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Alveolar Bone Loss (alveolar + bone_loss)

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Medical Sciences	100%

Selected Abstracts

Alveolar bone loss associated with glucose tolerance in Japanese men

DIABETIC MEDICINE, Issue 9 2003
T. Marugame
Abstract Aims Type 2 diabetes is known to affect alveolar bone loss (ABL). The purpose of this study was to examine whether impaired glucose tolerance (IGT) is associated with ABL, as is diabetes. Methods A case,control study was performed with 664 Japanese men aged 46,57 years. Panoramic radiographs revealed 513 severe ABL cases, 22 moderate ABL cases, and 129 controls with good alveolar bone. Diabetes status was classified into normal glucose tolerance (NGT), impaired fasting glucose (IFG), IGT, and newly diagnosed diabetes according to the fasting plasma glucose and 75-g oral glucose tolerance test (OGTT). Diabetes under treatment was excluded. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained from ordinal logistic regression analysis. Statistical adjustment was made for total cholesterol, HDL-cholesterol, triglyceride, rank in the Self Defence Forces (SDF), cigarette-years, alcohol use, body mass index, previous 10 years' brushing habits and instrument use other than toothbrush, and history of periodontal treatment. Results A significant, approximately three-fold increase in the crude OR (crude OR = 3.28; 95% CI = 1.16,9.27) and non-significant 2.6-fold increase in the adjusted OR (adjusted OR = 2.55; 95% CI = 0.86, 7.54) of ABL was observed among men with newly diagnosed Type 2 diabetes compared with the reference group (NGT combined with IFG). However, there was no association between IGT and ABL (adjusted OR = 0.99; 95% CI = 0.59,1.64). Conclusions Type 2 diabetes, but not IGT, was positively associated with ABL. Preventive maintenance against periodontitis is important in middle-aged men with diabetes. [source]

Validation of a dental image analyzer tool to measure alveolar bone loss in periodontitis patients

JOURNAL OF PERIODONTAL RESEARCH, Issue 1 2009
W. J. Teeuw
Background and Objective:, Radiographs are an essential adjunct to the clinical examination for periodontal diagnoses. Over the past few years, digital radiographs have become available for use in clinical practice. Therefore, the present study investigated whether measuring alveolar bone loss, using digital radiographs with a newly constructed dental image analyzer tool was comparable to the conventional method, using intra-oral radiographs on film, a light box and a Schei ruler. Material and Methods:, Alveolar bone loss of the mesial and distal sites of 60 randomly selected teeth from 12 patients with periodontitis was measured using the conventional method, and then using the dental image analyzer tool, by five dentists. The conventional method scored bone loss in categories of 10% increments relative to the total root length, whereas the software dental image analyzer tool calculated bone loss in 0.1% increments relative to the total root length after crucial landmarks were identified. Results:, Both methods showed a high interobserver reliability for bone loss measurements in nonmolar and molar sites (intraclass correlation coefficient , 0.88). Also, a high reliability between both methods was demonstrated (intraclass correlation coefficient nonmolar sites, 0.98; intraclass correlation coefficient molar sites, 0.95). In addition, the new dental image analyzer tool showed a high sensitivity (1.00) and a high specificity (0.91) in selecting teeth with , 50% or < 50% alveolar bone loss in comparison with the conventional method. Conclusion:, This study provides evidence that, if digital radiographs are available, the dental image analyzer tool can reliably replace the conventional method for measuring alveolar bone loss in periodontitis patients. [source]

Immunization of Macaca fascicularis against experimental periodontitis using a vaccine containing cysteine proteases purified from Porphyromonas gingivalis

MOLECULAR ORAL MICROBIOLOGY, Issue 3 2007
R. C. Page
Introduction:, Periodontitis is a common infectious disease to which Porphyromonas gingivalis has been closely linked, in which the attachment tissues of the teeth and their alveolar bone housing are destroyed. We conducted a study to determine if immunization using a purified antigen could alter the onset and progression of the disease. Methods:, Using the ligature-induced model of periodontitis in Macaca fascicularis, we immunized five animals with cysteine protease purified from P. gingivalis and used an additional five animals as controls. Alveolar bone loss was measured by digital subtraction radiography. Results:, Immunization induced high titers of specific immunoglobuin G serum antibodies that were opsonic. Total bacterial load, levels of P. gingivalis in subgingival plaque and levels of prostaglandin E2 in gingival crevicular fluid were significantly reduced. Onset and progression of alveolar bone loss was inhibited by approximately 50%. No manifestations of toxicity were observed. Conclusions:, Immunization using a purified protein antigen from P. gingivalis inhibits alveolar bone destruction in a ligature-induced periodontitis model in M. fascicularis. [source]

Effects of a herbal gel containing carvacrol and chalcones on alveolar bone resorption in rats on experimental periodontitis

PHYTOTHERAPY RESEARCH, Issue 4 2008
Marco Antonio Botelho
Abstract Carvacrol and dimeric chalcones are the respective bioactive components of Lippia sidoides and Myracrodruon urundeuva, popular medicinal plants of Northeastern Brazil with proven antimicrobial and antiinflammatory properties. Periodontal disease is associated with inflammation and microbiological proliferation, thus the study aimed to investigate the effect of a topical gel based on carvacrol and chalcones in the experimental periodontal disease (EPD) in rats. Animals were treated with carvacrol and/or chalcones gel, immediately after EPD induction, three times a day for 11 days. Appropriate controls were included in the study. Animals were weighed daily. They were killed on day 11, the mandibles dissected and alveolar bone loss was measured. The periodontium were examined at histopathology and the neutrophil influx into the gingiva was assayed using myeloperoxidase activity. The bacterial flora were assessed through culture of the gingival tissue. Alveolar bone loss was significantly (p < 0.05) inhibited by combined carvacrol and chalcones gel, compared with the vehicle and non-treated groups. The treatment with the combined gel reduced tissue lesion at histopathology, decreased myeloperoxidase activity in gingival tissue and inhibited the growth of oral microorganisms as well as the weight loss. Carvacrol and chalcones combination gel has a beneficial effect upon EPD in this model. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Alveolar bone loss associated with glucose tolerance in Japanese men

