Home About us Contact
|
Home About us Contact | ||
|
|
||
Gingival Inflammation (gingival + inflammation)
Selected AbstractsGingival health status in renal transplant recipients: relationship between systemic inflammation and atherosclerosisINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 4 2007G. Genctoy Summary Cardiovascular disease (CVD) is the leading cause of mortality in renal transplant recipients (RTR). Systemic and periodontal inflammation has been suggested to have a possible role in the development of atherosclerosis. In the present study, we aimed to investigate the relationship between gingival health status, inflammation and atherosclerosis in RTRs. Eighty-three RTR (50 male, 33 female) were enrolled in the study. Routine biochemical analyses, serum lipoproteins, C-reactive protein, fibrinogen, homocystein, parathyroid hormone (PTH) and cyclosporin A (CsA) trough levels were studied. All patients had 24-h ambulatory blood pressure monitoring and B-mode ultrasound of the common carotid arteries. Gingival status was evaluated by the Löe and Silness gingival index (GI). Mean GI value was 2.3 ± 0.5. Fifty patients (60.3%) had GI value , 2.1 (severe gingivitis; group A). Thirty-three patients (39.7%) had GI value < 2.1 (no or moderate gingivitis; group B). Age, carotid intima-media thickness (CIMT) and mean time on dialysis before transplantation were significantly higher in group A than in B. Systemic inflammation markers were not different between group A and group B. Mean CIMT was positively correlated with GI (r = 0.425; p = 0.001) and negatively correlated with high-density lipoprotein cholesterol (r = ,0.256; p = 0.023). After the correction for confounding variables, mean CIMT was still significantly correlated with GI (r = 0.376, p = 0.02). In RTR, gingival inflammation seems to be associated with CIMT in the absence of systemic inflammation. Thus, gingivitis may, in part, play a role in the development of systemic atherosclerosis without causing any aggravation in systemic inflammatory response. [source] Orthodontic considerations for gingival health during pregnancy: a reviewINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 1 2010PM Mukherjee Abstract:, Gingivitis is caused by several known systemic and local factors. Among systemic factors, the role of hormonal changes during pregnancy is well established. While presence of fixed orthodontic appliances alone may not cause gingivitis, factors such as pregnancy and poor oral hygiene combined together could precipitate acute gingival inflammation that may progress to a periodontal condition in a patient receiving orthodontic therapy. There has been an increase in the number of adult patients who are receiving orthodontic treatment. Orthodontic appliances could act as a potential plaque retentive source and aggravate inflammatory reactions that are seen during pregnancy. There is a lack of awareness regarding oral healthcare issues among patients who are pregnant and choose to seek orthodontic treatment. In addition, there is a need in the literature to outline management guidelines for patients who want to receive orthodontic treatment during pregnancy, with or without pre-existing gingival conditions. This review focuses on the aetiology of pregnancy gingivitis and the management of orthodontic patients during pregnancy. Our emphasis is on patient education, oral hygiene maintenance, preventive and treatment strategies for the management of gingival health in orthodontic patients during pregnancy. We also highlight some of the possible complications of initiating orthodontic treatment during pregnancy. [source] Effect of oral hygiene instruction and scaling on oral malodour in a population of Turkish children with gingival inflammationINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 6 2006C. KARA Summary. Aim., Oral malodour affects a large proportion of the population, and may cause a significant social or psychological handicap to those suffering from it. The condition has a positive correlation with the accumulation of bacterial plaque in the oral cavity. The aim of the present study was twofold: first, to determine whether oral malodour and periodontal disease parameters are associated with one another in 150 Turkish subjects (mean age ± SD = 9·1 ± 2·7 years; age range = 7,12 years); and secondly, to investigate the impact of oral hygiene instruction and scaling on oral malodour. Design., The parameters measured included whole-mouth odour judge scoring, halimeter measurements, saliva pH scores, gingival index, plaque index, and probing depth before and after the treatment procedures. Results., Odour judge scores were significantly associated with halimeter findings. However, gingival index, plaque index and probing depth were significantly associated with odour judge scores and halimeter scores. The statistical analysis revealed that periodontal treatments caused a significant reduction (P < 0·001) in volatile sulphur compound formation. Conclusion., These results suggest that, in the population studied, periodontal health and oral malodour are associated with one another. Oral malodour levels were significantly reduced after treating gingival inflammation. Thus, in order to avoid oral malodour in children, oral care should not be neglected. [source] Interleukin-1, levels in gingival crevicular fluid and serum under naturally occurring and experimentally induced gingivitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2010Leonardo Trombelli Trombelli L, Scapoli C, Carrieri A, Giovannini G, Calura G, Farina R. Interleukin-1, levels in gingival crevicular fluid and serum under naturally occurring and experimentally induced gingivitis. J Clin Periodontol 2010; 37: 697-704 doi: 10.1111/j.1600-051X.2010.01573.x. Abstract Aims: To evaluate the interleukin-1, (IL-1,) levels in gingival crevicular fluid (GCF) and serum in either naturally occurring (N-O) or experimentally induced (E-I) plaque-associated gingivitis. Material and Methods: Thirty-seven periodontally healthy subjects were evaluated in real life conditions (N-O gingivitis) as well as after 21 days of experimental gingivitis trial (E-I gingivitis). During the experimental gingivitis trial, in one maxillary quadrant (test quadrant), gingival inflammation was induced by oral hygiene abstention, while in the contralateral (control) quadrant, oral hygiene was routinely continued. IL-1, concentrations in N-O and E-I gingivitis were investigated for IL-1B+3954 and IL-1B,511 gene polymorphisms. Results: (i) GCF IL-1, concentrations in E-I gingivitis were significantly higher compared with N-O gingivitis; (ii) an intra-individual correlation between GCF concentrations of IL-1, detected in N-O and E-I gingivitis was observed in control quadrants, but not in test quadrants; (iii) IL-1, concentration in GCF was associated with IL-1B+3954 genotype only at test quadrants; (iv) IL-1, was detectable in serum only at low levels in a limited number of subjects, without difference between gingivitis conditions. Conclusions: Aspects of the bacterial challenge to the gingival tissues, such as the amount of plaque deposits and plaque accumulation rate, appear to affect the IL-1, levels in GCF in subjects with a specific IL-1B genotype. [source] Gingival changes during pregnancy: I. Influence of hormonal variations on clinical and immunological parametersJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2010Elena Figuero Figuero E, Carrillo-de-Albornoz A, Herrera D, Bascones-Martínez A. Gingival changes during pregnancy: I. Influence of hormonal variations on clinical and immunological parameters. J Clin Periodontol 2009; 37: 220,229. doi: 10.1111/j.1600-051X.2009.01516.x. Abstract Aim: To test whether exacerbated gingival inflammation in pregnancy is associated with increased salivary hormone levels and changes in gingival crevicular fluid (GCF) interleukin-1, (IL-1,) and prostaglandin-E2 (PGE2) levels. Material and methods: In this cohort study, 48 pregnant women without periodontitis were evaluated in the first, second, and third trimesters and at 3 months postpartum. Twenty-eight non-periodontitis non-pregnant women were evaluated twice, with a 6-month interval. Plaque and gingival indices (PlI, GI), salivary progesterone and estradiol and GCF IL-1, and PGE2 levels were determined. anova for repeated measures or Friedman's test were used for intragroup analyses. Inter-group comparisons were analysed with t -test or Mann,Whitney U -test. Correlations were evaluated with Pearson's and Spearman's test. Results: Pregnant women showed an increase in GI (p<0.05) despite maintaining low PlI values. No changes in IL-1, and PGE2 levels were observed during pregnancy. No significant correlation was found between the GI increase and salivary hormone levels. GI (p<0.05) and IL-1, levels (p<0.001) were lower in non-pregnant than in pregnant women. Conclusions: This study confirms the presence of an exacerbated gingival inflammation during pregnancy, but this phenomenon could not be associated with an increase in progesterone or estradiol or with changes in PGE2 or IL-1,. [source] Gingival changes during pregnancy: II.JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2010Influence of hormonal variations on the subgingival biofilm Carrillo-de-Albornoz A, Figuero E, Herrera D, Bascones-Martínez A. Gingival changes during pregnancy: II. Influence of hormonal variations on the subgingival biofilm. J Clin Periodontol 2010; 37: 230,240. doi: 10.1111/j.1600-051X.2009.01514.x. Abstract Aim: To determine whether the exacerbated gingival inflammation that develops in pregnant women is related to a change in the subgingival biofilm induced by the increase in hormone levels during pregnancy. Material and Methods: This open cohort study included 48 pregnant and 28 non-pregnant women without periodontitis. Pregnant women were evaluated in the first, second and third trimester and at 3 months after delivery. Non-pregnant women were evaluated twice, with a 6-month interval, assessing microbiological, clinical and hormonal variables at each visit. Total anaerobic counts and frequency of detection and proportions were calculated. The Friedman test with the Bonferroni correction was used for intra-group comparisons and Mann,Whitney U -tests for inter-group assessment. Correlations were analysed by means of Spearman's rank correlation coefficient. Results: Proportions of the subgingival periodontal pathogens did not differ throughout pregnancy, although significant differences were found for all the pathogens after delivery. Porphyromonas gingivalis -positive patients presented an increase in gingival inflammation (p<0.001) that was not related to plaque. Correlations were found between maternal hormone levels and P. gingivalis and Prevotella intermedia. Conclusion: Qualitative differences in periodontal pathogens were found from pregnancy to post-partum. Patients harbouring P. gingivalis presented