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PubMedDate not supplied

[Antimicrobial approaches to periodontal therapy].

The relationship between the periodontal microbiota and the threshold for periodontal disease is dependent on the specific bacterial composition of the plaque and the resistance of the host. Supragingival plaque is the cause of gingivitis and plays a primary role in the initiation of periodontitis. The 0.2% chlorhexidine mouthwash (twice a day) is safe and most effective antiplaque and anti-gingivitis agent. The use of adjunctive tetracycline for 2 week periods (1 gm daily) with root debridement is highly effective against Actinobacillus actinomycetemcomitans and many of suspected virulence microorganisms, the major etiological agents of juvenile periodontitis. For rapidly progressive periodontitis and refractory adult periodontitis, metronidazole for 1-2 week periods (600 mg.daily) has excellent activity against strictly anaerobic bacteria such as Bacteroides gingivalis, Spirochetes and others. Clinical use of antimicrobial agent in adjuvant with scaling, root planing, and personal oral hygiene instruction cause a significant improvement of the periodontium.

Actinobacillus↗
PubMed1990

[Instrumentation for periodontal treatment].

Since the introduction of scalers in the beginning of the century for the mechanical removal of plaque, instruments with few major modifications are still in clinical use today. New approaches in diagnosis of periodontal disease such as microbiological analysis, enzyme diagnosis of crevicular fluid or computer-aided procedures are presently in clinical trials. A set of periodontal instruments is presented which has been well established and is recommended for the treatment of periodontal disease. The discussion of the specific instruments is presented according to the sequence of patient treatment, which is divided into diagnosis, initial therapy, scaling and root planing, periodontal surgery and maintenance therapy.

Adolescent↗
PubMed1990

Problems associated with the management of periodontal disease in clinical practice.

Periodontal disease is caused by poor oral hygiene. It is the most common cause of oral infection and tooth loss in dogs. Simple periodontal therapy such as repeated root planing at strategic intervals can prevent many serious problems. This chapter presents the origin, clinical presentation, and treatment of periodontal disease in a format that is directly applicable to clinical practice.

Age Factors↗
PubMed1990

[Sharpening of periodontal instruments].

Sharp hand instruments are the first pre-requisite for scaling and root planing. Different sharpening techniques are reported, and the time at which an instrument is evaluated for its sharpness or dullness is indicated. The shape and form of several instruments are described together with the appropriate sharpening technique.

Dental Instruments↗
PubMed1989

[Simplified oral hygiene with subgingival pulsating jet irrigation with and without a dilute metronidazole solution as an adjunct for control of chronic periodontal disease].

This study compared the clinical effects of 0.05% metronidazole solution (MD) applied subgingivally using pulsated monojet irrigation following a single episode of scaling and root planing and simplified oral hygiene instruction, with the same system using a placebo solution (MDP). Twelve patients with 129 approximal units (pocket depth greater than or equal to 4 mm) in the MD group and 170 in the MDP group took part in the study. Within procedure comparisons revealed statistically highly significant reductions in Plaque Index, gingival oedema, Sulcus Bleeding Index, and probeable pocket depth in both groups. However between procedure comparisons indicated that the MD group showed more reduction in PI1, SBI and gingival oedema. Improvements in PPD were not significant except at day 56. The differences between groups were small clinically.

Adult↗
PubMed1989

Assessment of curette sharpness.

Nothing to date has appeared in the literature addressing the relationship of specific bevel dimension and clinical sharpness of curette blades. This study investigated the degree of clinical sharpness of Gracey curettes following four periods of simulated root planning and, using the scanning electron microscope (SEM), determined the approximate number of strokes at which loss of clinical sharpness became apparent. Seventy-five new stainless steel curette blades were standardized and randomly assigned to one of five groups: control, 30-stroke, 50-stroke, 70-stroke, and 90-stroke. With the exception of the control group, blades underwent a simulated root-planing procedure, on extracted, periodontally involved teeth, which employed a device to standardize pressure and stroke length. Blades were then tested for clinical sharpness using light reflection, with two degrees of magnification; and plastic stick, a tactile evaluation. Blades were photographed under the SEM at a magnification of x1,000. Bevel width was measured at 10 standardized locations on the photomicrographs, and a mean was calculated. Nonparametric data were analyzed using the Kruskal-Wallis statistical test and SEM parametric data using ANOVA and post hoc Newman-Kuels tests. Results showed no significant differences among treatment groups when either tactile or magnification sharpness tests were used. Analysis of the SEM data showed no statistically significant differences among bevel dimensions for any of the five groups. A Spearman rank order correlation, used to compare the clinical data to the SEM bevel measurements, showed no correlation of clinical sharpness and SEM-determined bevel dimension.

Dental Instruments↗
PubMed1989

[Epidemiological study of periodontal disease in an Oviedo school population].

