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Periodontal Treatment (periodontal + treatment)
Kinds of Periodontal Treatment Selected AbstractsSalt fluoridation and dental caries in JamaicaCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 4 2001Saskia R. Estupiñán-Day Abstract ,Purpose: In 1987, Jamaica initiated a comprehensive island-wide salt fluoridation program. A survey was conducted in 1995 to monitor the impact of salt fluoridation among children in Jamaica. Methods: Dental examinations of 1120 children aged 6,8, 12, and 15 years were conducted according to World Health Organization criteria to assess dental caries, fluorosis, the presence of and need for dental sealants, and Community Periodontal Treatment Needs (CPI). Results: Age specific DMFT means observed in 1995 were 0.2 at age 7, 0.4 at age 8, 1.1 at age 12 and 3.0 at age 15. The mean DMFT scores in children 6, 12 and 15 years of age were dramatically lower than the corresponding scores of 1.7, 6.7 and 9.6 obtained at the baseline examination in 1984 for children of the same age groups, respectively (baseline data for 7- and 8-year-olds were not collected). The mean percentage of sound permanent teeth for all age groups was 90% in 1995. The percentage of children caries-free at baseline was 27.6% for 6 years, 2.8% for 12 years and 0.3% for 15 years of age. In 1995, the percentage of caries-free children (permanent teeth) was 61%. In 1984, 23 children were scored as having very mild or mild fluorosis. In 1995, five children were scored in the same categories of fluorosis, using Dean's criteria; thus, fluorosis remained at negligible levels in 1995. Conclusions: The oral health survey conducted in Jamaica in 1995 indicated a significant decline in dental caries compared with findings in 1984. The major change in Jamaica during the interval was the introduction of salt fluoridation in 1987. Dental fluorosis was low in the 1995 survey. [source] Periodontal treatment of patients with Papillon,Lefèvre syndrome: a 3-year follow-upJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2004T. Lundgren Abstract Background/aim: Conventional mechanical periodontal treatment of Papillon,Lefèvre syndrome (PLS) has often been reported to fail. This study describes the outcome of a non-surgical periodontal therapy including antimicrobial treatment of nine patients diagnosed with PLS. The patients originate from a total of 15 children and adolescents with PLS for which clinical characteristics are presented. Methods: Clinical examination including conventional periodontal measurements. Initial treatment including oral hygiene instruction, scaling and root planing and systemic amoxicillin,metronidazole therapy for 6 weeks. After that the patients were enrolled in a 3-month recall maintenance program. In addition to this mechanical supportive maintenance treatment, tetracycline was prescribed and used continuously for 1.5 years. Results/Conclusion: On five patients who were showing acceptable standard of oral hygiene and also compliance with the antibiotic medication, development of periodontitis on erupting teeth was prevented and disease activity on the previously periodontally involved teeth controlled during a 3-year period. Poor results of treatment were observed for three patients, all siblings. These patients failed to comply with the medication and also failed to improve their oral hygiene. [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] Alveolar bone loss associated with glucose tolerance in Japanese menDIABETIC MEDICINE, Issue 9 2003T. Marugame Abstract Aims Type 2 diabetes is known to affect alveolar bone loss (ABL). The purpose of this study was to examine whether impaired glucose tolerance (IGT) is associated with ABL, as is diabetes. Methods A case,control study was performed with 664 Japanese men aged 46,57 years. Panoramic radiographs revealed 513 severe ABL cases, 22 moderate ABL cases, and 129 controls with good alveolar bone. Diabetes status was classified into normal glucose tolerance (NGT), impaired fasting glucose (IFG), IGT, and newly diagnosed diabetes according to the fasting plasma glucose and 75-g oral glucose tolerance test (OGTT). Diabetes under treatment was excluded. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained from ordinal logistic regression analysis. Statistical adjustment was made for total cholesterol, HDL-cholesterol, triglyceride, rank in the Self Defence Forces (SDF), cigarette-years, alcohol use, body mass index, previous 10 years' brushing habits and instrument use other than toothbrush, and history of periodontal treatment. Results A significant, approximately three-fold increase in the crude OR (crude OR = 3.28; 95% CI = 1.16,9.27) and non-significant 2.6-fold increase in the adjusted OR (adjusted OR = 2.55; 95% CI = 0.86, 7.54) of ABL was observed among men with newly diagnosed Type 2 diabetes compared with the reference group (NGT combined with IFG). However, there was no association between IGT and ABL (adjusted OR = 0.99; 95% CI = 0.59,1.64). Conclusions Type 2 diabetes, but not IGT, was positively associated with ABL. Preventive maintenance against periodontitis is important in middle-aged men with diabetes. [source] Step-wise treatment of two periodontal-endodontic lesions in a heavy smokerINTERNATIONAL ENDODONTIC JOURNAL, Issue 11 2008C. Walter Abstract Aim, To report a clinical case of two advanced periodontal-endodontic lesions with a focus on treatment issues related to tobacco use. Summary, A 53-year-old Caucasian male was referred to the School of Dentistry, Basel, Switzerland, for periodontal treatment. The major diagnoses were chronic (smoker) periodontitis and advanced combined periodontal-endodontic lesions on the mandibular left lateral incisor and right incisor. Conventional root canal treatment was performed, and subsequently led to reduced radiolucencies around the affected roots after 14 months. The remaining osseous defect was augmented by guided tissue regeneration using bovine bone substitute and resorbable membrane. The follow-up revealed a stable situation from clinical (probing depth 2,4 mm) and radiological points of view 32 months after initiation of treatment. Treatment considerations related to tobacco use are discussed. Key learning points, ,,After conventional root canal treatment, osseous healing should occur before further complementary therapy is taken into account. ,,Issues related to tobacco use have to be considered before treatment is initiated. [source] Sonic and ultrasonic scalers in periodontal treatment: a reviewINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 1 2007T Arabaci Abstract:, Periodontal therapy aims at arresting periodontal infection and maintaining a healthy periodontium. The periodic mechanical removal of subgingival microbial biofilms is essential for controlling inflammatory periodontal disease. Mechanical periodontal therapy consists of scaling, root planing and gingival curettage. The sonic and ultrasonic scalers are valuable tools in the prevention of periodontal disease. The vibration of scaler tips is the main effect to remove the deposits from the dental surface, such as bacterial plaque, calculus and endotoxin. However, constant flushing activity of the lavage used to cool the tips and cavitational activity result in disruption of the weak and unattached subgingival plaque. The aim of the study was to review the safety, efficacy, role and deleterious side-effects of sonic and ultrasonic scalers in mechanical periodontal therapy. [source] Prospective study of complier individuals under periodontal maintenance therapy: analysis of clinical periodontal parameters, risk predictors and the progression of periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2009Telma Campos Medeiros Lorentz Abstract Aim: This prospective study aimed to evaluate the progression of periodontitis and the influence of risk variables among individuals attending a programme of periodontal maintenance treatment in an academic environment. Material and Methods: A total of 150 individuals diagnosed with chronic moderate-advanced periodontitis, and who had finished active periodontal treatment, were incorporated into the periodontal maintenance therapy. Social, demographic and biological variables of interest from subjects were collected at quarterly recalls, over a 12-month period. The effect of variables of interest and confounding on the periodontal status and progression of periodontitis was tested by univariate and multivariate logistic analysis. Results: A total of 130 subjects (86.7%) showed stable periodontal status, whereas 20 subjects (13.3%) presented periodontitis progression. Twenty-eight subjects (18.66%) presented tooth loss that resulted in a total of 47 lost teeth (1.38%). Diabetes was not found to be associated with periodontitis progression (p=0.67). Smoking was significantly associated with a greater progression of periodontitis (OR=2.7, 95% CI 1.01,7.22). Conclusions: Periodontal maintenance programmes in academic environment can stabilize the periodontal condition obtained after active periodontal therapy as well as control the action of risk