Oral disease experience of older adults seeking oral health services

GERODONTOLOGY, Issue 2 2010
Kavita P. Ahluwalia
doi:10.1111/j.1741-2358.2009.00311.x Oral disease experience of older adults seeking oral health services Objective:, The objective of this investigation was to describe the dental disease (dental caries and alveolar bone loss) experience in a sample of community-dwelling older adults who regularly utilize dental services in New York City. Background:, Public financing for dental care directed at older adults in the United States is minimal. Improved preventive methods, primarily the use of fluorides, have resulted in declines in tooth loss, and concomitant increase in risk for dental diseases among older adults. While the oral disease burden in institutionalized elderly and those unable to access services is well-documented, the dental care needs of older adults who access dental services are not well documented. Materials and Methods:, Radiographic and record review were used to determine prevalence of dental caries, alveolar bone loss, frequency of service utilization, and medical status in this cross-sectional investigation of a sample of older adults (N = 200) using dental services at Columbia University College of Dental Medicine. Results:, Only 9% of the sample was completely edentulous, the mean DMFT was 19.9 and mean alveolar bone loss was 3.6 mm. Missing and Decayed Teeth accounted for 57.8% and 6.5% of the total caries burden respectively. Missing Teeth and alveolar bone loss increased with increasing age, but there was no increase in Decayed Teeth. Conclusions:, While access to and utilization of dental services may result in improved tooth retention, older adults who use dental services continue to have dental care needs, especially periodontal care needs. [source]

Selective Blockade of Voltage-Gated Potassium Channels Reduces Inflammatory Bone Resorption in Experimental Periodontal Disease,,

JOURNAL OF BONE AND MINERAL RESEARCH, Issue 1 2004
Paloma Valverde
Abstract The effects of the potassium channel (Kv1.3) blocker kaliotoxin on T-cell-mediated periodontal bone resorption were examined in rats. Systemic administration of kaliotoxin abrogated the bone resorption in conjunction with decreased RANKL mRNA expression by T-cells in gingival tissue. This study suggests a plausible therapeutic approach for inflammatory bone resorption by targeting Kv1.3. Introduction: Kv1.3 is a critical potassium channel to counterbalance calcium influx at T-cell receptor activation. It is not known if Kv1.3 also regulates RANKL expression by antigen-activated T-cells, and consequently affects in vivo bone resorption mediated by activated T-cells. Materials and Methods:Actinobacillus actinomycetemcomitans 29-kDa outer membrane protein-specific Th1-clone cells were used to evaluate the expression of Kv1.3 (using reverse transcriptase-polymerase chain reaction [RT-PCR] and Western blot analyses) and the effects of the potassium channel blocker kaliotoxin (0,100 nM) on T-cell activation parameters ([3H]thymidine incorporation assays and ELISA) and expression of RANKL and osteoprotegerin (OPG; flow cytometry, Western blot, and RT-PCR analyses). A rat periodontal disease model based on the adoptive transfer of activated 29-kDa outer membrane protein-specific Th1 clone cells was used to analyze the effects of kaliotoxin in T-cell-mediated alveolar bone resorption and RANKL and OPG mRNA expression by gingival T-cells. Stimulated 29-kDa outer membrane protein-specific Th1 clone cells were transferred intravenously on day 0 to all animals used in the study (n = 7 animals per group). Ten micrograms of kaliotoxin were injected subcutaneously twice per day on days 0, 1, 2, and 3, after adoptive transfer of the T-cells. The control group of rats was injected with saline as placebo on the same days as injections for the kaliotoxin-treated group. The MOCP-5 osteoclast precursor cell line was used in co-culture studies with fixed 29-kDa outer membrane protein-specific Th1-clone cells to measure T-cell-derived RANKL-mediated effects on osteoclastogenesis and resorption pit formation assays in vitro. Statistical significance was evaluated by Student's t -test. Results: Kaliotoxin decreased T-cell activation parameters of 29-kDa outer membrane protein-specific Th1 clone cells in vitro and in vivo. Most importantly, kaliotoxin administration resulted in an 84% decrease of the bone resorption induced in the saline-treated control group. T-cells recovered from the gingival tissue of kaliotoxin-treated rats displayed lower ratios of RANKL and OPG mRNA expression than those recovered from the control group. The ratio of RANKL and osteoprotegerin protein expression and induction of RANKL-dependent osteoclastogenesis by the activated T-cells were also markedly decreased after kaliotoxin treatments in vitro. Conclusion: The use of kaliotoxin or other means to block Kv1.3 may constitute a potential intervention therapy to prevent alveolar bone loss in periodontal disease. [source]

Monozygotic twins are discordant for chronic periodontitis: clinical and bacteriological findings

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2010
Gaudy L. Torres de Heens
Torres de Heens GL, Loos BG, van der Velden U. Monozygotic twins are discordant for chronic periodontitis: clinical and bacteriological findings. J Clin Periodontol 2010; 37: 120,128. doi: 10.1111/j.1600-051X.2009.01511.x. Abstract Objectives: The aim of this study was to assess, in monozygotic (MZ) and dizygotic (DZ) twin pairs in whom the proband of the twin pair was suffering from moderate to severe chronic periodontitis, the contribution of genetics, periodontal pathogens and lifestyle factors towards the clinical phenotype. Material and Methods: For this study, 18 adult twin pairs were selected on the basis of interproximal attachment loss (AL) 5 mm in 2 non-adjacent teeth in one twin member. The study included 10 MZ and eight DZ twin pairs, in whom the periodontal condition, presence of periodontal pathogens, educational level, smoking behaviour and body mass index (BMI) were evaluated. Results: Both MZ and DZ twins were discordant regarding AL and alveolar bone loss. Discordance was greater in DZ compared with MZ twins. In MZ twins, the discordance could not be explained by education, smoking, BMI and periodontal pathogens. In DZ twins, 45.6% of the discordance could be explained by more pack-years of the probands. Conclusion: The results confirm a possible role of genetic factors in periodontitis. However, the magnitude of the genetic effects on disease severity may have been overestimated previously. [source]

Strain-dependent activation of the mouse immune response is correlated with Porphyromonas gingivalis -induced experimental periodontitis

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2009
Asaf Wilensky
Abstract Aims: To evaluate the effect of oral infection with three Porphyromonas gingivalis strains on alveolar bone loss (ABL) and its correlation with the mouse immune response. Materials and Methods: Mice were orally infected with P. gingivalis strains 381, 33277 and 53977. After 42 days, maxillae were analysed for ABL using micro-computed tomography and the serum for anti- P.gingivalis IgG1 and IgG2a levels. The cytokine response to P. gingivalis was tested using the subcutaneous chamber model. Results: The P. gingivalis 53977-infected group showed the highest ABL, which was significantly different from all other groups (p<0.001). In addition, the humoral response to P. gingivalis 53977 was significantly lower than the response to P. gingivalis 381 and 33277 (p0.01). The IgG2a/IgG1 ratio was higher in the P. gingivalis 33277-infected group (1.6) compared with the P. gingivalis 381-infected group (0.51). Four days post-infection, interleukin (IL)-1, levels remained significantly higher in the P. gingivalis 53977-infected group only (1198.2±260.0, p<0.05), while IL-4 levels remained significantly higher in the P. gingivalis 381-infected group (265.8±131.6, p<0.05). Conclusions: The high levels of ABL induced by P. gingivalis 53977 were inversely correlated with the humoral response to this bacterium. In addition, ABL was correlated with an elevated pro-inflammatory response. [source]