1,276 young people, between 6-20 years old, representing the urban school population from Oviedo (Spain) were evaluated by the Community Periodontal Index of Treatment Needs (C.P.I.T.N.). From this population: 1. 66.1% were found to have bleeding on probing, without evidence of attachment loss (gingivitis), or presence of local irritants. This population represented a treatment need of improving oral hygiene. 2. 29.6% had moderate attachment loss (probing pocket depths between 4-5 mm.) and/or presence of local irritants. They were determined to need scaling and root planing. 3. 0.7% had probing pocket depths higher than 6 mm., which requires a more complex specialized type of therapy. Based on these treatment needs, the number of treatment hours was determined, estimating that it would be necessary to spend 1649 hrs. to diagnose and treat this detected periodontal conditions. 93% of this time could be provided by dental auxiliary personnel. The therapeutic needs were higher in males and clearly augmented with age.

Adolescent↗
PubMedDate not supplied

[Metronidazole: application in periodontal disease].

Metronidazole is effective against certain anaerobic infections such as Bacteroides gingivalis and Spirochetes with clinical signs of rapidly progressive periodontitis and refractory adult periodontitis. The use of Metronidazole in adjuvant with scaling, root planing, and personal oral hygiene instruction caused a significant improvement of the periodontium.

Humans↗
PubMed1989

Factors influencing periodontal therapy for the geriatric patient.

Anatomic changes in the periodontium occur with aging. There is no indication that these changes predispose to periodontal breakdown. In the United States, there is evidence that older individuals are retaining more teeth and that these teeth have less periodontal disease than previous generations of seniors. Studies comparing the healing of older and younger patients have clearly demonstrated that both groups of patients respond equally well to therapy. Proven methods of periodontal therapy include modified Widman surgery, pocket elimination surgery, or nonsurgical scaling and root planing. Surgical treatment may be used with confidence unless there are medical contraindications. In these cases, nonsurgical therapy may be preferred. If there are physical or mental disabilities that make effective home care difficult, antimicrobial agents, such as the extensively tested chlorhexidine rinse, may be valuable adjuncts. In the future, senior adults can look forward to the benefits of regenerative periodontal procedures that seek to regain lost periodontal support. Age alone should not diminish an individual's right to care because the practitioner has qualms about his or her longevity. Successful treatment of periodontitis by surgical and nonsurgical methods has been extensively documented. Senior patients can benefit from these treatments as much as younger patients, and age is not a barrier to effective periodontal therapy.

Aged↗
PubMed1989

[The therapeutic effects of non-surgical technics applied in the treatment of periodontitis].

The aim of the present investigation was to study the non-surgical periodontal therapy efficiency. 126 patients were selected for this study. 20,052 sites were observed during 2 years. Patients were instructed in oral hygiene before treatment and, if necessary, during the study. All the sites were treated by scaling and root planing. The treatment was followed by a three months maintenance. The pockets were classified in three depth groups (less than 3, greater than 3 less than 7, greater than = 7 mm). At base line, male patients showed a greater deep pockets number. Probing pockets measurements were recorded 3, 12 and 24 months after treatment. The results showed, after three months, an important reduction of the pockets number (greater than 3 less than 7 and greater than = 7 mm). A smaller reduction was also observed after 12 and 24 months. During the last 21 months of this study, a therapeutic effect of the maintenance appeared more clearly when a correlation was made with the initial pocket number. The healing was not influenced by the initial pocket depth. Only incisors and canines deepest pockets showed a better healing. In the same way, molars and premolars proximal sides showed a better answer. This last observation is, maybe, the consequence of the frequent papillectomy performed around the posterior teeth. The differences between female and male patients or between the age groups were not significative. Nevertheless, the therapeutic effect of the maintenance seemed to be more effective with younger patients.

Adult↗
PubMed1979

Preventive periodontics in the dental hygiene curriculum: results of a nationwide survey.

The contemporary concept of prevention for the dental hygienist incorporates detection and initial treatment of periodontal disease. A nationwide survey of 192 schools of dental hygiene indicates that nearly all of these schools have minimal requirements in preventive periodontics including didactic presentations, periodontal charting, and instruction in root planing techniques. Data from this survey suggest that schools of dental hygiene may not be fulfilling their responsibility in preventive dental health.

Accreditation↗
PubMed1988

Changing concepts of periodontal treatment: surgical and non-surgical.

Periodontal disease can be successfully treated by non-surgical procedures including supra- and subgingival scaling and root planing with hand or ultrasonic instruments. This non-surgical treatment is recommended for the initial management of all cases with the institution of a plaque control programme. Such management should be the basis of all periodontal therapy. The results obtained are mainly dependent on the skillfulness of the operator and the morphology of the pockets as well as upon patient related factors. Additional treatment, i.e. periodontal surgery, may be necessary if resolution of subgingival inflammation is not obtained. Pocket elimination by the use of surgical procedures (gingivectomy, flap operation with bone surgery) may be preferred in regions of the mouth where the aesthetic result is unimportant and where the removal of alveolar bone does not jeopardize the periodontal support of neighbouring teeth. In situations with deep infrabony pockets especially in anterior regions and in furcation areas a reconstructive surgical technique is the therapy of choice. Recent research in the field of guided tissue regeneration may, in the future, change the traditional approach to periodontal surgery.

