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BOP
Selected AbstractsPeptide Bond Formation Using Polymer-Bound BOPEUROPEAN JOURNAL OF ORGANIC CHEMISTRY, Issue 9 2004Sorin V. Filip Abstract A new polymer-supported BOP (P -BOP) has been prepared starting from the commercially available polystyrene-bound 1-hydroxybenzotriazole (P -HOBt) and successfully used as a solid-supported reagent for peptide-coupling reactions. Compared to BOP, less epimerization was observed. P -BOP is also a suitable activating reagent for difficult peptide coupling reactions involving ,,,-dialkyl amino acids. (© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2004) [source] Serum levels of interleukin-10 and tumour necrosis factor- , in chronic periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2010Anna Passoja Passoja A, Puijola I, Knuuttila M, Niemelä O, Karttunen R, Raunio T, Tervonen T. Serum levels of interleukin-10 and tumour necrosis factor- , in chronic periodontitis. J Clin Periodontol 2010; 37: 881,887. doi: 10.1111/j.1600-051X.2010.01602.x Abstract Aims: To investigate, using a cross-sectional study design, whether the extent of periodontal inflammation associates with the serum levels of cytokine interleukin (IL)-10 and tumour necrosis factor (TNF)- , and their ratio. Material and Methods: The study group consisted of 61 subjects with chronic periodontitis and 30 control subjects with minimally inflamed periodontal tissues. Probing pocket depth (PD), bleeding on probing (BOP) and periodontal attachment level (AL) were measured. The serum IL-10 (pg/ml) and TNF- , (U/l) levels were analysed using enzyme-linked immunosorbent assays. After categorization of the subjects, associations between serum IL-10 and TNF- , levels and the extent of periodontal inflammation were studied using linear regression models adjusted for age, gender, body mass index and smoking. Results: A negative, partly dose-dependent association existed between the extent of BOP, PD4 mm and AL4 mm and serum IL-10 level. The subjects in the periodontitis group presented significantly higher serum TNF- , levels and their TNF- ,/IL-10 ratio was approximately threefold when compared with the ratio in the control group. Conclusions: The significantly higher serum TNF- ,/IL-10 ratio in the subjects with chronic periodontitis when compared with the ratio in the controls is indicative of a stronger systemic pro-inflammatory state in chronic periodontitis. [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] Connective tissue graft plus resin-modified glass ionomer restoration for the treatment of gingival recession associated with non-carious cervical lesion: a randomized-controlled clinical trialJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2009Mauro Pedrine Santamaria Abstract Background: The aim of this clinical study was to evaluate the treatment of gingival recession, associated with non-carious cervical lesions by a connective tissue graft (CTG) alone, or in combination with a resin-modified glass ionomer restoration (CTG+R). Materials and Methods: Forty patients presenting Miller Class I buccal gingival recessions, associated with non-carious cervical lesions, were selected. The defects were randomly assigned to receive either CTG or CTG+R. Bleeding on probing (BOP), probing depth (PD), relative gingival recession (RGR), clinical attachment level (CAL) and cervical lesion height (CLH) coverage were measured at baseline and 45 days, and 2, 3 and 6 months after treatment. Results: Both groups showed statistically significant gains in CAL and soft tissue coverage. The differences between groups were not statistically significant in BOP, PD, RGR and CAL, after 6 months. The percentages of CLH covered were 74.88 ± 8.66% for CTG and 70.76 ± 9.81% for CTG+R (p>0.05). The estimated root coverage was 91.91 ± 17.76% for CTG and 88.64 ± 11.9% for CTG+R (p>0.05). Conclusion: Within the limits of the present study, it can be concluded that both procedures provide comparable soft tissue coverage. The presence of the glass ionomer restoration may not prevent the root coverage achieved by CTG. [source] Cervical restoration and the amount of soft tissue coverage achieved by coronally advanced flap: A 2-year follow-up randomized-controlled clinical trialJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 5 2009Mauro Pedrine Santamaria Abstract Background: The aim of this study was to evaluate the 2-year follow-up success of the treatment of gingival recession associated with non-carious cervical lesions by a coronally advanced flap (CAF) alone or in combination with a resin-modified glass ionomer restoration (CAF+R). Material and Methods: Sixteen patients with bilateral Miller Class I buccal gingival recessions, associated with non-carious cervical lesions, were selected. The defects received either CAF or CAF+R. Bleeding on probing (BOP), probing depth (PD), relative gingival recession (RGR), clinical attachment level (CAL) and cervical lesion height (CLH) coverage were measured at the baseline and 6, 12 and 24 months after the treatment. Results: Both groups showed statistically significant gains in CAL and soft tissue coverage. The differences between groups were not statistically significant in BOP, PD, RGR and CAL, after 2 years. The percentages of CLH covered were 51.57 ± 17.2% for CAF+R and 53.87 ± 12.6% for CAF (p>0.05). The estimated root coverage was 80.37 ± 25.44% for CAF+R and 83.46 ± 20.79% for CAF (p>0.05). Conclusion: Within the limits of the present study, it can be concluded that both procedures provide acceptable soft tissue coverage after 2 years, with no significant differences between the two approaches. [source] IL-6,174 genotype associated with the extent of periodontal disease in type 1 diabetic subjectsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2009Taina Raunio Abstract Aim: The aim of this study was to investigate whether genetic polymorphism in certain cytokine and receptor molecule genes and diabetic status associate with the extent of periodontal disease in type 1 diabetes mellitus (DM). Material and Methods: Eighty patients with type 1 DM participated. Visible plaque, bleeding on probing (BOP), probing pocket depth (PD) and attachment level (AL) were examined clinically and glycosylated haemoglobin (HbA1c) levels were used to assess the glycemic control of DM. CD-14, IL-6, TNF- ,, IL-10, IL-1,, IL-1, and TLR-4 gene polymorphisms were studied using the polymerase chain reaction (PCR). Results: The 3-year HbA1c was good (<7.5%) in 16%, acceptable (7.5,8.5%) in 36% and poor (>8.5%) in 48% of the subjects. IL-6,174 genotype and 3-year GHbA1c associated significantly with BOP and PD4 mm, subjects with the GG genotype of the IL-6,174 exhibiting more severe periodontal disease than those with the GC/CC genotype. After stratification by IL-6 genotype, associations between the extent of periodontal disease and 3-year HbA1c levels remained significant in subjects carrying the GC/CC but not the GG genotype. Conclusions: In addition to the HbA1c level, the IL-6,174 genotype is a significant susceptibility factor for periodontal disease among type 1 diabetics. [source] Periodontal inflamed surface area: quantifying inflammatory burdenJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2008Willem Nesse Abstract Background: Currently, a large variety of classifications is used for periodontitis as a risk factor for other diseases. None of these classifications quantifies the amount of inflamed periodontal tissue, while this information is needed to assess the inflammatory burden posed by periodontitis. Aim: To develop a classification of periodontitis that quantifies the amount of inflamed periodontal tissue, which can be easily and broadly applied. Material and Methods: A literature search was conducted to look for a classification of periodontitis that quantified the amount of inflamed periodontal tissue. A classification that quantified the root surface area affected