoring of these subjects during the maintenance phase was analyzed by three methods. First, changes in mean attachment level and mean probing depth were calculated at 3-month intervals to determine if the subjects continued to lose or gain attachment and/or had periodontal pockets of increasing or decreasing depth. Second, the frequency of periodontal breakdown was determined and compared to breakdown rates of subjects in other patient populations. Third, future changes in attachment level were related to the presence or absence of two putative periodontal pathogens, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in subgingival plaque. Mean attachment level remained constant in 13 subjects who completed one year of maintenance therapy. However, mean probing depth increased at a yearly rate of 0.19 mm and in periodontally-involved sites pocket depth increased at a yearly rate of 0.65 mm both of which were statistically significantly different from 0 (P < .05). The frequency of periodontal breakdown in this study was higher than reported in other similar studies of different periodontitis patient populations. The remainder of the data in the study was from 21 subjects who had completed at least two recall appointments.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Immunoglobulin isotypes in gingival crevicular fluid: possible protective role of IgA.

In order to simultaneously assess the local humoral immune and polymorphonuclear leukocyte (PMN) responses in periodontal disease, IgG, IgM, and IgA, as well as the PMN lysosomal enzyme beta-glucuronidase (beta G), were examined in gingival crevicular fluid (GCF) from patients with varying degrees of periodontal pathology. Evaluations were made before and after conservative therapy (scaling and root planing). Thirty patients with varying degrees of periodontal pathology, ranging from mild inflammatory gingivitis to moderate periodontitis, were studied. GCF was collected from the mesial surfaces of all teeth. The presence of the 3 immunoglobulin isotypes was determined by enzyme linked immunosorbent assays (ELISA), while total beta G activity in GCF was determined by a fluorometric assay. Clinical parameters were obtained from 6 sites per tooth. Our data indicate that prior to treatment, total beta G activity is strongly related to the severity of periodontal disease as measured by mean probing attachment level (AL; r = 0.89; P < .005), mean probing depth (PD; 4 = 0.89; P < .0005) and percentage of sites exhibiting bleeding on probing (% BOP; r = 0.49; P < .005). Following treatment, no statistically significant relationship of disease severity and beta G is found. The concentrations of IgG and IgM in GCF do not follow a specific pattern when related to disease severity. In contrast, prior to treatment the concentration of IgA is negatively correlated to mean AL (r = -0.54; P < .005), mean PD (r = -0.59; P < .005), and % BOP (r = -0.47, P < .005).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1996

The effect of periodontal treatment on periodontal bacteria on the oral mucous membranes.

The aim of this study was to investigate the effect of conventional periodontal treatment on the prevalence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia on oral mucous membranes in patients with periodontitis. Fifteen patients were selected with moderate to severe periodontitis (mean age: 39.8 years, range: 26 to 58). From each patient the 4 deepest sites with bleeding on probing were selected for clinical and microbiological evaluation. At baseline, 6 weeks after oral hygiene instruction and extensive scaling and root planing, and 3 months after periodontal surgery, clinical parameters and microbiological samples including saliva, oral mucous membranes, and supra- and subgingival plaque were evaluated for the presence of the 3 test bacteria using indirect immunofluorescence. All clinical variables, except redness, showed a significant improvement after surgery. After treatment, the subgingival prevalence of the 3 putative periodontal pathogens had decreased significantly. However, almost no concomitant reduction in the prevalence of the bacteria was seen on the oral mucous membranes. This suggests that the oral mucous membranes may serve as a source for reinfection of the periodontium after treatment.

Adult↗
PubMed1996

A multi-center clinical trial of a new chairside test in distinguishing between diseased and healthy periodontal sites. II. Association between site type and test outcome before and after therapy.

The aim of the present study was to evaluate the association between the outcome of a chairside test measuring gingival crevicular fluid (GCF) levels of the enzyme aspartate aminotransferase (AST) and other clinical measures of disease including probing depth, severity of inflammation, and GCF flow before and after therapy. We studied 91 patients with moderate to severe periodontitis. Eight sites with probing depths between 5 mm and 8 mm and obvious signs of inflammation were selected and designated diseased sites. Four sites with probing depth < or = 3 mm with no or minimal signs of inflammation were selected and designated non-diseased sites in patients. Thirty healthy individuals were enrolled and four sites in each were selected and designated healthy controls. Patients were treated with scaling and root planing and control subjects with supragingival prophylaxis. Measurements including GCF volume, gingival inflammation, and probing depth were performed at screening baseline, 1 week later at pretreatment baseline, and at weeks 2 and 4 after treatment. AST content of GCF was measured using a chairside colorometric test. It was concluded that the outcome of the test is an effective objective measure distinguishing between diseased sites and non-diseased sites in patients and control subjects when evaluated both prior to and following application of therapy. Use of this simple chairside test, when combined with other standard diagnostic procedures, provides an objective measurement permitting improved capacity to distinguish between diseased and non-diseased periodontal sites, and to better assess and monitor the outcome of therapy.

Adult↗