and increased gingival inflammatory status. [source] Gingivitis as a risk factor in periodontal diseaseJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2009Niklaus P. Lang Abstract Background: Dental plaque has been proven to initiate and promote gingival inflammation. Histologically, various stages of gingivitis may be characterized prior to progression of a lesion to periodontitis. Clinically, gingivitis is well recognized. Material & Methods: Longitudinal studies on a patient cohort of 565 middle class Norwegian males have been performed over a 26-year period to reveal the natural history of initial periodontitis in dental-minded subjects between 16 and 34 years of age at the beginning of the study. Results: Sites with consistent bleeding (GI=2) had 70% more attachment loss than sites that were consistenly non-inflamed (GI=0). Teeth with sites that were consistently non-inflamed had a 50-year survival rate of 99.5%, while teeth with consistently inflamed gingivae yielded a 50-year survival rate of 63.4%. Conclusion: Based on this longitudinal study on the natural history of periodontitis in a dentally well-maintained male population it can be concluded that persistent gingivitis represents a risk factor for periodontal attachment loss and for tooth loss. [source] Clinical changes in periodontium during pregnancy and post-partumJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2008Mervi Gürsoy Abstract Background and Aim: Pregnancy has been presented to increase susceptibility to gingival inflammation. It is unclear whether pregnancy gingivitis exposes or proceeds to periodontitis. We examined longitudinally the severity of periodontal changes during pregnancy and post-partum, and compared the findings with an age-matched group of non-pregnant women. Material and Methods: Thirty generally healthy, non-smoking women at an early phase of their pregnancy and 24 non-pregnant women as controls were recruited. The pregnant group was examined three times during pregnancy and twice during post-partum, and the non-pregnant group three times, once per subsequent month. At each visit, visible plaque index (VPI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were measured from six sites per tooth. Results: In the pregnant group, BOP and PPD increased simultaneously without relation to plaque between the first and second trimesters, and thereafter decreased during subsequent visits. No changes were detected in CAL during the study period. In the non-pregnant group, BOP stayed invariable during the follow-up and correlated with the amount of plaque. Neither periodontal pocket formation nor significant changes in attachment levels were observed. Conclusion: Based on this study, changes in clinical parameters during pregnancy are reversible, indicating that pregnancy gingivitis does not predispose or proceed to periodontitis. [source] Bleeding on probing differentially relates to bacterial profiles: the Oral Infections and Vascular Disease Epidemiology StudyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2008Ryan T. Demmer Abstract Aim: Various bacterial species are differentially prevalent in periodontal health, gingivitis or periodontitis. We tested the independent associations between three bacterial groupings and gingival inflammation in an epidemiological study. Material and Methods: In 706 Oral Infections and Vascular Disease Epidemiology Study (INVEST) participants 55 years, bleeding on probing (BoP), pocket depth (PD) and subgingival plaque samples (n=4866) were assessed in eight sites per mouth. Eleven bacterial species were quantitatively assayed and grouped as follows: (i) aetiologic burden (EB, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia); (ii) putative burden (PB, Campylobacter rectus, Eikenella corrodens, Fusobacterium nucleatum, Micromonas micros, Prevotella intermedia); (iii) health-associated burden (HAB, Actinomyces naeslundii, Veillonella parvula). Results: After mutual adjustment for EB, PB and HAB, the BoP prevalence increased by 45% ( p<0.0001) across increasing quartiles of EB while BoP decreased by 13% ( p<0.0001) across increasing quartiles of HAB. Mean PD increased 0.8 mm and decreased 0.3 mm from the first to fourth quartiles of EB (p<0.0001) and HAB ( p<0.0001), respectively. Among 1214 plaque samples with fourth quartile EB, 60% were collected from sites with PD 3 mm. Conclusion: Bacterial species believed to be aetiologically related to periodontitis were associated with BoP in sites with minimal PD and/or attachment level (AL). Species presumed to be associated with periodontal health demonstrated inverse associations with BoP. [source] The efficacy of three different surgical techniques in the management of drug-induced gingival overgrowthJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2006M. Mavrogiannis Abstract Objectives: The aim of the present study was to evaluate the efficacy of three different surgical techniques in both the management and effect upon rate of overgrowth recurrence of drug-induced gingival overgrowth (DIGO). Materials and methods: Two cohorts of patients who required surgical correction of their DIGO participated in the study. After baseline periodontal measures (plaque index, gingival inflammation and probing pocket depths), the patients underwent surgery. A split-mouth, crossover design was used to compare conventional gingivectomy with flap surgery (n=27), and conventional gingivectomy with laser excision (n=23). The main outcome variable was the rate of recurrence of DIGO following surgery. Results: At 6 months, there was significantly less recurrence (p=0.05) in patients treated with laser excision, compared with those treated by conventional gingivectomy. The differences in rate of recurrence of DIGO were also reflected in changes in several periodontal parameters. Flap surgery offered no advantage over conventional gingivectomy with respect to the rate of recurrence. Conclusions: DIGO can be managed by a variety of techniques. Laser excision results in a reduced rate of recurrence. [source] Effects of smoking and gingival inflammation on salivary antioxidant capacityJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2006Nurcan Buduneli Abstract Aim: This study evaluated possible effects of smoking and gingival inflammation on salivary antioxidants in gingivitis patients. Methods: Twenty otherwise healthy gingivitis patients (10 self-reported smokers) and 20 periodontally and systemically healthy volunteer subjects were enrolled in the study. Whole saliva samples and full-mouth clinical periodontal recordings were obtained at baseline and one month following initial phase of treatment in gingivitis patients. Salivary cotinine, glutathione and ascorbic acid concentrations, and total antioxidant capacity were determined, and the data generated were tested by non-parametric tests. Results: Salivary cotinine measurements resulted in re-classification of three self-reported non-smokers as smokers. Smoker patients revealed significantly higher probing depths but lower bleeding values than non-smoker patients (p=0.044 and 0.001, respectively). Significant reductions in clinical recordings were obtained in non-smoker (all p<0.05) and smoker (all p<0.01) patients following periodontal treatment. Salivary total glutathione concentrations were reduced following therapy in gingivitis patients who smoke (p<0.01). Otherwise, no statistically significant differences were found between the groups in biochemical parameters at baseline or following treatment (p>0.05). Conclusions: Within the limits of this study, neither smoking nor gingival inflammation compromised the antioxidant capacity of saliva in systemically healthy gingivitis patients. [source] Modulation of clinical expression of plaque-induced gingivitis: response in aggressive periodontitis subjectsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2006Leonardo Trombelli Abstract Aim: The aim of this study was to characterize the gingival inflammatory response to de novo plaque accumulation in subjects treated for aggressive periodontitis (AP). The gingival inflammatory response of the AP subjects was retrospectively compared with that of periodontally healthy individuals (PH) matched for exposure to plaque and of periodontally healthy subjects previously identified as "high responders" (HR) and "low responders" (LR). Materials and Methods: 13 AP subjects and 26 matched PH subjects participated in a 21-day experimental gingivitis trial. Plaque index (PlI), Gingival index (GI), gingival crevicular fluid volume (GCF) and angulated bleeding score (AngBS) were recorded at days 0, 7, 14 and 21. Cumulative plaque exposure (CPE), i.e. PlI over time, was also calculated. Results: GCF was significantly higher in AP compared with PH group at each observation interval (p0.001). In addition, GCF was significantly higher in AP group compared with either LR or HR groups at each observation interval (p<0.001). Conclusions: These results suggest that susceptibility to gingival inflammation in response to de novo plaque accumulation may be related to susceptibility to periodontitis. [source] Effects of 0.2% chlorhexidine spray applied once or twice daily on plaque accumulation and gingival inflammation in a geriatric populationJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2003Javier Clavero Abstract Background/aims: Chlorhexidine (CHX) spray has proven to be an easily applicable method for the chemical control of plaque in elderly and handicapped patients. A randomized double-blind cross-over placebo-controlled trial was undertaken to compare the effects of 0.2% CHX spray applied once or twice daily on the plaque and gingival indexes in 13 institutionalized elderly patients. Method: The study subjects were randomly assigned to one of two groups. During the first 30-day period, one group received 0.2% chlorhexidine spray twice daily and the other received 0.2% CHX spray once daily plus placebo spray once daily. A washout period of 42 days then followed, after which the groups were interchanged and the process was repeated for another 30-day period. Plaque index and gingival index were determined at the beginning and end of each period. The patients continued with their usual oral hygiene practices throughout the study. Results: A significant reduction in plaque and gingival indexes was produced in both the groups. There were no significant differences in index scores between the groups. Conclusions: The results of the present study suggest that a single-daily application of 0.2% CHX spray is equally as effective in reducing plaque accumulation and gingival inflammation in institutionalized elderly patients as are two-daily applications of the same spray. Zusammenfassung Grundlagen/Ziele: Es hat sich herausgestellt, dass Chlorhexidinspray eine leicht zu handhabende Methode der chemischen Plaquekontrolle bei älteren und behinderten Patienten ist. Um die Unterschiede zwischen