by attachment loss was found. This classification did not quantify the surface area of inflamed periodontal tissue, however. Therefore, an Excel spreadsheet was developed in which the periodontal inflamed surface area (PISA) is calculated using clinical Attachment Level (CAL), recessions and bleeding on probing (BOP). Results: The PISA reflects the surface area of bleeding pocket epithelium in square millimetres. The surface area of bleeding pocket epithelium quantifies the amount of inflamed periodontal tissue. A freely downloadable spreadsheet is available to calculate the PISA. Conclusion: PISA quantifies the inflammatory burden posed by periodontitis and can be easily and broadly applied. [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] Gingival crevicular fluid interleukin-1,, prostaglandin E2 and periodontal status in a community populationJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2007Y. Zhong Abstract Aim: Interleukin-1 , (IL-1,) and prostaglandin E2 (PGE2) are key inflammatory mediators involved in periodontal disease. The purposes of this molecular cross-sectional epidemiological study were to investigate relationships in a community sample between mean concentrations of IL-1, and PGE2 in gingival crevicular fluid (GCF) and (1) clinical periodontal signs and (2) risk factors of host inflammatory response and/or periodontal disease. Material and Methods: The sample comprised 6277 community-dwelling adults aged 52,74 years enrolled in the Atherosclerosis Risk in Communities (ARIC) study. IL-1, and PGE2 concentrations were measured using enzyme-linked immunosorbent assay. Person-level summary variables were computed for maximum pocket depth (MaxPD), maximum clinical attachment level (MaxCAL) and presence/absence of bleeding on probing (BOP). Mean GCF IL-1, and PGE2 concentrations were dependent variables in multiple linear regression models with periodontal measures and covariates as explanatory variables. Results: Both GCF IL-1, and PGE2 were positively related to MaxPD and BOP in multiple regression models (p<0.01). Increased levels of IL-1, and PGE2 were associated with body mass index 30 kg/m2. Conclusion: Higher levels of GCF IL-1, and PGE2 were significantly associated with clinical signs of periodontal disease and independently related to patient-based anthropomorphic measures, behaviours and exposures in community-dwelling adults. [source] Evaluation of the relationship between smoking during pregnancy and subgingival microbiotaJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2005Nurcan Buduneli Abstract Background: Numerous studies have shown that smoking negatively affects periodontal health. Hormonal changes, which occur during pregnancy have also been reported to have adverse effects on the periodontal tissues or indirectly through alterations in the subgingival bacterial flora. At present, no knowledge exists concerning possible effects of smoking on the composition of subgingival plaque in pregnancy. The purpose of the present study was to evaluate the effects of smoking during pregnancy on the subgingival plaque bacteria most commonly associated with periodontal disease. Methods: A total number of 181 women were examined within 72 h post-partum. Smoking status was recorded by means of a self-reported questionnaire and the study population was divided into three groups; non-smokers, light smokers, and heavy smokers. In each woman, two subgingival plaque samples were obtained from mesio- or disto-buccal aspect of randomly selected one molar and one incisor tooth by sterile paperpoints. Clinical periodontal recordings comprising presence of dental plaque, bleeding on probing (BOP), and probing pocket depth (PPD) were performed at six sites per each tooth at all teeth. Plaque samples were analysed by checkerboard DNA,DNA hybridization with respect to 12 bacterial species. In all analyses, the individual subject was the computational unit. Thus, mean values for all clinical parameters were calculated and bacterial scores from each individual sample were averaged. Statistical methods included ,2 test, Kruskal,Wallis test and Mann,Whitney U -test. Results: Mean ages were similar in the study groups. Plaque, BOP and PPD recordings were lower in the heavy-smoker group, but the differences were not statistically significant (p>0.05). The detection rates and bacterial loads of the specific subgingival bacteria exhibited no significant differences between the groups. No correlation could be found between smoking status and detection rates and bacterial loads of various bacterial species. Conclusion: The present findings suggest that smoking during pregnancy does not have a significant effect on the composition of subgingival plaque bacteria. [source] Long-term stability of periodontal conditions achieved following guided tissue regeneration with bioresorbable membranes: case series results after 6,7 yearsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2004Andreas Stavropoulos Abstract Objectives: To evaluate the results of guided tissue regeneration (GTR) treatment of intrabony defects with bioresorbable membranes after 6,7 years, and to disclose factors that may influence the long-term outcome of the treatment. Methods: Twenty-five defects in 19 patients were treated by means of polylactic acid/citric acid ester copolymer bioresorbable membranes. At baseline and after 1 and 6,7 years, the following parameters were recorded: (1) probing pocket depth (PPD), (2) gingival recession (REC), (3) probing attachment level (PAL)=PPD+REC, (4) presence/absence of plaque (PI), (5) presence/absence of bleeding on probing (BOP). Smoking habits and frequency of dental-control visits were also recorded. Significance of differences between categorical variables was evaluated with McNemar's test, and between numerical variables with the t -test for paired observations. Generalized linear models were constructed to evaluate the influence of various factors on PAL gain and PPD changes from 1 to 6,7 years. Association of smoking, frequency of dental controls, oral hygiene, and BOP with sites losing 2 mm in PAL was evaluated with Fisher's exact test. Results: At baseline, a mean PPD of 8.7±1.1 mm and a mean PAL of 9.8±1.5 mm was recorded. Statistically significant clinical improvements were observed at 1 and 6,7 years after GTR treatment. An average residual PPD of 3.8±1.1 mm and a mean PAL gain of 3.8±1.4 mm were observed after 1 year. After 6,7 years the corresponding values were 4.7±1.3 and 3.6±1.4 mm, respectively. There were no statistically significant differences between the 1- and the 6,7-year values. At the 6,7-year control, only 16% of the sites had lost 2 mm (maximum 3 mm), of the PAL gain obtained 1 year after GTR treatment. None of the sites had lost all of the attachment gained 1 year after treatment. Smoking, frequency of dental controls, oral hygiene, and BOP did not seem to influence the change of PPD and PAL gain, or the stability of PAL gain (i.e. losing PAL or not) from 1 to 6,7 years from treatment. Conclusion: Clinical improvements achieved by GTR treatment of intrabony defects by means of bioresorbable membranes can be maintained on a long-term basis. [source] Subgingival microbiota of chronic periodontitis subjects from different geographic locationsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2004A. D. Haffajee Abstract Background: Most clinical studies assume that the subgingival microbiota is similar from one geographic location to another. The purpose of the present investigation was to examine the composition of the subgingival microbiota in chronic periodontitis subjects from four countries. Method: Subjects with chronic periodontitis (N, Sweden=101; USA=115; Brazil=58; Chile=26) were recruited. Subjects were measured at baseline for plaque, gingivitis, bleeding on probing (BOP), suppuration, pocket depth (PD) and attachment level (AL) at six sites per tooth. Subgingival plaque samples taken from the mesial