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PPD
Kinds of PPD Terms modified by PPD Selected Abstractsp -Phenylenediamine sensitization is more prevalent in central and southern European patch test centres than in Scandinavian: results from a multicentre studyCONTACT DERMATITIS, Issue 6 2009Jacob Pontoppidan Thyssen Background:, Positive patch test reactions to p -phenylenediamine (PPD) are common. PPD is used in oxidative hair dyes and is also present in dark henna temporary ,tattoos'. Cross-sensitization to other contact allergens may occur. Because subjects sensitized to PPD are at risk of clinically severe reactions upon hair dyeing, there is a need for ,current' prevalence data on PPD sensitization. Objectives:, To compare PPD patch test results from dermatitis patients tested between 2003 and 2007 in 10 European patch test centres and to analyse the causes and determine relevance of positive PPD patch test reactions. Materials:, Patch testing was performed using PPD (1% free base in petrolatum from Trolab (Almirall Hermal GmbH, Reinbeck, Germany) or Chemotechnique (Malmö, Sweden), equivalent to 0.090 mg/cm2 in the TRUE® test from MEKOS Laboratories AS). Statistical analysis was performed using the chi-squared test. Results:, The weighted average prevalence was 4.6% among 21 515 patients. PPD sensitization occurred more often in centres located in Central and Southern Europe than in Scandinavian centres (odds ratio = 2.40; 95% confidence interval = 2.07,2.78). The overall proportion of positive patch test reactions to PPD that were registered as being of either current or ,past' relevance was high (weighted average 53.6% and 20.3%, respectively). Consumer hair dyeing was the most prominent cause of PPD sensitization (weighted average 41.8%). Furthermore, occupational hair dye exposure (10.6%) and cross-sensitization to textile dyes (12.6%) were frequently reported. Conclusions:, PPD sensitization caused by exposure to hair dyes is frequent and remains a present problem for patients visiting contact dermatitis clinics, especially in patch test centres located in Central and Southern Europe. [source] Epidemiological data on consumer allergy to p -phenylenediamineCONTACT DERMATITIS, Issue 6 2008Jacob Pontoppidan Thyssen Many women and men now dye their hair. p-Phenylenediamine (PPD) is a frequent and important component of permanent hair dye products; exposure to it may cause allergic contact sensitization, acute dermatitis, and severe facial oedema. To increase our understanding of PPD allergy, we reviewed published literature containing PPD patch test data from dermatitis patients and individuals in the general population. This was performed to estimate the median prevalence and the weighted average of PPD sensitization and thereby assess the burden of PPD-containing hair care products on health. Literature was examined using PubMed,MEDLINE, Biosis, and Science Citation Index. The median prevalence among dermatitis patients was 4.3% in Asia, 4% in Europe, and 6.2% in North America. A widespread increase in the prevalence of PPD sensitization was observed among Asian dermatitis patients. In Europe, a decrease in the 1970s was replaced by a plateau with steady, high prevalences ranging between 2% and 6%. The prevalence remained high in North America, although a decreasing tendency was observed. Contact allergy to PPD is an important health issue for both women and men. More stringent regulation and enforcement are required as public health measures to reduce the burden of disease that exposure to PPD has brought to populations. [source] Reactivity of in vitro activated human T lymphocytes to p -phenylenediamine and related substancesCONTACT DERMATITIS, Issue 4 2008Claudia Skazik Background:, Patch tests to p -phenylenediamine (PPD) and related substances often show concurrent reactions that can be attributed to separate sensitization or cross-reactivity. Objectives:, In order to understand the health risks associated with cross-reactivity, we studied cross-reactivity of eight chemicals in vitro by measurement of T-cell proliferation of peripheral blood mononuclear cells (PBMC), T-cell lines (TCL), and T-cell clones (TCC) of subjects with a positive patch test result to PPD. Patients/Methods:, We studied PBMC from 13 patients and were able to generate TCL from seven and TCC from four patients. Their proliferative responses to the chemicals were estimated. Results:, Concurrent reactions to these compounds on the polyclonal and monoclonal level were found. A restricted T-cell receptor (TCR) V,16-usage was observed (5/8 clones). A detailed analysis of 34 TCL showed broad cross-reactivity (64.7%) between PPD, p -toluenediamine, Bandrowski's Base, and p -aminoazobenzene. More restricted patterns were found in 8.8%, which responded only to compounds with two or three benzene rings, whereas 26.5% of the clones reacted specifically only to one compound. Conclusion:, More than 60% of the clones showed a broad cross-reactivity pattern. Hence, clinically observed cross-reactivity between different para-amino compounds can be based on a TCR recognizing similar epitopes of these compounds with low specificity. [source] Intermittent exposure to low-concentration paraphenylenediamine can be equivalent to single, higher-dose exposureCONTACT DERMATITIS, Issue 5 2007Jonathan M. L. White Hair dye allergy is an important and increasingly common cause of allergic contact dermatitis. The role of repeated exposure in elicitation of allergy has not previously been extensively studied. We have therefore compared elicitation between single and intermittent exposure to paraphenylenediamine (PPD). 23 subjects known to be allergic to PPD from positive patch tests were exposed to 0.3% and 0.03% PPD, both in petrolatum and water, for 5 min at the same site every day for up to 8 D. In the same subjects, single exposures were also performed at different sites, from 5 to 40 min. Other experiments exposed rat skin to radiolabelled PPD as one-off application or multiple exposures. There were 8 reactions in the cumulative exposure site using 0.3% PPD in aqueous solution. In 7 of these, there was an exact correlation with reaction to the cumulative time needed for repeat exposures to elicit a reaction and the time needed for a reaction to the single exposure. There were no reactions to 0.03% PPD in water or pet under either type of exposure condition. There was also a positive correlation between grade of original reaction in clinic (+++, ++, +) and appearance/intensity of elicitation reactions. In the animal study, cumulative time and single exposure time sites correlated with regards to retention of radiolabelled substance within the skin. This study therefore demonstrates for the first time that, over the time period tested, the allergenic component of PPD accumulates in the skin. Hence, intermittent exposure to lower concentrations of PPD may be equivalent to higher