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Clinical Attachment Loss (clinical + attachment_loss)
Selected AbstractsMetabolic syndrome, insulin resistance, and periodontitis: a cross-sectional study in a middle-aged French populationJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2010Catherine Benguigui Benguigui C, Bongard V, Ruidavets J-B, Chamontin B, Sixou M, Ferrières J, Amar J. Metabolic syndrome, insulin resistance and periodontitis: a cross-sectional study in a middle-aged French population. J Clin Periodontol 2010; 37: 601,608. doi: 10.1111/j.1600-051X.2010.01571.x. Abstract Aim: Metabolic syndrome consists of a cluster of clinical and biological abnormalities, influenced by insulin resistance and promoting cardiovascular diseases. We examined the relationships between metabolic syndrome, its various components, insulin resistance, and periodontitis. Materials and Methods: The study included 276 subjects (35,74 years) recruited within a cross-sectional survey on cardiovascular risk factors. Twenty-one were excluded because of infectious risk or total tooth loss. Clinical attachment loss (CAL), probing pocket depth (PD), gingival and plaque indexes were recorded. Periodontitis was classified into moderate and severe forms. Results: The mean age was 58, 41% of the subjects had moderate and 39% had severe periodontitis. In univariate comparisons, periodontitis was associated with metabolic syndrome (p=0.050), most of its components, and HOMA index (homoeostasis model assessment of insulin resistance). After adjustment for confounders, only HOMA index remained associated with severe periodontitis (odds ratio [OR]=3.97 [95% confidence interval: 1.22,12.9], OR=3.78 [1.14,12.5] for third and fourth versus the first quartile of the HOMA index, respectively). The HOMA index was also associated with the number of periodontal sites with CAL4 mm, CAL5 mm, or PD4 mm (greater number for higher HOMA-index values). This relationship disappeared in never-smokers. Conclusions: Our data support the relationships between metabolic disturbances and periodontitis, with a central role of insulin resistance. [source] Clinical attachment loss produced by curettes and ultrasonic scalersJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2005Renato Vasconcelos Alves Abstract Objectives: The aim of this study was to clinically detect the immediate effect of root instrumentation with curettes and ultrasonic scalers on clinical attachment level. Material and Methods: Twelve subjects with moderate chronic periodontitis, presenting probing depths of 3.5,6.5 mm on anterior teeth, upper and/or lower, were selected. Teeth were randomly assigned to one of the following groups: US group , scaled with an ultrasonic scaler; and CC group , scaled and planed with 5,6 Gracey curettes. The selected teeth were probed with a computerized electronic probe, guided by an occlusal stent and subjected to scaling and root planing. Immediately following instrumentation, teeth were probed again. The difference between relative attachment level (RAL) immediately before and after instrumentation was considered trauma from instrumentation. Results: Intra-group analysis revealed statistically significant differences between RAL immediately before and after instrumentation in both groups (0.77±0.51 for US group; and 0.73±0.41 for CC group, p<0.0001). However, inter-group analysis did not show statistically significant difference in trauma from instrumentation caused by the two different instruments (p=0.816). Conclusions: Within the limits of this study, it was concluded that root instrumentation causes a mean immediate attachment loss of 0.75 mm, and that instrumentation with either curettes or ultrasonic scalers do not seem to reduce significantly the trauma from of instrumentation produced. [source] The effect of the Vector® scaler system on human teeth: a systematic reviewINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 3 2008DE Slot Abstract:, Aim:, To review the available literature, considering the effect of instrumentation with the Vector® ultrasonic scaler on human teeth in vitro and in vivo compared to conventional ultrasonic instruments and/or hand instrumentation. The assessed effects are calculus removal, time of instrumentation, root surface aspects, cell attachment, patients' perception, bleeding upon probing, pocket depth, clinical attachment loss and microbiological effects. Materials and methods:, MEDLINE,PubMed and the Cochrane Central register of controlled trials (CENTRAL) were searched up through January 2008 to identify appropriate studies. Results:, Independent screening of the titles and abstracts of 270 MEDLINE,PubMed and 15 Cochrane papers resulted in 15 suitable publications. The studies differed in design and outcome, so this review summarizes the outcomes in a descriptive manner. Comparisons are presented against conventional ultrasonic system and scaling and root planing. Conclusion:, The Vector® ultrasonic scaler provided comparable clinical and microbiological periodontal healing results as scaling and root planing and conventional ultrasonic system in moderately deep pockets. The Vector® ultrasonic scaler may be used as a gentle root debridement device for supportive periodontal therapy, as an alternative to other conventional ultrasonic system. The operator should however consider the extra time needed for instrumentation. [source] Intraoral