Assessment of periodontal conditions and systemic disease in older subjects

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2002
I. Focus on osteoporosis
Abstract Background: Osteoporosis (OPOR) is a common chronic disease, especially in older women. Patients are often unaware of the condition until they experience bone fractures. Studies have suggested that OPOR and periodontitis are associated diseases and exaggerated by cytokine activity. Panoramic radiography (PMX) allows studies of mandibular cortical index (MCI), which is potentially diagnostic for OPOR. Aims: i) To study the prevalence of self-reported history of OPOR in an older, ethnically diverse population, ii) to assess the agreement between PMX/MCI findings and self-reported OPOR, and iii) to assess the likelihood of having both a self-reported history of OPOR and a diagnosis of periodontitis. Materials and methods: PMX and medical history were obtained from 1084 subjects aged 60,75 (mean age 67.6, SD ± 4.7). Of the films, 90.3% were useful for analysis. PMXs were studied using MCI. The PMXs were used to grade subjects as not having periodontitis or with one of three grades of periodontitis severity. Results: A positive MCI was found in 38.9% of the subjects, in contrast to 8.2% self-reported OPOR. The intraclass correlation between MCI and self-reported OPOR was 0.20 (P < 0.01). The likelihood of an association between OPOR and MCI was 2.6 (95%CI: 1.6, 4.1, P < 0.001). Subjects with self-reported OPOR and a positive MCI had worse periodontal conditions (P < 0.01). The Mantel-Haentzel odds ratio for OPOR and periodontitis was 1.8 (95%CI: 1.2, 2.5, P < 0.001). Conclusions: The prevalence of positive MCI was high and consistent with epidemiological studies, but only partly consistent with a self-reported history of osteoporosis with a higher prevalence of positive MCI in Chinese women. Horizontal alveolar bone loss is associated with both positive self-reported OPOR and MCI. [source]

The relationship of some negative events and psychological factors to periodontal disease in an adult Swedish population 50 to 80 years of age

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2002
A. Hugoson
Abstract Background: Clinical observations and epidemiological studies suggest that experiences of negative life events, especially those manifested as depression, may contribute to an increased susceptibility to periodontal disease. Objective: In the present study, the prevalence of some negative life events and psychological factors and their relation to periodontal disease were investigated. The sample consisted of individuals 50,80 years of age from an extensive cross-sectional epidemiological study performed in 1993 in the city of Jönköping, Sweden. Method: 298 dentate individuals from the Jönköping study were randomly selected. Clinical and radiographic examinations included registration of the number of existing teeth, plaque index, gingival index, pocket depth, and alveolar bone loss. In addition, a questionnaire about socioeconomic status, life events, and psychological and stress-related factors was used. Results: The results revealed that, in addition to the well-documented periodontal disease risk factors such as increased age, oral hygiene status, and smoking, the loss of a spouse (being a widow or widower) and the personality trait of exercising extreme external control were also associated with severe periodontal disease. Conclusion: The findings support recent studies suggesting that traumatic life events such as the loss of a spouse may increase the risk for periodontal disease. Above all, the present results indicate that an individual's ability to cope with stressful stimuli (coping behavior), as measured by the beliefs of locus of control of reinforcements may play a role in the progression of periodontal disease. Zusammenfassung Hintergrund: Klinische Beobachtungen und epidemiologische Studien legen den Schluss nahe, dass negative Ereignisse im Laufe des Lebens, insbesondere solche, die sich in Depression manifestieren, zu einer erhöhten Empfänglichkeit für Parodontitis beitragen. Zielsetzung: Untersuchung der Prävalenz von negativen Ereignissen im Lebenslauf sowie psychologischen Faktoren und deren Beziehung zu Parodontalerkrankungen in einer Population im Alter zwischen 50 und 80 Jahren, die im Rahmen einer extensiven epidemiologischen Querschnittsstudie im Jahre 1993 in der Stadt Jönköping in Schweden untersucht worden war. Material und Methoden: 298 bezahnte Personen wurden randomisiert aus der Jönköping-Studie ausgewählt. Die klinischen und röntgenologischen Untersuchungen umfassten die Erhebung der vorhandenen Zähne, der Plaque Index, Gingival Index, Sondierungstiefen und alveolärem Knochenabbau. Zusätzlich wurden durch Befragung sozioökonomischer Status, Lebensereignisse sowie psychologische und stressbezogene Faktoren erfasst. Ergebnisse: Die Resultate ergaben, dass zusätzlich zu den bekannten Parodontitisrisikofaktoren wit Alter, Mundhygienestatus und Rauchen der Verlust des Ehepartners, also eine Witwe oder ein Witwer zu sein, und das Persönlichkeitsmuster extreme externe Kontrolle auszuüben, mit schwerer Parodontitis assoziiert waren. Schlussfolgerungn: Diese Ergebnisse unterstützen neuere Studien, die Hinweise dafür gegeben haben, dass traumatische Lebensereignisse wie der Verlust eines Ehenpartners das Risiko an Parodontitis zu erkranken erhöhen. Darüber hinaus legen die Ergebnisse den Schluss nahe, dass die individuelle Fähigkeit mit Stress umzugehen (Coping), die in dieser Studie durch die Erfragung der Überzeugung über die Lokalisation der Kontrolle von Verstärkungen erfasst wurde, eine Rolle in der Progression der Parodontitis spielen. Résumé Origine: Des observations cliniques et des études épidémiologiques suggèrent que des évènements négatifs, particulièrement ceux manifestés par une dépression, puisse contribuer à une susceptibilité augmentée à la maladie parodontale. But: Dans cette étude, la prévalence de ces évènements négatifs et les facteurs psychologiques et leurs relations avec la maladie parodontale ont été recherchés. L'échantillon était composé de personnes âgées de 50 à 80 ans issues d'une étude épidémiologique extensive croisée réalisé en 1993 dans la ville de Jonkoping en Suède. Méthode: 298 individus dentés de cette étude furent sélectionnés au hasard. Les examens cliniques et radiographiques comprenaient l'enregistrement du nombre de dents présentes, l'indice de plaque, l'indice gingival, la profondeur de poche et la perte osseuse alvéolaire. De plus, un questionnaire sur le statut socio économique, les évènements de la vie et les facteurs psychologiques en relation avec le stress, fut utilisé. Résultats: Les résultats montrèrent qu'en plus des facteurs de risque bien documentés de maladie parodontale comme l'âge, l'hygiène orale et le tabagisme, la perte d'un époux (que l'on soit veuf ou veuve) et le trait de personnalité de pouvoir exercer un contrôle externe extrême étaient aussi associés avec une maladie parodontale sévère. Conclusion: Ces résultats soutiennent de récentes études qui suggèrent que des évènements traumatisant de la vie quotidienne comme la perte d'un époux puisse augmenter le risque pour la maladie parodontale. Par-dessus tout, ces résultats indiquent que la capacité d'un individu à gérer des stimuli stressants, (comportement gestionnel), mesurés par les convictions de contrôle des renforcements pourrait jouer un rôle dans la progression de la maladie parodontale. [source]