concentration, one-off exposure. [source] Allergic contact dermatitis from hair dye and development of lichen simplex chronicusCONTACT DERMATITIS, Issue 1 2004Won Young Chey Those who dye their hair frequently manifest allergic contact dermatitis (ACD) from p -phenylenediamine (PPD)-containing hair dye. PPD is known to be the most frequent sensitizer in hair dye, but there has been no documentation of this sensitizer having a role in chronic dermatologic conditions. Our department experienced a case of a 62-year-old woman with lichen simplex chronicus (LSC), who complained of aggravation after hair dyeing and made such an association. We conducted a prospective and retrospective study to further evaluate the clinical associations between the two. In our prospective study, patch testing was performed in selected patients who regularly carried out hair dyeing and also had clinical manifestations of LSC. Also a retrospective examination was conducted in cases where patch testing had been performed with PPD in the past for suspected ACD and further selected cases with concurrent LSC and/or other neurodermatitis. 11 and 14 patients in our prospective and retrospective study, respectively, presented with both LSC and positive findings to PPD. 5 (45.5%) and 4 (28.6%) patients in our prospective and retrospective study showed clinical relevance from clinical improvement after stopping use and rechallenge. We report several cases of patients diagnosed as having LSC and/or prurigo nodularis who showed clinical improvement after discontinuing the use of hair dye. The suggestion can therefore be made that hair dye could be a possible aetiologic agent causing LSC in those using hair dyes. [source] Hair dye contact allergy: quantitative exposure assessment of selected products and clinical casesCONTACT DERMATITIS, Issue 6 2004Heidi SØsted Colouring of hair can cause severe allergic contact dermatitis. The most frequently reported hair dye allergens are p -phenylenediamine (PPD) and toluene-2,5-diamine, which are included in, respectively, the patch test standard series and the hairdressers series. The aim of the present study was to identify dye precursors and couplers in hair dyeing products causing clinical hair dye dermatitis and to compare the data with the contents of these compounds in a randomly selected set of similar products. The patient material comprised 9 cases of characteristic clinical allergic hair dye reaction, where exposure history and patch testing had identified a specific hair dye product as the cause of the reaction. The 9 products used by the patients were subjected to chemical analysis. 8 hair dye products contained toluene-2,5-diamine (0.18 to 0.98%). PPD (0.27%) was found in 1 product, and m -aminophenol (0.015 to 0.38%) and p -aminophenol (0.16 to 2.1%) were found in 3 products. The concentration levels were similar in the patient's products compared to a random sample of 16 hair dye products. The concentration present of toluene-2,5-diamine elicited allergic reactions in concentrations that were 10-fold lower than the legal EU limit of 10%. Hair dye allergy may cause severe clinical reactions, and the current regulation is insufficient in protection of the users. A preventive strategy is needed. [source] FS01.3 Disperse (yes), orange (yes), 3 (no): what do we test in textile dye dermatitis?CONTACT DERMATITIS, Issue 3 2004Christophe J Le Coz Introduction:, Patients sensitized to para-phenylenediamine (PPD) have a high degree of patch test reactivity to Disperse Orange 3 (DO3), and a lesser one to Disperse Red 1 and Red 17. Two successive patients positive to PPD, Disperse Red 1 and 17, negative to DO3 were real eye-openers for our considerations about purity of our current allergen DO3. Materials and methods:, We realized comparative thin-layer chromatography (TLC), with DO3 from Chemotechnique®(DO3-Chem) and Trolab®(both extracted from petrolatum), and "pure" DO3 from two chemical providers. TLC clearly indicated that DO3-Chem was not DO3. HPLC analysis with pure DO3 from Chemotechnique® and comparison of structures by NMR with samples of DO3, revealed that DO3-Chem was Disperse Orange 31 (DO31). In addition, signals through the GERDA network allowed the collection of test materials and observations. Among other members, only 2 used DO3-Chem (from 2 different batches) that was DO31 too, according to TLC Results: According to their data, they observed no or a lower reactivity to DO3 than expected (4 patients DO3-Chem + among 23 PPD+ e.g.). Finally, the error was proved to be due to the provider of the dye to Chemotechnique®, who likely deleted the 1 of Disperse Orange 31 on his packaging. Discussion:, Chemical structure of DO31 indicates a possible in vivo hydrolysis into nitroaniline and a second compound, a substituted PPD derivative that clearly does not frequently react in PPD positive patients. Like drugs, patch tests are submitted to post-commercialization controls. In addition to allergens providers who should enhance their quality controls, dermato-allergologists have to be vigilant, and must active networks when they observe a rare bird. [source] How to make a zone of polarizing activity: Insights into limb development via the abnormality preaxial polydactylyDEVELOPMENT GROWTH & DIFFERENTIATION, Issue 6 2007Robert E. Hill Early in vertebrate limb development, a program initiates that polarizes the limb along the antero-posterior axis. The mesenchyme at the posterior margin is ultimately responsible for the asymmetry due to a region called the zone of polarizing activity (ZPA). The ZPA produces and secretes the molecule SHH, which coordinates the patterning of the resulting digits. Preaxial polydactyly (PPD) is a commonly occurring limb abnormality; investigating the genetic basis of this defect has provided insights into our understanding of digit patterning. PPD disrupts limb asymmetry by producing an ectopic ZPA at the opposite margin of the limb bud. Mutations in the long-range, limb-specific regulatory element of the Shh gene are responsible for the defect. Genetic analysis of this limb abnormality provides an important approach in understanding the mechanisms that control digit patterning. [source] A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum womenACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2009J. Gibson Objective:, The Edinburgh Postnatal Depression Scale (EPDS) is the most widely used screening tool for postpartum depression (PPD). We systematically reviewed the published evidence on its validity in detecting PPD and antepartum depression (APD) up to July 2008. Method:, Systematic review of validation studies of the EPDS included 1987,2008. Cut-off points of 9/10 for possible PPD, 12/13 for probable PPD and 14/15 for APD were used. Results:, Thirty-seven studies met the inclusion criteria. Sensitivity and specificity of cut-off points showed marked heterogeneity between different studies. Sensitivity