condition in children with juvenile idiopathic arthritis compared to controlsINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 6 2008EVA LEKSELL Aims. The aims of this study were to compare the periodontal conditions in children and adolescents with juvenile idiopathic arthritis (JIA) in comparison to age-matched healthy individuals, and to describe intraoral health in relation to medical assessments. Design. Forty-one JIA patients, 10,19 years old, were compared to 41 controls. Plaque, calculus, probing depth, bleeding on probing, clinical attachment loss, as well as mucosal lesions were registered. Marginal bone level was recorded on radiographs. A questionnaire was included. Data were analysed with chi-squared test, Fisher's exact test, and Mann,Whitney U -test (P < 0.05). Results. The JIA patients reported pain from jaws (P = 0.001), hands (P = 0.001), and oral ulcers (P = 0.015) more often than controls. They avoided certain types of food because of oral ulcers (P = 0.037). The frequencies of sites with plaque (32% vs. 19%, P = 0.013), calculus (11% vs. 5%, 5 = 0.034), bleeding on probing (26% vs. 14%, P < 0.01), and probing depth 2 mm (32% vs. 2%, P < 0.001) were higher among JIA patients. No sites with attachment loss or reduced marginal bone level were observed. Conclusions. These obtained results are probably because of joint pain, making it difficult to perform oral hygiene as well as the use of medication and general disease activity. [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] 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] Effect of partial recording protocols on severity estimates of periodontal diseaseJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2008Albert Kingman Abstract Objectives: The study aim was to assess bias magnitudes of periodontal disease severity estimates for specific partial recording protocols (PRPs) in epidemiological studies. Material and Methods: Estimates of mean clinical attachment loss (MCAL) and mean probing pocket depth (MPPD) were derived for 20 different PRPs using full-mouth periodontal data from 1437 dentate Brazilian subjects 14,103 years old having at least four teeth. Biases, relative biases and intra-class correlations for all PRPs were evaluated. Graphical methods were used to assess how well the PRP-based estimates agreed with full-mouth scores across levels of disease. Results: Slightly higher levels of disease were evidenced on lingual than on buccal sites. Seven multi-site PRPs and the Ramfjörd PRP produced small biases in MPPD (,0.17 to 0.04 mm) and MCAL with relative biases under 8% and 4% in absolute value for MPPD and MCAL, respectively. Biases for full- and random half-mouth-based PRPs were similar. The three-site random half-mouth MB,B,DL and the Ramfjörd PRPs produced the smallest biases, with relative biases <3% in absolute value for MPPD and MCAL. Conclusions: Bias for MPPD or MCAL estimates varies by site type, number of sites per tooth and number of quadrants included in the PRP. [source] Clinical characteristics and microbiota of progressing slight chronic periodontitis in adultsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2007Anne C. R. Tanner Abstract Aim: This study sought clinical and microbial risk indicators for progressing slight periodontitis. Material and Methods: One hundred and seventeen periodontally healthy or slight periodontitis adults (20,40 years) were monitored clinically at 6-month intervals followed by supragingival cleaning. Inter-proximal sites with >1.5 mm increase in clinical attachment over 18 months were considered disease active. Subgingival plaque was analysed by 78 16S rDNA and 38 whole-genomic DNA probes and by PCR to Porphyromonas gingivalis and Tannerella forsythia. Characteristics were compared between active and inactive subjects. Results: Twenty-two subjects showed disease activity principally at molars. Mean baseline gingival and plaque indices, bleeding on probing, probing depth and clinical attachment level (CAL) were higher in active subjects. DNA probes detected species and not-yet-cultivated phylotypes from chronic periodontitis, although few species were associated with active subjects. By PCR P. gingivalis (p=0.007) and T. forsythia (p=0.075) were detected more frequently during monitoring in active subjects. Stepwise logistic analysis associated baseline levels of gingival index, clinical attachment and bleeding with subsequent clinical attachment loss. Conclusions: Gingivitis and CAL were significantly associated with progressing slight periodontitis in 20,40-year-old adults. Species associated with moderate and advanced chronic periodontitis were detected in slight 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] Genetic polymorphisms in the MMP-1 and MMP-3 gene may contribute to chronic periodontitis in a Brazilian populationJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2006Claudia Maria Astolfi Abstract Objectives: Matrix metalloproteinase-1 and -3 (MMP-1, MMP-3) represent proteinases that degrade macromolecules of the extracellular matrix. These enzymes play a fundamental role during destruction of periodontal tissues. Genetic polymorphisms were characterized in the promoter region of the MMP-1 and MMP-3 genes. The aim of this study was to investigate the relationship between these genetic variations with chronic periodontitis in a Brazilian population. Material and Methods: Non-smoking