Female↗
PubMed1982

The effects of a continuing education course on dental hygiene practice.

Thirty-three dental hygienists were evaluated to measure the immediate and long-term effects of a continuing education course on their knowledge, attitudes, and clinical skills. The group demonstrated a significant gain in knowledge at the conclusion of the course. A postcourse evaluation was conducted after six months to determine students' ability to apply clinically the knowledge gained. the evaluation revealed no favorable change from the precourse state. Students rated themselves as having significantly improved in their ability to perform root planing, soft tissue curettage, and probing procedures from precourse to six months postcourse. No relationship was found between knowledge gained and students' evaluation of the effectiveness of the course.

Adult↗
PubMed1994

[Changes in the alveolar bone after periodontal therapy. A follow-up by computerized radiographic analysis].

In this study the authors evaluated radiographic variations of alveolar bone treated with periodontal therapy, through computerized analysis. Five adult patients with severe periodontitis were included in this study. In everyone of these patients, three sites were selected and treated in the following ways: 1) root planing (LCC), 2) open flap debridement (LCA) and 3) guided tissue regeneration with polytetrafluoroethylene membrane (GTR-PTFE). Every site was subjected to radiographic examination before treatment and six, eight, twelve and twenty-four weeks later. Radiographic images were evaluated through digital processing in order to show and compare one to another changes of alveolar bone of sites treated with different therapeutic procedures. Analysis of data indicated that sites treated by GTR-PTFE developed better than sites treated with other therapeutic procedures and evolution of sites treated with surgery was usually characterized by a beginning phase of alveolar bone loss and by a phase of variable bone regeneration later. Early variations of alveolar bone have been pointed out by mean of this computerized analysis.

Adult↗
PubMed1994

Principles and clinical applications of periodontal controlled drug delivery with tetracycline fibers.

Controlled drug delivery of antibiotics in the periodontal pocket is a scientifically tested clinical reality. Application of pharmacokinetic principles allows effective suppression of the pathogenic microflora, which, in turn, results in resolution of inflammatory signs. In the cases presented, tetracycline fibers were employed as a supplement to mechanical therapy and oral hygiene in a variety of clinical situations. Outcomes included depression of periodontal pathogens, reduction of bleeding on probing, decrease in probing pocket depths, and increase in probing attachment levels. A novel therapeutic approach based on root planing for debridement, local drug delivery for control of the pathogens, and oral hygiene for preventing recolonization is discussed.

Adult↗
PubMed1994

Guided tissue regeneration in surgically created 3-walled and 2-walled periodontal osseous defects in monkeys.

BACKGROUND: In the previous clinical studies, guided tissue regeneration resulted in periodontal regeneration after treatment of 3-walled intrabony defects. The purpose of the present study was to compare the regenerative potential of 3-walled and 2-walled surgically created periodontal osseous defects in monkeys following placement of a biocompatible, porous polytetrafluorethylene membrane. METHODS: In each of 8 Taiwan monkeys, 2 maxillary and 2 mandibular teeth were selected for experimentation. Using a diamond bur, 3-walled osseous defects were created on the distal of the maxillary cuspid and the mesial of the mandibular second bicuspid of one side. Two-walled (lingual wall and proximal wall) osseous defects were created on the contralateral side. After root planing, teflon membranes were applied to the mandibular test teeth. In the maxilla, all procedures were the same except for the placement of teflon membranes. Two monkeys were sacrificed 3, 6 and 9 months after operation and prepared for histologic and histometric evaluation. Reentries were performed while the other 2 monkeys were terminated 11 months after operation. RESULTS: Histologic evaluation revealed that new connective tissue attachments were found to a greater extent in the 3-walled periodontal osseous defects treated with teflon membranes compared with the non-membrane sites (p = 0.05). More periodontal regeneration was not predictably obtained in the surgically created 2-walled osseous defects when the teflon membranes were used. CONCLUSIONS: For 3-walled periodontal osseous defects, guided tissue regeneration was superior to conventional periodontal flap surgery. For 2-walled defects, new connective tissue attachment could not be predictably achieved.

Alveolar Bone Loss↗
PubMed1994

Clinical evaluation of guided tissue regeneration in the treatment of grade II molar furcation invasions.

This paper evaluates the use of guided tissue regeneration for treating 19 pairs of molar grade II furcation defects. Presurgical measurements were taken for the determination of aveolar crestal resorption, vertical open probing attachment, and horizontal open probing attachment. The surgical procedure consisted of sulcular incision, full-thickness facial and lingual flaps, soft tissue debridement, and root planing. One defect from each pair of furcas was treated with an expanded polytetrafluoroethylene membrane, which was left in place for 4 to 6 weeks. Postsurgery soft tissue measurements showed a reduction in probing depth and a gain in vertical and horizontal open probing attachment.

Adult↗