results ranged from 34 to 100% and specificity from 44 to 100%. Positive likelihood ratios ranged from 1.61 to 78. Conclusion:, Heterogeneity among study findings may be due to differences in study methodology, language and diagnostic interview/criteria used. Therefore, the results of different studies may not be directly comparable and the EPDS may not be an equally valid screening tool across all settings and contexts. [source] Cell proliferation and apoptosis: dual-signal hypothesis tested in tuberculous pleuritis using mycobacterial antigensFEMS IMMUNOLOGY & MEDICAL MICROBIOLOGY, Issue 1 2004Sulochana D. Das Abstract Antigens and mitogens have the innate ability to trigger cell proliferation and apoptosis thus exhibiting a dual-signal phenomenon. This dual-signal hypothesis was tested with mycobacterial antigens (PPD and heat killed Mycobacterium tuberculosis, MTB) in tuberculous pleuritis patients where the immune response is protective and compartmentalized. We compared and correlated the cell-cycle analysis and antigen-induced apoptosis in normal and patients' peripheral blood mononuclear cells (PBMCs) and patients' pleural fluid mononuclear cells (PFMCs). In cell-cycle analysis, PFMCs showed good mitotic response with PPD and MTB antigens where 10% and 7% of resting cells entered the S and G2/M phases of cell cycle, respectively. This antigen-induced proliferation of PFMCs correlated well with the lymphocyte transformation test (LTT) results. On the other hand, PFMCs also showed 21% of spontaneous apoptosis, which further increased to 43%, by induction with known apoptotic agent like Dexamethasone (DEX) and the mycobacterial antigens PPD and MTB. Further we demonstrated by anti-CD3 induction experiments that prior activation of cells is prerequisite for them to undergo apoptosis. Our results showed that PPD and MTB antigens induced both cell proliferation and apoptosis in PFMCs, which were pre-sensitized to mycobacterial antigens in vivo. Thus the dual-signal phenomenon was operative against these antigens in tuberculous pleuritis. We also demonstrated that the activated cells are more predisposed to apoptosis. [source] Long-lasting increased excitability differs in dentate gyrus vs.HIPPOCAMPUS, Issue 3 2002CA1 in freely moving chronic epileptic rats after electrically induced status epilepticus Abstract A paired-pulse (PP) stimulation protocol was used to examine changes in field potentials (fEPSPs), locally evoked in CA1 via Schaffer/commissural fiber stimulation and in the dentate gyrus (DG) through angular bundle stimulation, in freely moving epileptic rats. This epilepsy model is characterized by recurrent spontaneous seizures that occur after a latent period of 1,2 weeks following an electrically induced status epilepticus (SE). In the control period, i.e., before induction of SE, the PP stimulation protocol given at the appropriate intensity evoked fEPSPs with a pronounced paired-pulse depression (PPD). In the acute period, immediately after SE, the fEPSPs in the CA1 and DG areas were generally depressed. During the latent period in the CA1 stratum radiatum, the negative fEPSP was followed by a large positive potential that remained for the rest of the recording period. CA1 PPD, observed during the control period, was changed to paired-pulse facilitation (PPF) that remained for the rest of the recording period. Also during the latent period, a broad late component appeared in DG fEPSPs. The initial decrease in PPD was partly restored in the following weeks. Timm staining at different time points after SE showed an increase of mossy-fiber sprouting in the inner molecular layer within 6 days, which was robust within 6 weeks. We noted Timm granules positioned on parvalbumin immunoreactive neurons in the granule-cell layer of rats that had survived SE, suggesting that restoration of PPD could be partly due to reinnervation of a population of GABAergic neurons. The broad late component of DG fEPSPs, which was sensitive to the NMDA receptor antagonist ketamine, was still present for at least 6 weeks into the chronic epileptic phase, indicating lasting increased excitability. These observed changes indicate a lasting increased excitability in CA1 and DG networks that could play a role in the recurrence of spontaneous seizures. Hippocampus 2002;12:311,324. © 2002 Wiley-Liss, Inc. [source] Differential CD4+ T-cell memory responses induced by two subsets of human monocyte-derived dendritic cellsIMMUNOLOGY, Issue 3 2007Sandra Bajaña Summary Dendritic cells (DC) are powerful inducers of primary T-cell responses, but their role in secondary responses has not been extensively analysed. Here, we address the role of two DC subsets derived from human CD16+ (16+ mDC) or CD16, (16, mDC) monocytes on the reactivation of memory responses. CD4+ CD45RA, memory T cells were obtained from adult blood donors, and central (TCM) and effector (TEM) memory T cells were isolated by fluorescence-activated cell sorting with anti-CCR7 antibodies. The 16+ mDC and 16, mDC were cocultured with autologous lymphocytes, either unpulsed or loaded with purified protein derivatives of Mycobacterium tuberculosis (PPD) or tetanus toxoid (TT), and were analysed for up to 8 days. Over a range of doses, 16+ mDC drove stronger T-cell proliferative responses against both antigens. Overall, antigen-specific memory cells tended to acquire a phenotype of TEM at later time-points in the culture, whereas cells that had completed fewer cycles of division were similar to TCM. The 16+ mDC induced higher rates of proliferation on both TCM and TEM lymphocytes than 16, mDC. This phenomenon was not related to the ability of both DC to induce CD25 expression on T cells, to lower secretion of interleukin-2, or to raise production of interleukin-10 during T-cell/16, mDC cocultures. The induction of TCM effector capacity in terms of interferon-, production was faster and more pronounced with 16+ mDC, whereas both DC had similar abilities with TEM. In conclusion, these data might reveal new potentials in vaccination protocols with 16+ mDC aimed at inducing strong responses on central memory T cells. [source] Oral hygiene practices, periodontal conditions, dentition status and self-reported bad mouth breath among young mothers, TanzaniaINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 4 2006EGS Mumghamba Abstract:,Objectives:,To determine the oral hygiene practices, periodontal conditions, dentition status and self-reported bad mouth breath (S-BMB) among young mothers. Study participants and methods:,This was a cross-sectional descriptive study conducted at Muhimbili National Hospital, Dar es Salaam, Tanzania. A total of 302 postpartum mothers, aged 14,44 years, were interviewed on oral hygiene practices and S-BMB using structured questionnaire. Oral hygiene, dentition and periodontal status were assessed using the Community Periodontal Index probe and gingival recessions (GR) using