variables for the progression of periodontitis. [source] Periodontal diseases and health: Consensus Report of the Sixth European Workshop on PeriodontologyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2008Denis Kinane Abstract Introduction: The remit of this group was to update the knowledge base on periodontal diseases and health. Material and Methods: The literature was systematically searched and critically reviewed in five specific topics. Results: Prevalence of periodontitis: The data suggest a trend towards a lower prevalence of periodontitis in recent years. Adverse pregnancy outcome: The findings indicate a likely association between periodontal disease and an increased risk of adverse pregnancy outcomes. There is no evidence that treating periodontal disease decreases the rate of adverse pregnancy outcomes. Prevalence and distribution of periodontal pathogens: Genetic analysis of bacteria has demonstrated an unanticipated diversity within species. Carriage rates and particular subsets of these species vary between ethnic groups. Few of these differences can be related to differences in disease prevalence. Diabetes mellitus: Evidence on the association supports the concept of increased severity but not extent of periodontitis in subjects with poorly controlled diabetes. It is inconclusive that periodontal treatment results in improved metabolic control. Cardiovascular diseases: Evidence suggests that having periodontitis contributes to the total infectious and inflammation burden and may contribute to cardiovascular events and stroke in susceptible subjects. The impact of periodontal therapy must be further investigated. [source] Incomplete adherence to an adjunctive systemic antibiotic regimen decreases clinical outcomes in generalized aggressive periodontitis patients: a pilot retrospective studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2007Adrian Guerrero Abstract Aim: The objective of this study was to explore the effect of incomplete adherence to the prescribed antibiotic regimen, amoxicillin and metronidazole, in the non-surgical treatment of generalized aggressive periodontitis (GAP). Methods: This retrospective study included 18 GAP subjects who received a conventional course of full-mouth non-surgical periodontal treatment using machine-driven and hand instruments and an adjunctive course of systemic antibiotics (500 mg amoxicillin and 500 mg metronidazole three times a day for 7 days). Clinical parameters were collected at baseline and at 2 months post-treatment. Self-reported adherence to the prescribed medication regimen was recorded at 2 months. Results: All clinical parameters, except for the mean clinical attachment level (CAL) in sites with initial probing pocket depth (PPD) 3 mm, improved at 2 months in all subjects. PPD reduction was 3.7 mm [95% confidence interval (CI) 3.2, 4.3 mm] in deep pockets (7 mm) and 2.2 mm (95% CI 1.9, 2.4 mm) in moderate pockets (4,6 mm), while CAL gain was 2.2 mm (95% CI 1.7, 2.6 mm) and 1.2 mm (95% CI 0.8, 1.5 mm), respectively. However, only 11 subjects (61.1%) reported full adherence to the medication. In deep pockets (7 mm), the difference between an adherent and non-adherent/partially adherent subject was 0.9 mm (95% CI 0.1, 1.7 mm, ancova, p=0.027) in PPD reduction and 0.8 mm (95% CI ,0.2, 1.9, p=0.129) in CAL gain at 2 months. In moderate pockets (4,6 mm) this difference was smaller in magnitude: 0.4 mm (95% CI 0.1, 0.9 mm, p=0.036) in PPD reduction and 0.2 mm (95% CI ,0.3, 0.9 mm, p=0.332) in CAL gain. Conclusions: Within the limits of this design, these data suggest that incomplete adherence to a 7-day adjunctive course of systemic metronidazole and amoxicillin is associated with decreased clinical outcomes in subjects with generalized aggressive periodontitis. [source] Periodontal therapy alters gene expression of peripheral blood monocytesJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2007Panos N. Papapanou Abstract Aims: We investigated the effects of periodontal therapy on gene expression of peripheral blood monocytes. Methods: Fifteen patients with periodontitis gave blood samples at four time points: 1 week before periodontal treatment (#1), at treatment initiation (baseline, #2), 6-week (#3) and 10-week post-baseline (#4). At baseline and 10 weeks, periodontal status was recorded and subgingival plaque samples were obtained. Periodontal therapy (periodontal surgery and extractions without adjunctive antibiotics) was completed within 6 weeks. At each time point, serum concentrations of 19 biomarkers were determined. Peripheral blood monocytes were purified, RNA was extracted, reverse-transcribed, labelled and hybridized with AffymetrixU133Plus2.0 chips. Expression profiles were analysed using linear random-effects models. Further analysis of gene ontology terms summarized the expression patterns into biologically relevant categories. Differential expression of selected genes was confirmed by real-time reverse transcriptase-polymerase chain reaction in a subset of patients. Results: Treatment resulted in a substantial improvement in clinical periodontal status and reduction in the levels of several periodontal pathogens. Expression profiling over time revealed more than 11,000 probe sets differentially expressed at a false discovery rate of <0.05. Approximately 1/3 of the patients showed substantial changes in expression in genes relevant to innate immunity, apoptosis and cell signalling. Conclusions: The data suggest that periodontal therapy may alter monocytic gene expression in a manner consistent with a systemic anti-inflammatory effect. [source] Tooth loss in well-maintained patients with chronic periodontitis during long-term supportive therapy in BrazilJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2006Luiz A. Chambrone Abstract Aim: The objective of this retrospective study was to assess the reasons for tooth loss in a sample of patients who underwent periodontal therapy and supportive periodontal therapy (SPT) in a Brazilian private periodontal practice. Material and Methods: A sample of 120 subjects who had been treated and maintained for 10 years or longer was selected from patients attending a periodontal practice. All patients followed a similar treatment: basic procedures, re-evaluation and periodontal surgery where indicated. Reasons for tooth loss were categorized as periodontal, caries, endodontal, root fractures and extraction of retained or partially erupted third molars. Results: Of the 2927 teeth present at the completion of active periodontal treatment, 53 (1.8%) were lost due to periodontal disease, 16 (0.5%) for root fracture, six (0.2%) to caries, five (0.2%) for endodontic reasons and 31 (1.0%) were lost to extraction of retained or partially erupted third molars. Logistic regression analysis was performed to investigate the association between five independent variables with tooth loss due to periodontitis. Only age (>60 years) and smoking were statistically significant (p<0.05). Conclusion: The findings of this survey were consistent with previous studies. Older subjects and smokers were more susceptible to periodontal tooth loss. In addition, patients with generalized chronic periodontitis were treated and maintained for long-term periods with low rates of tooth loss. [source] Orthodontic movement after periodontal regeneration of class II furcation: a pilot study in dogsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2006Vanessa Camila Da Silva Abstract Purpose: The effect of orthodontic movement on the periodontal tissues of maxillary second pre-molars, after regenerative treatment for class II furcations, was evaluated in four mongrel dogs. Material and Methods: Class II furcation lesions were created. After 75 days they were treated with bovine bone mineral matrix and guided tissue regeneration with absorbable membrane. After 2 months of daily plaque control, each of the dog's furcation pre-molars was randomly assigned to a test or control group. Orthodontic appliances were placed on both sides of the maxilla using third pre-molars and canines as anchorages. In the test group, bodily orthodontic movement of the second pre-molars was performed in the mesial direction for 3 months while control pre-molars remained unmoved. The dogs were sacrificed for histometric and histologic analyses. Results: There were no statistically significant differences between the two groups in total bone and biomaterial areas or linear extension of periodontal regeneration on the radicular surfaces. In the test group, however, there was a tendency to a greater quantity of bone and a lesser quantity of biomaterial. Conclusion: The orthodontic movement was not pre-judicial to the results obtained with the regenerative periodontal treatment. [source] Effects of smoking and gingival inflammation on salivary antioxidant capacityJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2006Nurcan Buduneli Abstract Aim: This study evaluated possible effects of smoking and gingival inflammation on salivary antioxidants in gingivitis patients. Methods: Twenty otherwise healthy gingivitis patients (10 self-reported smokers) and 20 