subjects (n=114) exhibiting sites 5 mm clinical attachment loss were recruited for study. Control subjects (n=109) should not exhibit clinical signals of periodontitis. MMP-1 (,1607 1G/2G, ,519 A/G) and MMP-3 (,1612 5A/6A) gene promoter polymorphisms were genotyped using PCR-RFLP methods. Results: Analysis of polymorphisms showed no differences in distribution of the ,1607 1G/2G and ,519 A/G variants in the MMP-1 gene between the healthy and periodontitis group (p>0.05). However, the distribution of genotype frequencies of the ,1612 5A/6A polymorphism in the MMP-3 gene showed that the 5A/5A genotype was significantly more frequent in the periodontitis group (p=0.008). The same was not observed in the 5A/6A genotype once only one 5A allele is carried. We also observed a trend to increase the frequency of the MMP-1/MMP-3 haplotype (2G/5A) in the periodontitis group (p=0.08). Conclusion: On the basis of the results, no significant association is found for the MMP-1 polymorphisms with susceptibility of periodontitis, while the MMP-3 gene polymorphism may contribute to periodontal tissue destruction during periodontitis in Brazilian subjects. [source] Gingival crevicular fluid laminin-5 ,2-chain levels in periodontal diseaseJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2006Gülnur Emingil Abstract Aim: Our study aimed to examine the molecular forms and gingival crevicular fluid (GCF) levels of laminin-5 ,2-chain in patients with different periodontal disease, and compare the effects of P.gingivalis trypsin-like proteinase on intact laminin-5 ,2-chain species. Methods: Eighteen patients with generalized aggressive periodontitis (G-AgP), 29 patients with chronic periodontitis (CP), 20 with gingivitis and 20 periodontally healthy subjects were included. Probing depth, clinical attachment loss, presence of bleeding on probing and plaque were recorded. Molecular forms and GCF laminin-5 ,2-chain levels and the effects of P. gingivalis trypsin-like proteinase on intact laminin-5 ,2-chain were analysed by computer-quantitated Western immunoblotting. Results: Laminin-5 ,2-chain 40 and 70 kDa fragments could be detected in all groups, in varying levels. The CP group had elevated GCF laminin-5 ,2-chain fragment levels compared with the gingivitis and healthy groups (p<0.008). The G-AgP group had GCF laminin-5 ,2-chain fragment levels similar to the gingivitis and healthy groups (p>0.008). GCF laminin-5 ,2-chain fragments differed clearly from the multiple lower molecular size fragments of P.gingivalis trypsin-laminin-5 ,2-chain proteinases. Conclusion: Increased GCF laminin-5 ,2-chain fragments in periodontitis sites with deep periodontal pocket suggest that these cleaved 40 and 70 kDa fragments could reflect the extent of the inflammatory reaction in CP. [source] Periodontal disease in the oldest-old living in Kungsholmen, Sweden: findings from the KEOHS projectJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2006Poul Holm-Pedersen Abstract Aims: The Kungsholmen Elders Oral Health Study evaluated the oral health status of generally healthy, community-dwelling persons aged 80 years and over living in Stockholm, Sweden. This paper reports periodontal disease findings and evaluates the distribution by sociodemographic factors. Methods: Eligible persons were identified through the Kungsholmen Project, an ongoing, longitudinal, population-based study of older adults. A total of 121 study subjects received a periodontal examination. Results: The mean pocket probing depth was 2.6 mm and the mean clinical attachment loss was 3.7 mm. Gingival bleeding was common. Over half of all study participants met the criteria used for "serious periodontitis" (SP). In the best fit adjusted odds ratio (OR) model, males were 3.1 times more likely than females to have "SP" (OR=3.1, 95% CI 1.2, 8.0), a statistically significant observation. A sub-analysis of the differences in proportion of participants with SP revealed that the difference by sex also increased by age. Conclusions: These findings document the substantial and ongoing impact of periodontal disease in a sample of generally healthy, community dwelling older adults and underscore the importance of continued periodontal disease prevention and treatment in the oldest-old. [source] Alcohol consumption and periodontal diseaseJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2004Nutrition Examination Survey, The Third National Health Abstract Objective: This study was carried out to evaluate the effect of alcohol consumption on the severity of periodontal disease. Material and Methods: This cross-sectional study employed 13,198 subjects of the Third National Health and Nutrition Examination Survey (NHANES III) aged 20 and older who have at least six natural teeth. Alcohol intake was represented both as a continuous variable and dichotomized using 5, 10, 15, and 20 drinks/week as cut-points. Periodontal disease was represented by clinical attachment loss (CAL) and was assessed both as a continuous variable and dichotomized as <1.5 mm and 1.5 mm. Independent effect of alcohol on CAL was assessed by weighted multiple linear and logistic regression analyses adjusting simultaneously for the effects of age, gender, race, education, income, smoking, diet, diabetes, gingival bleeding, number of remaining teeth. Results: There was a significant linear relationship between number of drinks per week and log CAL (p=0.0001). Odds