aspect of each tooth at baseline were individually analyzed for their content of 40 bacterial species using checkerboard DNA,DNA hybridization (total samples=6036). % DNA probe counts comprised by each species was determined for each site and averaged across sites in each subject. Significance of differences in proportions of each species among countries was determined using ancova adjusting for age, mean pocket depth, gender and smoking status. p- Values were adjusted for multiple comparisons. Results: On average, all species were detected in samples from subjects in the four countries. Thirteen species differed significantly in adjusted mean proportions among countries even after adjusting for multiple comparisons. Porphyromonas gingivalis, one species that differed in proportions among countries, comprised adjusted means of 7.5, 11.9, 1.6 and 6.6% of the microbiota in subjects from Brazil, Chile, Sweden and USA (p<0.001), while mean proportions of Treponema denticola were 6.7, 4.2, 0.8 and 2.3, respectively (p<0.001). In contrast, a key periodontal pathogen, Tannerella forsythensis, exhibited mean proportions ranging from 6.2,8.5% and did not differ significantly among countries. Besides these species, prominent species in Brazil were Actinomyces naeslundii genospecies 1 and 2 (8.4%, 7.2%) and Prevotella intermedia (6.5%); in Chile, Prevotella melaninogenica (6.4%) and Neisseria mucosa (5.3%); in Sweden A. naeslundii genospecies 2 (8.4%), Capnocytophaga gingivalis (7.1%) and Peptostreptococcus micros (5.0%); in USA A. naeslundii genospecies 2 (7.5%), P. intermedia (6.8%) and C. gingivalis (6.1%). Conclusions: The microbial profiles of subgingival plaque samples from chronic periodontitis subjects in four countries showed surprisingly marked differences. These differences persisted after adjusting for age, mean pocket depth, gender and smoking status. [source] Non-surgical periodontal treatment with a new ultrasonic device (VectorÔ-ultrasonic system) or hand instrumentsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2004A prospective, controlled clinical study Abstract Objectives: The aim of this prospective, randomized, controlled clinical study was to compare the effectiveness of a newly developed ultrasonic device to that of scaling and root planing for non-surgical periodontal treatment. Material and Methods: Thirty-eight patients with moderate to advanced chronic periodontal disease were treated according to an "one-stage procedure" with either a newly developed ultrasonic device (VUS) (VectorÔ-ultrasonic system) or scaling and root planing (SRP) using hand instruments. Clinical assessments by plaque index (PlI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were made prior to and at 6 months after treatment. Differences in clinical parameters were analyzed using the Wilcoxon signed ranks test and Mann and Whitney U -test. Results: No differences in any of the investigated parameters were observed at baseline between the two groups. The mean value of BOP decreased in the VUS group from 32% at baseline to 20% after 6 months (p<0.001) and in the SRP group from 30% at baseline to 18% after 6 months (p<0.001). The results have shown that at moderately deep sites (initial PD 4,5 mm) mean CAL changed in the test group from 4.6±1.2 to 4.2±1.6 mm (p< 0.001) and in the control group from 4.8±1.3 to 4.4±1.5 mm (p<0.001). At deep sites (inital PD>6 mm) mean CAL changed in the test group from 8.5±1.9 to 7.9±2.4 mm (p<0.001) and in the control group from 7.9±1.6 to 7.2±2.2 mm (p<0.001). No statistically significant differences in any of the investigated parameters were found between the two groups. Conclusion: Non-surgical periodontal therapy with the tested ultrasonic device may lead to clinical improvements comparable to those obtained with conventional hand instruments. [source] Longitudinal evaluation of GCF IFN-, levels and periodontal status in HIV+ patientsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2003T. Alpagot Abstract Background/Aim: Loss of periodontal support and related tooth loss is a common finding among HIV+ patients. The etiology of this destruction may be an increase in the levels of pro-inflammatory cytokines and subsequent increase in periodontal disease activity. The purpose of this study was to investigate the associations between gingival crevicular fluid interferon gamma (GCF IFN- ,) and clinical measures of periodontal disease in HIV+ individuals. We monitored GCF IFN- , and periodontal status of selected sites in 33 HIV+ subjects over a 6-month period. Method: Clinical measurements including gingival index, plaque index, bleeding on probing, probing depth, attachment loss (AL), and GCF samples were taken from four lower incisors and the upper right posterior sextant of each patient at baseline and 6-month visits by means of sterile paper strips. GCF levels of IFN- , were determined by sandwich ELISA assays. A progressing site was defined as a site that had 2 mm or more AL during the 6-month study period. Results: Twenty-five of the 264 examination sites showed 2 mm or more clinical AL during the 6-month study period. Significantly higher GCF levels of IFN- , were found at progressing sites than in nonprogressing sites (p<0.001). GCF levels of IFN- , were highly correlated with clinical measurements taken at baseline and 6-month visits (0.001 Relationship between periodontal pocket sulfide levels and subgingival speciesJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2003G. Torresyap Abstract Background: Many species implicated in the pathogenesis of periodontal disease produce volatile sulfur compounds (VSC). This investigation examined the relationship between levels of sulfide and subgingival bacterial species in the same periodontal pockets. Material and Methods: Twenty chronic periodontitis subjects were measured clinically at six sites per tooth for plaque, gingivitis, bleeding on probing, suppuration, pocket depth and attachment level. Subgingival plaque samples, taken from the mesial aspect of each tooth, were individually analyzed for their content of 40 bacterial species using checkerboard DNA,DNA hybridization. Sulfide levels were measured at the same sites using a Diamond Probe/Perio 2000 system. Clinical and microbiological data were averaged for sulfide-positive and -negative sites separately in each subject and then averaged across subjects. Significance differences in clinical and microbial parameters between sulfide-positive and -negative sites were sought using the Wilcoxon signed ranks test. Results: Mean total DNA probe counts (×105, ±SEM) at sulfide-negative and -positive sites were 44.0±9.9 and 65.0±13.3, respectively (p<0.01). Seventeen species were found at significantly higher levels in sulfide-positive than -negative sites. These included abundant producers of VSC such as members of the genera Fusobacterium, Campylobacter, Prevotella, Treponema and Eubacterium, and Bacteriodes forsythus, Selenomonas noxia and Propionibacterium acnes. Prevotella intermedia, Bacteriodes forsythus, Prevotella nigrescens, Fusobacterium nucleatum ss vincentii and Treponema denticola exhibited the greatest difference in mean counts between sulfide-negative and -positive sites. Orange and red complex species were at higher counts at shallow (<4 mm) sulfide-positive than shallow sulfide-negative sites. Although not statistically significant, mean clinical parameters were somewhat higher at sulfide-positive than sulfide-negative sites. Conclusions: Intra-pocket sulfide levels reflect the levels of sulfide-producing species and may provide useful diagnostic information. Zusammenfassung Grundlagen: Viele Spezies, die mit der Pathogenese der Parodontalerkrankung verbunden sind produzieren flüchtige Schwefelkomponenten (VSC). Diese Studie untersuchte die Verbindung zwischen dem Sulfid-Niveau und subgingivalen Spezies in den gleichen parodontalen Taschen. Methode: 20 Patienten mit chronischer Parodontitis wurden an 6 Stellen