periodontally and systemically healthy volunteer subjects were enrolled in the study. Whole saliva samples and full-mouth clinical periodontal recordings were obtained at baseline and one month following initial phase of treatment in gingivitis patients. Salivary cotinine, glutathione and ascorbic acid concentrations, and total antioxidant capacity were determined, and the data generated were tested by non-parametric tests. Results: Salivary cotinine measurements resulted in re-classification of three self-reported non-smokers as smokers. Smoker patients revealed significantly higher probing depths but lower bleeding values than non-smoker patients (p=0.044 and 0.001, respectively). Significant reductions in clinical recordings were obtained in non-smoker (all p<0.05) and smoker (all p<0.01) patients following periodontal treatment. Salivary total glutathione concentrations were reduced following therapy in gingivitis patients who smoke (p<0.01). Otherwise, no statistically significant differences were found between the groups in biochemical parameters at baseline or following treatment (p>0.05). Conclusions: Within the limits of this study, neither smoking nor gingival inflammation compromised the antioxidant capacity of saliva in systemically healthy gingivitis patients. [source] Loss of molars in periodontally treated patients: a retrospective analysis five years or more after active periodontal treatmentJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2006Bettina Dannewitz Abstract Objectives: Evaluation of tooth loss in molars and prognostic factors for molar survival. Material and Methods: Five hundred and five molars in 71 patients (mean age 46 years; 40 females) were evaluated. The following inclusion criteria were required: periodontal therapy of at least one molar, at least 5 years of supportive periodontal therapy, and baseline assessment of furcation involvement (FI). Results: At baseline 200 of 505 molars exhibited no FI, 116 degree I, 122 degree II, and 67 degree III FI. Twenty-seven molars did not receive periodontal treatment; 127 molars were subjected to non-surgical therapy, and 227 to flap surgery. Tunnel preparation was performed on 14 molars, root resection on 20, regenerative therapy on 57 teeth, and 33 molars were extracted. During the average follow-up period of 107 months 38 molars were lost additionally. Molars with degree III FI had the highest mortality. A multi-level proportional hazard model revealed smoking, baseline bone loss, number of molars left, and degree III FI as risk factors influencing the retention time of molars. Conclusion: Overall periodontal therapy results in a good prognosis of molars. Degree III FI leads to a significant deterioration of prognosis. Beyond FI smoking, baseline bone loss, and number of molars left influence molar survival. [source] Nicotine inhibits human gingival fibroblast migration via modulation of Rac signalling pathwaysJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2005Yiyu Fang Abstract Aim: Cigarette smoking is a risk factor in the development of periodontal diseases. In addition, a delayed healing process has been shown in smokers compared with non-smokers after periodontal treatment. Cell migration is a key process of wound healing and it is highly regulated by a variety of signalling pathways. The small G protein, Rac, is necessary for cell migration. Our aim was to determine if nicotine disrupted Rac and its downstream signalling proteins, p21-activated kinase 1/2 (PAK1/2), and p44/42 mitogen-activated protein kinase (MAPK) (extracellular regulated kinase 1/2). Material and Methods: Primary human fibroblasts from healthy gingival tissues were cultured and grown to confluence. Cells were serum starved for 24 h, and then treated with nicotine (0 or 0.5 ,M) prior to in vitro wounding. Cell migration was analysed in live cell assays following in vitro wounds. Rac activity, phosphorylation levels of PAK1/2, and p44/42 MAPK were assessed in cultures treated with or without nicotine after multiple wounds. Results: Nicotine decreased cell migration rates by 50% compared with controls. In addition, nicotine altered the activation patterns of Rac and PAK 1/2 and up-regulated p44/42 MAPK. Conclusion: Decreased cell migration in periodontal wounds exposed to nicotine may be mediated through the Rac and PAK1/2 signalling pathways. [source] Adjunctive benefits of systemic amoxicillin and metronidazole in non-surgical treatment of generalized aggressive periodontitis: a randomized placebo-controlled clinical trialJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2005Adrian Guerrero Abstract Background: The objective of this study was to assess the adjunctive clinical effect of the administration of systemic amoxicillin and metronidazole in the non-surgical treatment of generalized aggressive periodontitis (GAP). Methods: Forty-one systemically healthy subjects with GAP were included in this 6-month double-blind, placebo-controlled, randomized clinical trial. Patients received a course of full-mouth non-surgical periodontal treatment delivered over a 24 h period using machine-driven and hand instruments. Test subjects received an adjunctive course of systemic antibiotic consisting of 500 mg amoxicillin and 500 mg metronidazole three times a day for 7 days. Clinical parameters were collected at baseline, and at 2 and 6 months post-treatment. Results: In both the test and the placebo groups, all clinical parameters improved at 2 and 6 months. In deep pockets (7 mm), the test treatment resulted in an additional 1.4 mm (95% confidence interval 0.8, 2.0 mm) in full-mouth probing pocket depth (PPD) reduction and 1 mm (0.7, 1.3 mm) of life cumulative attachment loss (LCAL) gain at 6 months. In moderate pockets (4,6 mm), the adjunctive benefit was smaller in magnitude: PPD reduction was 0.4 mm (0.1, 0.7 mm) and LCAL gain was 0.5 mm (0.2, 0.8 mm). In addition, the 6-month data showed LCAL gains 2 mm at 25% of sites in test patients compared with 16% in placebo (p=0.028). Similarly, PPD reductions of 2 mm or more were observed in 30% of sites in test and 21% of sites in placebo patients. Seventy-four percent of pockets with PPD 5 mm at baseline were 4 mm or shallower at 6 months in the test group. This compared with 54% in the placebo group (p=0.008). Disease progression at 6 months was observed at 1.5% of test and 3.3% of sites in test and placebo, respectively (p=0.072). Conclusions: These data indicate that a 7-day adjunctive course of systemic metronidazole and amoxicillin significantly improved the short-term clinical outcomes of full-mouth non-surgical periodontal debridement in subjects with GAP. [source] Effectiveness of periodontal therapy on the severity of cyclosporin A-induced gingival overgrowthJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2005Mario Aimetti Abstract Aim: The purpose of the present study was to evaluate the clinical effects of aetiological periodontal treatment in a group of transplant patients medicated with cyclosporin A (CsA) who exhibited severe gingival overgrowth. Materials and Methods: Twenty-one patients received oral hygiene instructions, supra- and subgingival scaling and periodontal maintenance therapy and were monitored for 12 months. Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), periodontal probing depth and degree of gingival overgrowth (Seymour index GO) were recorded at baseline, 6 and 12 months after treatment. Results: Statistical evaluation revealed that all clinical variables significantly decreased compared with baseline. At baseline 18 out of 21 treated patients (85.71%) exhibited clinically significant overgrowth. Initial GO score of 2.38±1.92 in the anterior sextants and of 1.29±1.59 in the posterior segments were reduced to 0.56±0.83 and to 0.45±0.84 at 12 months (p<0.001). A difference of 1.82 and 0.84 in the severity of treated GO was accompained by a 42% and 34% decrease in FMPS and FMBS, respectively. Conclusions: Aetiological periodontal treatment and regular maintenance therapy were effective in resolving the inflammation and in eliminating the need for surgical treatment in patients receiving CsA. [source] Periodontal health improves systemic inflammatory and haemostatic status in subjects with coronary heart diseaseJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2005L. Montebugnoli Abstract Objectives: A relationship between poor oral health and coronary heart disease (CHD) and systemic inflammatory and haemostatic factors has been recently documented in an Italian population. The present study was performed to assess whether intensive dental care may produce a periodontal improvement along with a change in systemic inflammatory and haemostatic factors. Material and Methods: The study population consisted of 18 males aged 40,65 years with proven CHD and elevated values of systemic inflammatory and haemostatic factors. A detailed description of their oral status was given by using two different dental indices (clinical periodontal sum score and clinical and radiographic sum score). Blood samples were taken for measurement of the following systemic markers of inflammation [(C-reactive