Initial outcome and long-term effect of surgical and non-surgical treatment of advanced periodontal disease

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2001
G. Serino
Abstract Aim: A clinical trial was performed to determine (i) the initial outcome of non-surgical and surgical access treatment in subjects with advanced periodontal disease and (ii) the incidence of recurrent disease during 12 years of maintenance following active therapy. Material and Methods: Each of the 64 subjects included in the trial showed signs of (i) generalized gingival inflammation, (ii) had a minimum of 12 non-molar teeth with deep pockets (6 mm) and with 6 mm alveolar bone loss. They were randomly assigned to 2 treatment groups; one surgical (SU) and one non-surgical (SRP). Following a baseline examination, all patients were given a detailed case presentation which included oral hygiene instruction. The subjects in SU received surgical access therapy, while in SRP non-surgical treatment was provided. After this basic therapy, all subjects were enrolled in a maintenance care program and were provided with meticulous supportive periodontal therapy (SPT) 3,4 times per year. Sites that at a recall appointment bled on gentle probing and had a PPD value of 5 mm were exposed to renewed subgingival instrumentation. Comprehensive re-examinations were performed after 1, 3, 5 and 13 years of SPT. If a subject between annual examinations exhibited marked disease progression (i.e., additional PAL loss of 2 mm at 4 teeth), he/she was exited from the study and given additional treatment. Results: It was observed that (i) surgical therapy (SU) was more effective than non-surgical scaling and root planing (SRP) in reducing the overall mean probing pocket depth and in eliminating deep pockets, (ii) more SRP-treated subjects exhibited signs of advanced disease progression in the 1,3 year period following active therapy than SU-treated subjects. Conclusion: In subjects with advanced periodontal disease, surgical therapy provides better short and long-term periodontal pocket reduction and may lead to fewer subjects requiring additional adjunctive therapy. Zusammenfassung Zielsetzung: Eine klinische Studie wurde durchgeführt, um 1.) die Kurzzeitergebnisse nicht-chirurgischer und chirurgischer Therapie von Patienten mit fortgeschrittener marginaler Parodontitis und 2.) das Auftreten von Parodontitisrezidiven im Verlauf von 12 Jahren unterstützender Parodontitistherapie (UPT) zu untersuchen. Material und Methoden: Jeder der 64 Patienten, die in diese Studie aufgenommen wurden, wies 1.) Zeichen generalisierter gingivaler Entzündung auf und hatte 2.) mindestens 12 Zähne, die keine Molaren waren, mit tiefen Taschen (6 mm) sowie 6 mm Knochenabbau. Diese Patienten wurden zufällig auf 2 Therapiegruppen verteilt: 1.) chirurgische (MW: modifizierter Widman-Lappen) und 2.) nicht-chirurgische (SRP: subgingivales Scaling und Wurzelglättung) Therapie. Nach der Anfangsuntersuchung wurden allen Patienten ihre Erkrankung ausführlich erläutert und eine Mundhygieneinstruktion gegeben. Sowohl MW als SRP wurden unter Lokalanästhesie und in 4,6 Sitzungen durchgeführt. Nach der aktiven Therapiephase wurden die Patienten in ein UPT-Programm eingegliedert, das 3,4 Sitzungen pro Jahr umfasste. Stellen, die während der UPT-Sitzungen auf Sondierung bluteten (BOP) und Sondierungstiefen (ST) 5 mm aufwiesen, wurden einer erneuten subgingivalen Instrumentierung unterzogen. Gründliche Nachuntersuchungen wurden in den Jahren 1, 3, 5 und 13 der UPT durchgeführt. Wenn ein Patient zwischen den jährlichen Routineuntersuchungen deutliche Parodontitisprogression zeigte (zusätzlicher Attachmentverlust 2 mm an 4 Zähnen) wurde er/sie aus der Studie herausgenommen und einer weiterführenden Behandlung zugeführt. Ergebnisse: Es wurde beobachtet, dass 1.) die chirurgische Therapie (MW) hinsichtlich Reduktion der mittleren ST (ST nach 1 Jahr: MW: 2.6 mm; SRP: 4.2 mm; p<0.01) und Eliminierung der tiefen Taschen effektiver war als nicht-chirurgische Therapie (SRP) und dass 2.) in den ersten 1,3 Jahren nach aktiver Therapie bei mehr Patienten aus der SRP-Gruppe (8/25%) ein Fortschreiten der Parodontitis auftrat also bei Patienten der MW-Gruppe (4/12%). Schlussfolgerungen: Bei Patienten mit fortgeschrittener marginaler Parodontitis führte chirurgische Therapie zu günstigeren Kurz- und Langzeitergebnissen hinsichtlich ST-Reduktion und scheint deshalb bei weniger Patienten eine zusätzliche unterstützende Therapie erforderlich zu machen als SRP. Résumé But: Un essai clinique a été réalisé pour déterminer (i) le résultat initial des traitements non chirurgicaux et chirurgicaux chez des sujets présentant des parodontites avancées et (ii) l'incidence de maladie récurrente pendant les 12 ans de maintenance qui ont suivi la thérapeutique active. Matériaux et méthodes: Chacun des 64 patients inclus dans cette étude présentait des signes de (i) inflammation gingivale généralisée, (ii) avaient au minimum 12 dents en dehors des molaires avec des poches profondes (6 mm) et avec une perte osseuse 6 mm. Ils furent assignés au hasard à deux groupes de traitement (chirurgical (SU) et non chirurgical (SRP)). Après un examen initial, tous les patients reçurent une mallette de présentation détaillée comportant des instructions d'hygiène bucco-dentaire. Les sujets SU subirent une chirurgie d'accès alors qu'un traitement non chirurgical était donné au groupe SRP. Suite à ce traitement de base, tous les sujets suivirent un programme de maintenance comportant de méticuleux soins parodontaux de soutien (SPT) 3,4 × par an. Les sites qui, lors d'une visite de contrôle saignaient légèrement au sondage et présentatient une valeur de PPD 5 mm étaient à nouveau instrumentés. De nouveaux examens complets êtaient réalisées après 1, 3, 5, 13 ans de SPT. Si un sujet présentait entre deux visites annuelles une progression évidente de la maladie, (par exemple, une perte d'attache supplémentaire 2 mm sur plus de 4 dents), il ou elle était exclu de l'étude et recevait un traitement complémentaire. Resultats: Il fut observé que (i) le traitement chirurgical (SU) était plus efficace que le traitement non-chirurgical (SRP) pour réduire les profondeurs de poche au sondage moyennes générales et pour l'élimination des poches profondes, (ii) et plus de sujets du groupe SRP présentaient des signes de progression de leur maladie avancée dans la période de 1,3 ans suivant le traitement actif. Conclusions: Chez les sujets présentant une maladie parodontale avancée, le traitement chirurgical apporte de meilleures réductions des poches parodontales à court et long terme et pourrait diminuer le nombre de sujets nécessitant une traitement supplémentaire. [source]

