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PubMed2004

[Combined orthodontic-periodontal treatment on periodontal patients with anterior displaced incisors].

OBJECTIVE: Combined orthodontic-periodontal treatment with supracrestal fiberotomy was undergone on the periodontal patients with anterior displacement of incisors. Evaluate of the changes before and after treatment. METHODS: Periodontal indices, periapical x-ray analysis, and model analysis were used for investigating the changes of alveolar bone height and periodontal health by orthodontic treatment following supracrestal fiberotomy of anterior displaced incisors on periodontal patients. RESULTS: Alveolar bone height was increase by 1.2 mm in fiberotomy patients. The overjet was reduced from 7.0 mm to 2.0 mm, while the overbite was decreased from 4.0 mm to 2.0 mm, and the periodontal health maintained as well. CONCLUSION: Combined orthodontic periodontal treatment with supracrestal fiberotomy could correct the malpositioned teeth, and improve the periodontium conditions and gain the crest bone.

Adolescent↗
PubMedDate not supplied

A comparison of characteristics of implant failure and survival in periodontally compromised and periodontally healthy patients: a clinical report.

PURPOSE: This study compares implant survival and patterns of implant failure in periodontally compromised and periodontally healthy patients. MATERIALS AND METHODS: In a private periodontal practice, over a 13-year period, implants were placed in both periodontally compromised and periodontally healthy patients. Implants were classified in 5 different groups according to surface texture. Survival rates in each group were compared according to implant location, diameter, length, and phase of treatment. RESULTS: A total of 1,511 implants were placed in 334 patients. One hundred fifty-one of these patients, classified as periodontally compromised patients (PCP), received 923 implants. The remaining 183 patients, classified as periodontally healthy patients (PHP), received 588 implants. The overall survival rate for implants placed in the PHP group was 93.7%, compared to 90.6% in the PCP group. The survival rate of hydroxyapatite-coated implants was 92.6% in the PHP group and 81% in the PCP group. The survival rate of the turned-surface implants was similar in both groups. DISCUSSION: Two types of implant failure were identified. The first was failure of the implant to osseointegrate. This type of failure occurred early in treatment and appeared to be related to smooth-surface implants placed in bone of low density. Failures of this type were distributed equally between the PHP and PCP groups. The second type of failure was related to peri-implantitis. It was observed most often with implants with hydroxyapatite surfaces, occurred as the result of a progressive condition, and was most prevalent in the PCP group. CONCLUSION: Further long-term controlled investigations are needed to determine the influences of implant suface and host susceptibility on implant failure in both PHP and PCP.

Coated Materials, Biocompatible↗
PubMed2005

Association between coinfection of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Treponema denticola and periodontal tissue destruction in chronic periodontitis.

BACKGROUND: The association between the infection of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Treponema denticola in chronic periodontitis (CP) and the severity of periodontal disease remains to be elucidated. The aim of this study was to investigate the subgingival infection frequencies of three periodontopathic bacteria in Chinese CP patients and to evaluate the correlations between infection by these bacteria and periodontal destruction. METHODS: A multiple PCR assay using primers derived from 16SrDNA genes of P. gingivalis, A. actinomycetemcomitans and T. denticola was established to measure simultaneously the presence of the three microbes in 162 subgingival samples from 81 Chinese CP patients. RESULTS: The positive rates of P. gingivalis, A. actinomycetemcomitans and T. denticola in the subgingival samples were 84.6%, 83.3% and 88.3%, respectively. Of the subgingival samples, 68% revealed the coinfection of all the three microbes. The infection rates with P. gingivalis, A. actinomycetemcomitans or T. denticola alone was 5.9% (1/17), 17.6% (3/17) and 76.5% (13/17), respectively. A close association was present between the A. actinomycetemcomitans infection and gingival index (GI) (P < 0.01), but not between P. gingivalis or T. denticola infection and GI (P > 0.05). P. gingivalis and A. actinomycetemcomitans were more frequently detectable in middle and deep pockets than in shallow ones (P < 0.01), while T. denticola was found remarkably often in deep pockets (P < 0.05). The coinfection rate of the three microbes was significantly higher in sites with severe periodontitis than in those with mild periodontitis (P < 0.01). CONCLUSIONS: The multiple PCR established in this study can be used as a sensitive and specific method to simultaneously detect all three microbes in subgingival samples. A. actinomycetemcomitans infection may be associated with CP and play an important role in the periodontal tissue destruction. The coinfection of P. gingivalis, A. actinomycetemcomitans and T. denticola can cause more serious periodontal destruction than infection of any one or two of the three microbes.