pro Zahn klinisch befundet hinsichtlich Plaque, Gingivitis, BOP, Eiterentleerung, Taschentiefe und Attachmentniveau. Unter Verwendung der Schachbrett-DNA,DNA-Hybridisierung wurden subgingivale Plaqueproben von der mesialen Stelle eines jeden Zahns individuell hinsichtlich des Vorkommens von 40 bakteriellen Spezies untersucht. An der gleichen Stelle wurde mittels des Diamond Probe/Perio 2000 Systems das Niveau des Sulfids gemessen. Von den klinischen und mikrobiologischen Daten wurden bei jedem Patienten getrennt für Sulfid-positiv und Sulfid-negativ ein Durchschnitt gebildet und anschließend der Durchschnitt für alle Patienten berechnet. Nach signifikanten Unterschieden in den klinischen und mikrobiologischen Parametern zwischen Sulfid-positiven und Sulfid-negativen Stellen wurde unter Verwendung des Wilcoxon signed ranks Test gesucht. Ergebnisse: Die mittlere Bakterienanzahl mit Gesamt-DNA-Sonden (× 105, ±SEM) betrug an den Sulfid-negativen Stellen und Sulfid-positiven Stellen 44.0±9.9 bzw. 65.0±13.3 (p<0.01). Bei 17 Spezies wurde ein signifikant höheres Niveau in den Sulfid-positiven Stellen vorgefunden. Die umfasste Bakterien die reichlich VSC produzieren, wie Mitglieder der Genera Fusobacterium, Campylobacter, Prevotella, Treponema und Eubacterium und B. forsythus, S. noxia und P. acnes. P. intermedia, B. forsythus, P. nigrescens, F. nucleatum ssvincentii und T. denticola zeigten den größten Unterschied zwischen Sulfid-positiven und Sulfid-negativen Stellen in der durchschnittlichen Bakterienanzahl. Spezies des orangen und roten Komplexes lagen in höherer Anzahl in flachen (<4 mm) Sulfid-positiven, als in flachen Sulfid-negativen Taschen vor. Obwohl statistisch nicht signifikant, lagen die durchschnittlichen klinischen Parameter bei den Sulfid-positiven etwas höher als bei den Sulfid-negativen Taschen Schlussfolgerungen: Die innerhalb der Taschen gemessenen Sufiid-Niveaus spiegeln das Niveau der Sulfid-produzierenden Spezies wieder und könnten eine nützliche diagnostische Information liefern. Résumé Plusieurs espèces impliquées dans la pathogenèse de la maladie parodontale produisent des composés de sulfate volatiles (VSC). Cette étude examine la relation entre les niveaux de sulfate et les espèces bactériennes sous-gingivales dans les mêmes poches parodontales. Vingt sujets avec parodontite chronique ont subi un examen clinique au niveau de six sites par dent pour la plaque dentaire, la gingivite, la profondeur de poche au sondage (BOP), la suppuration, la profondeur de poche et le niveau d'attache. Des échantillons de plaque sous-gingivale prélevés en mésial de chaque dent ont été analysés individuellement pour leur contenu de 40 espèces bactériennes à l'aide de l'hybridisation ADN-ADN croisée. Les niveaux de sulfate ont été mesurés au niveau des mêmes sites par le système de sonde Diamond/Perio 2000. Les moyennes des données cliniques et microbiologiques ont étéétablies pour les sites sulfate positif et négatif chez chaque sujet et par sujet. Des différences significatives dans les paramètres cliniques et microbiologiques entre les sites sulfate positif et négatif ont été observées via le test de Wilcoxon. Les moyennes totales des comptes de la sonde ADN (x105,+/,ES) au niveau des sites sulfate négatif et positif étaient respectivement de 44,0 +/,9,9 et 65,0+/,13,3 (p<0,01). Dix sept espèces ont été trouvées à des niveaux hautement plus significatifs dans des sites sulfate positif que négatif. Ceux-ci comprennaient d'abondants producteurs de VSC tels que les Fusobacterium, Catnpylobacter, Prevotella, Treponema, Eubacterium, B. forsythus, S. noxia etP. acnes, P. intermedia, B. forsythus, P. nigrescens, F. nucleatum ss vincentii et T. denticola qui montraient la plus grande différence dans la moyenne des comptes entre les sites sulfate négatif et positif. Les espèces complexe orange et rouge étaient plus nombreuses dans les sites de faible profondeur (<4 mm) sulfate positif que dans les sites peu profonds sulfate négatif. Bien que statistiquement non significative la moyenne des paramètres cliniques a été quelque peu plus élevée au niveau des sites sulfate positif qu'au niveau des négatifs. Les niveaux de sulfate intrapoche reflètent les niveaux des espèces produisant du sulfate et pourraient apporter une information de diagnostic pratique. [source] Interleukin-1 gene polymorphisms and experimental gingivitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2003Søren Jepsen Abstract Background: Recently, an association between the severity of periodontitis and specific variations in the interleukin-1 (IL1) , and , genes has been demonstrated. Aim: The purpose of this study was to evaluate the relationship of the IL1 genotype to the development of experimental gingivitis. Materials and Methods: Twenty young adult subjects presenting with healthy gingival conditions participated after giving their informed consent. The group included 10 risk genotype positive (P+) and 10 risk genotype negative (P,) individuals. The IL1 genotypes were determined on DNA samples from peripheral blood using PCR-RFLP analyses for the IL1, and IL1, polymorphisms. Experimental gingivitis was allowed to develop in two posterior sextants per subject. Bleeding on probing (BOP%) and gingival crevicular fluid volume (GCF) were assessed at baseline and days 2, 7, 9, 14, 16 and 21. The day 21 results for BOP and GCF as well as the rate of increase of these parameters , mean area under the curve (AUC) and mean increase per day (slope) , were evaluated using risk analyses for IL1 genotype, smoking status and gender. Results: Experimental gingivitis developed with a gradual increase in BOP scores and GCF values (expressed as Periotron units=PU) from baseline to day 21 (BOP, P+: 0.5 to 26.0%; P,: 1.0 to 28.1%; GCF, P+: 36.8 to 138.5 PU, P,: 43.1 to 143.4 PU). No significant risk was associated with P+ and P, for day 21 results, AUC or slope. Conclusion: The results of this study failed to provide evidence that the IL1 risk genotype was associated with higher GCF volume and percentage BOP during the development of experimental gingivitis. Zusammenfassung Hintergrund: Kürzlich ist eine Beziehung zwischen dem Schweregrad von Parodontitis und speziellen Varianten der Interleukin-1 (IL1),- und -,-Gene gezeigt worden. Zielsetzung: Untersuchung des Zusammenhanges zwischen dem ILl-Genotyp und der Entwicklung einer experimentellen Gingivitis. Material und Methoden: 20 junge Erwachsene mit gesunden parodontalen Verhältnissen, von denen 10 für den Risikogenotyp positiv (P+) und 10 negativ (P-) waren, nahmen an der Studie teil, nachdem sie ihr Einverständnis dazu gegeben hatten. Die IL1 -Genotypen wurden aus DNS-Proben aus peripherem Blut mittels PCR-RFLP-Analyse auf ILl,- und IL1/,-Polymorphismen untersucht. In 2 Seitenzahnsextanten ließ jeder Proband eine experimentelle Gingivitis entwickeln. Bluten auf Sondieren (BOP%) und Sulkiksfiüssigkeitsvolumen (SFV) wurden zu Beginn der Studie und nach 2, 7, 9, 14, 16 und 21 Tagen bestimmt. Sowohl die Ergebnisse für BOP und SFV an Tag 21 als auch die Zunahme dieser Werte , mittlere Fläche unter der Kurve (AUC) und mittlere Zunahme pro Tag (Steigung) , wurden mittels Risikoanalyse fur IL1 -Genotyp, Rauchen und Gescnlecht bestimmt. Ergebnisse: Die experimentelle Gingivitis entwickelte sich mit einem stetigen Anstieg der BOP- und SFV-Werte (ausgedrückt als Periotroneinheiten=PU) vom Beginn der Studie bis zum 21. Tag (BOP, P+: 0,5% to 26,0%, P-: 1,0% to 28,1%; GCF, P+: 36,8 to 138,5 PU, P-: 43,1 to 143,4 PU). Mit P+und P- war kein signifikantes Risiko für die Werte am 21. Tag, die AUC oder die Steigung verbunden. Schlussfolgerung: Die Ergebnisse dieser Studie konnten keine Beziehung zwischen dem IL1 -Risikogenotype und erhöhtem SFV bzw. Anteil von Stellen mit BOP in % während der Entwicklung einer experimentellen Gingivitis zeigen. Résumé Contexte: Récemment, une association entre la sévérité de la parodontite et des variations spéifiques des gènes codant pour