Bone mineral content and bone metabolism in young adults with severe periodontitis

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2001
Nina Von Wowern
Abstract Objectives: To clarify in young adults with severe periodontitis (1) whether the bone mineral content (BMC) or density (BMD) in the mandible/other skeletal sites and the systemic bone metabolism differed from normal and (2) whether mandibular/forearm BMC did change during the 5 to 10-year follow-up. Material and Methods: 24 young otherwise normal patients with verified severe periodontitis were included, of which 20 attended the follow-up visit. Mandibular/forearm BMC was measured at both visits by dual-photon absorptiometry, supplemented with femoral neck/lumbar spine BMD measurements at follow-up visit by dual-energy X-ray absorptiometry. Serum alkaline phosphatase/ionized calcium, urinary excretion of pyridinoline/deoxy-pyridinoline were analysed at the follow-up visit. A conventional periodontal examination was performed at both visits. Results: Mandibular BMC was significantly below normal mean BMC at both visits. The mandibular Z-scores were ,2.00 in 33.3% (8/24). BMC/BMD in the remaining sites and the values for bone markers did not differ from normal. Mandibular/forearm BMC was stable while a significant aggravation of alveolar bone loss occurred during the trial without change of probing depth. Conclusions: Severe periodontitis in young adults seems to be a local disorder associated with relatively low BMC in the jaws without systemic alterations of BMC/BMD and bone metabolism. Zusammenfassung Zielsetzung: Abklärung ob bei jungen Erwachsenen mit schwerer Parodontitis (1) der Mineralgehalt und die Dichte des Knochens im Unterkiefer bzw. anderen Teilen des Skeletts sowie deer Knochenstoffwechsel sich von normalen Verhältnissen unterscheiden und (2) ob sich der Mineralgehalt des Unterkiefer- bzw. des Unterarmknochens während eines Beobachtungszeitraums von 5 bis 10 Jahren verändern. Material und Methoden: 24 allgemein gesunde Patienten mit schwerer Parodontitis nahmen an der Studie teil von denen 20 an der Nachuntersuchung teilnahme. Der Mineralgehalt des Unterkiefer- bzw. Unterarmknochens wurde bei beiden Untersuchungen mittels Dual-Photonen-Absorptiometrie bestimmt. Zusätzlich wurden bei der Nachuntersuchung die Knochendichte des Obserschenkelhalses und der Lendenwirbel mittels Dual-Energie-Röntgen-Absorptiometrie erfaßt. Die Serumkonzentrationen alkalischer Phosphatase sowie der Kalzium-Ionen und die Ausscheidung von Pyridinolin sowie Desoxypyridinolin im Urin wurden bei der Nachuntersuchung analysiert. Zu jedem Untersuchungstermin fand eine klinische Untersuchung der parodontalen Verhältnisse statt. Ergebnisse: Der Mineralgehalt des Unterkieferknochens lag zu beiden Untersuchungsterminen unter den mittleren Normalwerten. Die Z-Werte des Unterkiefers lagen in 8 von 24 Fällen (33.3%) ,2.00. Der Mineralgehalt und die Dichte des Knochens der übrigen Regionen und die Werte der Knochenmarker unterschieden sich nicht von den Normalwerten. Der Mineralgehalt des Unterkiefer- und Unterarmknochens verhielt sich während des Untersuchungszeitraumes stabil, während es zu einer deutlichen Verschlimmerung des alveolären Knochenabbaus ohne Veränderung der Sondierungstiefen kam. Schlußfolgerungen: Bei schwerer Parodontitis bei jungen Erwachsenen scheint es sich um eine lokale Störung mit relativ geringem Mineralgehalt der Kieferknochen zu handeln ohne systemische Veränderungen von Mineralgehalt und Dichte des Knochens bzw. des Knochenstoffwechsels. Résumé Le but de cette étude était de connaître chez les jeunes adultes souffrant de parodontite sévère (1) si le contenu en minéraux osseux (BMC) ou la densité (BMD) dans des sites mandibulaires ou du squelette et le métabolisme osseux systémique étaient différents par rapport à ceux de personnes normales et (2) si le BMC de la mandibule ou de l'avant-bras changeait durant une période de suivi de 5 à 10 années. 24 patients normaux mais souffrant de parodontite sévère ont été inclus dans cette investigation mais seul 20 ont poursuivi l'étude. Le BMC de la mandibule et de l'avant-bras ont été mesurés aux 2 sites par absorptiométrie par photon double, avec également des mesures BMD au niveau du fémur et de la colonne vertébrale lors de la visite de suivi par absorptiométrie par RX àénergie double. Le calcium ionisé par phosphatase alcaline sérique et l'excrétion urinaire de pyridinoline/deoxypyridinoline ont été analysés lors de l'examen de suivi. Un examen parodontal conventionnel a été effectué aux 2 visites. Le BMC mandibulaire était significativement inférieur au BMC moyen normal lors des deux visites. Les scores Z mandibulaires étaient ,2.00 dans 33.3% (8/24) des cas. BMC/BMD dans les sites restants et les valeurs des marqueurs osseux ne différaient pas des normaux. BMC mandibulaire/avant-bras était stable tandis qu'une aggravation significative de la perte osseuse alvéolaire se produisait durant l'étude sans changement de la profondeur au sondage. La parodontite sévère chez les jeunes adultes semble être un désordre local associéà un BMC relativement bas dans les mâchoires sans altération systémique de BMC/BMD ni du métabolisme osseux. [source]

The outcome of a preventive dental care programme on the prevalence of localized aggressive periodontitis in Down's syndrome individuals

JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 7 2006
M. Zigmond
Abstract Background Periodontal disease in Down's syndrome (DS) individuals develops earlier and is more rapid and extensive than in age-matched normal individuals. The present study evaluated a group of DS patients, who had been participating in a 10-year preventive dental programme, for the impact of the programme on their periodontal status. Methods Thirty DS patients (mean age 23.3 ± 4 years) were compared with 28 age-matched healthy controls (mean age 22.8 ± 5 years). The hygiene level, gingival condition and periodontal status (periodontal probing depth, clinical attachment level and radiographic alveolar bone loss) were determined. Results In spite of similar oral hygiene and gingival measures, DS patients, as opposed to the control ones, had a severe periodontal disease. The prevalence, extent and severity of periodontitis in the DS group were significantly greater than in the control group. The teeth most commonly and severely affected were the lower central incisors and the upper first molars. DS patients lost significantly more teeth due to periodontitis. Conclusions The clinical and radiographic picture found in the present DS group is characteristic of localized aggressive periodontitis. Within the limitations of this study, it seems that the preventive dental programme had no effect on periodontal destruction progression of localized aggressive periodontitis in DS individuals and that impaired oral hygiene plays a relatively minor role in the pathogenesis of this disease. Future controlled studies are needed to assess the effectiveness of different preventive dental programmes in preventing the progression of periodontitis in DS patients. [source]