Adult↗
PubMed2005

[Cell transplantation for periodontal diseases. A novel periodontal tissue regenerative therapy using bone marrow mesenchymal stem cells].

A major goal of periodontal therapy is to reconstruct healthy periodontium destroyed by periodontal diseases. Basic studies have revealed that transplantation of mesenchymal stem cells (MSC) into periodontal defects promotes regeneration of periodontal tissue. We have developed a novel method for periodontal therapy using MSC. Human bone marrow cells are obtained from the iliac crest and expanded in vitro at Cell and Tissue Engineering Center in Hiroshima University Hospital. MSC are, then, isolated and mixed with Atelocollagen at final concentrations of 2 x 10(7) cells/mL. These MSC in Atelocollagen are transplanted into periodontal osseous defects at the periodontal surgery. The results in all seven patients who received the own MSC transplantation have shown good clinical course. Further basic studies and the continuous clinical trial are needed to prove the effectiveness of the clinical application.

Humans↗
PubMedDate not supplied

[The effect of periodontal cytomedin on lipid peroxidation and hemostasis in spontaneous periodontitis in rats].

Rats with spontaneous periodontitis develop lipid peroxidation in the blood and periodontal tissues, that is associated with hypercoagulation and fibrinolysis inhibition, reduced antiaggregation activity of the periodontal tissues. Administration of periodontal cytomedin results in normalization of lipid peroxidation, blood coagulation, and euglobulin lysis, as well as in increase in the activities of periodontal antioxidant enzymes and antiaggregation properties. Cytomedin effect on lipid peroxidation and antioxidant enzymes was more manifest in periodontal tissues than in the blood. Visual examination has shown an improvement of the periodontal tissue status, thus indicating good prospects for such therapy.

Animals↗
PubMed1989

[Bacterial invasion in periodontitis, is it important in periodontal treatment?].

During the progression of periodontal disease bacteria invade the epithelial lining of the gingival pocket and the underlying connective tissue. This invasion was demonstrated in acute necrotizing ulcerative gingivitis (ANUG), localized juvenile periodontitis (LJP), rapidly progressive periodontitis in adults (RPP) and in children with Papillon-Lefèvre syndrome associated periodontitis. Using morphologic criteria or fluorescent antibody staining techniques spirochetes, Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, B. intermedius, Actinomyces species, Fusobacterium nucleatum and Mycoplasma have been identified in these tissue compartments. Recent light microscopic, electron microscopic and bacteriological studies demonstrated the presence of invading bacteria in the cementum and in the radicular dentin of teeth with periodontal disease. In 83% of 69 carries free periodontally diseased teeth bacteria were present in one of the dentin layer from the root. In 59% of these teeth the dental pulps contained bacteria. The composition of the flora resembled that of the subgingival flora. The use of chlorhexidine, fluoride, tetracyclines or metronidazole in the elimination of invading bacteria following mechanical periodontal therapy is discussed.

Adult↗
PubMed1993

Periodontal awareness: the key to periodontal health.