protein (CRP), leucocytes, fibrinogen)] and haemostatic factors [(von Willebrand factor, fibrin D-dimer and oxidized-low density lipoprotein (Ox-LDL)]. All parameters were determined in each subject at baseline, after 4 months as a control and 3 months after an intensive protocol of scaling and root planing. anova for repeated measures was used for the statistical analysis. Results: No statistical difference was found between values at baseline and at the 4-month-control. All oral indexes showed a significant decrease (p<.01) 3 months after periodontal treatment. All systemic inflammatory indexes decreased but only the decrease in CRP reached statistical significance (p<.05). A significant decrease (p<.01) was also found as regards Ox-LDL among haemostatic factors. Conclusions: Preliminary results from the present study suggest an association between poor oral status and CHD, and provide evidence that the improvement of periodontal status may influence the systemic inflammatory and haemostatic situation. [source] Periodontal treatment of patients with Papillon,Lefèvre syndrome: a 3-year follow-upJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2004T. Lundgren Abstract Background/aim: Conventional mechanical periodontal treatment of Papillon,Lefèvre syndrome (PLS) has often been reported to fail. This study describes the outcome of a non-surgical periodontal therapy including antimicrobial treatment of nine patients diagnosed with PLS. The patients originate from a total of 15 children and adolescents with PLS for which clinical characteristics are presented. Methods: Clinical examination including conventional periodontal measurements. Initial treatment including oral hygiene instruction, scaling and root planing and systemic amoxicillin,metronidazole therapy for 6 weeks. After that the patients were enrolled in a 3-month recall maintenance program. In addition to this mechanical supportive maintenance treatment, tetracycline was prescribed and used continuously for 1.5 years. Results/Conclusion: On five patients who were showing acceptable standard of oral hygiene and also compliance with the antibiotic medication, development of periodontitis on erupting teeth was prevented and disease activity on the previously periodontally involved teeth controlled during a 3-year period. Poor results of treatment were observed for three patients, all siblings. These patients failed to comply with the medication and also failed to improve their oral hygiene. [source] Tooth loss during maintenance following periodontal treatment in a periodontal practice in NorwayJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2004Øystein Fardal Abstract Background: Periodontal therapy coupled with careful maintenance has been shown to be effective in maintaining periodontal health; however, a small number of teeth are still lost because of progressive periodontitis. Aim: To investigate factors associated with tooth loss due to periodontal reasons during maintenance following periodontal treatment in patients in a Norwegian specialist periodontal practice. The study also examined how initial prognosis related to actual outcome as measured by periodontal tooth loss. Methods: Hundred consecutive patients (68 females, 32 males) who had comprehensive periodontal treatment and attended for 9.8 (SD: 0.7), range: 9,11 years of maintenance care, were studied. All teeth classified as being lost due to periodontal disease over the period were identified. Results: Only 36 (1.5%) of the 2436 teeth present at baseline were subsequently lost due to periodontal disease. There were 26 patients who lost at least one tooth. Logistic regression analysis showed that tooth loss was significantly related to male gender (p=0.049; adjusted odds ratio: 2.8; confidence interval (c.i.): 1.0,8.1), older age, i.e.>60 years (p=0.012; adjusted odds ratio: 4.0; c.i.: 1.3,12.0) and smoking (p=0.019; adjusted odds ratio: 4.2; c.i.: 1.4,13.8). The majority 27 (75%) of the teeth lost due to periodontal disease had been assigned an uncertain, poor or hopeless initial prognosis; however, nine teeth (25%) lost had been assigned a good prognosis at baseline. The prognosis for 202 teeth was judged to have worsened over the period of the study. Conclusion: Compliance with maintenance following periodontal treatment was associated with very low levels of tooth loss in a referral practice in rural Norway. Male gender, older age (>60 years) and smoking were predictors of tooth loss due to progressive periodontitis. [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] Bone resorbing activity and cytokine levels in gingival crevicular fluid before and after treatment of periodontal diseaseJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2004Anders Holmlund Abstract Background: The aim of the present study was to investigate bone resorption activity (BRA), interleukin-1, (IL-1,), IL-1, and interleukin-1 receptor antagonist (IL-1ra) in gingival crevicular fluid (GCF) in sites with no signs of periodontol disease and in sites with horizontal or angular loss of periodontal bone. These assessments were performed before and after periodontal treatment. Methods: GCFs were collected from 10 individuals with filter strips from two healthy sites and four sites with deep pathological periodontal pockets, two of which showed horizontal bone loss and two with angular bone loss. All diseased pockets were treated with flap surgery and systemic Doxyferm®. Twelve months later GCF was collected again and treatment outcome evaluated. BRA in GCFs was assessed in a bone organ culture system by following the release of 45Ca from neonatal mouse calvariae. The amounts of IL-1,, IL-1, and IL-1ra in GCFs were quantified by enzyme-linked immunosorbent assay (ELISA). Results: Treatment resulted in reduction of pocket depths with 3.5±0.5 mm in sites with angular bone loss and 2.8±0.3 mm in sites with horizontal bone loss. Initially, BRA, IL-1,, IL-1, and IL-1ra were significantly higher in GCFs from diseased sites compared with healthy sites. No differences in BRA and cytokine levels were seen between GCFs from pockets with horizontal and angular bone losses. The levels of IL-1,, IL-1, and IL-1ra were significantly reduced after treatment of diseased pockets. Pocket depths were significantly correlated to BRA only in pre-treatment sites with angular bone loss. BRA was correlated to Il-1,, IL-1,, but not to IL-1ra, in diseased sites with angular bone loss, before and after treatment. The reductions of BRA in the individual sites, seen after treatment, were not correlated to the reductions of Il-1,, IL-1, or IL-1ra. Conclusions: These data show that BRA and cytokine levels are increased in GCFs from sites with periodontal disease and that periodontal treatment results in reduction of the cytokines. Our findings further indicate that IL-1, and IL-1, play important roles for the BRA present in GCFs, but that other factors also contribute to this activity. [source] Effects of specific nutrients on periodontal disease onset, progression and treatmentJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2003Rodrigo F. Neiva Abstract Objectives: The aim of this paper is to review the available literature pertaining to the effects of specific nutritional elements (e.g. vitamin B-complex, vitamin C and dietary calcium) on general wound healing, periodontal disease status and response to periodontal therapy. Methods: Critical appraisal of various studies that have evaluated the effects of calcium, ascorbic acid and vitamin B-complex in wound healing and periodontal treatment. Results: Periodontal disease onset, progression and response to therapeutic interventions have been shown to be influenced by several systemic, local and environmental modifying factors. Nutritional supplementation has been suggested as a possible influencing factor on periodontal status and wound healing. Several studies have reported various degrees of association between nutritional elements/supplements and periodontal status, and others have reported possible positive influences of nutritional supplementation on periodontal therapeutic outcomes. Future research needs to more fully explore the presence and strength of association between nutrition and periodontal health. Conclusions: Data collected from the literature suggests that nutrient supplementation causes minimal or no side effects. However, the efficacy of prophylactic nutrient supplementation for the prevention of the onset and progression of periodontal disease, or for the enhancement of periodontal wound healing, remains to be determined. Zusammenfassung Es konnte gezeigt werden, dass der Beginn, der Verlauf und das Ansprechen auf therapeutische Intervention parodontaler Erkrankungen durch verschiedene modifizierende systemische, lokale und Umweltfaktoren beeinflusst werden. Ergänzungen zur Ernährung wurden als mögliche Einflussfaktoren für den parodontalen Status und die Wundheilung diskutiert. Diese Arbeit gibt eine Übersicht über die verfügbare Literatur zum Einfluss spezieller Elemente der Ernährung (z.B. Vitamin-B-Komplex, Vitamin C und Kalzium) auf die generelle Wundheilung, parodontale