ratios for the risk of attachment loss using 5, 10, 15, and 20 drinks/week as cut-points were 1.22 [1.02,1.47], 1.39 [1.13,1.71], 1.54 [1.22,1.93], and 1.67 [1.25,2.23], respectively. Conclusion: Alcohol consumption may be associated with increased severity of CAL in a dose-dependent fashion. Prospective studies and studies of mechanism are needed to confirm the role of alcohol as a risk factor for periodontal disease. [source] The association of gingivitis and periodontitis with ischemic strokeJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 5 2004Christof E. Dörfer Abstract Objectives: The aim of this study was to assess the associations of different periodontal parameters with cerebral ischemia. Methods: In a case,control study, 303 consecutive patients with ischemic stroke or transient ischemic attack, and 300 representative population controls received a complete clinical and radiographic dental examination. Patients were examined on average 3 days after ischemia. The individual mean clinical attachment loss measured at four sites per tooth was used as indicator variable for periodontitis. Results: Patients had higher clinical attachment loss than population (p<0.001). After adjustment for age, gender, number of teeth, vascular risk factors and diseases, childhood and adult socioeconomic conditions and lifestyle factors, a mean clinical attachment loss >6 mm had a 7.4 times (95% confidence interval 1.55,15.3) a gingival index >1.2 a 18.3 times (5.84,57.26) and a radiographic bone loss a 3.6 times (1.58,8.28) higher risk of cerebral ischemia than subjects without periodontitis or gingivitis, respectively. Conclusion: Periodontitis is an independent risk factor for cerebral ischemia and acute exacerbation of inflammatory processes in the periodontium might be a trigger for the event of cerebral ischemia. [source] Periodontal disease among indigenous people in the Amazon rain forestJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2001Mauricio Ronderos Abstract Background: People are not all equally susceptible to periodontitis. To understand the epidemiology and natural history of this disease, it is important to study populations with varying genetic backgrounds and environmental exposures. Aim: Characterize the periodontal condition of a sample of indigenous adults in a remote region of the Amazon rain forest and determine the association of periodontal disease with various demographic, behavioral and environmental factors. Methods: A cross-sectional evaluation of 244 subjects aged 20,70 years was conducted. Pocket depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), plaque and calculus were assessed for the Ramfjord index teeth. Results: These people had high levels of plaque, calculus and BOP. The mean PD was rather shallow (2.45 mm in 20,29 year-olds to 2.73 mm in 50+ year-olds) and did not increase significantly with age. Mean CAL (0.57 mm in 20,29 year-olds and 2.26 mm in 50+ year-olds) and mean location of the free gingival margin in relation to the cemento-enamel junction changed significantly with age (p<0.0001). Multivariate analysis revealed that increasing age, bleeding on probing and calculus scores were positively associated with mean CAL (p<0.01). Sex, ethnicity, level of modern acculturation, use of coca or tobacco paste, frequency of dental visits and plaque were not associated with mean CAL. Conclusions: Periodontal disease in these people was mainly associated with gingival recession rather than deep pockets. Most people had clinical attachment loss but despite poor oral hygiene and extensive gingival inflammation, they did not have very severe periodontal destruction. [source] Generalized cervical root resorption associated with periodontal diseaseJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2001Wouter Beertsen Abstract Background and description of case: The etiology and pathogenesis of generalized cervical root resorptions is not well understood. In the present report, a case of severe cervical root resorption involving 24 anterior and posterior teeth is presented. The lesions developed within a period of 2 years after the patient had changed to an acid-enriched diet. They extended far into the coronal dentin and were associated with gingival inflammation and crestal bone resorption. However, no generalized clinical attachment loss had occurred. Culturing of subgingival plaque revealed the presence of several putative periodontal pathogens among which Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Treatment consisted of mechanical debridement supported by systemic antibiotics (amoxycillin plus metronidazole) and dietary advice. Results: Within 1 year after the onset of treatment, all resorptive lesions had repaired by ingrowth of a radio-opaque mineralized tissue. The crestal areas showed radiological evidence of bone repair. 