The maintenance of periodontal health requires an informed public and patient. Treatments will fail, and in fact will not ever start, if individuals are not aware of the differences between periodontal health and disease, the significance of these differences and the part they can play in prevention and control. Self awareness begins the process, with self care and professional assistance following. A periodontal awareness programme was started in New Zealand in 1986 aimed at improving periodontal health, through increasing the knowledge of both the public and the profession. It is on such a knowledge base that self care and assisted care programmes can be developed. This paper presents the New Zealand programme, the public and professional messages and the way these were linked. Patient self assessment and self care are emphasised. The new basic periodontal examination for the dentist and auxiliary staff begins a stepped and structured programme of assisted care. An examination of this awareness programme is presented together with future directions. Chronic inflammatory periodontal diseases are universal but the profession knows it is possible to prevent, manage and control almost all of these diseases. Awareness of the need for the right actions by patients and dental professionals is seen as the key to improving periodontal health.

Adult↗
PubMed1989

Periodontal condition and microbiology of healthy and diseased periodontal pockets in type 1 diabetes mellitus patients.

On the basis of glycosylated hemoglobin (HbA1c) values, 22 type 1 (insulin-dependent) diabetic adults were grouped into patients with near normal (HbA1c less than or equal to 7.7%) and poor (HbA1c greater than or equal to 9.9%) metabolic control. A total of 44 subgingival sites were examined for Actinobacillus actinomycetemcomitans, black-pigmented Bacteroides species and Capnocytophaga species. No significant difference could be demonstrated between patients in the 2 test groups with regard to periodontal condition. Neither age of diabetic patients nor duration of diabetes mellitus influenced the periodontal parameters. In both test groups, pocket depth of 4 mm or more (greater than or equal to 4 mm) was found to be significantly associated with increased swelling, bleeding after probing and amount of marginal plaque. Proportionally high %s of cultivable A. actinomycetemcomitans (mean 4.3%; range 2.8-5.8%), Bacteroides gingivalis (33.2% and 34.6%) and Bacteroides intermedius (mean 4.2%; range 0.001-13.5%) were isolated from diseased periodontal pockets. In diabetic patients with poor metabolic control, B. intermedius was isolated from diseased periodontal pockets with a mean % of 7.2%, range 0.3-12.5%. Independent of the degree of metabolic control, low %s of Capnocytophaga species were isolated from diseased and healthy periodontal pockets, mean 0.9% (range 0.003-3.9%) and mean 1.4% (range 0.04-4.9%), respectively. It was concluded from this study that metabolic control seems to have no direct effect on the periodontium. Furthermore, the rôle of Capnocytophaga species in the pathogenesis of infectious periodontal disease in type 1 diabetic patients seems to be overestimated.(ABSTRACT TRUNCATED AT 250 WORDS)

Actinobacillus↗
PubMed2001

Effect of long-term intermittent periodontal care on canine periodontal disease.

The periodontal health status was assessed in two groups of dogs which had received different levels of periodontal care over a two-year period. The dental group received regular dental scaling and polishing, and intermittent daily tooth brushing, while the control group received no periodontal care. All dogs developed gingivitis, and two (one from each group) showed evidence of incipient periodontitis. The dental group had a reduced gingivitis index (GI) compared with the control group only when they had received daily tooth brushing before the GI assessment. When the dogs had not had their teeth brushed for four weeks before the assessment, the GI was not significantly different to that in the control dogs. This suggests that continual periodontal care throughout life is of great importance and questions the benefits of intermittent oral care. The GI of the palatal and lingual surfaces in all dogs was significantly higher than the GI of the buccal surfaces. Thus, all tooth surfaces may need to be cleaned to achieve optimal periodontal health.

Animals↗
PubMed1987

Relationship of serum antibody to attachment level patterns in young adults with juvenile periodontitis or generalized severe periodontitis.

The goal of this study was to relate attachment loss patterns in early onset periodontitis subjects (juvenile periodontitis n = 47 and severe (generalized) periodontitis n = 52) with antibody reactivities to 25 bacterial strains which were suspected periodontal pathogens. The 25 antibody reactivities were screened by correlation analysis. Eleven strains were found to be significantly related to attachment loss. Using these 11 reactivities, stepwise multiple linear regression with plaque and age as covariates was used to further relate the reactivities within each subject group. Plaque was significantly related to the number of teeth with slight, moderate, or severe attachment loss. A significant inverse relationship was found between antibody reactivity with Haemophilus actinomycetemcomitans Y4 and the number of teeth having slight or moderate attachment loss. Similarly a significant inverse relationship between antibody reactivity with Bacteroides gingivalis and the number of teeth having moderate or severe attachment loss was found. The inverse relationship between the two antibody reactivities and attachment loss patterns were independent of the positive relationship of plaque. These relationships suggest that the failure to mount a substantial antibody response to these organisms leads to greater and more widespread periodontal disease in early onset periodontitis subjects.