ein- oder zweimaliger Applikation von 0.2%-Chlorhexidinspray auf die Plaque- und Gingiva-Indizes zu vergleichen wurde an 13 institutionalisierten älteren Patienten eine randomisierte Plazebo-kontrolierte Crossover-Studie unternommen. Methode: Die Studienteilnehmer wurden randomisiert einer von zwei Gruppen zugeteilt. Während der ersten 30-Tageperiode erhielt eine Gruppe zweimal täglich 0.2%-Chlorhexidinspray und die andere Gruppe einmal täglich 0.2%-Chlorhexidinspray und einmal täglich einen Plazebo-Spray. Es folgte eine Auswaschperiode von 42 Tagen, nach der die Gruppen vertauscht wurden und der Prozess für weitere 30 tage wiederholt wurde. Zu Beginn und am ende einer jeden Periode wurden Plaque-Index (PI) und Gingival-Index (GI) bestimmt. Während der ganzen Studienperiode praktizierten die Patienten ihre üblichen Mundhygienemaßnahmen. Ergebnisse: In beiden Gruppen ergab sich eine signifikante Reduktion der Plaque- und Gingiva-Indizes. Zwischen den beiden Gruppen gab es keine signifikanten Unterschiede der Indexwerte. Schlussfolgerungen: Die Ergebnisse der vorliegenden Studie lassen annehmen, dass bei institutionalisierten älteren Patienten eine einzige Applikation pro Tag von 0.2%-Chlorhexidinspray bei der Reduktion der Plaqueakkumulation sowie der Gingivaentzündung genauso effektiv ist, wie die täglich zweimalige Applikation des gleichen Sprays. Résumé Le spray de chlorhexidine (CHX) a prouvé sa facilité d'application pour le contrôle chimique de la plaque dentaire chez les patients âgés et handicapés. Un essai clinique contrôlé, croisé, en double aveugle, randomisé et placebo-contrôle a été entrepris pour comparer les effets d'un spray de CHX 0.2% appliqué une ou deux fois par jour sur la plaque dentaire et les indices gingivaux de patients âgés de douze institutions. Les sujets ont été répartis en deux groupes. Durant une première période de 30 jours, un groupe recevait un spray de CHX 0.2% deux fois par jour tandis que l'autre recevait un spray de CHX 0.2% un fois par jour plus un spray placebo une fois par jour. Une période sans traitement de 42 jours a ensuite étéétablie suivie à la suite de laquelle les groupes ont été interchangés et le processus répété pour une nouvelle période de 30 jours. L'indice de plaque dentaire et l'indice gingival ont été déterminés au début et à la fin de chaque période. Les patients ont continué leurs habitudes d'hygiène buccale habituelles durant toute l'étude. Une réduction significative des indices de plaque et de gencive ont été relevés dans les deux groupes. Il n'y avait aucune différence significative de scores entre les deux groupes. Les résultats de l'étude présente suggèrent qu'une application unique d'un spray de CHX 0.2% est tout aussi efficace dans la réduction de la plaque dentaire et l'inflammation gingivale chez les patients âgés qu'une double application du même spray. [source] Antiplaque and antigingivitis effectiveness of a hexetidine mouthwashJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2003N. C. Sharma Abstract Objective: To assess the antiplaque/antigingivitis efficacy of a hexetidine-containing mouthwash. Methods: This examiner-blind, parallel group, controlled clinical study examined the effectiveness of a hexetidine (0.1%) mouthwash both in inhibiting the development of supragingival plaque and in reducing gingivitis. One hundred and thirty-four adult subjects completed the 2-week experimental gingivitis model study. Following baseline examinations, which included plaque index, modified gingival index and gingival bleeding index, subjects received a full dental prophylaxis. Subjects were randomly assigned to one of three mouthwashes (hexetidine 0.1%, chlorhexidine 0.12% (positive control) or a 5% hydroalcohol negative control) and commenced three times daily supervised rinsing as their sole method of oral hygiene. All indices were rescored after 2 weeks. Results: Compared to the negative control group, the hexetidine group demonstrated a statistically significant inhibition and reduction of supragingival plaque and gingival inflammation with reductions of 6.3%, 33.5% and 56% for gingivitis, plaque and gingival bleeding, respectively. The results of the chlorhexidine group were used to validate the study. Conclusion: The study confirms the efficacy of a hexetidine rinse in reducing supragingival plaque and gingival inflammation. Zusammenfassung Zielsetzung: Untersuchung der Antiplaque- und Antigingivitiseffektivität einer Hexetidin-Mundspüllösung. Methoden: Diese kontrollierte klinische Studie mit verblindetem Untersucher im Parallelarm-Design untersuchte die Effektivität einer Hexitidin-Mundspüllösung (0,1%) sowohl für die Hemmung supragingivaler Plaquebildung als auch zur Reduktion der Gingivitis. 134 erwachsene Probanden beendeten die 2 Wochen dauernde Studie mit experimenteller Gingivitis. Nach der Erstuntersuchung, die die Erhebung des Plaque Index, des Modifizierten Gingival Index und des Gingivalen Blutungs Index umfasste, erhielten die Probanden eine professionelle Zahnreinigung. Den Probanden wurden randomisiert 3 Spüllösungen zugewiesen (Hexitidin 0,1%, Chlorhexidin 0,12% [positive Kontrolle] oder ein 5%iger Hydroalkohol [negative Kontrolle]) und begannen damit als alleinige Mundhygienemaßnahme 3 mal täglich unter Aufsicht zu spülen. Nach 2 Wochen wurden die Indizes erneut erhoben. Ergebnisse: Im Vergleich zur negativen Kontrolle zeigte die Hexitidin-Gruppe eine statistisch signifikante Hemmung und Reduktion der supragingivalen Plaque und gingivalen Entzündung mit Reduktionen von 6,3%, 33,5% bzw. 56% für Gingivitis, Plaque bzw. gingivale Blutung. Die Ergebnisse der Chlorhexidin-Gruppe dienten zur Validierung der Studie. Schlussfolgerung: Diese Studie bestätigt die Wirksamkeit von Hexitidin zur Reduktion supragingivaler Plaque und gingivaler Entzündung. Résumé Cette étude clinique contrôlée par groupe parallèle avec examinateur aveugle a estimé l'efficacité d'un bain de bouche à 0,1% d'héxatidine tant à inhiber le développement de la plaque sus-gingivale qu'à réduire la gingivite. Cent trente-quatre adultes ont achevé un gingivite expérimentale de deux semaines. A la suite de l'examen de base comprenant l'indice de plaque, l'indice gingival modifié et l'indice de saignement gingival, les sujets ont reçu une prophylaxie dentaire complète. Ils ont ensuite été répartis de manière randomisée pour utiliser un des trois bains de bouche suivants : héxatidine 0,1%, chlorhexidine 0,12% (contrôle positif) ou l'hydroalcool 5% (contrôle négatif), et ont commencé a effectuer un rinçage supervisé trois fois par jour comme unique méthode d'hygiène buccale. Tous les indices ont été relevés après deux semaines. Comparé au groupe négatif le groupe héxatidine montrait une inhibition et une réduction significatives de la plaque sus-gingivale et de l'inflammation gingivale avec des réductions respectives de 6,3, 33,5 et 56% pour la gingivite, la plaque dentaire et le saignement gingival. Les résultats du groupe chlorhexidine ont été utilisés pour valider cette étude. Celle-ci confirme l'efficacité de l'héxatidine à réduire la plaque dentaire sus-gingivale et l'inflammation gingivale. [source] The antioxidant capacity of salivaJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2002M. Battino Abstract Background/aims: Saliva, a heterogeneous fluid comprising proteins, glycoproteins, electrolytes, small organic molecules and compounds transported from the blood, constantly bathes the teeth and oral mucosa. It acts as a cleansing solution, an ion reservoir, a lubricant and a buffer. In addition to its other host-protective properties, saliva could constitute a first line of defence against free radical-mediated oxidative stress, since the process of mastication and digestion of ingested foods promotes a variety of reactions, including lipid peroxidation. Moreover, during gingival inflammation, gingival crevicular fluid flow increases the change of saliva composition with products from the inflammatory response; this, in turn, could have some rôle in controlling and/or modulating oxidative damages in the oral cavity. This is the reason why the antioxidant capacity of saliva has led to increasing interest, and the development of techniques suitable for saliva antioxidant evaluation. Materials and Methods: Here, we review the current peer-reviewed literature concerning the nature and characteristics of free radicals, reactive oxygen species, oxidants, pro-oxidants and antioxidants in saliva, especially pro-oxidant and antioxidant features, as well as current methods for assessing the antioxidant capacity of saliva. Results and Conclusions: In the last decade, several methods have been developed for assaying the antioxidant activity of saliva, indicating an increasing interest of researchers and clinicians. Unfortunately, systematic studies of saliva are still lacking, even in healthy populations. Zusammenfassung Hintergrund/Zielsetzung: Der Speichel, eine heterogene Flüssigkeit bestehend aus Proteinen, Glykoproteinen, Elektrolyten, kleinen organischen Molekülen und Bestandteilen aus dem Blut, umspült andauernd Zähne und Mundschleimhäute. Er wirkt als Reinigungslösung, Reservoir für Ionen, als Schmiermittel und als Puffer. Zusätzlich zu seinen anderen Abwehreigenschaften könnte der Speichel eine erste Verteidigungslinie gegen durch freie Radikal verursachten oxidativen Stress sein, da der Prozess der Nahrungszerkleinerung und -verdauung eine Vielzahl von Reaktionen auslöst einschließlich der Lipidperoxidation. Darüber hinaus erhöht sich während gingivaler Entzündung der Sulkusflüssigkeitsfluss und verändert die Zusammensetzung des Speichels durch Produkte der Entzündungsreaktion. Dies könnte eine Rolle bei der Kontrolle und/oder Beeinflussung oxidativer Schäden in der Mundhöhle spielen. Dies sind die Gründe dafür, warum die antioxidative Kapazität des Speichels zu einem wachsenden Interesse und zur Entwicklung von Techniken geführt hat, die die Bestimmung der antioxidativen Kapazität des Speichels erlauben. Material und Methoden: In diesem Übersichtsartikel wird die akutelle Literatur hinsichtlich der Natur und Charakteristika freier Radikale, reaktiver Sauerstoffarten, Oxidantien, Prooxidantien und Antioxidantien im Speichel, insbesondere Eigenschaften der Pro- und Antioxidantien sowie aktuelle Methoden zur Bestimmung der antioxidative Kapazität des Speichels, dargestellt. Ergebnisse/Schlussfolgerungen: Während des vergangenen Jahrzehnts wurden mehrere Methoden für die Bestimmung der antioxidativen Kapazität des Speichels entwickelt, was für ein wachsendes wissenschaftliches und klinisches Interesse spricht. Unglücklicherweise fehlen noch systematische Studien zum Speichel selbst für gesunde Kollektive. Résumé Origine/but: La salive, fluide hétérogène constitué de protéines, de glycoprotéines, d'électrolytes, de petites molécules organiques et de composés transportés du sang, baigne constamment les dents et les muqueuses buccales. Elle agit comme une