l'interleukin-1 (IL1) , et , a été démontrée. But: Cette étude se propose d'évaluer la relation entre le génotype IL1 dans le developpment de la gingivite expérimentale. Méthods: 20 jeunes sujets adultes présentant une bonne santé gingivale ont participé cette étude après consentement éclairé. Dans ce groupe, il y avait 10 individus à risque positif (P+) et 10 individus à génotype de risque négatif (P,). génotypes lL1 furent déterminés sur des échantillons d'ADN prélevés du sang périphérique par analyse en PCR-RFLP pour les polymorphismes d' IL1, et IL1,. On a laissé se développer une gingivite expérimentale sur 2 sextants postérieurs chez chaque sujet. Le saignement au sondage (BOP%) et le volume de fluide gingival (GCF) furent notes au départ et aux jours 2, 7, 9, 14, 16, et 21. Au vingt et unième jour, les résultats pour BOP et GCF ainsi que le taux d'augmentation de ces paramètres- La surface moyenne sous la courbe (AUC) et l'augmentation moyenne par jour (pente) - furent évalués par analyses du risque pour les génotypes IL1, le tabagisme et le sexe. Résultats: gingivite expérimentale se développa avec une augmentation graduelle des et scores de BOP et des valeurs de GCF (exprimées en unités Periotron=PU) du début de l'étude jusqu'au jour 21 (BOP, P+: 0.5%à 26.0%, P-: 1.0%à 28.1%; GCF, P+: 36.8 à 43.1 à 143.4 PU). Aucun risque significatif ne fut associe avec P+et P-ats à 21 jours, AUC ou la pente. Conclusion: -es résultats de cette étude n'ont pas pu donner de preuves d'associations entre le génotype de risque IL1 et un volume accru de GCF et le % BOP lors du t d'une gingivite expérimentale. [source] Effect of a controlled-release chlorhexidine chip on clinical and microbiological parameters of periodontal syndromeJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2002Daniela C. Grisi Abstract Aim: The aim of this study was to evaluate the effectiveness of a controlled-released chlorhexidine chip (CHX) as adjunctive therapy to scaling and root planing (SRP) in the treatment of chronic periodontitis. Material and methods: Twenty patients with at least four sites with probing depth ,,5 mm and bleeding on probing were selected. This randomized single-blind study was carried out in parallel design. The control group received SRP alone, while the test group received SRP plus CHX chip. The clinical parameters, Plaque Index (PlI), Papillary Bleeding Score (PBS), Bleeding on Probing (BOP), Gingival Recession (GR), Probing Depth (PD) and Relative Attachment Level (RAL), and the microbiological parameter BANA test were recorded at baseline and after 3, 6 and 9 months. Results: Both groups presented significant improvements in all parameters analyzed over the study period. There were no statistically significant differences between the two groups for any parameter analyzed after 9 months, except for BOP, which was significantly reduced in the control group. The mean reductions on PD and RAL were 2.4 mm and 1.0 mm for the control group and 2.2 mm and 0.6 mm for the test group, respectively. Conclusion: The CHX chip did not provide any clinical or microbiological benefit beyond that achieved with conventional scaling and root planning, after a 9-month period. Zusammenfassung Wirkung eines Chlorhexidin-Chips mit kontrollierter Wirkstoff-Freisetzung auf klinische und mikrobiologische Parameter parodontaler Erkrankungen Zielsetzung: Das Ziel der vorliegenden Studie war die Evaluierung der Wirksamkeit eines Chlorhexidin-Chips mit kontrollierter Wirkstoff-Freisetzung (CHX) als Adjunktivtherapie zu Zahnsteinentfernung (Scaling) und Wurzelglätten (Root planing) bei der Behandlung einer chronischen Parodontitis. Material und Methodik: Zur Teilnahme an der Studie wurden zwanzig Patienten mit mindestens vier Stellen mit einer Sondiertiefe von ,5 mm und Blutung bei der Sondierung ausgewählt. Diese randomisierte einfach-blinde Studie wurde mit Parallelgruppenaufbau durchgeführt. Die Kontrollgruppe erhielt ausschliesslich SRP, die Testgruppe dagegen erhielt SRP plus den CHX-Chip. Zu Baseline und nach 3, 6 und 9 Monaten wurden die klinischen Parameter Plaque-Index (PlI), Papillarblutungs-Score (PBS), Blutung bei Sondierung (BOP), Gingivaretraktion (GR), Sondiertiefe (PD), Relatives Attachmentniveau (RAL) und die mikrobiologischen Parameter (BANA-Test) verzeichnet. Ergebnisse: Beide Gruppen zeigten signifikante Verbesserungen aller analysierten Parameter über den Studienzeitraum. Nach 9 Monaten konnten mit Ausnahme von BOP, was in der Kontrollgruppe eine signifikante Reduktion zeigte, keine statistisch signifikanten Unterschiede zwischen den beiden Gruppen für die untersuchten Parameter festgestellt werden. Die durchschnittlichen Reduktionen bei PD und RAL waren 2,4 mm und 1,0 mm in der Kontrollgruppe und 2,2 mm bzw. 0,6 mm in der Testgruppe. Schlussfolgerung: Nach einer 9-monatigen Behandlungszeit konnten mit dem CHX-Chip zusätzlich zu dem durch konventionelles Scaling und Wurzelglätten erzielten klinischen und mikrobiologischen Nutzen keine weiteren Vorteile erzielt werden. Résumé Influence d'une capsule de chlorhexidine à libération contrôlée sur les paramètres cliniques et microbiologiques de la maladie parodontale But: Le but de cette étude était d'évaluer l'efficacité d'une capsule de chlorhexidine (CHX) à libération contrôlée comme thérapie complémentaire au détartrage et au surfaçage radiculaire (scaling and root planing, SRP) dans le traitement de la parodontite chronique. Matériaux et méthodes: Vingt patients avec au moins quatre sites présentant une profondeur au sondage ,5 mm et un saignement au sondage ont été sélectionnés. Cette étude randomisée en simple aveugle a été conduite en parallèle. Le groupe contrôle a uniquement bénéficié de SRP, tandis que le groupe test a reçu SRP plus une capsule CHX. Les paramètres cliniques, l'indice de plaque (plaque index, PlI), l'indice de saignement papillaire (papillary bleeding score, PBS), la saignement au sondage (bleeding on probing, BOP), la récession gingivale (gingival recession, GR), la profondeur au sondage (probing depth, PD), le niveau d'attache relatif (relative attachment level, RAL) et les paramètres microbiologiques (test BANA) ont été enregistrés à la base puis après 3, 6 et 9 mois. ésultats: Les deux groupes présentaient une amélioration significative de tous les paramètres analysés au cours de la période d'étude. Entre les deux groupes, il n'y avait de différence statistiquement significative pour aucun des paramètres analysés au bout de 9 mois, sauf pour le BOP qui était considérablement réduit dans le groupe contrôle. Les baisses moyennes de PD et RAL valaient respectivement 2,4 mm et 1,0 mm pour le groupe contrôle, et 2,2 mm et 0,6 mm pour le groupe test. Conclusion: A l'issue d'une période de 9 mois, la capsule CHX n'a apporté aucun bénéfice clinique ou microbiologique supérieur à celui obtenu par détartrage et surfaçage radiculaire conventionnels. [source] Local application of n,3 or n,6 polyunsaturated fatty acids in the treatment of human experimental gingivitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2002Jörg Eberhard Abstract Background: Polyunsaturated fatty acids have the potential to attenuate inflammation by the synthesis of mediators of the 15-lipoxygenase pathways, which show opposite effects to the pro-inflammatory arachidonic acid metabolites such as leukotriene B4 (LTB4). Aims: The aim of this clinical study was to evaluate the effects of topical application of n,6 or n,6 polyunsaturated fatty acids in patients with experimental gingivitis. Methods: In each subject, similar teeth served as experimental and control over a 21-day non-hygiene phase and a 9-day resolving phase. Efficacy assessment was based on the bleeding on probing frequency (BOP) and the gingivocrevicular fluid volume (GCF). GCF was determined by inserting a filter paper strip for 30 s and measurements were performed on a Periotron 8000. The LTB4 concentration was analyzed by reversed-phase high-pressure liquid