Cervical sympathectomy causes alveolar bone loss in an experimental rat model

JOURNAL OF PERIODONTAL RESEARCH, Issue 6 2009
Y. Kim
Background and Objective:, Periodontal disease, a pathological destructive inflammatory condition, is characterized by alveolar bone loss. Recent studies have suggested a correlation between the sympathetic nervous system and bone remodeling. To confirm the importance of the sympathetic nervous system in bone resorption, we investigated the effects of superior cervical ganglionectomy and oral challenge with Porphyromonas gingivalis on alveolar bone loss in rats. Material and Methods:, Rats were divided into three groups: group A underwent a sham operation as the control group; group B underwent superior cervical ganglionectomy; and group C underwent a sham operation and oral challenge with P. gingivalis. Horizontal alveolar bone loss was evaluated by measuring the distance between the cemento-enamel junction and the alveolar bone crest. Cytokine gene expression in the gingival tissues was assessed using reverse transcription,polymerase chain reaction analyses. The furcation areas of the mandibular molars were examined histologically. Results:, Both superior cervical ganglionectomy and oral challenge with P. gingivalis resulted in accelerated alveolar bone loss. Gingival tissues in the superior cervical ganglionectomy group showed increased expression of the cytokines interleukin-1alfa, tumor necrosis factor-alfa and interleukin-6. The density of neuropeptide Y-immunoreactive fibers was decreased following superior cervical ganglionectomy. Osteoclasts were observed in the superior cervical ganglionectomy and P. gingivalis- challenged groups. Conclusion:, Both superior cervical ganglionectomy and oral challenge with P. gingivalis induced alveolar bone loss. These results provide new information on the occurrence of alveolar bone loss, in that both oral challenge with P. gingivalis and superior cervical ganglionectomy are important accelerating factors for alveolar bone loss. Thus, we suggest that the sympathetic nervous system is linked with the prevention of alveolar bone loss. [source]

Experimental periodontitis in mice selected for maximal or minimal inflammatory reactions: increased inflammatory immune responsiveness drives increased alveolar bone loss without enhancing the control of periodontal infection

JOURNAL OF PERIODONTAL RESEARCH, Issue 4 2009
A. P. F. Trombone
Background and Objective:, Inflammatory immune reactions that occur in response to periodontopathogens are thought to protect the host against infection, but may trigger periodontal destruction. However, the molecular and genetic mechanisms underlying host susceptibility to periodontal infection and to periodontitis development have still not been established in detail. Material and Methods:, In this study, we examined the mechanisms that modulate the outcome of Aggregatibacter (Actinobacillus) actinomycetemcomitans -induced periodontal disease in mice mouse strains selected for maximal (AIRmax) or minimal (AIRmin) inflammatory reactions. Results:, Our results showed that AIRmax mice developed a more severe periodontitis than AIRmin mice in response to A. actinomycetemcomitans infection, and this periodontitis was characterized by increased alveolar bone loss and inflammatory cell migration to periodontal tissues. In addition, enzyme-linked immunosorbent assays demonstrated that the levels of the cytokines interleukin-1,, tumor necrosis factor-, and interleukin-17 were higher in AIRmax mice, as were the levels of matrix metalloproteinase (MMP)-2, MMP-13 and receptor activator of nuclear factor-,B ligand (RANKL) mRNA levels. However, the more intense inflammatory immune reaction raised by the AIRmax strain, in spite of the higher levels of antimicrobial mediators myeloperoxidase and inducible nitric oxide synthase, did not enhance the protective immunity to A. actinomycetemcomitans infection, because both AIRmax and AIRmin strains presented similar bacterial loads in periodontal tissues. In addition, the AIRmax strain presented a trend towards higher levels of serum C-reactive protein during the course of disease. Conclusion:, Our results demonstrate that the intensity of the inflammatory immune reaction is associated with the severity of experimental periodontitis, but not with the control of A. actinomycetemcomitans periodontal infection, suggesting that the occurrence of hyperinflammatory genotypes may not be an evolutionary advantage in the complex host,pathogen interaction observed in periodontal diseases. [source]

Role of systemic and local administration of selective inhibitors of cyclo-oxygenase 1 and 2 in an experimental model of periodontal disease in rats

JOURNAL OF PERIODONTAL RESEARCH, Issue 2 2009
C. M. Queiroz-Junior
Background and Objective:, Periodontal disease is an inflammatory condition of tooth-supporting tissues. Arachidonic acid metabolites have been implicated in development of periodontal disease, especially those derived from the cyclo-oxygenase (COX) pathway. This study investigated the role of inhibitors of cyclo-oxygenases (COX-1 and COX-2) in a model of periodontal disease in rats. Material and Methods:, A ligature was placed around the molar of rats. Losses of fiber attachment and of alveolar bone were measured morphometrically in histologically prepared sections. Infiltration of cells into gingival tissue surrounding the ligated tooth was also determined. Results:, Systemic and local administration of non-selective and selective COX-2 inhibitors, preventively, resulted in significant reduction of the losses of fiber attachment and alveolar bone, as well as decreased leukocyte numbers in gingival tissue. Preventive selective inhibition of COX-1 was as effective as COX-2 inhibition in reducing local fiber attachment loss and cell migration, but did not prevent alveolar bone loss. Conclusion:, Our results provide evidence for participation of COX-1 and COX-2 in early stages of periodontal disease in rats. Furthermore, local administration of COX inhibitors reduced the signs of periodontal disease to the same extent as systemic treatment. Therapeutic approaches incorporating locally delivered anti-inflammatory drugs could be of benefit for patients suffering from periodontal disease. [source]

Validation of a dental image analyzer tool to measure alveolar bone loss in periodontitis patients