3 years after the onset of therapy, one premolar was extracted and examined histologically. It appeared that irregularly-shaped masses of woven bone-like tissue had invaded into the domain of the resorbed coronal dentin and were bordered by thin layers of acellular cementum. Conclusion: It is concluded that, in this patient, the cervical resorptions were likely the result of an osteoclastic response extending into the roots because the root-protective role of the junctional epithelium did not develop. We hypothesize that this was due to the combined effects of a periodontopathogenic microflora and a dietary confounding factor. Zusammenfassung Hintergrund und Beschreibung des Falls: Die Ätiologie und die Pathogenese der generalisierten Wurzelresorptionen ist nicht besonders bekannt. In der vorliegenden Fallpräsentation wird ein schwerer Fall von Wurzelresorption gezeigt, die 24 anteriore und posteriore Zähne einbezog. Die Läsionen entwickelten sich innerhalb einer Periode von 2 Jahren, nachdem der Patient zu einer Säure-angereicherten Diät gewechselt hatte. Die Läsionen dehnten sich in das koronale Dentin aus und waren mit gingivaler Entzündung und krestaler Knochenresorption verbunden. Jedoch wurde kein generalisierter Attachmentverlust beobachtet. Die Kultur der subgingivalen Plaque erbrachte das Vorhandensein von verschiedenen putativen parodontalen Pathogenen, unter ihnen Actinobacillus actinomycetemcomitans und Porphyromonas gingivalis. Die Behandlung bestand in der mechanischen Reinigung unterstützt mit systemischen Antibiotika (Amoxicillin und Metronidazol) und Diätanweisungen. Ergebnisse: Innerhalb eines Jahres nach dem Beginn der Therapie waren alle Resorptionsläsionen repariert durch das Einwachsen von röntgenopakem mineralisierten Gewebe. Die krestalen Regionen zeigten radiologisch nachgewiesene Knochenreparatur. 3 Jahre nach Therapiebeginn wurde ein Prämolar extrahiert und histologisch untersucht. Es schien, daß irreguläre geformte Massen von verflochtenem knochen-ähnlichen Gewebe in den Hauptteil des resorbierten koronalen Dentins hineingelangt sind und von dünnen Schichten azellulären Zementes begrenzt wurden. Zusammenfassung: Es wird geschlußfolgert, daß bei diesem Patient die zervikalen Resorptionen wahrscheinlich das Ergebnis einer osteoklastischen Reaktion waren, bis in die Wurzeln ausgedehnt, weil sich die wurzelschützende Rolle des Verbindungsepithels nich entwickelt hatte. Wir nehmen an, daß dies in der Folge eines kombinierten Effektes von parodontopathogenen Keimen und eines verwirrenden diätetischen Faktors geschah. Résumé Origine: L'étiologie et la pathogenèse des résorptions radiculaires cervicales généralisées ne sont pas suffisamment connues. Dans le rapport présent, un cas de résorption radiculaire cervicale sévère se rapportant à 24 dents antérieures et postérieures est présenté. Les lésions s'étaint développées durant les 2 années qui ont suivi le changement de régime alimentaire du patient vers un régime plus acide. Elles s'étendaient profondément dans la dentine coronaire et étaient associées à une inflammation gingivale et une résorption osseuse crestale. Cependant, aucune perte d'attache clinique généralisée n'est apparue. La culture de la plaque dentaire sous-gingivale a révélé la présence de plusieurs pathogènes parodontaux putatifs parmi lesquels l'Actinobaccilus actinomycetemcomitans et le Porphyromonas gingivalis. Le traitement a consisté en un nettoyage mécanique associéà l'utilisation d'antibiotiques par voie systémique (amoxycilline + métronidazole) et un conseil diététique. Résultats. Dans l'année qui a suivi ce traitement, toutes les lésions de résorption ont été guéries par la croissance d'un tissu minéralisé radio-opaque. Les zones crestales montraient une évidence radiologique de réparation osseuse. 3 ans après le démarrage de ce traitement, une prémolaire a été avulsée et examinée histologiquement. Il est apparu que des masses de formes irrégulières de tissus ressemblant à de l'os ouaté avaient envahi le domaine de dentine coronaire résorbé et étaient entourées par de fines couches de cément acellulaire. Conclusions: Chez ce patient, les résorptions cervicales étaient vraisemblablement dûes à une réponse ostéoclastique s'étendant dans les racines parce que le rôle de protection radiculaire de l'épithélium de jonction ne s'étaient pas développé. Cette situation était vraisemblablement dûe à des effets combinés de la microflore parodonto-pathogène et d'un facteur diététique. [source] Gingival crevicular fluid and plasma levels of neuropeptide Substance-P in periodontal health, disease and after nonsurgical therapyJOURNAL OF PERIODONTAL RESEARCH, Issue 2 2009A. R. Pradeep Background and Objective:, The level of Substance-P in gingival crevicular fluid has been found to correlate with clinical measures of periodontal disease. The present study was designed to assess the relationship between clinical parameters and levels of Substance-P in the gingival crevicular fluid from inflamed gingiva, periodontitis sites and after treatment of periodontitis sites, and to correlate them to the Substance-P levels of plasma. Material and Methods:, Thirty, age- and gender-matched subjects were divided into three groups (healthy, gingivitis and chronic periodontitis) based on modified gingival index scores and clinical attachment loss. A fourth group consisted of 10 subjects from the periodontitis group, 6,8 wk after initial therapy. Plasma and gingival crevicular fluid samples were collected and quantified for Substance-P using an enzyme immunoassay. Results:, The mean concentration of Substance-P, both in gingival crevicular fluid and plasma, was observed to be highest in the periodontitis group (45.13 pg/mL in gingival crevicular fluid and 67.8 pg/mL in plasma) and lowest in the healthy group (6.07 pg/mL in gingival crevicular fluid and below the detection level in plasma). The mean Substance-P concentration in the gingivitis group (11.42 pg/mL in gingival crevicular fluid and 38.8 pg/mL in plasma) and