Williams Periodontal probe. Results:,Tooth brushing practice was 99%; tongue brushing (95%), plastic toothbrush users (96%), chewing stick (1%), wooden toothpicks (76%), dental floss (<1%); and toothpaste (93%). The prevalence of plaque and gingival bleeding on probing was 100%, gum bleeding during tooth brushing (33%), calculus (99%), probing periodontal pocket depth (PPD) 4,5 mm (27%), PPD 6+ mm (3%), GR 1+ mm (27%) and tooth decay (55%). The prevalence of S-BMB was 14%; the S-BMB had higher mean number of sites with plaque compared to the no S-BMB group (P = 0.04). Factors associated with S-BMB were gum bleeding on tooth brushing (OR = 2.4) and PPD 6+ mm (OR = 5.4). Conclusion:,Self-reported bad mouth breath is a cause of concern among young mothers, and associated significant factors were gum bleeding on tooth brushing and deep periodontal pockets of 6+ mm. Further research involving clinical diagnosis of bad mouth breath and intervention through oral health promotion and periodontal therapy are recommended. Clinical relevance:,This study provides baseline information on oral health status and the complaint on bad mouth breath which necessitates in the future need for objective assessment, diagnosis and management of bad mouth breath for enhanced social and professional interaction without embarrassments. [source] Unusual case of cutaneous tuberculosis associated with rheumatoid arthritis: a case report and literature reviewINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 12 2002G. Faghihi MD We report a 47-year-old female patient with a 10-year history of rheumatoid arthritis who presented with painful ulcerative plaques on the extremities at our clinic in St. Zahra University Hospital on February 2001. These plaques, diagnosed as cutaneous leishmaniasis, were 2 years old, but the patient was without any cure from the specific treatment she had been prescribed. Later, these skin lesions were misdiagnosed as pyoderma gangrenosum and she was treated by high-dose oral prednisolone, but she did not improve at all. After she was referred to our clinic, routine laboratory tests, PPD, chest X-ray and skin biopsy with tissue cultures were carried out. Finally, her cutaneous lesions turned out to be cutaneous tuberculosis, which responded successfully to antituberculosis treatment. [source] Erythema induratum with pulmonary tuberculosis: histopathologic features resembling true vasculitisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2001Yong Suk Lee MD A 22-year-old South Korean woman presented with a 4-month history of several nodules on both legs. She looked healthy, but suffered from tenderness and swelling of the legs. Physical examination showed multiple, nonulcerating, erythematous nodules occurring on the calves, knee joints, and thighs (Fig. 1). A biopsy specimen of the skin revealed necrotizing vasculitis of medium-sized arteries with fibrinoid necrosis at the border between the dermis and the subcutis. Dense cellular infiltrates, including numerous neutrophils and lymphocytes, presented within and around the vessel walls as in polyarteritis nodosa, with some eosinophils (Fig. 2A,B). There were no other generalized symptoms. She was diagnosed with cutaneous polyarteritis nodosa and was initially treated with systemic steroids. She was given an intravenous injection of Solu-Cortef, 60 mg/6 h for 7 days. This was replaced with oral prednisolone for 2 weeks. The skin lesions and symptoms improved. Figure 1. Small, nut-sized, erythematous, brown-colored nodules and patches on the lower extremities, even above the knee joints Figure 2. (A) Dense infiltration within and around artery (× 40). (B) Slightly expanded lobular panniculitis with vasculitis (× 100) Six months later, she complained of general weakness and recurrent skin lesions. Purified protein derivative (PPD) test gave a moderate positive reaction and chest X-ray examination showed the features of pulmonary tuberculosis: radio-opaque infiltrations in the right lower lung field. A repeated biopsy revealed mild vasculitis with more diffuse lobular infiltrations of the subcutaneous tissue compared with the former specimen. Polymerase chain reaction (PCR) and tissue culture for Mycobacterium tuberculosis were performed from a biopsy specimen. DNA was extracted from skin tissue with an AplisystemTM DNA/RNA detection kit using the resin-mediated boiling method (Stargene, Seoul, South Korea). The primers were designed on the basis of the M. tuberculosis gene IS6110 target (sense primer, 5,-CCA GAT GCA CCG TCG AAC GGC TGA T-3, antisense primer, 5,-CGC TCG CTG AAC CGG ATC GAT GTG T-3,). The amplification was performed with uracil- N -glycosylase (UNG), to prevent carry-over contamination, and internal control primers, to correct for false-negative reaction (Kox LF, Rhienthong D, Miranda AM et al. A more reliable PCR for detection of Mycobacterium tuberculosis in clinical samples. J Clin Microbiol 1994; 32: 672,678; Longo MC, Berninger MS, Hartley JL. Use of uracil DNA glycosylase to control carry-over contamination in polymerase chain reactions. Gene 1990; 93: 125,128). According to the manufacturer's instructions, amplification was carried out for 40 cycles with denaturation at 94 °C for 40 s, annealing at 70 °C for 1 min, and extension at 72 °C for 1 min in a thermal cycler (Perkin,Elmer Cetus, Norwalk, CT, USA). The results of PCR and tissue culture for M. tuberculosis using the biopsy specimen were all negative (Fig. 3). Figure 3. Negative result in PCR for M. tuberculosis (negative control is not shown; M, marker; P, positive control; I, internal control; S, specimen) The patient was finally diagnosed with erythema induratum with pulmonary tuberculosis and was started on antituberculosis medication (isoniazid 400 mg, rifampicin 600 mg, ethambutol 800 mg, and pyrazinamide 1500 mg daily). She showed prompt improvement after 2 weeks of medication. After 9 months of antituberculosis therapy, her skin lesions and chest X-ray had cleared. She was followed up for 4 months with no recurrence of skin and pulmonary lesions. [source] Persecutory symptoms and perceptual disturbance in a community sample of older people: the Islington studyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2001G. Livingston Abstract Background While there are extensive studies of paranoid symptoms and perceptual disturbance (PPD) in younger adults, relatively little is known about older adults with similar symptoms. Method This study took place in Islington, an inner London borough. Enumeration Districts were randomised to provide a sampling frame. Residents aged 65 or over were interviewed at home. The Short-CARE was used to elicit psychiatric symptoms and diagnosis. Sociodemographic particulars were elicited using the Client Sociodemographic and Service Receipt Inventory. Questions were asked regarding sight and hearing. We used subsections of the geriatric mental scale to identify people who had PPD