Topical administration of simvastatin recovers alveolar bone loss in rats

JOURNAL OF PERIODONTAL RESEARCH, Issue 3 2008
H. Seto
Background and Objective:, Simvastatin, a cholesterol-lowering drug, has been reported to show anabolic effects on bone metabolism. We examined the effects of simvastatin in vitro using cultured rat calvaria cells and in vivo using periodontitis-induced rats. Material and Methods:, Alkaline phosphatase activity and bone nodule formation were measured in cultured rat calvaria cells. Nylon ligature was placed around the maxillary molars of Fischer male rats for 20 d to induce alveolar bone resorption. After ligature removal, simvastatin was topically injected into the buccal gingivae for 70 d and then microcomputed tomography and histological examinations were performed. Results:, Simvastatin maintained high alkaline phosphatase activity and increased bone nodule formation in rat calvaria cells in a dose-dependent manner, showing that simvastatin increased and maintained a high level of osteoblastic function. Microcomputed tomography images revealed that treatment with simvastatin recovered the ligature-induced alveolar bone resorption, showing a 46% reversal of bone height. Histological examination clarified that low-mineralized alveolar bone was formed in simvastatin-treated rats. Conclusion:, These findings demonstrate that simvastatin has the potential to stimulate osteoblastic function and that topical administration of simvastatin may be effective for the recovery of alveolar bone loss in rats. [source]

Protective effects of baicalin on ligature-induced periodontitis in rats

JOURNAL OF PERIODONTAL RESEARCH, Issue 1 2008
X. Cai
Background and Objective:, Baicalin is a flavonoid compound purified from the medicinal plant, Scutellaria baicalensis Georgi, and has been reported to possess anti-inflammatory and antioxidant activities. The purpose of this study was to test the ability of baicalin to influence the progression of experimental periodontitis in rats, as well as the expression of cyclooxygenase-2 and inducible nitric oxide synthase. Material and Methods:, Adult male Sprague,Dawley rats were subjected to placement of a nylon thread around the bilateral lower first molars and killed after 7 d. Baicalin (50, 100 or 200 mg/kg) was supplied to the animals by oral gavage, starting 1 d before the induction of periodontitis. The ligature group consisted of rats subjected to periodontitis and receiving vehicle (0.5% carboxymethylcellulose) alone. The alveolar bone loss and the area fraction occupied by collagen fibers were assessed. The expression of cyclooxygenase-2 and inducible nitric oxide synthase protein in the gingiva were detected by immunohistochemistry and western blotting. Results:, Baicalin-treated groups presented with lower alveolar bone loss than that of the ligature group, reaching statistical significance at the dose of 200 mg/kg (p = 0.009). The area fraction of collagen fibers was significantly higher in the baicalin (200 mg/kg)-treated group than in the ligature group (p = 0.047). Baicalin treatment significantly down-regulated the protein expression for cyclooxygenase-2 (p = 0.000) and inducible nitric oxide synthase (p = 0.003), compared with the ligature group. Conclusion:, Baicalin protects against tissue damage in ligature-induced periodontitis in rats, which might be mediated, in part, by its inhibitory effect on the expression of cyclooxygenase-2 and inducible nitric oxide synthase. These activities could support the continued investigation of baicalin as a potential therapeutic agent in periodontal disease. [source]

Milk basic protein increases alveolar bone formation in rat experimental periodontitis

JOURNAL OF PERIODONTAL RESEARCH, Issue 1 2007
H. Seto
Background and Objective:, It is conceivable that the active components extracted from milk whey protein (i.e. milk basic protein, MBP) stimulate bone formation and suppress bone resorption. Periodontitis is characterized by excessive alveolar bone resorption. We examined whether milk basic protein could recover alveolar bone loss in rat experimental periodontitis. Material and Methods:, A nylon ligature was placed around the cervix of molars in 8-wk-old male Fischer rats for 20 d. Then, the ligature was removed and a powder diet containing 0.2 or 1.0% milk basic protein was provided daily for another 45,90 d. On days 45 and 90, the maxillae were extracted and analyzed using microcomputerized tomography (micro-CT), followed by histological analysis. Results:, Micro-CT images showed that alveolar bone resorption was severely induced around the molar by the 20-d ligature procedure. Treatment with high-dose milk basic protein (1.0%) clearly recovered ligature-induced alveolar bone resorption on days 45 and 90, whereas low-dose milk basic protein (0.2%) did not show such a clear effect. Histological examination clarified that the osteoid thickness of alveolar bone was dose dependently increased by milk basic protein treatment for 90 d. Conclusion:, These findings suggest that a systemic administration of milk basic protein may be effective for the recovery of alveolar bone loss in periodontitis. [source]

Porphyromonas gingivalis heat shock protein vaccine reduces the alveolar bone loss induced by multiple periodontopathogenic bacteria

JOURNAL OF PERIODONTAL RESEARCH, Issue 1 2006
Ju-Youn Lee
Objectives:, Heat shock protein (HSP) can be utilized as a vaccine to cross-protect against multiple pathogenic species. The present study was performed to evaluate Porphyromonas gingivalis heat shock protein 60 (HSP60) as a vaccine candidate to inhibit multiple bacteria-induced alveolar bone loss. Material and methods:, Recombinant P. gingivalis HSP60 was produced and purified from P. gingivalis GroEL gene. Rats were immunized with P. gingivalis HSP60, and experimental alveolar bone loss was induced by infection with multiple periodontopathogenic bacteria. Results:, There was a very strong inverse relationship between postimmune anti- P. gingivalis HSP immunoglobulin G (IgG) levels and the amount of alveolar bone loss induced by either P. gingivalis or multiple bacterial infection (p = 0.007). Polymerase chain reaction data indicated that the vaccine successfully eradicated the multiple pathogenic species. Conclusions:, We concluded that P. gingivalis HSP60 could potentially be developed as a vaccine to inhibit periodontal disease induced by multiple pathogenic bacteria. [source]

Induction of immune responses and prevention of alveolar bone loss by intranasal administration of mice with Porphyromonas gingivalis fimbriae and recombinant cholera toxin B subunit

MOLECULAR ORAL MICROBIOLOGY, Issue 6 2007
Y. Takahashi
Introduction:, Adult periodontitis is initiated by specific periodontal pathogens represented by Porphyromonas gingivalis; however, an effective measure for preventing the disease has not yet been established. In this study, the effectiveness of a vaccine composed of fimbriae of P. gingivalis and recombinant cholera toxin B subunit (rCTB) was evaluated using BALB/c mice. Methods:, Fimbriae and rCTB were co-administered intranasally to BALB/c mice on days 0, 14, 21, and 28. On day 35, mice were sacrificed to determine immunoglobulin levels in serum, saliva, and nasal and lung extracts by enzyme-linked immunosorbent assay. The prevention effect of the vaccine on P. gingivalis -induced periodontitis in mice was evaluated by measuring alveolar bone loss. Results:, The rCTB significantly increased serum immunoglobulin (Ig)A levels when mice were administered with a minimal amount (0.5 ,g) of the fimbrial antigen. The adjuvant effect on serum IgG production was indistinct because the minimal amount of the antigen still induced a large amount of IgG. In contrast to systemic responses, a fimbria-specific secretory IgA response was strongly induced by co-administration of rCTB and 0.5 ,g fimbriae; the same amount of the antigen alone scarcely induced a response. Histopathological examination revealed IgA-positive plasma cells in the nasal mucosal tissue but no observable mast cells in the area. In addition, nasal administration of the fimbrial vaccine significantly protected the mice from P. gingivalis -mediated alveolar bone loss. Conclusion:, Nasal vaccination with a combination of fimbriae and rCTB can be an effective means of preventing P. gingivalis -mediated periodontitis. [source]