solution nettoyante, comme réservoir d'ions, comme lubrifiant et comme tampon. En plus de ces propriétés protectrices pour l'hôte, la salive pourrait constituer une première ligne de défense contre le stress oxydatif dû aux radicaux libres puisque le processus de mastication et de digestion des nourritures ingérées induit une variété de réactions, telle la peroxidation des lipides. De plus, pendant l'inflammation gingivale, le flux gingival sulculaire augmente et altère la compositon de la salive par les produits de la réponse inflammatoire. Cela, à son tour, pourrait avoir un rôle dans le contrôle ou la modulation des dommages oxydatifs dans la cavité buccale. C'est la raison pour laquelle la capacité antioxydant de la salive a connu un intérêt croissant et le développement de techniques fiables pour l'évaluation des antioxydants salivaires. Matériaux et méthodes: Ici, nous passons en revue de façon concise la littérature actuelle concernant la nature et les caractéristiques des radicaux libres, des espèces réactives à l'oxygène, des oxydants, des pro-oxydants et des antioxydants dans la salive, particulièrement les caractéristiques pro-oxydante et antioxydante et les méthodes actuelles de mise en évidence des capacités antioxydantes de la salive. Résultats et conclusions: Lors de la dernière décade, plusieurs méthodes ont été développées pour tester l'activité antioxydante de la salive, ce qui prouve un intérêt grandissant des chercheurs et des cliniciens. Malheureusement, des études systématiques sur la salive manquent même pour les populations saines. [source] Comparison of the bleeding on marginal probing index and the Eastman interdental bleeding index as indicators of gingivitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2002D. S. Barendregt Abstract Aim: The purpose of the present study was to compare 2 indices, i.e., the Eastman interdental bleeding (EIB) index and the bleeding on marginal probing (BOMP) index. The comparison was made (a) in terms of the degree of bleeding provoked and the relationship with plaque in natural gingivitis and (b) for the ability of these 2 methods to detect differences between the development of experimental gingivitis in a control group and a group in which the development of gingival inflammation was suppressed by treatment. For the present studies, subjects were selected without interdental recession of the gingival tissues. Methods experiment 1: In this experiment, 43 subjects having established moderate gingivitis were assessed using a random splitmouth design (1st and 3rd/2nd and 4th quadrant). Plaque was scored on all approximal sites after which the BOMP index was assessed in one half of the mouth and the EIB index in the other. Results experiment 1: The BOMP index showed a bleeding score of 84% and the EIB index of 87%. The significant correlation between plaque and gingival bleeding for the BOMP index (0.55) was higher than for the EIB index (0.44). Methods experiment 2: For this experiment, 25 subjects participated in an experimental gingivitis trial of the lower jaw. At baseline, first the BOMP index and immediately thereafter the EIB index were assessed at all approximal sites. Experimental gingivitis (EG) was carried out in one randomly assigned quadrant and as a treatment modality only floss was used in the other (FL). Results experiment 2: In the EG quadrant, the BOMP index increased to 69% and the EIB index to 73%. Both indices showed a significant correlation with plaque; 0.60 and 0.64 respectively. In the FL quadrant, the BOMP index increased to 38% and the EIB index to 30%. No significant correlation between both gingivitis indices and the amount of plaque was present in the FL quadrant. Conclusion: The ability of the BOMP index and the EIB index to assess the level gingival inflammation appears to be comparable. Zusammenfassung Ziel: Der Zweck der vorliegenden Studie war es, die 2 Indizes, den Eastman Interdental Bleeding (EIB) Index und den Bleeding On Marginal Probing (BOMB) Index zu vergleichen. Der Vergleich erfolgte. (A) hinsichtlich des provozierten Blutungsgrades und der Relation zwischen Plaque und natürlicher Gingivitis sowie: (B) bezüglich der Fähigkeit dieser 2 Methoden hinsichtlich des Nachweises von Unterschieden zwischen der Entwicklung einer experimentellen Gingivitis in einer Kontrollgruppe und einer Gruppe in der die Ausbildung einer gingivalen Entzündung durch die Behandlung unterdrückt wurde. Für die vorliegende Studie wurden Personen ohne interdentale Gingivarezession ausgewählt. Methoden Experiment 1: Bei diesem Experiment wurden 43 Personen mit etablierter moderater Gingivitis nach einem randomisierten Splitmouth-Design untersucht (1. Und 3./2. Und 4. Quadrant). Die Plaque wurde an allen approximalen Flächen bestimmt und anschließend wurde BOMP-Index in der einen Hälfte des Gebisses und der EIB-Index in der anderen erhoben. Ergebnisse Experiment 1: Der BOMP-Index zeigte einen Blutungswert von 84% und der EIB-Index einen von 87%. Die signifikante Korrelation zwischen der Plaque und einer gingivalen Blutung war für den BOMP-Index (0.55) höher als für den EIB-Index (0.44). Methoden Experiment 2: Für diese Experiment wurde bei 25 Personen eine experimentelle Gingivitis im Unterkiefer erzeugt. Bei der Eingangsuntersuchung wurde an allen Approximalflächen zuerst der BOMP-Index und sofort anschließend der EIB-Index erhoben. Die experimentelle Gingivitis (EG) wurde in einem randomisiert bestimmten Quadranten erzeugt und als Behandlungsart wurde im anderen Quadranten nur Zahnseide (FL) verwendet. Ergebnisse Experiment 2: Im EG-Quadranten stiegen der BOMP-Index auf 69% und der EIB-Index auf 73% an. Beide Indizes zeigten eine signifikante Korrelation mit der Plaque, die bei 0.60 bzw. 0.64 lag. Im FL-Quadranten stiegen der BOMP-Index auf 38% und der EIB-Index auf 30% an. Zwischen beiden Gingivitis-Indizes und der Plaquemenge, die im FL-Quadranten vorhanden war, gab es keine signifikante Korrelation. Schlussfolgerung: Die Möglichkeit mit dem BOMP-Index und den EIB-Index das Niveau der gingivalen Entzündung zu Bestimmen scheint vergleichbar zu sein. Résumé But: Le but de cette étude a été de comparer 2 indices, c-à-d. l'indice du saignement interdentaire d'Eastman (EIB) et l'indice du saignement au sondage marginal (BOMP). La comparaison a été effectuée (a) en termes de saignement provoqué et de relation avec la plaque dentaire dans la gingivite naturelle et (b) sur l'aptitude de ces 2 méthodes à détecter des différences lors du dévelopment d'une gingivite expérimentale dans un groupe contrôle et dans un groupe test dont le dévelopement de l'inflammation gingivale a été entravé par un traitement. Pour ces études, des sujets qui ne présentaient pas de récession interdentaire ont été sélectionnés. Méthodes, expérience 1: Dans la première expérimentation, 43 sujets étant porteurs d'une gingivite modérée ont été enregistrés en utilisant un modèle de bouche divisée au hasard (1er et 3ième quadrants VS 2ième et 4ième quadrants). La plaque dentaire a été estimée sur tous les sites interproximaux. Résultats expérience 1: L'indice BOMP a ensuite été relevé sur une partie de la bouche et l'indice EIB sur l'autre. L'indice BOMP a eu un score de 84% et l'EIB de 87%. La corrélation significative entre la présence de plaque dentaire et le saignement gingival était pour l'indice BOMP de 0.55, supérieur donc à celui de l'EIB qui était de 0.44. Méthodes expérience 2: Lors de la seconde expérience, 25 sujets ont participéà une gingivite expérimentale au niveau de la mandibule. Lors de l'examen de départ l'indice BOMP a été relevé en premier suivi de celui de l'EIB au niveau de tous les sites interproximaux. La gingivite expérimentale (EG) a été effectuée sur un quadrant choisi de manière randomisée et un traitement avec de la soie dentaire uniquement a été utilisé dans l'autre (FL). Résultats expérience 2: Dans le quadrant avec EG l'indice BOMP atteignait 69% et l'indice EIB à 73%. Les deux indices avaient une corrélation significative avec la plaque dentaire, respectivement de 0.60 et 0.64. Dans le quadrant FL, l'indice BOMP grimpait à 38% et l'indice EIB à 30%. Aucune corrélation significative entre les deux indices de gingivite et la quantité de plaque n'a été trouvé dans le quadrant FL. Conclusions: L'aptitude des indices BOMP et EIB à mesurer le niveau d'inflammation gingivale semble comparable. [source] Oral health and cardiovascular disease in SwedenJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2002Results of a national questionnaire survey Abstract Objective: The purpose of the present study was to assess the relation between dental health and cardiovascular disease in an adult Swedish population. Material and method: A questionnaire was sent to 4811 randomly selected Swedes. It contained 52 questions about dental care habits, oral health, cardiovascular disease and their socio-economic situation. Odd ratios for all cardiovascular diseases (CVD) and the subgroup myocardial infarction, stroke and high blood pressure were calculated with a logistic regression model adjusted for age, gender, smoking, income, civil status and education. These ratios were calculated for subjects 41 years since few people suffer from CVD before this. Results: The national questionnaire was answered by 2839 (59%) people between 20,84 years of age and, of them, 1577 were 41 years of age or more. We found a significant association between self-reported bleeding gums (odds ratio 1.60, p=0.0017), presence of dentures (odds ratio 1.57, p=0.0076) and known CVD, which has also been reported in international studies. However, no association between loose teeth, deep pockets and known CVD was detected. Conclusion: The results indicate that oral health and, especially gingival inflammation is associated with CVD. Zusammenfassung Zielsetzung: Untersuchung des Zusammenhanges von oraler Gesundheit und kardiovaskulären Erkrankungen in einer Population schwedischer Erwachsener. Material und Methoden: Ein Fragebogen wurden an 4811 zufällig ausgewählten Schweden verschickt. Er enthielt 52 Fragen zu Zahnhygienegewohnheiten, Mundhygiene, Herz-Kreislauf-Erkrankungen und sozioökonomischem Status. Odds Ratios (OR) für alle kardiovaskulären Erkrankungen (KVE) und für die Untergruppen Myocardinfarkt, Schlaganfall sowie Bluthochdruck wurden mit einem logistischen Regressionsmodell berechnet, das für Alter, Geschlecht, Rauchen, Einkommen, sozialen Status und Ausbildung korrigiert war. Dies erfolgte für Personen 41 Jahre, da jüngere Individuen selten an KVE leiden. Ergebnisse: Der Fragebogen wurde von 2839 Personen (59%) im Alter zwischen 20 und 84 Jahren beantwortet, von denen 1577,41 Jahre oder älter waren. Es ergab sich eine signifikante Assoziation zwischen von den Patienten berichtetem Zahnfleischbluten (OR 1.60, p=0.0017) sowie Vorhandensein von Prothesen (OR 1.57, p=0.0076) und bekannter KVE. Allerdings konnte keine Assoziation zwischen lockeren Zähnen bzw tiefen Taschen