symptoms. Medications taken were recorded. We asked ,Do you have any health problems?' as a screening question for subjective health problems. Results We interviewed 720 people. Twenty-eight (3.9%) participants scored positively on the PPD sub-scales of the GMS. A forward logistic regression analysis for independent predictors of PPD found the significant independent predictors were dementia (p,=,0.0000; odds ratio 6.8), drinking alcohol in last 6 months (p,<,0.03; odds ratio 0.3), drinking alcohol to help sleep (p,<,0.005; odds ratio 9.6), subjective memory loss (p,<,0.007; odds ratio 3.3) and uncorrected visual impairment (p,<,0.02; odds ratio 2.8). Conclusion There is a relatively high prevalence of PPD in older people living in the community. This is not associated with higher use of services despite the increased needs. Further studies should consider interventions to meet this unmet need. Copyright © 2001 John Wiley & Sons, Ltd [source] The Effects of Plant Population Density on the Growth and Chemical Composition of Lablab purpureus Grown for Fodder Production in a Semi-Arid RegionJOURNAL OF AGRONOMY AND CROP SCIENCE, Issue 2 2001Y. Shehu Lablab purpureus was grown in two 6-month field experiments in the Savannah region of Africa, with high rainfall and hot temperatures in the first 2 months, followed by low rainfall and cool temperatures until harvesting in January. The experiments evaluated the effects of plant population density (PPD), using rows at 70-, 110- and 150-cm intervals, on the yield and nutritive value of the crop, and the effect of an interim harvest on response to PPD. Lablab yield ha,1 was increased to a greater extent by an increase in PPD from 110 to 70 cm interrow spacing than by an increase from 150 to 110 cm, and yield plant,1 decreased as PPD increased to a greater extent for double-harvested than for single-harvested plants. This suggested that high PPD in the early stages of growth is important to promote high crop yields in this environment, probably because it mitigates drought effects in autumn. The effects of PPD on herbage composition were small and suggested that plant maturity had not been greatly affected by density. It is concluded that the maintenance of plant cover in the early stages of growth is important for high yields in the Savannah region, which can be achieved by an interrow spacing of no more than 70 cm and avoidance of an interim harvest. Die Einflüsse der Bestandesdichte auf Wachstum und chemische Zusammensetzung von Lablab purpureus im Anbau zur Futterproduktion in einer semiariden Region Lablab purpureus wurde in zwei 6 Monate andauernden Feldexperimenten in der Savannenregion von Afrika angebaut, wobei hoher Regenfall und hohe Temperaturenin den ersten beiden Monaten, gefolgt durch niedrigen Regenfall und kühle Temperatur bis zur Ernte im Januar vorherrschten. Die Experimente wurden im Hinblick auf die Einflüsse der Bestandesdichte (PPD) ausgewertet, wobei Reihenabstände von 70, 110 und 150 cm hinsichtlich des Ertrages und des Nährwertes des Bestandes und des Einflusses auf eine Zwischenernte in Abhängigkeit von PPD untersucht wurden. Der Lablab -Ertrag/ha war stärker durch Zunahmen in PPD von 110,70 cm Reihenabständen erhöht als bei Abständen von 150,110 cm; in diesem Fall nahm der Ertrag je Pflanze mit einer Zunahme von PPD für zweifache Ernte stärker zu als bei Pflanzen mit einmaliger Aberntung. Dies lässt vermuten, dass hohe PPD in frühen Stadien des Wachstums bedeutend ist für die Förderung des Bestandesertrages in dieser Umwelt, da wahrscheinlich Trockeneinflüsse im Herbst abschwächt werden. Die Einflüsse von PPD auf die Spross-Zusammensetzung war gering und lässt vermuten, dass die Pflanzenreife kaum von der Bestandesdichte abhängig ist. Es wird angenommen, dass der Halt der Pflanzenbedeckung in den frühen Stadien des Wachstums Bedeutung für hohe Erträge in der Savannenregion hat; dies kann mit Reihenabständen nicht über 70 cm und dem Vermeiden einer Zwischenernte erreicht werden. [source] Effects of Plant Population Density and Intercropping with Soybean on the Fractal Dimension of Corn Plant Skeletal ImagesJOURNAL OF AGRONOMY AND CROP SCIENCE, Issue 2 2000K. Foroutan-pour Three-year field experiments were conducted to determine whether the temporal pattern of fractal dimension (FD) for corn (Zea mays L.) plant structure is altered by plant population density (PPD) or intercropping with soybean [Glycine max. (L.) Merr.], and how changes in the FD are related to changes in other canopy characteristics. Plants in monocropped corn and intercropped corn,soybean plots were randomly sampled and labelled for later identification. Corn plant structure was photographed from the side that allowed the maximum appearance of details (perpendicular to the plane of developed leaves) and from two fixed sides (side 1: parallel to the row and side 2: perpendicular to the row). Images were scanned and skeletonized, as skeletal images provide acceptable information to estimate the FD of plant structure two-dimensionally by the box-counting method. Differences in the FD estimated from images taken perpendicular to the plane of developed leaves were not significant among competition treatments. An adjustment of corn plants to treatments, by changing the orientation of the plane of developed leaves with respect to the row, was observed. Based on overall FD means, competition treatments were ranked as: high > normal , intercrop , low for side 1 and intercrop > low , normal > high for side 2. Leaf area index (LAI) and plant height had a positive correlation with FD. In contrast, light penetration had a negative correlation with FD. In conclusion, FD provides a meaningful and effective tool for quantifying corn plant structure, measuring the structural response to cultural practices, and modelling corn plant canopies. Zusammenfassung Folgende Ziele der Untersuchungen wurden berücksichtigt: 1) Eine geeignete Methode für die Abschätzung der Anteile (FD) 2-dimensional für Pflanzen mit einer einfachen dreidimensionalen Vegetationsstruktur wie z. B. Mais (Zea mays L.) zu bestimmen; 2) der Frage nachzugehen, ob die zeitlichen Muster von FD bei der Maispflanzenstruktur durch die Bestandesdichte verändert wird (PPD: low, normal und hoch) oder in Mischanbau mit Sojabohnen (Glyzine max. L.) Merr.); und 3) in welcher Beziehung Änderungen in der FD in der Maispflanzenstruktur zu Änderungen in anderen Bestandeseigenschaften stehen. Pflanzen im Reinanbau von Mais und im Mischanbau in Mais-Sojabohnen-Parzellen wurden randomisiert gesammelt und für die spätere Identifikation gekennzeichnet. Die Maispflanzenstruktur wurde von der Seite fotografiert, so dai eine maximale Darstellung der Details (perpendiculär zu der Ebene der entwickelten Blätter) und von zwei festgelegten Seiten (Seite 1: parallel zur Reihe und Seite 2 perpendikulär zur Reihe) verfügbar war. Die Abbildungen wurden gescannt und skelettiert; Skelettabbildungen