Erkrankungen sowie das Ansprechen auf parodontale Therapie. Verschiedene Studien haben über Zusammenhänge zwischen Elementen der Nahrung bzw. Ernährungsergänzungen und dem parodontalen Status berichtet. Andere berichten über mögliche positive Einflüsse von Ernährungsergänzungen auf das Ergebnis parodontaler Therapie. Besonderer Wert wird auf die kritische Bewertung der vorhandenen Studien gelegt und es werden Empfehlungen für zukünftigen Forschungsbedarf gegeben, um die Existenz und Ausprägung von Zusammenhängen zwischen Ernährung und parodontaler Gesundheit vollständig zu erfassen. Daten, die aus der Literatur gesammelt wurden, legen den Schluss nahe, dass eine Ergänzung der Ernährung minimale oder keine Nebenwirkungen hat. Allerdings die Wirksamkeit einer prophylaktischen Ernährungsergänzung für die Prävention der Entstehung und Progression von Parodontitis oder die Verbesserung der parodontalen Wundheilung muss noch bestimmt werden. Résumé L'apparition, la progression et la réponse de la maladie parodontale aux interventions thérapeutiques sont influencées par différents facteurs systémiques locaux et environnementaux. L'apport supplémentaire de substances nutritives a été suggéré comme facteur influençant l'état parodontal et la guérison. Cette étude revoit la littérature concernant les effets des éléments nutritionnels spécifiques comme le complexe vitaminique-B, le vitamine-C et le calcium diététique sur la guérison en général, l'état de la maladie parodontale et la réponse au traitement parodontal. Différentes études ont rapporté différents degrés d'association entre les éléments/suppléments nutritifs et l'état parodontal, et d'autres ont rapporté des influences positives possibles des suppléments nutritionnels sur la guérison thérapeutique parodontale. L'importance est axée sur l'appréciation critique d'études disponibles et sur une recommandation en recherches futures pour explorer davantage la présence et la force de l'association entre la nutrition et la santé parodontale. Des données collectées de la littérature suggèrent que l'apport de suppléments nutritifs n'est suivi que de peu ou pas d'effets secondaires. Cependant, l'efficacité d'un supplément nutritif prophylactique pour la prévention primaire et de la progression de la maladie parodontale, ou pour l'augmentation de la guérison parodontale reste à déterminer. [source] Five-year maintenance follow-up of early-onset periodontitis patientsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2003Joanna J. Kamma Abstract Objectives: The purpose of this study was to evaluate the clinical and microbiological status of patients with early-onset or aggressive periodontitis (EOP) who had received supportive periodontal care (SPC) every 3,6 months for a period of 5 years, following active periodontal treatment. Material & Methods: The study population consisted of 25 individuals with early-onset periodontitis. Clinical examination and recordings of probing pocket depth (PPD) and clinical attachment level (CAL) were performed at baseline prior to treatment (T0), 3 months following the termination of active periodontal treatment (T1) and annually at the SPC appointments (T2,T3,T4,T5). Microbiological samples were obtained at the 5-year SPC (T5). Subgingival plaque samples for each individual were collected from one deep pocket (>5 mm), based on pretreatment measurements, randomly selected in each quadrant. The levels of Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Porphyromonas gingivalis and Treponema denticola were determined using oligonucleotide probe hybridization. Results: During the 5-year period, the mean of SPC/patient was 12.7 sessions. A significant improvement was observed in PPD, CAL, gingival bleeding index and suppuration following treatment. However, between T1 and T5, 134 sites in 20 patients deteriorated with a CAL loss of,2 mm. Out of these 134 sites showing disease progression, microbial samples were randomly obtained in 13 sites (9.7%) from 8 patients. Among other factors, smoking and stress were found to have significant predictive value on the future attachment loss. P. gingivalis, T. denticola and total bacterial load were statistically significantly higher in patients who experienced disease progression during the 5-year maintenance period. Conclusions: For most EOP patients, regular SPC was effective in maintaining clinical and microbiological improvements attained after active periodontal therapy. However, a small percentage of sites was identified as progressive in 20 patients. Variables found to be related to periodontal progression were the presence of as well as the high bacterial counts of P. gingivalis, T. denticola and total bacterial load, number of acute episodes, number of teeth lost, smoking and stress. Zusammenfassung Erhaltungstherapie über fünf Jahre bei Patienten mit früh einsetzender Parodontitis (EOP) Ziele: Der Zweck dieser Studie war es, 5 Jahre nach aktiver Parodontalbehandlung den klinischen und mikrobiologischen Zustand von Patienten mit früh einsetzender oder aggressiver Parodontitis (EOP), bei welchen alle 3-6 Monate eine parodontale Erhaltungstherapie (SPC) erfolgte, zu evaluieren. Material & Methoden: Die Studienpopulation bestand aus 25 Individuen mit früh einsetzender Parodontitis. Die klinische Untersuchung und Aufzeichnung der Sondierungstiefe (PPD) sowie des klinischen Attachmentniveaus (CAL) erfolgten bei der Eingangsuntersuchung vor der Behandlung (T0), drei Monate nach Beendigung der aktiven Parodontalbehandlung (T1) und jährlich bei den SPC-Terminen (T2,T3,T4,T5). Die mikrobiologischen Proben wurden bei der 5-Jahres-SPC gewonnen (T5). Für jedes Individuum wurden die subgingivalen Plaqueproben in jedem Quadranten aus einer tiefen Tasche (>5mm) entnommen. Dies geschah randomisiert und auf der Grundlage der Messungen vor der Behandlung. Das Niveau von Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Porphyromonas gingivalis und Treponema denticola wurden unter Verwendung der Hybridisierung mit Oligonukleotid-Sonden bestimmt. Ergebnisse: Während der 5-jährigen Periode betrug die mittlere Anzahl der SPC-Sitzungen pro Patient 12,7. Nach der Behandlung wurden bei PPD, CAL, Gingiva-Blutungs-Index und der Pusentleerung signifikante Verbesserungen beobachtet. Jedoch haben sich zwischen T1 und T5 bei 20 Patienten 134 Taschen mit einem CAL-Verlust von=2mm verschlechtert. Bei 8 Patienten wurden aus diesen 134 Taschen, mit Progression der Erkrankung, von 13 Taschen (9,7%) randomisiert mikrobiologische Proben entnommen. Innerhalb anderer Faktoren wurde bei Rauchen und Stress ein signifikanter Vorhersagewert für zukünftigen Attachmentverlust vorgefunden. Bei den Patienten, die in der 5-jährigen Erhaltungsperiode eine Progression der Erkrankung erfuhren lagen P. gingivalis, T. denticola und die bakterielle Gesamtbelastung höher. Schlussfolgerungen: Für die meisten EOP-Patienten die regelmäßig an der parodontalen Erhaltungstherapie teilnahmen war diese hinsichtlich der Aufrechterhaltung der nach der aktiven Parodontaltherapie erzielten klinischen und mikrobiologischen Verbesserungen erfolgreich. Jedoch wurde bei 20 Patienten ein geringer Prozentsatz von Taschen als fortschreitend identifiziert. Die Variablen, von denen gefunden wurde, dass sie eine Beziehung zur Progression haben waren: sowohl Vorhandensein von P. gingivalis, T. denticola als auch hohe Bakterienzahl von P. gingivalis, T. denticola und die bakterielle Gesamtbelastung, Anzahl der akuten Episoden, Anzahl verlorener Zähne, Rauchen und Stress. Résumé Suivi en maintenance sur 5 ans de patients atteints de parodontites d'apparition précoce. Objectifs: Cette étude se propose d'évaluer l'état clinique et microbiologique de patients atteints de parodontites d'apparition précoce ou agressive (EOP) qui furent suivis en maintenance (SPC) tous les 3-6 mois pendant une période de 5 ans après un traitement parodontal actif. Matériel & Méthodes: La population étudiée consistait en 25 individus atteints de parodontites d'apparition précoce. L'examen clinique et l'enregistrement des profondeurs de poche (PPD) et du niveau d'attache (CAL) furent réalisés avant le traitement (T0), 3 mois après la fin du traitement actif (T1) et chaque année aux rendez vous de maintenance (T2,T3,T4,T5). Des échantillons microbiologiques furent prélevés lors de la maintenance à 5 ans (T5). La plaque sous-gingivale de chaque patient fut prélevée d'une poche profonde (>5mm), sur la base des examens initiaux, choisis au hasard dans chaque quadrant. Les niveaux d' Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Porphyromonas gingivalis et Treponema denticola furent déterminés par hybridation par sonde d'oligonucleotides. Résultats: pendant la période d'examination de 5 ans, la moyenne des SPC par patient fut de 12.7 sessions. Une amélioration significative fut observée pour PPD, CAL, l'indice de saignement gingival et la suppuration suite au traitement. Cependant, entre T1 et T5, 134 sites chez 20 patients connurent une détérioration avec une perte d'attache de 2 mm. De ces 134 sites qui présentaient une progression de la maladie, des échantillons microbiologiques furent obtenus aléatoirement