in the after-treatment group (7.58 pg/mL in gingival crevicular fluid and 39.7 pg/mL in plasma) lay between the highest and lowest values. In all groups the gingival crevicular fluid levels showed a statistically significant positive correlation with that of plasma and clinical attachment loss. Conclusion:, Substance-P levels were highest in the gingival crevicular fluid from sites with periodontal destruction; however, periodontal treatment resulted in the reduction of Substance-P levels. Gingival crevicular fluid and plasma Substance-P levels showed a positive correlation in all of the groups. [source] Comparative analysis of putative periodontopathic bacteria by multiplex polymerase chain reactionJOURNAL OF PERIODONTAL RESEARCH, Issue 3 2008M. Morikawa Background and Objective:, The polymerase chain reaction (PCR) has been applied for the rapid and specific detection of periodontopathic bacteria in subgingival plaque and is potentially of clinical benefit in the diagnosis and treatment of periodontitis subjects. However, several technical points need to be modified before the conventional PCR detection system can be used by clinicians. Material and Methods:, To develop a PCR-based technique more applicable for clinical use than conventional PCR, we established a multiplex PCR for five putative periodontopathic (Treponema denticola, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia and Tannerella forsythia) and two nonperiodontopathic (Streptococcus sanguinis and Streptococcus salivarius) species of bacteria using whole-plaque suspension as templates, and detected bacteria in subgingival plaque taken from 85 subjects at the supportive periodontal therapy stage after active periodontal treatments. Results:, Among putative periodontopathic bacteria, the detection frequency of T. denticola and P. gingivalis was elevated in parallel with higher probing pocket depth and clinical attachment loss, and had 4.2,14.1 times increasing odds of the clinical parameters tested. Detection of any of the five species of putative periodontopathic bacteria markedly increased the odds ratio of a higher probing pocket depth, clinical attachment loss and bleeding on probing. Conclusion:, The multiplex PCR system developed in this study enabled the detection of all the bacteria under investigation in one reaction tube in a less time- and labor-intensive manner than conventional PCR. These results support the potential clinical use of multiplex PCR for detecting periodontopathic bacteria and for evaluating therapeutic strategies and predicting the prognosis for each subject. [source] Leptin levels in gingival crevicular fluid in periodontal health and diseaseJOURNAL OF PERIODONTAL RESEARCH, Issue 4 2007B. V. Karthikeyan Background and Objective:, A high concentration of leptin is associated with healthy gingival tissue, and the concentration of leptin decreases as periodontal disease progresses. However, to date, the leptin concentration in gingival crevicular fluid has not been documented. Hence, the present study was carried out to explore the presence of leptin in gingival crevicular fluid in periodontal health and disease, and to probe further into its possible role in periodontal disease progression. Material and Methods:, A total of 45 adult patients were selected, based on their body mass index, for the study. They were categorized into three groups of 15 patients each, based on their periodontal tissue status, as follows: group I (clinically healthy gingiva with no loss of attachment); group II (chronic gingivitis with no loss of attachment); and group III (chronic periodontitis). Gingival crevicular fluid samples of 1 µL were collected extracrevicularly using white color-coded 1,5 µL calibrated volumetric microcapillary pipettes from one site in each person, and samples were analyzed for leptin using a commercially available enzyme-linked immunosorbent assay kit. Results:, The concentration of leptin in gingival crevicular fluid of patients in group I (2292.69 pg/mL) was statistically higher (p < 0.05) than in those of groups II (1409.95 pg/mL) and III (1071.89 pg/mL). This suggests a negative correlation of gingival crevicular fluid leptin concentration with clinical attachment loss (p < 0.05). Conclusion:, As periodontal tissue destruction increased, there was a substantial decrease in gingival crevicular fluid leptin concentration. This observation extends our knowledge of the protective role of leptin in periodontal health. [source] Type 2 diabetes and periodontal indicators: epidemiology in France 2002,2003JOURNAL OF PERIODONTAL RESEARCH, Issue 4 2006C. Mattout Background and Objective:, ,Diabetes and periodontal disease have been associated in the literature. In the present study, the periodontal heath of noninsulin-dependent diabetic adults was compared with that of a general population of nondiabetic patients. Material and Methods:, In France, 2144 adults (age: 35,65 years) were examined for life habits (tobacco, alcohol), biological diagnosis (type II diabetes, arterial hypertension), biometry (weight, size) and biochemistry. Dental and periodontal data included plaque index, gingival index, probing depth, and clinical attachment loss. Results:, Descriptive and multifactorial analysis evidenced a more severe periodontal disease in diabetic patients. Moreover, when the plaque index was held constant, the gingival index was more elevated in diabetics. In