und bekannter KVE gefunden werden. Schlussfolgerungen: Diese Ergebnisse zeigen, dass ein Zusammenhang zwischen oraler Gesundheit, speziell gingivaler Entzündung, und KVE besteht. Résumé But: Le but de cette étude était de mettre en évidence la relation entre la santé dentaire et la maladie cardiovasculaire dans une population suédoise adulte. Matériaux et méthodes: Un questionnaire fut adresséà 4811 suédois sélectionnés au hasard. Il contenait 52 questions sur les habitudes de soins dentaires, la santé orale, la maladie cadiovasculaire et leur situation socio-économique. L'odds-ratio pour toutes les maladies cardiovasculaires (CVD) et le sous-groupe d'infarctus du myocarde, d'attaque et d'hypertension, fut calculé par un modèle de régression logistique ajusté pour l'âge, le sexe, le tabagisme, le revenu, l'état civil et le niveau d'éductation. Ces odds-ratio furent calculés pour les sujets de plus de 41 ans, puisque peu de gens souffrent de CVD avant cet âge. Resultats: 2839 (59%) personnes entre 20 et 84 ans, parmi lesquelles 1577 étaient âges d'au moins 41 ans répondirent à ce questionnaire national. Nous avons trouvé une association significative entre les saignement gingivaux (décrits par les sondés euxmêmes) (odds-ratio 1.60, p<0.0017), la présence de prothèse amovible (odds ratio 1.57, p=0.0076) et une CVD reconnu, ce qui a étéégalement rapporté dans les études internationales. Cependant, aucune association entre les dents perdues, la profondeur de poche et une CVD connue ne fut détectée. Conclusion: Les résultats indiquent que la santé orale et particulièrement l'inflammation gingivale est associée avec les CVD. [source] Effect of interleukin-1 gene polymorphism in a periodontally healthy Hispanic population treated with mucogingival surgeryJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2002Raul G. Caffesse Abstract Objectives: A genetic test for susceptibility of periodontal disease has been introduced. A positive test indicates a risk factor for more severe periodontal destruction. The prevalence of genotype positive subjects has been reported around 30%. In a Mexican population, we have found a 26% prevalence of genotype positive individuals. Few studies have reported the response to therapy in these individuals. The purpose of this study was to assess the response to mucogingival surgery in an otherwise periodontally healthy Hispanic population. Materials and methods: 22 subjects (7 male and 15 female) with a mean age of 45 years participated. They were treated 3 years prior for the treatment of Types I and II recession defects using connective tissue grafts. No other active periodontal treatment was required, except for preventive maintenance. A full-mouth clinical evaluation was performed which included assessment of gingival inflammation and measurements of probing pocket depth and clinical attachment levels. Mean values per patient were determined. A finger stick blood sample was collected using specially provided DNA filter paper, let dried, and mailed for processing. Results: Results indicated that 5 out of the 22 subjects were genotype positive. The genotype positive subjects presented the following values: GI 1.13±0.17, PPD 2.48±0.46, and CAL 3.38±0.66. The values for the genotype negative subjects were GI 1.06±0.14, PPD 2.38±0.31 and CAL 3.11±0.53. No statistical significant differences were found when both groups were compared (p>0.05). Furthermore, the treatment of the localized recessions was effective and provided similar amount of coverage in genotype positive and negative subjects. However, more genotype negative subjects showed complete coverage of the recession than genotype positive individuals. Conclusions: Within the limits of this study it is concluded that (1) periodontal health can be maintained with proper preventive maintenance irrespective of the genotype present, (2) the mean response to mucogingival surgery to cover localized gingival recessions is similar irrespective of the IL-1 periodontal genotype, however, full coverage is achieved more frequently in genotype negative subjects. Zusammenfassung Ziele: Es wurde ein Gentest für die Anfälligkeit bezüglich einer Parodontalerkrankung eingeführt. Ein positiver Test ist ein Zeichen für einen Risikofaktor für eine stärkere parodontale Destruktion. Die Prävalenz von genotyp-positiven Personen wurde mit etwa 30% angegeben. In einer mexikanischen Population haben wir eine Prävalenz von 26% von genotyp-positiven Individuen vorgefunden. Nur wenige Studien haben bei diesen Patienten über die Reaktion auf die Therapie berichtet. Der Zweck dieser Studie war es die Heilung nach mukogingivaler Chirurgie in einer im Übrigen parodontal gesunden Population mit spanischen Abstammung. Material und Methode: 22 Patienten (7 Männer und 15 Frauen) mit einem Durchschnittsalter von 45 Jahren nahmen an der Studie teil. Sie wurden vor 3 Jahren zur Deckung einer Rezession von Typ I oder II mit einem Bindegewebetransplantat behandelt. Es war keine weitere parodontale Behandlung außer präventiven Erhaltungstherapie notwendig. Es wurde eine vollständige klinische Untersuchung des Gebisses durchgeführt, die die Bestimmung der gingivalen Etnzündung, sowie die Messung der Sondierungstiefe und des klinischen Attachmentniveaus beinhaltete. Es wurden für jeden Patienten die Mittelwerte bestimmt. Eine Blutprobe von der Fingerbeere wurde entnommen, auf ein specielles DNA-Filterpapier aufgetragen, getrocknet und zur Weiterverarbeitung versendet. Ergebnisse: Die Ergebnisse zeigten, dass 5 von 22 Patienten genotyp-positiven waren. Die genotyp-positiven Patienten wiesen folgende Werte auf: GI 1.13±0.17, PPD 2.48±0.46 und CAL 3.38±0.66. Die Werte für die genotyp-negativen Patienten betrugen: GI 1.06±0.14, PPD 2.38±0.31 und CAL 3.11±0.53. Beim Vergleich beider Gruppen ergaben sich keine statistisch signifikanten Unterschiede (p>0.05). Des weiteren war die Behandlung der lokalisierten Rezession effektiv und lieferte bei genotyp-positiven und genotyp-negativen Patienten einen ähnlichen Anteil an Wurzeldeckung. Jedoch zeigten mehr genotyp-negative Patienten eine vollständige Rezessionsdeckung als genotyp-positive Patienten. Schlussfolgerungen: Mit den Einschränkungen dieser Studie kann die Schlussfolgerung gezogen werden, dass (1) unabhängig vom vorliegenden Genotyp mit geeigneten präventiven Maßnahmen die parodontale Gesundheit erhalten werden kann und (2) dass unabhängig vom IL-1-Genotyp, die durchschnittliche Reaktion auf die mukogingivale Chirurgie zur Deckung von lokalisierten Gingivarezessionen ähnlich ist. Jedoch wird eine vollständige Deckung häufiger bei genotyp-negativen Patienten erreicht. Résumé But: Un test génétique pour la suscpetibilitéà la maladie parodontale est présenté. Un test positif indique un facteur de risque pour une destruction parodontale plus sévère. La fréquence globale de sujets positifs au génotype semblerait être de 30%. Dans une population mexicaine, une fréquence globale de 26% d'individus positifs pour le génotype a été trouvée. Peu d'études ont apporté la réponse au traitement chez ces individus. Le but de cette investigation a été de mesurer la réponse de la chirurgie muco-gingivale dans une population hispanique parodontalement saine. Matériaux et méthodes: 7 hommes et 15 femmes d'un âge moyen de 45 ans y ont participé. Ils avaient été traités 3 ans auparavant pour des lésions de récession de type I et II en utilisant des greffes de tissu conjonctif. Aucun autre traitement parodontal actif n'avait été requis, sauf pour la maintenance. Une évaluation clinique de toute la bouche a été effectuée comprenant l'estimation de l'inflammation gingivale et les measures de la profondeur de poche au sondage et des niveaux d'attache clinique. Les valeurs moyennes par patient ont été déterminées. Un échantillon sanguin par piqûre du doigt a été récolté en utilisant un papier filtre ADN, qui fût séché et envoyé pour analyse. Résultats: Les résultats ont indiqué que 5 des 22 sujets étaient génotype positif. Ces sujets présentaient les valeurs suivantes: GI 1.13±0.17, PPD 2.48±0.46 mm et CAL 3.38±0.66 mm. Les valeurs chez les sujets génotype négatif étaient: GI 1.06±0.14, PPD 2.38±0.31 mm et CAL 3.11±0.53 mm. Aucune différence statistiquement significative n'a été trouvée lorsque les deux groupes ont été comparés. De plus le traitement des récessions locales était effectif et apportait une quantité semblable de recouvrement chez les deux types de sujets. Cependant davantage de sujets génotype négatif bénéficiaient d'un recouvrement complet de la récession. Conclusions: Dans les limites d l'étude présente: (1) la santé parodontale peut être maintenue avec des mesures préventives quelque soit le génotype présent, (2) la réponse moyenne de la chirurgie muco-gingivale pour recouvrir des récessions gingivales locales est semblable quelque soit le génotype parodontal IL-1, bien qu'un recouvrement complet est plus souvent réalisé chez les sujets génotype négatif. [source] Some effects of enamel matrix proteins on wound healing in the dento-gingival regionJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2002Jan L. Wennström Abstract Objective: The aim of the present study was to evaluate by clinical means the effect of enamel matrix proteins on the healing of a soft tissue wound produced by periodontal pocket instrumentation. Material and methods: The study was performed as an intra-individual, longitudinal trial of 3 weeks duration with a double-masked, split-mouth, placebo-controlled and randomized design. The patient material was comprised of 28 subjects with moderately advanced, chronic periodontitis. Each patient presented with 3 sites in each of 2 jaw quadrants with a probing pocket depth (PPD) of 5 mm and bleeding following pocket probing (BoP). Baseline examination, including assessments of plaque, gingival inflammation, PPD, BoP and root dentin sensitivity, was carried out one week after oral hygiene instruction and careful self-performed plaque control. All experimental sites were scaled and root planed, and the soft tissue wall of the pocket was curetted to remove the pocket epithelium and adjacent granulation tissue. The site was carefully irrigated with saline. When the bleeding from the pocket had ceased, a 24% EDTA gel was applied in the site and retained for 2 min. This was followed by careful irrigation with saline. Left and right jaw quadrants were then randomized to subgingival application of enamel matrix derivative (Emdogain®) or vehicle-control. All sites were re-examined after 1, 2 and 3 weeks. In addition, a visual analogue scale (VAS) was used to score the degree of post-treatment discomfort. The primary endpoints of treatment success were defined as (i) pocket closure (PPD 4 mm), (ii) no bleeding following pocket probing, (iii) no sign of gingival inflammation (GI score =0) and (iv) low degree of post-treatment discomfort (VAS 20). Statistical analyzes of intra-individual differences between the test and control