dans 13 sites (9.7%) chez 8 patients. Parmi d'autres facteurs, le tabagisme et le stress furent reconnus comme ayant une significative valeur prédictive pour de futures pertes d'attache. P. gingivalis, T. denticola et la charge bactérienne totale étaient de façon statistiquement significatif plus importants chez les patients chez qui la maladie progressait au cours des 5 ans de maintenance. Conclusions: pour la plupart des patients atteints d' EOP, des soins parodontaux de soutien réguliers sont efficaces pour maintenir les améliorations cliniques et microbiologiques obtenus par le traitement actif. Cependant, un petit pourcentage de sites progressait chez 20 patients. Les variables en ralation avec cette progression étaient la présence et aussi un comptage important de P. gingivalis, T. denticola et la charge bactérienne totale, le nombre d'épisodes aigus le nombre de dents perdues le tabagisme et le stress. [source] Systemic disorders in patients with periodontal diseaseJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2003Maria Lagervall Abstract Background, aims: Over the past 10 years several studies have been published pointing towards a relationship between periodontal disease and various systemic disorders or diseases. The purpose of this retrospective study was to investigate the occurrence of self-reported systemic disorders in patients referred to a specialist clinic for periodontal treatment and to explore possible relationships between general health and periodontal disease severity in this population. Material and Methods: Data were collected from the dental records and the health questionnaires of 1006 subjects. Stepwise multiple linear regression analyses were adopted to calculate correlations between systemic disorders as independent variables and number of remaining teeth and the relative frequency of periodontal pockets of 5 mm or more, respectively, as the dependent variable. Results: The number of remaining teeth was significantly and positively correlated to the presence of cardiovascular disease, diabetes and rheumatoid disease after adjustment for age, sex and smoking. The relative frequency of diseased sites, however, was not significantly correlated to any one of the investigated systemic health disorders. Conclusion: No significant associations between investigated systemic disorders and periodontal disease severity were found if the relative frequency of deep periodontal pockets was used as the clinical parameter for periodontal disease severity. However, cardiovascular disease, diabetes and rheumatoid disease were found to be significantly correlated to number of lost teeth, which may represent one aspect of periodontal health. This result held true in nonsmokers only. Zusammenfassung Hintergrund: Während der letzten 10 Jahre wurden zahlreiche Studien publiziert, die auf einen Zusammenhang zwischen Parodontitis und verschiedenen systemischen Störungen und Erkrankungen hinweisen. Zielsetzung: Feststellung der Häufigkeit von selbst angegebenen systemischen Erkrankungen bei Patienten, die an eine parodontologische Spezialklinik zur Parodontitistherapie überwiesen worden waren, in einer retrospektiven Studie und Untersuchung möglicher Zusammenhänge zwischen allgemeiner Gesundheit und dem Schweregrad parodontaler Erkrankungen in dieser Bevölkerungsgruppe. Material und Methoden: Die Daten wurden aus den Behandlungsakten und Gesundheitsfragebögen von 1006 Personen gewonnen. Eine schrittweise multiple lineare Regressionsanalyse wurde verwendet, um Korrelationen zwischen systemischen Erkrankungen als unabhängigen Variablen und der Zahl verbliebener Zähne bzw. der relativen Häufigkeit parodontaler Taschen 5 mm als abhängigen Variablen zu berechnen. Ergebnisse: Nach Korrektur für Alter, Geschlecht und Rauchen war die Zahl verbliebener Zähne signifikant positiv mit Herz-Kreislauf-Erkrankungen, Diabetes und rheumatischen Erkrankungen korreliert. Die relative Häufigkeit erkrankter Stellen war allerdings mit keiner der untersuchten systemischen Erkrankungen korreliert. Schlussfolgerung: Wenn die relative Häufigkeit tiefer parodontaler Taschen als Maß für den Schweregrad parodontaler Erkrankung gewählt wurde, ließ sich keine Assoziation zwischen den untersuchten systemischen Erkrankungen und dem Parodontitisschweregrad zeigen. Allerdings waren Herz-Kreislauf-Erkrankungen, Diabetes und rheumatischen Erkrankungen signifikant mit der Zahl verlorener Zähne korreliert, die einen Aspekt parodontaler Gesundheit repräsentieren. Dieses Ergebnis ergab sich aber nur für Nichtraucher. Résumé Références et buts: Au cours des 10 dernières années, plusieurs études ont été publiées pour souligner une relation entre la maladie parodontale et diverses désordres ou maladies systémiques. Cette étude rétrospective se propose de rechercher l'apparition de désordres systémiques racontés par des patients adressés à une clinique spécialisée pour traitement parodontal et d'explorer de possibles relations entre la santé générale et la sévérité de la maladie parodontale dans cette population. Matériel et Méthodes: Les données furent récoltées des dossiers dentaires et des interrogatoires médicaux de 1006 sujets. Une analyse de régression multiple linéaire échelonnée a été utilisée pour calculer les corrélations entre les désordres systémiques en tant que variables indépendantes et le nombre de dents restantes et la fréquence relative de poches parodontales d'au moins 5mm, respectivement, comme variable dépendante. Résultats: le nombre de dents restantes était significativement et positivement corréléà la présence de maladies cardiovasculaires, de diabète et de maladie rhumatoïde après ajustement pour l'âge, le sexe, et le tabagisme. La relative fréquence de sites malades, cependant, n'était corrélée à aucun des désordres systémiques étudiés. Conclusion: Aucune association significative entre les désordres systémiques étudiés et la sévérité de la maladie parodontale ne fut trouvée lorsque la fréquence relative de poches parodontales profondes était utilisée comme paramètre clinique pour définir la sévérité de la maladie parodontale. Cependant, une maladie cardio-vasculaire, le diabète, une maladie rhumatoïde sont corrélées significativement au nombre de dents perdues qui peut être représentatif d'un aspect de santé parodontale. Ces résultats n'étaient valables que chez les non fumeurs. [source] Toothbrushing promotes gingival fibroblast proliferation more effectively than removal of dental plaqueJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2002Masazumi Horiuchi Abstract Objectives: Removal of dental plaque is an essential element of periodontal treatment. However, there have also been studies of the effects of the mechanical stimulation provided by toothbrushing on gingival host-defense mechanisms. The aim of the study was to evaluate the effects of toothbrushing on gingival fibroblast proliferation in dogs over time, compared to effects of plaque removal without brushing. Methods: The mouths of six mongrel dogs were divided into four quadrants: two for daily toothbrushing, and two for daily plaque removal with a curette. After 1, 3 and 5 weeks of treatment, histometrical analyses were performed to assess inflammatory cell infiltration, proliferating cell nuclear antigen (PCNA)-positive fibroblasts, procollagen type I-positive fibroblasts in the subepithelial connective tissue of junctional epithelium. Results: Toothbrushing increased the number of PCNA-positive fibroblasts in the first week, increased the number of type I procollagen-positive fibroblasts at the fifth week, and reduced inflammatory cell infiltration at the third week. Conclusion: These findings suggest that mechanically stimulated fibroblasts begin proliferating within a week, and this cell division results in an increased number of fibroblasts at the third week. It takes 5 weeks before differences in collagen synthesis between brushing and plaque removal areas are detectable. Zusammenfassung Die Proliferation der gingivalen Fibroblasten wird durch Zähneputzen wirkungsvoller gefördert als durch Plaqueentfernung Ziele: Die Entfernung von Zahnplaque ist ein essenzieller Bestandteil der Parodontalbehandlung. Es gibt jedoch auch Studien über die Wirkung einer durch Zähneputzen bewirkten mechanischen Stimulation der gingivalen Abwehrmechanismen. Ziel dieser Studie war es, bei Hunden die Wirkung des Zähneputzen auf die Proliferation der gingivalen Fibroblasten über eine gewisse Zeit zu untersuchen und mit der Wirkung einer Plaqueentfernung ohne Zähneputzen zu vergleichen. Methoden: Das Maul von 6 Mischlingshunden wurde in vier Quadranten unterteilt: zwei mit täglichem Zähneputzen und zwei mit täglicher Plaqueentfernung mittels Kürette. 