chromatography. Results: After 21 days of plaque growth, the BOP, GCF and LTB4 levels were significantly increased in all groups, with no differences between the control and experimental side. Rinsing of an area with established gingivitis for a 9-day period significantly reduced the GCF in the n,6 group (71.9 (18.7) versus 47.4 (11.4) Periotron Units, median (inter quartile range)). Conclusion: The topical application of n,6 or n,6 fatty acids failed to inhibit the development of experimental gingivitis. Rinsing with n,6 fatty acids could reduce the level of GCF in established experimental gingivitis. Zusammenfassung Hintergrund: Vielfach ungesättigte Fettsäuren haben das Potential, die Entzündung durch die Synthese von Mediatoren des 15-Lipoxygenaseweges zu behindern. Dies zeigt Gegeneffekte zu den pro-inflammatorischen Arachnoidonsäuremetaboliten wie Leukotrien B4 (LTB4). Ziele: Das Ziel dieser klinischen Studie war die Überprüfung des Effektes einer topischen Applikation von n,3 oder n,6 vielfach ungesättigten Fettsäuren bie Patienten mit experimenteller Gingivitis. Methoden: Bei jeder Person dienten ähnliche Zähne als Experiment und Kontrollen über eine 21tägige Nichthygiene-Phase und einer 9tägigen Erholungsphase. Wirksamkeitsmessungen basierten auf der Häufigkeit von Provokationsblutung (BOP) und dem Volumen der gingivalen krevikulären Flüssigkeit (GCF). GCF wurde durch Einbringen von Filterpapierstreifen für 30 Sekunden bestimmt. Die Messungen wurden mit einen Periotron 8000 durchgeführt. Die LTB4 Konzentration wurde mit der Umkehrphasen-Hochdruck-Flüssigkeitschromatographie analysiert. Ergebnisse: Nach 21 Tagen des Plaquewachstums waren die Level für BOP, GCF und LTB4 in allen Gruppen signifikant erhöht, ohne Differenzen zwischen den Kontrollen und den experimentellen Flächen. Die Spülung eines Gebietes mit etablierter Gingivitis für eine 9tägige Periode reduzierte die GCF in der n,6 Gruppe signifikant (71.9 (18.7) versus 47.4 (11.4) Peritron-Einheiten, Median (Zwischenquartilstreuung)). Zusammenfassung: Die topische Applikation von n,3 oder n,6 Fettsäuren verhindert die Entwicklung einer experimentellen Gingivitis nicht. Die Spülung mit n,6 Fettsäure konnte den Level der GCF bei einer bestehenden experimentellen Gingivitis reduzieren. Résumé Origine: Les acides gras poly-insaturés ont le potentiel d'atténuer l'inflammation en synthétisant des médiateurs des voies de la lipoxygénase 15 qui montrent des effets opposés aux métabolites de l'acide arachidonique pro-inflammatoire comme la leucotriène B4 (LTB4). But: Le but de cette étude clinique a été d'évaluer les effets de l'application topique d'acide gras poly-insaturés n,3 ou n,6 chez des patients effectuant d'une gingivite expérimentale. Méthodes: Chez chaque sujet, des dents semblables ont servi de sites tests et contrôles durant une phase sans hygiène buccale de 21 jours et une phase de retour à la normale de 9 jours. L'efficacité a été mesurée sur base de la fréquence du saignement au sondage (BOP) et le volume de fluide gingivale (GCF). Le GCF a été déterminé en insérant des papiers filtres pendant 30 s et les mesures ont été lues à l'aide du Périotron 8000. La concentration de LTB4 a été analysée par chromotographie liquide à haute pression à phrase arrière. Résultats: Après 21 jours d'accumulation de plaque dentaire les niveaux de BOP, GCF et LTB4 ont augmenté significativement dans tous les groupes sans aucune différence entre les sites tests et contrôles. Le rinçage d'une zone avec gingivite établie durant une période de 9 journées diminuait les GCF dans le groupe n,6 (unités du Péritron 72 (médian 19) versus 47 (11)). Conclusion: L'application topique d'acide gras n,3 ou n,6 ne permettait pas d'inhiber le développement de la gingivite expérimentale. Le rinçage avec des acides gras n,6 pouvait réduire le niveau de GCF dans la gingivite expérimentale établie. [source] The effects of subgingival calculus on the clinical outcomes of locally-delivered controlled-release doxycycline compared to scaling and root planingJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2002Lonnie R. Johnson Abstract Background, aim: The effect of subgingival calculus on the clinical outcomes of the local delivery of antimicrobials is unknown. This study examines the clinical outcomes of treatment with locally delivered controlled-release doxycycline (DH) or scaling and root planing (SRP) in subsets of adult periodontitis patients with known baseline levels of subgingival calculus. Methods: The data examined were obtained from 393 patients who participated in 2 multi-center trials. All patients had baseline subgingival calculus levels assessed and were then treated at baseline and month 4 with either DH or SRP. Clinical attachment levels (CAL), pocket depth (PD) and bleeding on probing (BOP) were assessed at baseline and months 1, 2, 4, 5, 6, 8 and 9. Results: Treatment with either DH or SRP resulted in significant statistical and clinical improvements in CAL, PD and BOP. These clinical outcomes were equivalent regardless of the extent of subgingival calculus present at baseline. Conclusions: The results indicate that the primary clinical effects of these therapies are the result of a disruption and reduction of the subgingival plaque and not the effect of the removal of subgingival calculus and contaminated cementum. Zusammenfassung Hintergrund, Ziel: Der Effekt von subginvalem Zahnstein auf die klinischen Ergebnisse von lokal freigesetzten antimikrobiellen Mitteln ist unbekannt. Die Studie überprüfte die klinische Ergebnisse der Behandlung mit kontrolliert lokal freigesetztem Doxycyclin (DH) oder mit Wurzelreinigung und -glättung (SRP) bei einer Gruppe von Patienten mit Erwachsenen-Parodontitis mit bekanntem Ausmaß von subgingivalen Zahnstein zu Beginn der Studie. Methoden: Die zu überprüfenden Daten kamen von 393 Patienten, die an 2 multizentrischen Studien teilnahmen. Alle Patienten hatten zur Basis gemessene subgingivale Zahnsteinlevel, und sie wurden dann zur Basis und zum 4. Monat entweder mit DH oder SRP behandelt. Die klinischen Stützgewebeniveaus (CAL), die Sondierungstiefe (PD) und die Provokationsblutung (BOP) wurden zur Basis und zu den Monaten 1, 2, 4, 5, 6, 8 und 9 aufgezeichnet. Ergebnisse: Die Behandlung entweder mit DH oder SRP ergab statistisch signifikante und klinische Verbesserungen beim CAL, bei der PD und bei der BOP. Diese klinischen Ergebnisse waren unabhängig vom Ausmaß des subgingivalen Zahnsteins, der zur Basis vorhanden war, gleich. Schlussfolgerung: Die Ergebnisse zeigen, dass die primären klinischen Effekte von diesen Therapieformen das Resultat der Zerstörung und Reduktion der subgingivalen Plaque sind und nicht den Effekt von der Entfernung des subgingivalen Zahnsteins und kontaminierten Zementes darstellen. Résumé Origine, but: Les effets du tartre sous-gingival sur les comportements cliniques de l'application locale d'antimicrobiens sont inconnus. Cette étude examine le comportement clinique de traitement consistant en l'application locale de doxycycline à libération lente (DH) ou en un détartrage/surfaçage radiculaire seul (SRP) dans des groupes de patients atteints de parodontite de l'adulte avec des niveaux initiaux de tartre sous-gingival connus. Méthodes: Les données examinées sont obtenus chez 393 patients qui participèrent à 2 essais multi-centriques. Chez tous les patients, les niveaux de tartre sousgingivaux initiaux furent évalués et ils furent traités à 0 et à 4 mois avec soit DH, soit SRP. Les niveaux d'attache clinique (CAL), les profondeurs de poche (PD) et le saignement au sondage (BOP) furent évalués initialement et à 1, 2, 4, 5, 6, 8 et 9 mois. Résultats: Le traitement avec les 2 méthodes apportait des améliorations statistiquement significatives pour CAL, PD et BOP. Ces comportements cliniques étaient équivalents quel que fut l'importance du tartre sous-gingival initialement. Conclusions: Les résultats indiquent que les effets cliniques primaires de ces traitements