geben eine akzeptierbare Information zur Abschätzung von FD Pflanzenstrukturen in zweidimensionaler Form über die Box-counting-Methode. Unterschiede in der FD, die sich aus Bildern mit einer perpendikulären Aufnahme zu der Ebene der entwickelten Blätter ergaben, waren nicht signifikant innerhalb der Konkurrenzbehandlungen. Eine Anpassung der Maispflanzen an die Behandlungen durch Änderungen der Orientierung zur Ebene der entwickelten Blätter im Hinblick auf die Reihe, wurde beobachtet. Auf der Grundlage von gesamt FD-Mittelwerten ergab sich, dai Konkurrenzbehandlungen in folgender Reihe auftraten: Hoch (1,192) > (1,178) , zu Mischanbau (1,177) , zu gering (1,170) für Seite 1 und bei Mischanbau (1,147) > gering (1,158) , (1,153) > hoch für Seite 2. Der Blattflächenindex (LAI) und die Pflanzenhöhe hatten eine positive Korrelation zu FD. Im Gegensatz dazu wies die Lichtpenetration eine negative Korrelation zu FD auf. Es kann festgestellt werden, dai FD eine aussagekräftige und zweckmäiige Methode ist, die Maispflanzenstruktur zu quantifizieren, Strukturreaktionen zum Anbauverfahren zu messen und Maispflanzenbestände zu beschreiben. [source] Investigation on characterization and transfection of a novel multi-polyplex gene delivery systemJOURNAL OF APPLIED POLYMER SCIENCE, Issue 2 2007Yu Nie Abstract pDNA was condensed by polycationic peptide polylysine (PLL) to form a core, and then encapsulated in biodegradable monomethoxy (poly ethylene glycol)-poly(lactide- co -glycolide)-monomethoxy (poly ethylene glycol) (PELGE) to form core-shell nanoparticles (NPs) as a novel multi-polyplex gene delivery system,PPD(PELGE-PLL-DNA). NPs were prepared by a double emulsification-solvent evaporation technique, using F68 (Pluronic F68, namely Poloxamer 188) as surfactant (not traditional stabilizer PVA), and characterized by morphology, particle size, zeta potential, nuclease, and sonication protection ability, as well as transfection efficiency. Results showed that PPD had a regular spherical shape, with an average diameter of 155 ± 2.97 nm and a zeta potential of ,25.6 ± 1.35 mV. PPD could protect plasmid DNA from nuclease degradation and sonication during preparation, while the transfection efficiencies in HepG2 cells and Hela cells were much higher than that of NPs without PLL. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci, 2007 [source] Periodontal disease progression and glycaemic control among Gullah African Americans with type-2 diabetesJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2010Dipankar Bandyopadhyay Bandyopadhyay D, Marlow NM, Fernandes JK, Leite RS: Periodontal disease progression and glycaemic control among Gullah African Americans with type-2 diabetes. J Clin Periodontol 2010; 37: 501,509. doi: 10.1111/j.1600-051X.2010.01564.x. Abstract Aim: To evaluate associations between glycaemic control and periodontitis progression among Gullah African Americans with type-2 diabetes mellitus (T2DM). Materials and Methods: From an ongoing clinical trial among T2DM Gullah, we extracted a cohort previously in a cross-sectional study (N=88). Time from baseline (previous study) to follow-up (trial enrollment, before treatment interventions) ranged 1.93,4.08 years [mean=2.99, standard deviation (SD)=0.36]. We evaluated tooth site-level periodontitis progression [clinical attachment loss (CAL) worsening of 2 mm, periodontal probing depth (PPD) increases of 2 mm and bleeding on probing (BOP) from none to present] by glycaemic control status (well-controlled=HbA1c<7%, poorly-controlled=HbA1c7%) using multivariable generalized estimating equations logistic regression, nesting tooth sites/person. Results: Poorly-controlled T2DM (68.18%) was more prevalent than well-controlled T2DM (31.82%). Proportions of tooth sites/person with CAL progression between baseline and follow-up ranged 0.00,0.59 (mean=0.12, SD=0.12), while PPD and BOP progression ranged 0.00,0.44 (mean=0.09, SD=0.11) and 0.00,0.96 (mean=0.24, SD=0.18), respectively. Site-level PPD at baseline was a significant effect modifier of associations between poorly-controlled T2DM and site-level CAL and PPD progression [adjusted odds ratios (OR) according to poorly-controlled T2DM among PPD at baseline=3, 5 and 7 mm, respectively: CAL progression=1.93, 2.64, and 3.62, PPD progression=1.98, 2.76, and 3.84; p<0.05 for all]. Odds of site-level BOP progression were increased (OR=1.24) for poorly-controlled T2DM, yet the results were not significant (p=0.32). Conclusions: These findings from a distinct, homogenous population further support the clinical relevance of identifying patients with poor glycaemic control and periodontitis, particularly among those with disparities for both diseases. [source] Salivary interleukin-1, concentration and the presence of multiple pathogens in periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2009Ulvi Kahraman Gursoy Abstract Aim: This study aimed to find salivary enzymes and/or cytokines that would reflect periodontitis, alone or in combination with salivary microbial markers. Material and Methods: The salivary concentrations of elastase, lactate dehydrogenase, interleukin-1, (IL-1,), interleukin-6, and tumour necrosis factor- ,, and the presence of five periodontal pathogens, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola, were analysed from salivary specimens of 165 subjects, a subpopulation of Health 2000 Health Examination Survey in Finland; 84 of the subjects had probing pocket depth (PPD) of 4 mm at 14 or more teeth (the advanced periodontitis group), while 81 subjects had no teeth with PPD of 4 mm (the control group). All subjects had at least 20 teeth and no systemic diseases. Results: Among the salivary cytokines and enzymes tested, IL-1, was the only biomarker associated with periodontitis. An association was also found with the presence of multiple periodontal pathogens. Salivary IL-1, and the presence of multiple periodontal pathogens were associated with periodontitis at the same magnitude, when they were in the logistic regression model individually or together. Conclusion: We suggest that salivary IL-1, and the presence of multiple periodontal pathogens in saliva should be studied more thoroughly as markers of periodontitis. [source] Partial least squares path modelling for relations between baseline factors and treatment outcomes in periodontal regenerationJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2009Yu-Kang Tu Abstract Background: Some clinical outcome variables in periodontal research are mathematically coupled, and it is not feasible to include all the mathematically coupled variables in an ordinary least squares (OLS) regression analysis. The simplest solution to this problem is to drop at least one of the mathematically coupled variables. However, this solution is not satisfactory when the mathematically coupled variables have distinctive clinical implications. Material and Methods: Partial least squares (PLS) methods