1, 3 und 5 Wochen nach der Behandlung wurden histometrische Analysen durchgeführt um das entzündliche Zellinfiltrat, die proliferierenden Cell-Nuclear-Antigen (PCNA)-positiven Fibroblasten und die Prokollagen-I-positiven Fibroblasten des subgingivalen Bindegewebes des Saumepithels zu bestimmen. Ergebnisse: Zähneputzen erhöhte in der ersten Woche die Anzahl der PCNA-positiven Fibroblasten, erhöhte bis zur fünften Woche die Anzahl der Type-I-Prokollagen-positiven Fibroblasten und reduzierte das entzündliche Zellinfiltrat bis zur dritten Woche. Schlussfolgerung: Diese Ergebnisse lassen annehmen, dass mechanisch stimulierte Fibroblasten während einer Woche zu proliferieren beginnen und diese Zellteilung eine erhöhte Anzahl von Fibroblasten in der dritten Woche zum Ergebnis hat. Es dauert fünf Wochen bevor zwischen den Bereichen mit Zähneputzen und Plaqueentfernung Unterschiede in der Kollagensynthese nachweisbar sind. Résumé Le brossage dentaire favorise la prolifération des fibroblastes gingivaux d'une manière plus efficace que l'enlèvement de la plaque dentaire L'enlèvement de la plaque dentaire est un élément essentiel dans le traitement parodontal. Cependant, des études ont été menées sur les effets de la stimulation mécanique produit par le brossage dentaire sur les mécanismes de défense de l'hôte au niveau gingival. Le but de l'étude présente a été d'évaluer les effets du brossage dentaire sur la prolifération des fibroblastes gingivaux chez les chiens dans le temps, comparés aux effets de l'enlèvement de la plaque dentaire sans brossage. Les bouches de six chiens bâtards ont été divisés en quatre quadrants : deux pour un brossage dentaire journalier et deux pour l'enlèvement journalier de la plaque à l'aide d'une curette. Après une, trois et cinq semaines de traitement, les analyses histométriques ont été effectuées pour évaluer l'infiltration cellulaire inflammatoire, les fibroblastes positifs à l'antigène du noyau cellulaire proliférant (PCNA), les fibroblastes positifs au procollagène-I dans le tissu conjonctif sous-épithélial de l'épithélium de jonction. Le brossage dentaire augmentait le nombre de fibroblastes positifs (PCNA) durant la première semaine, augmentait le nombre de fibroblastes positifs au collagène type-1 à la cinquième semaine et réduisait l'infiltration cellulaire inflammatoire à la troisième semaine. Ces découvertes suggèrent que les fibroblastes stimulés mécaniquement commencent à proliférer en une semaine, et cette division cellulaire abouti en un nombre plus important de fibroblastes à la troisième semaine. Il faut attendre cinq semaines avant que des différences dans la synthèse du collagène entre les zones de brossage et d'enlèvement de la plaque dentaire ne soient détectables. [source] Changes in vasoactive intestinal peptide in gingival crevicular fluid in response to periodontal treatmentJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2002Gerard J. Linden Abstract Aims: To evaluate the role of the anti-inflammatory neuropeptide vasoactive intestinal peptide (VIP) in periodontal health and disease and to determine the effects of periodontal treatment, resulting in a return to periodontal health, on the levels of VIP in gingival crevicular fluid (GCF). Methods: At baseline, 10 subjects with periodontitis (nine females, one male, mean age 43.0, SD 7.3) started a course of non-surgical periodontal treatment. Clinical indices were measured at one periodontitis and one clinically healthy site at an initial visit and at 8 weeks after the completion of treatment in each subject. A 30-s sample of GCF was collected from each test site using perio paper strips. The volume of GCF was measured and each sample subsequently analysed for VIP by radioimmunoassay. One healthy site was sampled from each member of a control group (10 females, mean age 29.9, SD 8.2 years) with clinically healthy gingiva and no periodontitis. Results: The clinical condition of all periodontitis sites improved as a result of periodontal treatment. The levels of VIP (pg/30 s sample) in periodontitis-affected sites fell significantly from 302.0 (SD 181.2) at the initial visit to 78.0 (54.4) after treatment, p = 0.007. The reduction in the concentration of VIP (pg/µL) in GCF from 524.3 (322.3) to 280.8 (280.2) was not statistically significant. The levels of VIP in clinically healthy sites fell from 115.5.5 (74.3) to 77.8 (32.3), n.s. and the concentration changed little from 883.8 (652.1) to 628.7 (323.3), n.s. There were substantially smaller amounts of VIP (25.8, SD 12.8) pg in healthy sites sampled from control subjects. Conclusions: VIP is present in GCF in greater quantities in periodontitis-affected than clinically healthy sites. In addition, the reduction in inflammation resulting from effective periodontal treatment is associated with a reduction in the levels of VIP in gingival crevicular fluid. [source] Serum IgG to heat shock proteins and Porphyromonas gingivalis antigens in diabetic patients with periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2002Tom J. Sims Abstract Background: Past studies have reported a correlation between the presence and severity of periodontitis and serum antibody titers to species-specific antigens of Porphyromonas gingivalis or to cross-reactive antigens, such as lipopolysaccharide (LPS) and heat shock proteins (HSP), shared between P. gingivalis and other bacteria. Our recent study of periodontal treatment outcome in insulin-dependent (type 1) diabetes mellitus patients with severe periodontitis (IDDMI/periodontitis) resulted in two key findings: 1. serum glutamic acid decarboxylase autoantibody (GAD65 Ab) levels were significantly associated with periodontal pocket depth change (PDC) and 2. serum IgG titers to P. gingivalis cells were positively associated with GAD65 Ab level in seropositive (GAD65 Ab +) patients. We have therefore hypothesized that profiles of serum autoantibody levels and IgG titers, to P. gingivalis -specific antigens may be useful in assessing risk for refractory periodontitis in such patients. Aim: To determine whether PDC resulting from non-surgical periodontal treatment can be predicted using profiles of baseline IgG titers to P. gingivalisspecific antigens, human HSP, and GAD65. Methods: PDC was assessed two months after non-surgical periodontal treatment of 7 GAD65 Ab + and 11 GAD65 AbIDDM/periodontitis patients. Pretreatment titers to GAD65, recombinant human heat shock proteins (HSP90, HSP70, and HSP60), and various P. gingivalis antigens were measured using radioligand precipitation or enzyme-linked immunosorbent (ELISA) assays and compared to the same measurements for 154 recent-onset IDDM patients and 46 non-diabetic controls. Results: Median titers (ELISA units) to HSP90 and HSP70 were significantly higher than non-diabetic controls for GAD65 Ab + (p°= 0.002) and GAD65 Ab- (p =,0.034) IDDM/periodontitis patients, respectively. Multivariate regression analysis indicated significant partial correlation of PDC with log-transformed titers to HSP90 (r =,, 0.62, p = 0.008), HSP70 (r =,+ 0.62, p = 0.009), GAD65 (r =,, 0.60, p = 0.01) and P. gingivalis LPS (r = , 0.5 1, p = 0.04). Furthermore, hierarchical clustering of baseline profiles of log-transformed HSP90, HSP70, and GAD65 Ab titers sorted patients into two distinct clusters with significantly different median PDC (1.45 min, n = 10 vs. 0.65 min, n = 8; p = 0.016, Mann,Whitney). Conclusion: Pretreatment profiles of serum antibody titers to HSP90, HSP70, GAD65, and P. gingivalis LPS may be useful for predicting which patients with IDDM/periodontitis will have a poor response to non-surgical periodontal therapy. [source] Clinical and microbiological studies of periodontal disease in Sjögren's syndrome patientsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2002B. Kuru Abstract Background: Little is known about the periodontal status of patients with Sjögren's Syndrome (SS), a chronic inflammatory autoimmune disease characterized by xerophthalmia and xerostomia. The aim of the present study was to evaluate whether the periodontal status of SS patients, in terms of clinical and microbiological parameters, differs from systemically healthy age- and gender-matched controls. Methods: 8 primary SS and 10 secondary SS patients were examined in comparison with 11 control subjects. All patients were diagnosed by the European Community Criteria. Control subjects were systemically healthy and not undergoing periodontal treatment. The comparison of clinical status was made in terms of mean periodontal parameters (plaque index, gingival index, gingival recession, probing pocket depth, probing attachment level and bleeding on probing) as well as the frequency distribution of probing pocket depth and probing attachment level measurements. Microbiological assays of the subgingival dental plaque samples were carried out by both a chairside enzyme test (Periocheck®) for the detection of peptidase activity (PA) and a polymerase chain reaction (PCR) analysis for 9 selected periodontal micro-organisms (Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Treponema denticola, Porphyromonas gingivalis, Eikenella corrodens, Campylobacter rectus, Bacteroides forsythus, Streptococcus oralis). Results: The occurrence, severity and extent of periodontal lesions were not significantly different between the 3 patient groups for all periodontal parameters examined. No significant differences in the sub-gingival plaque samples from control, primary or secondary SS patients for the PA test, frequency or type of periodontal micro-organisms observed. Conclusion: No significant