sont le résultat de la réduction et de la désorganisation de la plaque sous-gingivale et non pas l'effet de l'élimination du tartre sous-gingival et du cément contaminé. [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] 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] The effect of repeated professional supragingival plaque removal on the composition of the supra- and subgingival microbiotaJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2000Laurie Ann Ximénez-Fyvie Abstract Background, aims: The purpose of the present investigation was to determine the effect of weekly professionally administered supragingival plaque removal on the composition of the supra and subgingival microbiota. Methods: 18 adult subjects with periodontitis who had been treated and were in a maintenance phase of therapy were clinically and microbiologically monitored at baseline, 3, 6 and 12 months. After the baseline visit, the subjects received scaling and root planing followed by professional supragingival plaque removal every week for 3 months. Clinical measures of plaque accumulation, bleeding on probing (BOP), gingival redness, suppuration, pocket depth and attachment level were made at 6 sites per tooth at each visit. Separate supra (N=1804) and subgingival (N=1804) plaque samples were taken from the mesial aspect of all teeth excluding third molars in each subject at each time point and evaluated for their content of 40 bacterial taxa using checkerboard DNA-DNA hybridization. Significance of changes in mean counts, prevalence and proportions of bacterial species over time in both supra and subgingival samples were determined using the Quade test and adjusted for multiple comparisons. Results: Mean % of sites exhibiting plaque, gingival redness and BOP were significantly reduced during the course of the study. Significant decreases in mean counts were observed in both supra and subgingival samples. Mean total DNA probe counts (×105, ±SEM) at baseline, 3, 6 and 12 months were: 133±19, 95±25, 66±6, 41±6 (p<0.001) for supragingival samples and 105±22, 40±10, 19±4, 13±3 (p<0.001) for subgingival samples. Mean counts of 22 of 40 and 34 of 40 species tested were significantly reduced in the supra and subgingival samples respectively over the monitoring period. For example, mean counts of Porphyromonas gingivalis×105 at baseline, 3, 6 and 12 months in the subgingival plaque samples were 2.0±0.4, 0.5±0.2, 0.6±0.3, 0.3±0.1 (p<0.001); Bacteroides forsythus 2.0±0.6, 0.4±0.1, 0.4±0.2, 0.1±0.2 (p<0.001); Treponema denticola 3.4±1.1, 0.8±0.3, 0.4±0.2, 0.3±0.3 (p<0.01). Similar reductions were seen in supragingival plaque samples. While counts were markedly reduced by professional plaque removal, the proportion and prevalence of the 40 test species were marginally affected. Conclusions: Weekly professional supragingival plaque removal profoundly diminished counts of both supra- and subgingival species creating a microbial profile comparable to that observed in periodontal health. This profile was maintained at the final monitoring visit, 9 months after completion of therapy. [source] Commodity price stabilisation: macroeconomic impacts and policy optionsAGRICULTURAL ECONOMICS, Issue 1 2000Chinna A. Kannapiran Abstract A macroeconometric simulation study is undertaken to evaluate the impact of commodity price stabilisation (CPS) schemes for the export tree crop industry in Papua New Guinea. The findings suggest that there is a negligible level of favourable macroeconomic impacts of CPS. Contrary to the expectation, CPS adversely affects the stability of monetary and external sectors (BOP). CPS policy has failed to stabilise the macroeconomy. The price stabilisation policies are no longer appropriate from the macroeconomic point of view. Technical change, futures market and rural savings are the possible alternative policy options to manage the price risk. [source] Monitoring periodontal disease status in smokers and nonsmokers using a gingival crevicular fluid matrix metalloproteinase-8-specific chair-side testJOURNAL OF PERIODONTAL RESEARCH, Issue 6 2006P. Mäntylä Background and Objective:, With current periodontal diagnostic tools it is difficult to identify susceptible individuals or sites at risk. The aim of this study was to evaluate the efficacy of the matrix metalloproteinase (MMP)-8-specific chair-side dip-stick test in longitudinally monitoring the periodontal status of smoking (S) and nonsmoking (NS) patients with chronic periodontitis, using their gingival crevicular fluid (GCF) MMP-8 concentrations. Material and Methods:, Clinical parameters, MMP-8 test results and concentrations were monitored in 16 patients after initial treatment and in 15 patients after scaling and root planing (SRP), every other month, over a 12-mo time period. Progressing and stable sites, and sites with exceptionally high MMP-8 concentrations, were analysed in smokers and nonsmokers. Results:, SRP reduced the mean GCF MMP-8 levels, test scores, probing depth (PD), attachment loss (AL) and bleeding on probing (BOP). In sites of periodontal disease progression, the distribution of MMP-8 concentrations was broader than in stable sites, indicating a tendency for elevated concentrations in patients with periodontal disease. The mean MMP-8 concentrations in smokers were lower than in nonsmokers, but in smokers' and nonsmokers' sites with progressive disease, MMP-8 concentrations were similar. Sites with exceptionally elevated MMP-8 concentrations were clustered in smokers who also showed a poor response to SRP. In these sites, the MMP-8 concentration did not decrease with SRP and these sites were easily identified by the MMP-8 test. Conclusion:, Persistently elevated GCF MMP-8 concentrations may indicate sites at risk, as well as patients with poor response to conventional periodontal treatment (e.g. SRP). MMP-8 testing may be useful as an adjunct to traditional periodontal diagnostic methods during the maintenance phase. [source] Effects of sub-antimicrobial dose doxycycline therapy on crevicular fluid MMP-8, and gingival tissue MMP-9, TIMP-1 and IL-6 levels in chronic periodontitisJOURNAL OF PERIODONTAL RESEARCH, Issue 1 2004Dong-Hoon Choi Objective:, To investigate whether sub-antimicrobial dose doxycycline (SDD) therapy for 120 d in chronic adult periodontitis patients had significant effects on gingival crevicular fluid (GCF) matrix metalloproteinase-8 (MMP-8) levels, and on gingival tissue MMP-9, tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) and interleukin-6 (IL-6) levels. Background:, Tetracycline can significantly inhibit MMP activity in GCF and in gingival tissue, even in much lower dosage then a traditional antimicrobial dosage used in conventional therapy. Sub-antimicrobial dose doxycycline (SDD) therapy has been shown to reduce periodontal disease activity to control MMP and pro-inflammatory cytokines. Methods:, A total of 32 patients with incipient to moderate (probing pocket depth ,,4,7 mm) chronic adult periodontitis were included in the study. Subjects were randomly assigned to two groups. After scaling and root planning (SRP), the SRP + SDD group received SDD, 20 mg bid, whereas the SRP + placebo group received placebo, 20 mg bid. In the follow-up, efficacy measures included the change in probing pocket depth (PD), clinical attachment level (CAL), bleeding on probing (BOP) and gingival crevicular fluid MMP-8 levels, gingival tissue MMP-9, TIMP-1 and IL-6 levels from baseline to 120 d. Results:, After 120 d, PD and CAL improved significantly in the SRP + SDD group. Initial MMP-8 levels for the SRP + SDD group and the SRP + placebo group were 407.13 ± 114.45 ng/ml and 378.71 ± 189.39 ng/ml, respectively, with no statistical difference between the two groups. MMP-8 levels for the SRP + SDD group and the SRP + placebo group were: 235.35 ± 134.58 ng/ml and 364.04 ± 219.27 ng/ml at 30 d; 157.50 ± 95.95 ng/ml and 236.60 ± 186.16 ng/ml at 60 d; 102.70 ± 67.64 ng/ml and 208.56 ± 