were used to analyse data from a study on guided tissue regeneration. Relationships between characteristics of baseline lesions and treatment outcomes after 1 year were analysed using PLS, and the results were compared with those from OLS regression. Results: PLS analysis suggested that there were multiple dimensions in the characteristics of baseline lesion: vertical dimension was positively associated with probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain, whilst horizontal dimension was negatively associated with the outcome. Baseline gingival recession had a negative association with PPD reduction but a small positive one with CAL gain. Conclusion: PLS analysis provides new insights into the relationships between baseline characteristics of infrabony defects and periodontal treatment outcomes. The hypothesis of multiple dimensions in baseline lesions needs to be validated by further analysis of different datasets. [source] Mechanical non-surgical treatment of peri-implantitis: a double-blind randomized longitudinal clinical study.JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2009I: clinical results Abstract Background: Peri-implantitis is a frequent finding in patients with dental implants. The present study compared two non-surgical mechanical debridement methods of peri-implantitis. Material and Methods: Thirty-seven subjects (mean age 61.5; S.D±12.4), with one implant each, demonstrating peri-implantitis were randomized, and those treated either with titanium hand-instruments or with an ultrasonic device were enrolled. Data were obtained before treatment, and at 1, 3, and 6 months. Parametric and non-parametric statistics were used. Results: Thirty-one subjects completed the study. The mean bone loss at implants in both groups was 1.5 mm (SD ±1.2 mm). No group differences for plaque or gingival indices were found at any time point. Baseline and 6-month mean probing pocket depths (PPD) at implants were 5.1 and 4.9 mm (p=0.30) in both groups. Plaque scores at treated implants decreased from 73% to 53% (p<0.01). Bleeding scores also decreased (p<0.01), with no group differences. No differences in the total bacterial counts were found over time. Higher total bacterial counts were found immediately after treatment (p<0.01) and at 1 week for ultrasonic-treated implants (p<0.05). Conclusions: No group differences were found in the treatment outcomes. While plaque and bleeding scores improved, no effects on PPD were identified. [source] A systematic review of definitions of periodontitis and methods that have been used to identify this diseaseJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2009Amir Savage Abstract Objective: To perform a systematic review and critical analysis of the definitions of periodontitis and the methods which have been used to identify and measure this disease. Material and Methods: Relevant publications were identified after searching MEDLINE, EMBASE, SCISEARCH and LILACS electronic databases. Screening of titles and abstracts and data extraction was conducted independently by two reviewers. To be included in the review, studies were required to define periodontitis and to indicate how it was measured. Studies that related purely to gingivitis, and/or intervention studies, and/or studies where prevalence or severity of periodontitis was not a principal outcome were excluded. Results: From a total of 3472 titles and abstracts, 104 potentially relevant full text papers were identified. Of these, 15 met the criteria for inclusion in the final stage of the review. The survey revealed heterogeneity between the studies in the measurement tools used, particularly the types of probes and the sites and areas of the mouth that were assessed. There was also heterogeneity in the use of clinical attachment loss (CAL) and pocket probing depth (PPD) as criteria for periodontitis. In the 15 studies, the threshold for a diagnosis of periodontitis when CAL was the criterion ranged from 2 to 6 mm and when PPD was used, from 3 to 6 mm. Conclusions: This review has confirmed previous work which has suggested that epidemiological studies of periodontal diseases are complicated by the diversity of methodologies and definitions used. The studies that were reviewed utilized a minimum diagnostic threshold defining periodontitis, at a given site in terms of CAL of 2 mm and PPD of 3 mm. [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] Incomplete adherence to an adjunctive systemic antibiotic regimen decreases clinical outcomes in generalized aggressive periodontitis patients: a pilot retrospective studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2007Adrian Guerrero Abstract Aim: The objective of this study was to explore the effect of incomplete adherence to the prescribed antibiotic regimen, amoxicillin and metronidazole, in the non-surgical treatment of generalized aggressive periodontitis (GAP). Methods: This retrospective study included 18 GAP subjects who received a conventional course of full-mouth non-surgical periodontal treatment using machine-driven and hand instruments and an adjunctive course of systemic antibiotics (500 mg amoxicillin and 500 mg metronidazole three times a day for 7 days). Clinical parameters were collected at baseline and at 2 months post-treatment. Self-reported adherence to the prescribed medication regimen was recorded at 2 months. Results: All clinical parameters, except for the mean clinical attachment level (CAL) in sites with initial probing pocket depth (PPD) 3 mm, improved at 2 months in all subjects. PPD reduction was 3.7 mm [95% confidence interval (CI) 3.2, 4.3 mm] in deep pockets (7 mm) and 2.2 mm (95% CI 1.9, 2.4 mm) in moderate pockets (4,6 mm), while CAL gain was 2.2 mm (95% CI 1.7, 2.6 mm) and 1.2 mm (95% CI 0.8, 1.5 mm), respectively. However, only 11 subjects (61.1%) reported full adherence to the medication. In deep pockets (7 mm), the difference between an adherent and non-adherent/partially adherent subject was 0.9 mm (95% CI 0.1, 1.7 mm, ancova, p=0.027) in PPD reduction and 0.8 mm (95% CI ,0.2, 1.9, p=0.129) in CAL gain at 2 months. In moderate pockets (4,6 mm) this difference was smaller in magnitude: 0.4 mm (95% CI 0.1, 0.9 mm, p=0.036) in PPD reduction and 0.2 mm (95% CI ,0.3, 0.9 mm, p=0.332) in CAL gain. Conclusions: Within the limits of this design, these data suggest that incomplete adherence to a 7-day adjunctive course of systemic metronidazole and amoxicillin is associated with decreased clinical outcomes in subjects with generalized aggressive periodontitis. [source] Periodontal conditions in male adolescents using smokeless tobacco (moist snuff)JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2006Ulrika Montén Abstract Aim: The aim of this study was to evaluate the potential association of the use of smokeless tobacco (moist snuff) on the periodontal conditions of adolescents. Material and methods: A subject sample of one hundred