treatments were performed by the use of Wilcoxon signed rank test. For comparison of the proportions of sites reaching the defined endpoints of treatment success, a site-based analysis was performed using 2×2 tables and the Fisher exact test. Results: The endpoint "GI score =0" was reached at 16% of the sites subjected to application of Emdogain® at 1 week and at 2% of the control sites (p=0.001). At 2 weeks, the corresponding figures were 25% versus 12% (p=0.028). Absence of BoP was at 1 week 57% for the Emdogain® treated sites compared to 35% for the control sites (p=0.003). At 2 weeks, this endpoint was reached in 73% and 59% of the test and control sites, respectively (p=0.051). In terms of the endpoint defined for probing pocket depth, PPD 4 mm, no differences between test and control sites were found. At 1 week, the proportion of patients reporting a VAS score 20 was significantly higher for the Emdogain® treated quadrants than for controls (p=0.002). Conclusion: The results indicated that Emdogain® topically applied in instrumented pockets enhance the early healing of periodontal soft tissue wounds. Zusammenfassung Zielsetzung: Klinische Untersuchung der Wirkung von Schmelzmatrixprotein (SMP) auf die Heilung der durch subgingivale Instrumentierung verursachten Wunde. Material und Methoden: Das Studiendesign entsprach einer randomisierten longitudinalen plazebokontrollierten doppelt verblindeten Halbseitenstudie, an der 28 Patienten mit mäßig fortgeschrittener chronischer Parodontitis teilnahmen. Jeder Patient wies an 3 Stellen zweier Quadranten Sondierungstiefen (ST) 5 mm und Bluten auf Sondieren (BOP) auf. Eine Woche nach Durchführung von Mundhygieneinstruktionen und gründlicher individueller Mundhygiene erfolgte die Basisuntersuchung: Plaque, gingivale Entzündung, ST, BOP und Zahnhalsüberempfindlichkeit. Alle Testzähne wurden subgingival instrumentiert (Scaling und Wurzelglättung), es wurde eine Weichgewebskürettage durchgeführt und mit Kochsalzlösung (NaCl) gespült. Nach dem Stillstand der Taschenblutung wurde ein 24%iges EDTA-Gel subgingival appliziert und für 2 min belassen. Nach gründlicher NaCl-Spülung erfolgte eine randomisierte Zuweisung der subgingivalen Instillation von SMP-Gel (Test) oder nur Trägergel (Plazebokontrolle) zum rechten bzw. linken Quadranten. Nachuntersuchungen erfolgten nach 1, 2 und 3 Wochen. Dabei wurden zusätzlich die postoperativen Beschwerden mit einer visuellen Analogskala (VAS) erfasst. Als Hauptzielkriterien des Behandlungserfolges wurden definiert: (1) Verschluß der parodontalen Tasche (ST 4 mm), (2) kein BOP, (3) keine Zeichen gingivaler Entzündung (GI=0) und (4) nur geringgradige postoperative Beschwerden (VAS 20). Der Vergleich zwischen Test und Kontrolle erfolgte mit dem Wilcoxon-Test bzw. mit 4-Felder-Tafeln und dem Fisher-Exakt-Test. Ergebnisse: Das Erfolgskriterium "GI=0" war nach 1 Woche bei 16% der Test- und und bei 2% der Kontrollstellen erfüllt (p=0.001). Nach 2 Wochen lagen die Proportionen für Test und Kontrolle bei 25% bzw. 12% (p=0.028). Kein BOP war nach 1 Woche bei 57% der Test- und bei 35% der Kontrollstellen zu beobachten (p=0.003), nach 2 Wochen lagen die Werte bei 73% bzw. 59% (p=0.051). Hinsichtlich des Kriteriums ST 4 mm konnten keine Unterschiede zwischen Test und Kontrolle gefunden werden. 1 Woche nach Instrumentierung war der Anteil der Patienten in der Testgruppe, die eine VAS 20 angaben, höher als in der Kontrollgruppe (p=0.002). 3 Wochen nach Therapie wiesen beide Gruppen hinsichtlich keines der Erfolgskriterien mehr statistisch signifikante Unterschiede auf. Schlussfolgerungen: Die topische subgingivale Applikation von SMP in instrumentierte parodontale Taschen könnte die frühe Wundheilung des Weichgewebes begünstigen. Résumé But: Le but de l'étude présente a été d'évaluer cliniquement l'effet des protéines de la matrice amélaire (Emdogain®) sur la guérison des tissus mous produits par l'instrumentation de la poche parodontale. Matériaux et méthodes: Cette étude a été effectuée en tant qu'essai longitudinal intra-individuel de 3 semaines avec un modèle en double aveugle, par bouche divisée, au hasard et contrôlé par placebo. 28 sujets avec parodontite chronique modérement avancée ont participéà cette étude. Chaque patient présentait 3 sites dans 2 quadrants avec une profondeur au sondage (PPD) 5 mm et un saignement au sondage (BoP). L'examen initial comprenant la prise des indices de plaque, d'inflammation gingivale, de PPD, de BoP et de la sensibilité dentinaire a été effectué une semaine après l'instruction en hygiène buccale et le contrôle de plaque dentaire réalisé par la personne elle-même. Tous les sites expérimentaux ont été détartrés et surfacés, et la paroi de tissu mou de la poche a été curetée pour enlever l'épithélium de la poche et le tissu de granulation adjacent. Ce site a été irrigué avec du sérum physiologique. Lorsque le saignement de la poche avait cessé, un gel d'EDTA 24% a été appliqué dans le site et est resté in situ pendant 2 min. Ensuite une nouvelle irrigation avec du sérum physiologique a été prodiguée. Les quadrants gauches et droits étaient ensuite distribués au hasard pour l'application sous-gingivale du dérivé de la matrice amélaire (Emdogain®) ou en tant que véhicule contrôle. Tous les sites ont été ré-éxaminés aprés 1, 2 et 3 semaines. De plus une échelle analogue de vision (VAS) a été utilisée pour mesurer le degré d'inconfort post-traitement. Les points principaux du succès du traitement étaient définis comme suit (1) fermeture de la poche (PPD 4 mm), (2) absence de saignement au sondage, (3) aucun signe d'inflammation gingivale (GI=0) et (4) un faible degré d'inconfort post-traitement (VS20). Les analyses statistiques des différences intra-individuelles entre les traitements tests et contrôles ont été effectuées à l'aide du test par Wilcoxon Signed Rank. Pour la comparaison des proportions de sites atteignant le succès souhaité, une analyse basée sur les sites a été effectuée en utilisant des tables 2×2 et le test exact de Fisher. Résultats: Le but GI=0 a été atteint dans 16% des sites avec Emdogain® après 1 semaine seulement et dans 2% des sites contrôles (p=0.001). A 2 semaines, les figures correspondantes étaient 25% versus 12% (p=0.028). L'absence de BoP a 1 semaine atteignait 57% des sites traités par Emdogain® contre 35% pour les contrôles (p=0.003). A 2 semaines, ce but était atteint dans respectivement 73% et 59% des sites tests et contrôles (p=0.051). En terme de PPD4 mm, aucune différence n'a été trouvée entre les sites. A 1 semaine, la proportion de patients qui avaient un VAS 20 était significativement plus importante dans le groupe traité par Emdogain® que chez les contrôle (p=0.002). Conclusions: Les résultats ont indiqué que l'Emdogain® placé localement dans des poches nettoyées peut augmenter la guérison précoce des tissus mous parodontaux. [source] Periodontal disease among indigenous people in the Amazon rain forestJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2001Mauricio Ronderos Abstract Background: People are not all equally susceptible to periodontitis. To understand the epidemiology and natural history of this disease, it is important to study populations with varying genetic backgrounds and environmental exposures. Aim: Characterize the periodontal condition of a sample of indigenous adults in a remote region of the Amazon rain forest and determine the association of periodontal disease with various demographic, behavioral and environmental factors. Methods: A cross-sectional evaluation of 244 subjects aged 20,70 years was conducted. Pocket depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), plaque and calculus were assessed for the Ramfjord index teeth. Results: These people had high levels of plaque, calculus and BOP. The mean PD was rather shallow (2.45 mm in 20,29 year-olds to 2.73 mm in 50+ year-olds) and did not increase significantly with age. Mean CAL (0.57 mm in 20,29 year-olds and 2.26 mm in 50+ year-olds) and mean location of the free gingival margin in relation to the cemento-enamel junction changed significantly with age (p<0.0001). Multivariate analysis revealed that increasing age, bleeding on probing and calculus scores were positively associated with mean CAL (p<0.01). Sex, ethnicity, level of modern acculturation, use of coca or tobacco paste, frequency of dental visits and plaque were not associated with mean CAL. Conclusions: Periodontal disease in these people was mainly associated with gingival recession rather than deep pockets. Most people had clinical attachment loss but despite poor oral hygiene and extensive gingival inflammation, they did not have very severe periodontal destruction. [source] Generalized cervical root resorption associated with periodontal diseaseJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2001Wouter Beertsen Abstract Background and description of case: The etiology and pathogenesis of generalized cervical root resorptions is not well understood. In the present report, a case of severe cervical root resorption involving 24 anterior and posterior teeth is presented. The lesions developed within a period of 2 years after the patient had changed to an acid-enriched diet. They extended far into the coronal dentin and were associated with gingival inflammation and crestal bone resorption. However, no generalized clinical attachment loss had occurred. Culturing of subgingival plaque revealed the presence of several putative periodontal pathogens among which Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Treatment consisted of mechanical debridement supported by systemic antibiotics (amoxycillin plus metronidazole) and dietary advice. Results: Within 1 year after the onset of treatment, all resorptive lesions had repaired by ingrowth of a radio-opaque mineralized tissue. The crestal areas showed radiological evidence of bone repair. 3 years after the onset of therapy, one premolar was extracted and examined histologically. It appeared that irregularly-shaped masses of woven bone-like tissue had invaded into the domain of the resorbed coronal dentin and were bordered by thin layers of acellular cementum. Conclusion: It is concluded that, in this patient, the cervical resorptions were likely the result of an osteoclastic response extending into the roots because the root-protective role of the junctional epithelium did not develop. We hypothesize that this was due to the combined effects of a periodontopathogenic microflora and a dietary confounding factor. Zusammenfassung Hintergrund und Beschreibung des Falls: Die Ätiologie und die Pathogenese der generalisierten Wurzelresorptionen ist nicht besonders bekannt. In der vorliegenden Fallpräsentation wird ein schwerer Fall von Wurzelresorption gezeigt, die 24 anteriore und posteriore Zähne einbezog. Die Läsionen entwickelten sich innerhalb einer Periode von 2 Jahren, nachdem der Patient zu einer Säure-angereicherten Diät gewechselt hatte. Die Läsionen dehnten sich in das koronale Dentin aus und waren mit gingivaler Entzündung und krestaler Knochenresorption verbunden. Jedoch wurde kein generalisierter Attachmentverlust beobachtet. Die Kultur der subgingivalen Plaque erbrachte das Vorhandensein von verschiedenen putativen parodontalen Pathogenen, unter ihnen Actinobacillus actinomycetemcomitans und Porphyromonas gingivalis. Die Behandlung bestand in der mechanischen Reinigung unterstützt mit systemischen Antibiotika (Amoxicillin und Metronidazol) und Diätanweisungen. Ergebnisse: Innerhalb eines Jahres nach dem Beginn der Therapie waren alle Resorptionsläsionen repariert durch das Einwachsen von röntgenopakem mineralisierten Gewebe. Die krestalen Regionen zeigten radiologisch nachgewiesene Knochenreparatur. 