124.54 ng/ml at 90 d; and 63.77 ± 53.33 ng/ml and 229.13 ± 168.09 ng/ml at 120 d, respectively. The amount of decrease in MMP-8 levels for the SRP + SDD group was statistically significant compared to that for the SRP + placebo group, especially apparent at 120 d (p < 0.05). TIMP-1 levels in both groups increased from the baseline to 120 d with statistical significance (p -value < 0.05), but there was no significant difference between the two groups. Changes in MMP-9 and IL-6 levels were not statistically significant. Conclusion:, Adjunctive SDD therapy can improve the clinical parameters and this clinical improvement is reflected by controlled level of MMP-8 in chronic adult periodontitis after the therapy. [source] Immunohistochemical analysis of Th1/Th2 cytokine profiles and androgen receptor expression in the pathogenesis of nifedipine-induced gingival overgrowthJOURNAL OF PERIODONTAL RESEARCH, Issue 4 2003W-T. Huang Background:, Numerous studies have demonstrated that gingival overgrowth may be associated with androgen and cytokine expression in tissues. Objectives:, The aim of this study was to compare the expression of androgen receptor-presenting cells (AR+ cells) and Th1/Th2 cytokine [Th1: interleukin (IL)-2, interferon-, (IFN-,); Th2: IL-4, IL-10, IL-13] expression cells in tissue sections of patients with gingival overgrowth. Materials and methods:, Tissue samples were collected from patients with healthy periodontium (H group), adult periodontitis (P group), surgically extracted teeth (S group), and nifedipine-induced gingival overgrowth (NIGO group). The clinical periodontal parameters of pocket depth (PD), bleeding on probing (BOP), and plaque control record (PCR) were measured around selected sample teeth. Gingival biopsies were further processed by immunohistochemical staining method. The expressions of cells positive for AR, IL-2, IFN-,, IL-4, IL-10, and IL-13 were counted by predetermined semiquantitative methods. Results:, Our results indicated that AR, IL-2, IFN-,, IL-4, IL-10, and IL-13 were intensively expressed in the nuclei of inflammatory cells and fibroblasts of gingival connective tissue. Stronger expressions of AR, IL-2, and IFN-, were found in the NIGO group. The AR+ cells/0.01 mm2 in gingival fibroblasts were significantly higher in the NIGO group (80.2 ± 10.7) than those of the periodontitis group (52.5 ± 11.8) and control group (37.4 ± 11.3) (P < 0.05). The cytokine expression of the NIGO group showed a trend towards Th1-type expression (IL-2; P = 0.0001). In the surgically extracted tooth group, a stronger expression of Th2-type cytokine (IL-4, Il-10, IL-13; P < 0.05) was found in inflammatory cells. In a comparison of the IL-2/IL-4-labeled cell ratio of the four groups, a descending sequence was discovered as NIGO group (0.92 ± 0.97) > H group (0.81 ± 0.61) > P group (0.77 ± 0.82) > S group (0.58 ± 1.77). Conclusions:, Our data support the following: (i) taking nifedipine may elevate the expression of AR in susceptible oral tissue, e.g. gingiva; (ii) the cytokine profile of T-cells in NIGO tissue indicates a trend preferentially towards Th1 activity; and (iii) elevation of AR expression cells and prominent Th1 cytokine-labeled cells are two significant factors in the pathogenesis of NIGO. [source] Hepatocyte growth factor (HGF) in jreiodontal disease: detection of HGF in gingival crevicular fluidJOURNAL OF PERIODONTAL RESEARCH, Issue 1 2002Mitsuhiro Ohshima Hepatocyte growth factor (HGF) acts as a mitogen, motogen, morphogen, anti-apoptotic factor, and scatter factor for various kinds of epithelial cells. It is a protein secreted by mesenchymal cells such as fibroblasts, and promotes motility and matrix invasion of epithelial cells. To clarify whether HGF is involved in jreiodontal disease, this study was conducted to determine whether HGF is present in gingival crevicular fluid (GCF) and to investigate the relationship between levels of HGF and the clinical parameters of jreiodontal disease, probing depth (PD), gingival index (GI) and bleeding on probing (BOP). We examined and collected GCF samples from 80 sites in 38 subjects with jreiodontal or other oral diseases. The concentrations of HGF, IL-1, and PGE2 were determined by ELISA, and active collagenase activity was determined by functional assay. The HGF level correlated positively with PD and GI, and was significantly higher in specimens from BOP-positive sites and those where PD exceeded 4 mm compared with those from sites that were BOP-negative or with a PD less than 3 mm. There was a significant positive correlation between the concentrations of HGF and IL-1,. These results indicate that the HGF level in GCF correlates well with clinical parameters of jreiodontal disease, and suggest that HGF may be involved in epithelial invasion through its role as a scatter factor. [source] Reduced expression of the Rassf1a gene and its aberrant DNA methylation in pancreatic duct adenocarcinomas induced by N-nitrosobis(2-oxopropyl)amine in hamstersMOLECULAR CARCINOGENESIS, Issue 2 2008Kyoko Shimizu Abstract Alterations of the Rassf1a gene were investigated in pancreatic duct adenocarcinomas (PDAs) induced by N-nitrosobis(2-oxopropyl)amine (BOP) in hamsters. Female Syrian golden hamsters received 70 mg/kg BOP, followed by repeated exposures to an augmentation pressure regimen consisting of a choline-deficient diet combined with a sequential course of DL -ethionine, L -methionine, and 20 mg/kg BOP. A total of 15 PDAs were obtained, and total RNAs were assessed by real-time quantitative reverse transcription (RT)-polymerase chain reaction (PCR). Expression of the Rassf1a was significantly reduced in PDAs (P,<,0.005) compared with normal pancreatic tissues. For analysis of methylation status, bisulfite sequencing was performed. Normal tissues were all unmethylated in the 5, upstream region of Rassf1a. In contrast, four PDAs were highly methylated, correlating with reduced expression of the Rassf1a gene. Using reverse transcription (RT)-polymerase chain reaction (PCR)-single strand conformation polymorphism (SSCP) analysis, mutations were detected in 3 out of 15 PDAs (20%). These results suggested that alterations of the Rassf1a gene may be involved in development of PDAs induced by BOP in hamsters. © 2007 Wiley-Liss, Inc. [source] Cytokines in gingival crevicular fluid of adolescents and young adultsMOLECULAR ORAL MICROBIOLOGY, Issue 1 2009J. Kamma Background/aim:, The purpose of this study was to compare the levels of the cytokines interleukin-1, (IL-1,), IL-4, and IL-8 in the gingival crevicular fluid (GCF) of adolescents and young adults. Methods:, Twenty-five adolescents aged between 14 and 16 years (Group A) and 20 periodontally healthy young adults aged between 25 and 35 years (Group B) were selected from two private dental clinics limited to pedodontics and periodontics respectively in Piraeus Greece. All subjects were systemically healthy. Clinical examination included probing pocket depth (PPD), presence or absence of plaque, and bleeding on probing (BOP). GCF was collected from four sites per subject. IL-1,, IL-4, and IL-8, measured as total amounts (pg/30 s), were evaluated in 180 samples using a commercially available sandwich enzyme-linked immunosorbent assay. Results:, IL-1, mean levels of Groups A and B were adjusted for BOP and PPD. Differences of IL-1, mean levels between the two age groups were statistically significant (F = 50.245, P < 0.001) in favour of Group A. Adolescents showed statistically significantly lower mean levels of IL-4 than young adults in the presence of BOP (F = 10.690, P = 0.001). There was no statistically significant difference between adolescents and adults for the means of IL-8 adjusted for BOP and plaque presence (F = 2.032, P = 0.161). Conclusions:, Within the limits of this study the differences reported in mean levels of IL-1, and IL-4 may be attributed to the different age status. [source]
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