Immunization of Macaca fascicularis against experimental periodontitis using a vaccine containing cysteine proteases purified from Porphyromonas gingivalis

Cytokine pattern determines the progression of experimental periodontal disease induced by Actinobacillus actinomycetemcomitans through the modulation of MMPs, RANKL, and their physiological inhibitors

MOLECULAR ORAL MICROBIOLOGY, Issue 1 2006
G. P. Garlet
Objective:, Inflammatory and immune reactions raised in response to periodontopathogens are thought to trigger periodontal tissue destruction. We therefore investigated the expression of matrix metalloproteinases (MMPs) and the osteoclastogenic factor RANKL (receptor activator of nuclear factor-,B ligand), their respective inhibitors TIMPs (tissue inhibitors of metalloproteinases) and OPG (osteoprotegerin) and their possible correlation with the expression of inflammatory and regulatory cytokines in the course of experimental periodontal disease in mice. Methods:, We characterized the time course of leukocyte migration and alveolar bone loss in C57BL/6 mice infected with Actinobacillus actinomycetemcomitans. Quantitative polymerase chain reaction (RealTime PCR) and ELISA were performed to determine the expression of MMPs, TIMPs, RANKL, OPG and cathepsin K, interleukin-1,, tumor necrosis factor-,, interferon-,, interleukin-12, interleukin-4 and interleukin-10 in periodontal tissue samples harvested throughout the course of experimental disease. Results:, Oral inoculation of A. actinomycetemcomitans results in an intense and widespread migration of leukocytes to the gingival tissues, besides marked alveolar bone resorption. Our data also demonstrate two distinct patterns of MMP/TIMP and RANKL/OPG expression in the course of experimental periodontal disease. The expression of MMPs (MMP-1, 2 and 9) and RANKL was correlated with the expression of interleukin-1,, tumor necrosis factor-, and interferon-,, in a time period characterized by the intense increase of inflammatory reaction and alveolar bone loss. On the other hand, interleukin-4 and interleukin-10 were associated with higher expression of TIMPs (TIMP 1, 2 and 3) and OPG, with a lower expression of MMPs and RANKL, and with reduced rates of increase of cellular infiltration in periodontal tissues and alveolar bone loss. Conclusions:, It is possible that the pattern of cytokines produced in periodontal tissues determines the progression and the severity of experimental periodontal disease, controlling the breakdown of soft and bone tissues through the balance between MMPs/TIMP and RANKL/OPG expression in gingival tissues. [source]

OC8 The short-term efficacy of osseointegrated implants in patients with non-malignant oral mucosal disease: a case series

ORAL DISEASES, Issue 2006
TA Hodgson
Purpose, The spectrum of patients who may wish or warrant osseointegrated implants is increasing, despite few reports of the impact of non-malignant oral mucosal disease upon implant placement. This report details the implant placement outcomes in three patients with pre-existing oral mucosal disease. Case reports,A: Four implants were placed in the lower anterior region of a 78-year-old female with longstanding mucous membrane pemphigoid (MMP) in 2004. The MMP had resulted in extensive cicatrisation of the upper and lower buccal and labial vestibules. One implant failed to osseointegrate, but was successfully replaced. There have been no other postplacement adverse events, despite the MMP remaining mildly active. B: A 36-years-old male with orofacial granulomatosis characterised by recurrent lip swelling and gingival enlargement, had a single implant placed in the upper canine region in 2001. Although still in situ significant peri-implant alveolar bone loss has occurred and has been stabilised by repeated debridement, local administration of topical minocycline and several courses of systemic metronidazole. C: A 53-years-old female with oral manifestations of diffuse systemic sclerosis and fibrosing alveolitis had four lower anterior mandibular implants placed in 1995 to support an 8 unit bridge. One episode of peri-implant inflammation was controlled with local debridement and topical chlorhexidine mouthrinse. The implants remain satisfactory 11 years postinsertion. Conclusion, The short-term failure of osseointegrated implant integration appears uncommon in patients with non-malignant oral mucosal disease. There remains a need to establish appropriate case selection criteria and monitor outcomes. [source]

Primary oral tuberculosis: a report of a case diagnosed by polymerase chain reaction

ORAL DISEASES, Issue 1 2003
H Rivera
We present a case of primary oral tuberculosis, affecting the maxillary gingiva and causing alveolar bone loss in a 34-year-old Colombian female patient. Definitive diagnosis was facilitated by polymerase chain reaction analysis, a useful modern tool for the diagnosis of infectious diseases. The location and clinical presentation of this lesion is unusual and underlines the importance of considering tuberculosis in the differential diagnosis of oral lesions that affect the gingiva and alveolar bone. [source]

Effects of a herbal gel containing carvacrol and chalcones on alveolar bone resorption in rats on experimental periodontitis

Periodontitis and incidence of cerebrovascular disease in men,

ANNALS OF NEUROLOGY, Issue 4 2009
Monik Jimenez SM
Objective To identify associations between periodontitis and incidence of cerebrovascular disease. Methods We analyzed data of 1,137 dentate men in the Veterans Affairs Normative Aging and Dental Longitudinal Study who were followed with triennial medical/dental exams for up to 34 years (mean, 24 years). We evaluated incidence of cerebrovascular events consistent with stroke or transient ischemic attack in relation to mean radiographic alveolar bone loss (a measure of periodontitis history) and cumulative periodontal probing depth (a measure of current periodontal inflammation). Cox proportional hazards models were fit controlling for age, baseline socioeconomic status, and time-varying effects of established cardiovascular risk factors. Results Eighty incident cases of cerebrovascular disease occurred from 27,506 person-years. Periodontal bone loss was significantly associated with an increased hazard rate (HR) of cerebrovascular disease (HR, 3.52; 95% confidence interval [CI], 1.59,7.81 comparing highest to lowest bone loss category; p for trend, <0.001). There was a stronger effect among men aged <65 years (HR, 5.81; 95% CI, 1.63,20.7) as compared with men aged ,65 years (HR, 2.39; 95% CI, 0.91,6.25). Periodontal probing depth was not associated with a significantly increased rate of cerebrovascular disease in the combined or age-stratified analyses. Interpretation These results support an association between history of periodontitis,but not current periodontal inflammation,and incidence of cerebrovascular disease in men, independent of established cardiovascular risk factors, particularly among men aged <65 years. Ann Neurol 2009;66:505,512 [source]