3 Jahre nach Therapiebeginn wurde ein Prämolar extrahiert und histologisch untersucht. Es schien, daß irreguläre geformte Massen von verflochtenem knochen-ähnlichen Gewebe in den Hauptteil des resorbierten koronalen Dentins hineingelangt sind und von dünnen Schichten azellulären Zementes begrenzt wurden. Zusammenfassung: Es wird geschlußfolgert, daß bei diesem Patient die zervikalen Resorptionen wahrscheinlich das Ergebnis einer osteoklastischen Reaktion waren, bis in die Wurzeln ausgedehnt, weil sich die wurzelschützende Rolle des Verbindungsepithels nich entwickelt hatte. Wir nehmen an, daß dies in der Folge eines kombinierten Effektes von parodontopathogenen Keimen und eines verwirrenden diätetischen Faktors geschah. Résumé Origine: L'étiologie et la pathogenèse des résorptions radiculaires cervicales généralisées ne sont pas suffisamment connues. Dans le rapport présent, un cas de résorption radiculaire cervicale sévère se rapportant à 24 dents antérieures et postérieures est présenté. Les lésions s'étaint développées durant les 2 années qui ont suivi le changement de régime alimentaire du patient vers un régime plus acide. Elles s'étendaient profondément dans la dentine coronaire et étaient associées à une inflammation gingivale et une résorption osseuse crestale. Cependant, aucune perte d'attache clinique généralisée n'est apparue. La culture de la plaque dentaire sous-gingivale a révélé la présence de plusieurs pathogènes parodontaux putatifs parmi lesquels l'Actinobaccilus actinomycetemcomitans et le Porphyromonas gingivalis. Le traitement a consisté en un nettoyage mécanique associéà l'utilisation d'antibiotiques par voie systémique (amoxycilline + métronidazole) et un conseil diététique. Résultats. Dans l'année qui a suivi ce traitement, toutes les lésions de résorption ont été guéries par la croissance d'un tissu minéralisé radio-opaque. Les zones crestales montraient une évidence radiologique de réparation osseuse. 3 ans après le démarrage de ce traitement, une prémolaire a été avulsée et examinée histologiquement. Il est apparu que des masses de formes irrégulières de tissus ressemblant à de l'os ouaté avaient envahi le domaine de dentine coronaire résorbé et étaient entourées par de fines couches de cément acellulaire. Conclusions: Chez ce patient, les résorptions cervicales étaient vraisemblablement dûes à une réponse ostéoclastique s'étendant dans les racines parce que le rôle de protection radiculaire de l'épithélium de jonction ne s'étaient pas développé. Cette situation était vraisemblablement dûe à des effets combinés de la microflore parodonto-pathogène et d'un facteur diététique. [source] Initial outcome and long-term effect of surgical and non-surgical treatment of advanced periodontal diseaseJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2001G. 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] Salivary cystatin activity and cystatin C in natural and experimental gingivitis in smokers and non-smokersJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2001M. A. Lie Abstract Background: Recent studies show that subjects with natural gingivitis or periodontitis have elevated levels of salivary cystatins compared to periodontally healthy individuals. Increased glandular output of cystatins in inflammatory conditions suggests an active, most likely protective, rôle for these proteins in inflammatory processes. Furthermore, it has been shown that the development of gingival inflammation is suppressed in smokers during experimental gingivitis. Aims: The purpose of the present study was to investigate whether (i) the levels of salivary cystatins in natural gingivitis are related to smoking status, and (ii) to study whether experimentally induced gingivitis is associated with changes in salivary cystatin levels, in both smokers and non-smokers. Material and Methods: Whole saliva samples were taken in relation to natural gingivitis, gingival health and 14-day experimental gingivitis in 25 non-dental students (14 non-smokers and 11 smokers). The salivary flowrate was determined. Samples were analyzed for levels of protein, cystatin and cystatin-C. Results: Salivary flow and protein concentrations in cleared human whole saliva samples of non-smokers and smokers were not different from each other at any timepoint during the trial. With regard to cystatins, the results showed that in the state of natural gingivitis cystatin activity is lower in smokers as compared to non-smokers. In smokers, the resolution of natural gingivitis to the state of gingival health did not result in a change of cystatin activity and levels of cystatin C. At the end of the 14-day experimental gingivitis period, smokers showed a decrease in cystatin activity and cystatin C as well as lower outputs of cystatin activity and cystatin C. Conclusion: Smoking is associated with lower cystatin activity and output of cystatin C during gingival inflammation. Zusammenfassung Hintergrund: Neuere Untersuchungen haben bezeigt, dass bei Patienten mit natürlicher Gingivitis oder Parodontitis die Cystatinspiegel im Speichel im Vergleich zu parodontal gesunden Personen erhöht sind. Ein erhöhter Ausstoß von Cystatinen durch Speicheldrüsen bei entzündlichen Prozessen spricht für eine aktive, sehr wahrscheinlich protektive Rolle dieser Proteine bei Entzündungen. Darüber steht die Unterdrückung der Entwicklung der gingivalen Entzündung bei Rauchern während einer experimentellen Gingivitis möglicherweise mit der verstärkten Expression von Cystatin C in Verbindung. Zielsetzung: Untersuchung, (1) ob die Cystatinspiegel im Speichel bei natürtlicher Gingivitis mit dem Zigarettenkonsum in Verbindung stehen und (2) ob eine Assoziation zwischen experimentell induzierter Gingivitis und Veränderungen der Cystatinspiegel im Speichel bei Rauchern und Nichtrauchern besteht. Material und Methoden: Bei 25 Studenten (14 Nichtraucher, 11 Raucher), die keine Zahnmediziner waren, wurden Speichelproben in Relation zu natürlicher Gingivitis, gingivaler Gesundheit und während einer 14 Tage dauernden experimentellen Gingivitis entnommen. Die Speichelsekretioinsrate wurde gemessen und die Speichelkonzentrationen von Protein, Cystatin und Cystatin C bestimmt. Ergebnisse: Die Speichelsekretionsraten und Proteinkonzentrationen der Speichelproben zeigten zu keinem Zeitpunkt der Untersuchung Unterschiede zwischen Rauchern und Nichtrauchern. Die Cystatinaktivität bei natürlicher Gingivitis war bei Rauchern geringer als bei Nichtrauchern. Bei Rauchern veränderten sich die Cystatinaktivität und der Cystatin-C-Spiegel beim Übergang von natur,rlicher Gingivitis zu gingivaler Gesundheit nicht. Am Ende der experimentellen Gingivitis von 14 Tagen war bei Rauchern eine Abnahme der Cystatinaktivität und des Cystatin C sowie ein geringerer Ausstoss von Cystatinaktivität und Cystatin C zu beobachten. Schlußfolgerungen: Rauchen ist geringerer Cystatinaktivität und geringerer Cystatin-C-Ausschüttng während gingivaler Entzündung assoziiert. Résumé Origine: De récentes études montrent que des sujets présentant des gingivites ou des parodontites naturelles ont des niveaux élevés de cystatines salivaires par rapport aux individus au parodonte sain. La production glandulaire augmentée de cystatine dans des conditions inflammatoires suggère un rôle actif, voire vraissemblablement protecteur, de ces protéines lors des processus inflammatoires. De plus, il a été montré que le développement de l'inflammation gingivale est supprimé chez le fumeur lors des gingivites expérimentales. But: Le but de cette étude était de rechercher si (i) le niveau de cystatine salivaire lors des gingivites naturelles est en relation avec le tabagisme et (ii) d'étudier si une gingivite expérimentale est associée une modification des niveaux salivaire de cystatine, chez les fumeurs et chez les non-fumeurs. Matériaux et méthodes: Des échantillons de salive totale était prélevés lors de gingivite naturelle, sur des patients avec des gencives saines, et lors de gingivites expérimentales sur 14 jours chez 25 étudiants (n'étudiant pas la chirurgie dentaire) (14 non-fumeurs et 11 fumeurs). Le taux de flux salivaire a été déterminé. Les échantillons furent étudiés pour les niveaux en protéine, cystatine et cystatine C. Resultats: Le flux salivaire, et les concentrations en protéines dans les échantillons de salive totale clarifiée des fumeurs et des non-fumeurs, ne présentaient aucune différence à aucun moment de l'étude. Pour la cystatine, les résultats montraient que lors des gingivites naturelles, l'activité de cette cystatine était moindre chez les fumeurs, et chez ces derniers, la résolution de cette gingivite vers l'état de santé gingivale n'entrainait pas de modifications de l'activité de la cystatine, ni du niveau de cystatine C. À la fin des 14 jours de gingivite expérimentale, les fumeurs montraient une diminution de l'activité de la cystatine et de la cystatine C ainsi qu'une diminution de la production de l'acitivité de la cystatine et de la cystatine C. Conclusion: Le tabagisme est associé avec une diminution de l'activité de la cystatine et une diminution de la production de cystatine C pendant l'inflammation gingivale. [source] A study to assess the plaque inhibitory action of a newly formulated triclosan toothpasteJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2001J. Moran Abstract Background/aims: Triclosan containing toothpastes have been noted for their potential to inhibit plaque and gingival inflammation. The aim of this study was to determine whether a toothpaste containing triclosan and an enhanced fluoride system would inhibit de novo plaque formation beyond that of a non-triclosan, conventional fluoride toothpaste. Methods: This study used a 4-day plaque regrowth model in which 24 volunteers used toothpaste rinses as the only form of oral hygiene. Following a prophylaxis and a single brushing with the toothpastes, 2× daily rinsing with toothpaste slurries was used over the following 96 h. Results: After 24 h, there was no difference in plaque area between the triclosan paste and its control paste. After 96 h, a reduction in plaque score of 5% was noted for the test toothpaste compared to the control paste which was