Adolescent↗
PubMed1999

An example of measurement and reporting of periodontal loss of attachment (LOA) in epidemiological studies: smoking and periodontal tissue destruction.

The measurement and reporting of periodontal disease in epidemiological studies can be complex, with the common indices having well-recognised shortcomings. The aim of this study was to illustrate the use of the periodontal loss of attachment (LOA) approach in investigating the association between cigarette smoking and loss of periodontal attachment in a convenience sample of adults, in order to determine whether or not smoking was a risk indicator for periodontal disease. All participants were given a detailed periodontal clinical examination in two randomly assigned contralateral diagonal quadrants, with LOA measurements made at six sites per tooth. Information was also collected on participants' socio-demographic characteristics, oral hygiene practices, smoking history, and attitudes towards smoking. The 240 participants examined comprised 81 current smokers (CS), 79 former smokers (FS) and 80 nonsmokers (NS). Substantial differences and a gradient in disease existed for LOA among the three groups. CS exhibited the greatest (and NS the least) prevalence, extent, and severity of LOA. CS had more plaque and calculus than either of the other two groups, but the groups did not differ with respect to bleeding on probing. Overall, smoking was associated with the disease outcome, and this persisted after potential confounders were controlled using multivariate analysis. Although the observed differences may have been due to the self-selected nature of the sample, the gradient evident across the three smoking exposure groups suggests that smoking cessation can slow the progression of the disease. The LOA approach appears to be a versatile and informative method for recording, analysing, and presenting data on periodontitis in epidemiological studies.

Adult↗
PubMed1989

[Changes of the periodontal vascular network, periodontal fiber and alveolar bone incident to tooth extrusion].

During the application of orthodontic force to a tooth, the surrounding tissues undergo changes of bone resorption and apposition, thereby resulting in tooth movement. The purpose of this study was to investigate the interrelationship between alveolar bone changes and the periodontal vascular network caused by extrusive orthodontic force using a scanning electron microscopy. Extrusive orthodontic force was applied to the mandibular 2nd and 3rd premolars of adult dogs. At the completion of the loading process, the inferior alveolar arteries were injected with a low viscosity MMA resin (Mercox). The following results were obtained. 1) At 3 days post-extrusion, various types of vascular network showing a loop pattern were seen along the direction of the tooth movement. 2) At 7 days post-extrusion, various types of vascular network with a hairpin loop pattern along the direction of the tooth movement were observed. Histologically, the fibers of periodontal ligament were stretched in the direction of the extrusion, Vascular hairpin loop formations were observed within the fibers of periodontal ligament. Bone apposition was not observed on the surface of alveolar bone. 3) At 14 days post-extrusion, a much more extensive and developed hairpin loop pattern occurred. Furthermore, new bone apposition was seen on the alveolar bone beneath under the hairpin loops. The periodontal ligament space was retained in the same width, even after bony apposition. 4) At 21 days post-extrusion, the tooth side microvascular network showed abundant low hairpin loops which anastomosed each other, and new spinous bony apposition was observed right below the periodontal vascular network. 5) At 30 days post-extrusion, the periodontal vascular network showed a almost normal appearance, with the rearrangement of vascular network. The surface of the spinous bony apposition became flat. The appositional bone had a lower degree of calcification than the alveolar bone in control group. 6) At 60 days post-extrusion, the periodontal vascular network completed the rearrangement of vasculature.

Alveolar Bone Loss↗
PubMed2003

Periodontal status of orthodontic patients and the relationship between dental aesthetic index and community periodontal index of treatment need.