and three 19-year-old male individuals (33 snuff users, 70 controls) living in Göteborg, Sweden, were clinically examined with regard to oral hygiene, gingivitis, probing pocket depth (PPD), clinical attachment loss (CAL) and gingival recession. Bitewing radiographs were obtained for assessments of alveolar bone level. Information about tobacco and oral hygiene habits was obtained by a structured questionnaire. Student 's t -test, ,2 -test and logistic regression analysis were used for statistical analysis. Results: The mean plaque and gingivitis scores in snuff-users were 59% (SD 21.0) and 47% (18.6), respectively, and in controls 64% (22.4) and 50% (18.3), respectively. The average PPD and CAL in snuff-users amounted to 2.3 mm (0.3) and 0.2 mm (0.1), respectively, and in controls 2.4 mm (0.3) and 0.1 mm (0.1) (p>0.05), respectively. The mean bone level was 1.3 mm (0.2) in both groups. The prevalence of subjects showing recession was 42% among snuff-users and 17% among controls (p=0.006). In snuff users, an average of 4% (0.9) of the teeth showed recession, compared with 1% (0.3) in controls (p<0.001). Limiting the analysis to the maxillary anterior tooth region, 33% of the snuff-users and 10% of the controls presented recessions (p=0.002). The use of snuff entailed an OR=5.1 to have gingival recessions. Conclusion: In the present population sample of adolescents, the use of smokeless tobacco (moist snuff) was not associated with the presence of periodontal disease except for a significantly high prevalence of gingival recessions. [source] Microbial colonization patterns predict the outcomes of surgical treatment of intrabony defectsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2006Lisa Heitz-Mayfield Abstract Aim: To explore the impact of bacterial load and microbial colonization patterns on the clinical outcomes of periodontal surgery at deep intrabony defects. Materials and Methods: One hundred and twenty-two patients with advanced chronic periodontitis and at least one intrabony defect of >3 mm were recruited in 10 centres. Before recruitment, the infection control phase of periodontal therapy was completed. After surgical access and debridement, the regenerative material was applied in the test subjects, and omitted in the controls. At baseline and 1 year following the interventions, clinical attachment levels (CAL), pocket probing depths (PPD), recession (REC), full-mouth plaque scores and full-mouth bleeding scores were assessed. Microbial colonization of the defect-associated pocket was assessed using a DNA,DNA checkerboard analysis. Results: Total bacterial load and counts of red complex bacteria were negatively associated with CAL gains 1 year following treatment. The probability of achieving above median CAL gains (>3 mm) was significantly decreased by higher total bacterial counts, higher red complex and T. forsythensis counts immediately before surgery. Conclusions: Presence of high bacterial load and specific periodontal pathogen complexes in deep periodontal pockets associated with intrabony defects had a significant negative impact on the 1 year outcome of surgical/regenerative treatment. [source] Adjunctive benefits of systemic amoxicillin and metronidazole in non-surgical treatment of generalized aggressive periodontitis: a randomized placebo-controlled clinical trialJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2005Adrian Guerrero Abstract Background: The objective of this study was to assess the adjunctive clinical effect of the administration of systemic amoxicillin and metronidazole in the non-surgical treatment of generalized aggressive periodontitis (GAP). Methods: Forty-one systemically healthy subjects with GAP were included in this 6-month double-blind, placebo-controlled, randomized clinical trial. Patients received a course of full-mouth non-surgical periodontal treatment delivered over a 24 h period using machine-driven and hand instruments. Test subjects received an adjunctive course of systemic antibiotic consisting of 500 mg amoxicillin and 500 mg metronidazole three times a day for 7 days. Clinical parameters were collected at baseline, and at 2 and 6 months post-treatment. Results: In both the test and the placebo groups, all clinical parameters improved at 2 and 6 months. In deep pockets (7 mm), the test treatment resulted in an additional 1.4 mm (95% confidence interval 0.8, 2.0 mm) in full-mouth probing pocket depth (PPD) reduction and 1 mm (0.7, 1.3 mm) of life cumulative attachment loss (LCAL) gain at 6 months. In moderate pockets (4,6 mm), the adjunctive benefit was smaller in magnitude: PPD reduction was 0.4 mm (0.1, 0.7 mm) and LCAL gain was 0.5 mm (0.2, 0.8 mm). In addition, the 6-month data showed LCAL gains 2 mm at 25% of sites in test patients compared with 16% in placebo (p=0.028). Similarly, PPD reductions of 2 mm or more were observed in 30% of sites in test and 21% of sites in placebo patients. Seventy-four percent of pockets with PPD 5 mm at baseline were 4 mm or shallower at 6 months in the test group. This compared with 54% in the placebo group (p=0.008). Disease progression at 6 months was observed at 1.5% of test and 3.3% of sites in test and placebo, respectively (p=0.072). Conclusions: These data indicate that a 7-day adjunctive course of systemic metronidazole and amoxicillin significantly improved the short-term clinical outcomes of full-mouth non-surgical periodontal debridement in subjects with GAP. [source] A chlorhexidine varnish implemented treatment strategy for chronic periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2005Short-term clinical observations Abstract Objectives: The aim of this study was to investigate the clinical outcome of a subgingivally applied chlorhexidine varnish when used as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. Material and methods: A randomized controlled, single blind, parallel trial was conducted on the basis of 16 volunteers suffering from chronic periodontitis. The control group received oral hygiene instructions and was scaled and root planed in two sessions. The test group received the same instructions and treatment, however, all pockets were additionally disinfected using a chlorhexidine varnish. The gingival index, plaque index, bleeding on probing, probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline and subsequently after 1 and 3 months. Results: Both treatment strategies showed significant reductions in PPD and CAL at both follow-up visits by comparison with baseline levels (p<0.001). Yet, at study termination, combination therapy resulted in additional pocket reductions between 0.73 and 1.23 mm (p<0.02), and clinical attachment gains between 0.63 and 1.09 mm (p<0.02). Conclusions: These findings suggest that a varnish-implemented strategy may improve the clinical outcome for the treatment of chronic periodontitis in comparison with SRP alone. [source] | |||||||||||||||||||||||||||||||||||||||||||