statistically significant (p=0.028). For plaque area this reduction was increased to 16%, which was also significant (p=0.006). Conclusions: These findings would appear to warrant further investigation into the potential value of the paste in inhibiting both plaque and gingivitis. [source] Resolution of interdental inflammation with 2 different modes of plaque controlJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2000Thomas Kocher Abstract Background, aims: The aim of the study was to assess the effect on existing plaque and gingivitis of an oral hygiene regimen which utilizes triclosan/copolymer and to compare it with a regimen which uses interdental cleaning devices to control the interdental inflammation. Method: For this investigation, 39 subjects were recruited. They were examined for plaque and gingivitis using the criteria of Turesky modification of the Quigley-Hein index and the papillary bleeding index. Plaque and gingivitis were only scored interdentally. Following the baseline examination, the subjects were randomly assigned into 2 groups. The control group used a dentifrice identical to the test dentifrice but without triclosan/copolymer; subjects in this group were taught to brush their teeth with the modified Bass technique and were instructed to additionally use appropriate interdental cleaning devices. The test group used a dentifrice containing triclosan/copolymer (Colgate Total). They were not instructed to use interdental cleaning devices. Results: Both groups were re-examined after 4 weeks, and 4 and 7 months. In both groups, plaque and gingivitis levels were modestly reduced, more pronounced in the anterior and less in the posterior teeth. Conclusions: This investigation demonstrated that a dentifrice containing triclosan in combination with a copolymer can reduce plaque and gingival inflammation to levels comparable to regular interdental cleaning. [source] Factors affecting human supragingival biofilm composition.JOURNAL OF PERIODONTAL RESEARCH, Issue 4 2009Background and Objective:, Little is known about the factors that affect the microbial composition of supragingival biofilms. This study was designed to examine the relationship between total DNA probe counts of supragingival biofilm samples, clinical parameters and supragingival biofilm composition. Material and Methods:, Supragingival plaque samples were taken from 187 systemically healthy adult subjects (n = 4745 samples). All samples were individually analyzed for their content of 40 bacterial species using checkerboard DNA,DNA hybridization. The relationship between total DNA probe counts and microbial composition was examined by subsetting the data into 10 groups based on 10 percentile increments of the total DNA probe counts. Differences among groups in terms of species counts and proportions were sought, as well as relationships of total plaque DNA probe count and clinical parameters. Results:, There was a wide distribution in mean total DNA probe counts among the 187 subjects. With increasing total plaque levels there was a change in the proportions of individual species and microbial complexes. ,Small plaques' were characterized by high proportions of species in the yellow, orange, purple and ,other' complexes; plaques of moderate mass were characterized by high proportions of Actinomyces and purple complex species, while ,large plaques' exhibited increased proportions of green and orange complex species. Measures of gingival inflammation, pocket depth and recession were significantly positively associated with total DNA probe counts. Increased plaque numbers were related to increased pocket depth irrespective of presence or absence of gingival inflammation. Conclusion:, The proportions of individual species and microbial complexes in supragingival biofilms are influenced by the total numbers of organisms in the biofilm. [source] Areca nut extract represses migration and differentiation while activating matrix metalloproteinase-9 of normal gingival epithelial cellsJOURNAL OF PERIODONTAL RESEARCH, Issue 5 2008Y-H Tseng Background and Objective:, Areca (betel) chewing is associated with an increase in the incidence of periodontal diseases. Aberrations in matrix metalloproteinase (MMP) expression have been reported to be associated with periodontal disease. This study investigated the effects of areca nut extract on MMP activity and the phenotype of human gingival epithelial cells. Material and Methods:, Reverse transcription-polymerase chain reaction, western blotting and gelatin zymography were used to assay MMPs. Cell viability, mobility and detachment assays were performed to characterize the phenotypic impact. Confocal microscopy was employed to evaluate cell aggregation and the distribution of E-cadherin and F-actin. Results:, Treatment of gingival epithelial cells with 10 µg/mL of areca nut extract reduced its cell viability. Treatment with 5 and 10 µg/mL of areca nut extract for 24 h activated MMP-9 but not MMP-2 in gingival epithelial cells. This activation could be nuclear factor-,B dependent and was abrogated by 10 µm curcumin. Areca nut extract also reduced the migration and detachment of gingival epithelial cells. The differentiated cell,cell contact of gingival epithelial cells was markedly impaired by areca nut extract. This was accompanied by a disruption of distribution of E-cadherin and F-actin. Conclusion:, The areca nut extract-mediated activation of MMP-9 in gingival epithelial cells could signify a potential periodontal pathogenesis in areca chewers. The areca nut extract-mediated inhibition of cell viability and migration, together with the changed aggregation in gingival epithelial cells, suggests that impairment of the re-epithelization underlies the process and this, in turn, might exacerbate gingival inflammation. [source] Expression of metalloproteinases and their tissue inhibitors in inflamed gingival biopsiesJOURNAL OF PERIODONTAL RESEARCH, Issue 5 2008L. D. R. Gonçalves Objectives:, Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are known to be involved in the periodontal disease process. Results of in vivo MMPs and TIMPs gene expressions in the gingiva, though, are still controversial. In the present study, we compared the gene expression of MMP-1, -2, -9, -13 and TIMP-1, -2 in healthy and inflamed gingiva. Methods:, 38 gingival samples were collected from gingivitis (n = 10), advanced chronic periodontitis (n = 10), generalized aggressive periodontitis (n = 8) and periodontally healthy individuals (n = 10). Total RNA isolated from those samples was subjected to reverse transcription followed by amplification by polymerase chain reaction (RT-PCR). Products were visualized in agarose gels and quantified by optical densitometry. Samples were also processed for gelatin zymography and Western blotting for MMP-2 and MMP-9 in order to assess for post-transcriptional MMP regulation at the protein level. Results:, The frequencies and levels of transcripts encoding MMPs and TIMPs were found to be not significantly different among groups (p > 0.05, Fisher's Exact and Kruskall-Wallis tests). There is a trend towards higher MMP-2 and -9 gelatinase activities in the inflamed samples, although not statistically significant. In contrast, zymography and Western blotting studies show that MMP-2 is virtually absent in the chronic periodontitis group. Conclusion:, These results could reflect a complex regulation of MMPs and TIMPs' gene expression in the course of gingival inflammation. They also reveal a great biological diversity even among individuals with similar periodontal status. [source] Periodontitis and premature death: a 16-year longitudinal study in a Swedish urban populationJOURNAL OF PERIODONTAL RESEARCH, Issue 4 2007B. Söder Background and Objective:, Growing experimental evidence implicates chronic inflammation/infection due to periodontal diseases as a risk factor for death. The objective was to evaluate the role of periodontitis in premature death in a prospective study. Methods:, The causes of death in 3273 randomly-selected subjects, aged 30,40 years, from 1985 to 2001 were registered. At baseline, 1676 individuals underwent a clinical oral examination (Group A) and 1597 did not (Group B). Mortality and causes of death from 1985 to 2001 were recorded according to ICD-9-10. Results:, In Groups A (clinically examined group) and B, a total of 110 subjects had died: 40 subjects in Group A, and 70 in Group B. In Group A significant differences were present at baseline between survivors and persons who later died, with respect to dental plaque, calculus, gingival inflammation and number of missing molars in subjects with periodontitis (p < 0.001). The multiple logistic regression analysis results of the relationship between being dead (dependent variable) and several independent variables identified periodontitis with any missing molars as a principal independent predictor of death. Conclusions:, Young individuals with periodontitis and missing molars seem to be at increased risk for premature death by life-threatening diseases, such as neoplasms, and diseases of the circulatory and digestive systems. [source] Hypothalamic-pituitary-adrenal axis activation by experimental periodontal disease in ratsJOURNAL OF PERIODONTAL RESEARCH, Issue 5 2001T. Breivik Organisms respond to inflammatory conditions by mounting a co-ordinated complex series of adaptive responses involving the immune, nervous and endocrine systems that are aimed at restoring the homeostatic balance. We have recently shown in a rat model that inappropriate hypothalamic-pituitary-adrenal (HPA) axis regulation and a subsequent inability to mount a suitable glucocorticoid response to gingival inflammation may influence susceptibility to periodontal disease. This study was designed to investigate whether ligature- and bacterial lipopolysaccharide (LPS)-induced inflammation in the gingival connective tissues may activate this physiological axis, and to further explore the significance of HPA regulation in periodontal disease. Experimental periodontal disease was induced in major histocompability complex (MHC)-identical but HPA low (LEW) and high (F344) responding rat strains. We tested (1) whether ongoing periodontal disease activates the HPA axis as measured by corticosterone levels, and (2) whether genetic differences in HPA regulation modulate periodontal disease progression. In the F344 strain, the periodontal tissue destruction was more severe. This observation was associated with a significant increase of corticosterone levels in F344 rats only. Addition of LPS at the gingival inflammatory site led to a further increase of corticosterone levels and disease severity in F344 rats. These findings illustrate a positive feedback loop between the HPA axis and periodontal disease: the disease activates the HPA axis, and a genetically determined high HPA responsitivity further increases disease susceptibility. [source] | ||||||||||