nondiabetics, age, gender, glycemia, alcohol, and tobacco smoking were identified as significant risk factors for periodontal disease. In contrast, in diabetic subjects, only tobacco smoking was a significant risk factor. Conclusion:, In type II diabetics, the diabetes factor is probably more significant than periodontal risk factors, age, and gender. [source] Efficacy of subgingivally applied minocycline in the treatment of chronic periodontitisJOURNAL OF PERIODONTAL RESEARCH, Issue 1 2005Hsein-Kun Lu Background:, The use of adjunctive minocycline with mechanical debridement in treating periodontitis has been widely studied using different methods. However, the results from these studies are equivocal. Objective:, The purpose of this study was to clarify the efficacy of the adjunctive use of subgingival minocycline application plus scaling/root planing as compared with the results of one episode of scaling/root planing in the treatment of chronic periodontitis. Methods:, Fifteen patients were enrolled in this split-mouth clinical trial. Probing depth, clinical attachment loss, gingival index, and bleeding on probing were evaluated at the baseline before scaling/root planing and 6, 10, 14, and 18 weeks later according to a single-blind protocol. The amount of interleukin-1, (interleukin-1, pg/site) at each lesion was also simultaneously measured in gingival crevicular fluid in a parallel comparison design. After full-mouth baseline measurements and scaling/root planing, 78 lesions with a residual mean probing depth of 5 mm at anterior teeth were selected and equally distributed in either right or left sites based on a split-mouth symmetrical design and randomly assigned to one of two treatment groups (with or without minocycline administration, n = 39 for each group). Results:, Probing depth significantly decreased from the baseline (week 0) to week 6 after scaling/root planing (p < 0.05) in both groups, but there was no statistically significant difference between the two groups (p > 0.05). However, at weeks 10, 14, and 18, the experimental group showed significantly greater improvement in pocket reduction than the control group (p < 0.05). Similarly, both groups also showed significant decreases in gingival index scores from weeks 0,6 (p < 0.05), but gingival index reductions at weeks 10, 14, and 18 were statistically significant in favor of the experimental group (p < 0.05). The experimental group had more attachment gain than the control group at weeks 14 and 18 (p < 0.05). Values of interleukin-1, (pg/site) at the experimental sites were significantly reduced at weeks 10, 14, and 18, as compared to values at control sites (p < 0.01). Finally, the incidence of bleeding on probing showed no differences between the two groups for any time interval (p > 0.05). Conclusions:, In this 18-week clinical trial, the results suggested that scaling/root planing with adjunctive subgingival administration of minocycline ointment has a significantly better and prolonged effect compared to scaling/root planing alone on the reduction of probing depth, clinical attachment loss, gingival index, and interleukin-1, content, but not on bleeding on probing. [source] Effect of periodontal treatment on the activity of chitinase in whole saliva of periodontitis patientsJOURNAL OF PERIODONTAL RESEARCH, Issue 4 2002G. J. Van Steijn Human salivary chitinase could play a role in the defence against chitin-containing oral pathogens. The activity levels of chitinase in the whole saliva of periodontitis patients were significantly higher than those in saliva from controls. Periodontal treatment for a period of 5,6 months resulted in a three- to fourfold decrease in this enzyme activity. The activity of ,- N -acetylhexosaminidase, which is another enzyme that hydrolyses glycosidic linkages, also decreased as a result of treatment, although to a lesser extent. The decrease in chitinase activity upon treatment of the disease did not correlate with the decrease that was seen in clinical attachment loss and bleeding on probing, and only a weak correlation was observed with the changes in probing pocket depth and plaque index. No correlations were found between the above clinical parameters and the decrease in ,- N -acetylhexosaminidase activity. [source] Periodontal disease in research beagle dogs , an epidemiological studyJOURNAL OF SMALL ANIMAL PRACTICE, Issue 12 2008H. E. Kortegaard Objectives: To estimate the prevalence and describe the extent and severity of periodontal disease and associated periodontal parameters in beagle dogs. Methods: A full-mouth, site-specific examination was performed in 98 beagle dogs. Focus was placed on clinical attachment loss, pocket depth and bleeding on probing. Results: The prevalence of clinical attachment loss greater than equal to 1 mm was 20 per cent in the one-year-old dogs, increasing to 84 per cent of the dogs aged more than three years. The number of sites affected with clinical attachment loss greater than equal to 1 mm showed a skewed distribution. The prevalence of clinical attachment loss greater than equal to 4 mm was only seven per cent. A probing pocket depth of 4+ mm was observed in 44 to 81 per cent of the dogs, depending on age. Also, the distribution of the number of deepened pockets/dog was skewed. The teeth most prone to clinical attachment loss greater than equal to 1 mm were the P2, the P3 and the P4 of the maxilla. The