This prospective clinic-based study evaluated the pretreatment periodontal status of the orthodontic patients seen at the University College Hospital, Ibadan, Nigeria, and assessed the relationship between dental aesthetic index (DAI) scores and periodontal status according to community periodontal index of treatment needs (CPITN) scores. One hundred forty five patients-70 (48.3%) males and 75 (51.7%) females from 6 to 45 years (mean 15.8 +/- 7.5)-were seen. World Health Organization (WHO) guidelines were followed in the examination and reporting of the periodontal status, and DAI scores were assessed based on WHO guidelines. The chi-square test was used to determine the association between the DAI and the CPITN scores. Most patients were in the 6-15 (55.9%) or 16-25 (35.9%) age groups. Based on the WHO preferred cumulative calculations of treatment need (TN), 35.2% of the patients had TN 0, 64.9% had TN 1, 24.9% had TN 2, and only 0.7% had TN 3. The relationship between DAI scores and periodontal treatment needs was not statistically significant (P >.05). Although many patients were yet to attain the WHO goal of no more than 1 sextant affected by bleeding or calculus at the age of 15, over one third had satisfactory periodontal health.

Adolescent↗
PubMed1999

The microbiota of periodontal pockets with different depths in therapy-resistant periodontitis.

This study presents the composition of the cultivable microbiota colonising periodontal pockets of different depths among 2 patient-groups classified as non-responsive (NR-group; 11 participants) or responsive (R-group; 10 participants) to periodontal treatment. Microbiological samples from three types of pocket (< 4 mm deep A-samples; 4-5 mm B-samples; > 5 mm C-samples) were analysed by cultural methods for putative periodontitis pathogens, microbial groups constituting > or = 5% of the total cultivable flora and opportunistic pathogens. Actinomyces naeslundii, A. israelii, Bacteroides forsythus, Fusobacterium spp, Porphyromonas gingivalis, Prevotella intermedia, Peptostreptococcus micros, anaerobic streptococci and facultative anaerobic streptococci were most prevalent. Actinobacillus actinomycetemcomitans, Staphylococcus aureus, enteric rods and yeasts were less prevalent. The periodontitis pathogens Bacteroides forsythus, Fusobacterium spp, Porphyromonas gingivalis, Prevotella intermedia and Peptostreptococcus micros constituted together (on average) < or = 23% of the viable counts in the A- and B-samples of both patient groups and in the C-samples of the R-group. In the C-samples of the NR-group their mean counts were 45%. Correlations were found between smoking habits and the five pathogens in the C-samples and in pooled pocket depth samples. The results show that groups of periodontopathogens should be considered a causal factor in therapy-resistant periodontitis. Further, smoking and deep pockets can enhance a shift in the balance of the subgingival microflora predisposing a site to disease and a susceptible host may be the pre-requisite to therapy-resistant periodontitis.

Actinomyces↗
PubMed2003

Clinical course of chronic periodontitis. II. Incidence, characteristics and time of occurrence of the initial periodontal lesion.

AIM: The purpose of this study was to assess the initiation and progression of periodontal disease during adult life. MATERIALS AND METHODS: In a 26-year longitudinal investigation of the initiation and progression of chronic periodontitis that started in 1969 and included 565 men of Norwegian middle class, 223 who had participated in some, but not all, intermediate examinations presented at the last survey in 1995. Fifty-four individuals were available for examination in all seven surveys. RESULTS: Covering the age range from 16 to 60 years, the study showed that at 16 years of age, 5% of the participants had initial loss of periodontal attachment (ILA > or = 2 mm) at one or more sites. Both the subject incidence and the site incidence increased with time, and by 32 years of age, all individuals had one or more sites with loss of attachment. As age progressed, new lesions affected sites, so that as these men approached 60 years of age approximately 50% of all available sites had ILA. An assessment of the intraoral distribution of the first periodontal lesion showed that, regardless of age, molars and bicuspids were most often affected. At and before the age of 40 years, the majority of ILA was found in buccal surfaces in the form of gingival recession. By 50 years, however, a greater proportion of sites presented with attachment loss attributed to pocket formation or a combination of pocket formation and gingival recession. As individuals neared 60 years of age, approximately half of the interproximal areas in posterior teeth had these lesions. CONCLUSION: This investigation has shown that, in a well-maintained population who practises oral home care and has regular check-ups, the incidence of incipient periodontal destruction increases with age, the highest rate occurs between 50 and 60 years, and gingival recession is the predominant lesion before 40 years, while periodontal pocketing is the principal mode of destruction between 50 and 60 years of age.