teeth most prone to pocket depth greater than equal to 4 mm were the maxillary canines. Clinical Significance: Periodontal disease in terms of clinical attachment loss greater than equal to 1 mm and pocket depth greater than equal to 4 mm is common in beagle dogs, but the major disease burden is carried by only a few dogs. The prevalence increases with increased age but is high already at the age of two years. [source] Biomarkers of periodontal inflammation in the Australian adult populationAUSTRALIAN DENTAL JOURNAL, Issue 2 2009TR Fitzsimmons Abstract Background:, Several inflammatory biomarkers are implicated in the pathogenesis of periodontitis including interleukin-1, (IL-1,) and C-reactive protein (CRP). This study investigated the presence of these factors in gingival crevicular fluid (GCF) and their relationship to clinical and social determinants of periodontitis in the Australian population. Methods:, Equal numbers of periodontitis cases and non-cases were sampled during oral epidemiologic examination in the National Survey of Adult Oral Health. GCF was sampled from four sites where probing pocket depth (PPD) and recession were recorded. From these, IL-1, and CRP were quantified by ELISA and the log amount of GCF IL-1, (pg) per person and the proportion of adults with detectable CRP was computed. Results:, Periodontitis cases (n = 511) had significantly higher levels of IL-1, and CRP than non-cases (n = 562). PPD, clinical attachment loss, plaque and gingivitis indices were positively associated with elevated levels of both biomarkers. Levels of both were positively associated with age, low socio-economic position and non-Australian birth. Conclusions:, The presence of IL-1, and CRP in GCF are associated with periodontal disease parameters within the Australian population. The levels of both biomarkers are influenced by age, education and eligibility for public dental care. [source] The effect of periodontal therapy on serum TNF-, and HbA1c levels in type 2 diabetic patientsAUSTRALIAN DENTAL JOURNAL, Issue 1 2009Abstract Background:, To determine the effect of non-surgical periodontal therapy on serum TNF-, and HbA1c levels in poorly and well-controlled type 2 diabetic patients. Methods:, In total, 45 patients were enrolled in the study; 30 patients with type 2 diabetes mellitus with periodontitis (15 with poorly controlled diabetes, HbA1c , 7%, group 1A and 15 with well-controlled diabetes, HbA1c < 7%, group 1B) and 15 patients that were systemically healthy with periodontitis (group 2). The plaque index, gingival index, probing depth, clinical attachment loss, gingival bleeding index, HbA1c value, and circulating TNF-, concentration were measured at baseline and three months after the non-surgical periodontal therapy. Results:, All periodontal parameters and serum TNF-, levels were significantly decreased three months after the non-surgical periodontal therapy compared to the baseline values in all groups. The HbA1c values were significantly decreased only in well-controlled diabetic patients. We found no significant differences in the periodontal parameters or TNF-, levels at baseline and after three months between the two groups. Conclusions:, Although non-surgical periodontal therapy eliminates local/systemic infection and inflammation via decreases in TNF-,, it is insufficient for significantly reducing HbA1c levels without strict glycaemic control in poorly controlled diabetic patients in a short time period. [source] The association between maternal periodontitis and low birth weight infants among Malay womenCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 4 2008Norkhafizah Saddki Abstract,,, Objectives:, Maternal periodontitis has been suggested as one of the risk factors for low birth weight (LBW) infants. The objective of this study was to determine the association between maternal periodontitis and LBW infants among Malay women. Methods:, Screening periodontal examinations were carried out on all eligible Malay pregnant women in the second trimester of pregnancy attending two randomly selected community maternal and child health clinics in Kota Bharu, Kelantan. Patients with four or more sites with pocket depth 4 mm or higher, and clinical attachment loss 3 mm or higher at the same site with presence of bleeding on probing were diagnosed as having periodontitis in this study. Using this definition, systematic random sampling was utilized for selection of 250 subjects for each exposed and non-exposed group. Of 500 subjects enrolled in the study, 28 (5.6%) were either dropped or lost to follow-up. Of the remaining 472 subjects, 232 with periodontitis were in the exposed group and 240 with healthy periodontium were in the nonexposed group. Results:, The incidence of LBW was 14.2% (95% CI: 9.70,18.75) in women with periodontitis, and 3.3% (95% CI: 1.05,5.62) in women without periodontitis. The relative risk of having LBW infants was 4.27 times higher for women with periodontitis compared with those without periodontitis (95% CI: 2.01,9.04). After adjustment for potential confounders using multiple logistic regression analysis, significant association was found between maternal periodontitis and LBW (OR = 3.84; 95% CI: 1.34,11.05). Conclusion:, The results of this study provide additional evidence that pregnant women with periodontitis are at a significantly higher risk of delivering LBW infants. [source] | |||||||||||||||||||||||||