Adolescent↗
PubMed2003

Change of antibiotic susceptibility following periodontal therapy. A pilot study in aggressive periodontal disease.

BACKGROUND: The hypothesis was tested that bacterial susceptibilities in aggressive periodontitis change upon administration of systemic antibiotics as adjuncts to periodontal therapy. METHODS: In 23 subjects (average age 38.9+/-6.7 years) with aggressive periodontitis, microbial parameters were assessed prior to and 1 year after completion of comprehensive mechanical/surgical and systemic antimicrobial therapy. Following identification of five selected pathogens with the Rapid ID 32 A system, their susceptibilities towards amoxicillin/clavulanate potassium, metronidazole, and tetracycline were examined with the E-test. Antibiotics were administered according to the test results, and the minimal inhibitory concentrations (MIC90) were reevaluated after 1 year. Statistical analysis was performed on a patient basis, with the site data used for evaluation of the MIC levels. RESULTS: Bacterial MIC levels remained constant among the three antibiotic treatment groups compared with baseline. Mean MIC90 values ranged from <0.02 to 0.11 microg/ml (amoxicillin/clavulanate potassium), <0.02 to 0.27 microg/ml (metronidazole), and <0.02 to 0.11 microg/ml (tetracycline). Observed changes in susceptibility were attributed to the elimination of single bacterial taxa in the subgingival environment after antibiotic therapy. There were no statistically significant differences in clinical parameters among the treatment groups. Single tetracycline MICs were 1.5- to 6-fold enhanced compared to amoxicillin/clavulanate potassium and metronidazole. CONCLUSION: The periodontal pathogens investigated prior to and 1 year after periodontal therapy are tested sensitive to the antimicrobial agents. In aggressive periodontitis, changes in bacterial susceptibility upon the administration of systemic antibiotics are associated with the limited number of isolates tested following therapy.

Adult↗
PubMedDate not supplied

Periodontal pocketing in HIV-associated periodontitis.

Gingival and periodontal involvement has been described in individuals with Human Immunodeficiency Virus (HIV) infection. The manifestations often include erythematous gingivitis, necrotizing gingivitis, and periodontal involvement characterized by rampant loss of bone and soft tissue, resulting in recession without the formation of periodontal pockets. We present cases of HIV-associated periodontitis (HIV-P) in which advanced periodontal pocket formation was present. Periodontal disease may show a broad range of severity in patients with various T4 helper cell counts.

AIDS-Related Opportunistic Infections↗
PubMed2001

The localization of periodontal-disease-associated bacteria in human periodontal pockets.

Some Gram-negative anaerobes are associated with the incidence and progression of periodontal disease. In periodontal pockets, however, the localization of those bacteria is unknown. We investigated the localization of 5 bacterial species in human periodontal pockets. Fifteen teeth with a part of periodontal pockets from 10 adult periodontitis patients were obtained, and the localization of bacteria was examined immunohistochemically. Positive reactions with anti-Prevotella nigrescens antibody were located at the epithelium-associated plaque area in the middle pocket zones. In the middle and deep pocket zones, Fusobacterium nucleatum and Treponema denticola were especially localized in the unattached plaque area, but Eikenella corrodens was observed in the tooth-attached plaque area. Actinobacillus actinomycetemcomitans, detected in 2 of 15 samples examined, was found in the unattached plaque area, in the middle pocket zone. The present findings indicated that the 5 bacterial species examined localized at distinct regions in human periodontal pockets.

Adult↗