differences could be detected in either clinical or microbiological parameters of primary or secondary SS patients compared with that of control subjects. The results of the present study thus support the notion that the periodontal status of patients with SS do not differ from systemically healthy age- and gender-matched controls. Zusammenfassung Hintergrund: Es ist wenig über den parodontalen Status von Patienten mit Sjögren Syndrom (SS) bekannt, einer chronischen entzündlichen Autoimmunerkrankung, die durch Xerophtalmie und Xerostomie charakterisiert ist. Das Ziel der vorliegenden Studie war zu überprüfen, ob der parodontale Status der SS-Patienten bi Berücksichtigung der klinischen und mikrobiologischen Parameter von demjenigen bei systemisch gesunden alters- und geschlechtspassenden Kontrollen abweicht. Methoden: 8 primäre SS und 10 sekundäre SS Patienten wurden mit 11 Kontrollpersonen vergleichend untersucht. Alle Patienten waren durch Kriterien der EU diagnostiziert. Die Kontrollpersonen waren systemisch gesund und erhielten keine parodontale Behandlung. Der Vergleich des klinischen Status wurde auf der Basis von mittleren parodontalen Parametern (Plaque-Index, Gingivaindex, gingivale Rezession, Sondierungstiefe, Stützgewebeniveau, Provokationsblutung) sowie der Verteilungsmuster der Sondierungstiefe und des Stützgewebeniveaus vorgenommen. Mikrobiologische Assay's von subgingivalen Plaqueproben wurden sowohl mit einem chairside Enzymtest (Periocheck®) für die Feststellung der Peptidaseaktivität (PA) und einer Polymerasekettenreaktion (PCR) für 9 selektierte parodontale Mikroorganismen (Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Treponema denticola, Porphyromonas gingivalis, Eikenella corrodens, Campylobacter rectus, Bacteroides forsythus, Streptococcus oralis) durchgeführt. Ergebnisse: Das Vorkommen, die Schwere und die Ausdehnung von parodontalen Läsionen unterschied sich nicht signifikant zwischen den 3 Patientengruppen für alle geprüften parodontalen Parameter. Es gab auch keine signifikanten Differenzen in den subgingivalen Plaqueproben von den Kontrollen, den primären oder sekundären SS Patienten für die PA Teste und Frequenz oder Art von beobachteten parodontalen Mikroorganismen. Schlussfolgerung: Es konnten keine signifikanten Differenzen sowohl bei den klinischen oder mikrobiologischen Parametern von primären oder sekundären SS Patienten im Vergleich mit Kontrollpersonen entdeck werden. Die Ergebnisse der vorliegenden Studie unterstützen die Ansicht, dass sich der parodontale Status von Patienten mit SS nicht von demjenigen gesunder alters- und geschlechtspassender Kontrollen unterscheidet. Résumé Origine: On en sait peu sur l'état parodontal des patients atteints du syndrome de Sjögren (SS), une maladie chronique autoimmune inflammatoire caractérisée par une xérophtalmie et une xérostomie. Le but de cette étude était d'évaluer si l'état parodontal des patients SS, en terme de paramètres cliniques et microbiologiques était différent de sujets contrôles en bonne santé générale du même âge et du méme sexe. Méthodes: 8 patients atteints de SS primaires et 10 de SS secondaires furent examinés et comparés avec des sujets contrôles. Tous les patients étaient diagnostiqués selon les critères de la communauté européenne. Les sujets contrôles étaient en bonne santé générale et ne suivaient pas de traitement parodontal. La comparaison des états parodontaux fut réalisée pour les paramètres cliniques moyens (indice de plaque, gingival, récession gingivale, profondeur de poche au sondage, niveau d'attache et saignement au sondage) et aussi pour la frèquence de distribution des mesures des profondeurs de poche au sondage et des niveaux d'attache. Les tests microbiologiques des échantillons de plaque sous-gingivale ont été réalisés à la fois par un test enzymatique au fauteuil (Periocheck®) pour la détection de l'activité peptidase (PA) et par réaction de polymérase en chaine (PCR) pour 9 micro-organismes parodontaux sélectionnés (Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Treponema denticola, Porphyromonas gingivalis, Eikenella corrodens, Campylobacter rectus, Bacteroides forsythus, Streptococcus oralis). Résultats: La survenue, la sévérité et l'étendue de la maladie parodontale n'étaient pas significativement différente entre les 3 groupes de patients pour tous les paramètres parodontaux examinés. Aucune différence significative ne fut observée entre les échantillons de plaque sous-gingivale des contrôles et ceux des patients atteints de SS primaire et secondaire, pour PA, la frèquence ou le type de micro-organismes. Conclusions: Aucune différence significative ne put être détectée, ni pour les paramètres cliniques, ni pour les paramètres microbiologiques des patients atteints de SS primaire ou secondaire lorsque l'on comparait avec les sujets contrôles. Les résultats de cette étude corroborent ainsi l'idée suivant laquelle l'état parodontal des patients atteints de SS ne différe pas de celui des sujets en bonne santé du même âge et du même sexe. [source] Effect of interleukin-1 gene polymorphism in a periodontally healthy Hispanic population treated with mucogingival surgeryJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2002Raul G. Caffesse Abstract Objectives: A genetic test for susceptibility of periodontal disease has been introduced. A positive test indicates a risk factor for more severe periodontal destruction. The prevalence of genotype positive subjects has been reported around 30%. In a Mexican population, we have found a 26% prevalence of genotype positive individuals. Few studies have reported the response to therapy in these individuals. The purpose of this study was to assess the response to mucogingival surgery in an otherwise periodontally healthy Hispanic population. Materials and methods: 22 subjects (7 male and 15 female) with a mean age of 45 years participated. They were treated 3 years prior for the treatment of Types I and II recession defects using connective tissue grafts. No other active periodontal treatment was required, except for preventive maintenance. A full-mouth clinical evaluation was performed which included assessment of gingival inflammation and measurements of probing pocket depth and clinical attachment levels. Mean values per patient were determined. A finger stick blood sample was collected using specially provided DNA filter paper, let dried, and mailed for processing. Results: Results indicated that 5 out of the 22 subjects were genotype positive. The genotype positive subjects presented the following values: GI 1.13±0.17, PPD 2.48±0.46, and CAL 3.38±0.66. The values for the genotype negative subjects were GI 1.06±0.14, PPD 2.38±0.31 and CAL 3.11±0.53. No statistical significant differences were found when both groups were compared (p>0.05). Furthermore, the treatment of the localized recessions was effective and provided similar amount of coverage in genotype positive and negative subjects. However, more genotype negative subjects showed complete coverage of the recession than genotype positive individuals. Conclusions: Within the limits of this study it is concluded that (1) periodontal health can be maintained with proper preventive maintenance irrespective of the genotype present, (2) the mean response to mucogingival surgery to cover localized gingival recessions is similar irrespective of the IL-1 periodontal genotype, however, full coverage is achieved more frequently in genotype negative subjects. Zusammenfassung Ziele: Es wurde ein Gentest für die Anfälligkeit bezüglich einer Parodontalerkrankung eingeführt. Ein positiver Test ist ein Zeichen für einen Risikofaktor für eine stärkere parodontale Destruktion. Die Prävalenz von genotyp-positiven Personen wurde mit etwa 30% angegeben. In einer mexikanischen Population haben wir eine Prävalenz von 26% von genotyp-positiven Individuen vorgefunden. Nur wenige Studien haben bei diesen Patienten über die Reaktion auf die Therapie berichtet. Der Zweck dieser Studie war es die Heilung nach mukogingivaler Chirurgie in einer im Übrigen parodontal gesunden Population mit spanischen Abstammung. Material und Methode: 22 Patienten (7 Männer und 15 Frauen) mit einem Durchschnittsalter von 45 Jahren nahmen an der Studie teil. Sie wurden vor 3 Jahren zur Deckung einer Rezession von Typ I oder II mit einem Bindegewebetransplantat behandelt. Es war keine weitere parodontale Behandlung außer präventiven Erhaltungstherapie notwendig. Es wurde eine vollständige klinische Untersuchung des Gebisses durchgeführt, die die Bestimmung der gingivalen Etnzündung, sowie die Messung der Sondierungstiefe und des klinischen Attachmentniveaus beinhaltete. Es wurden für jeden Patienten die Mittelwerte bestimmt. Eine Blutprobe von der Fingerbeere wurde entnommen, auf ein specielles DNA-Filterpapier aufgetragen, getrocknet und zur Weiterverarbeitung versendet. Ergebnisse: Die Ergebnisse zeigten, dass 5 von 22 Patienten genotyp-positiven waren. Die genotyp-positiven Patienten wiesen folgende Werte auf: GI 1.13±0.17, PPD 2.48±0.46 und CAL 3.38±0.66. Die Werte für die genotyp-negativen Patienten betrugen: GI 1.06±0.14, PPD 2.38±0.31 und CAL 3.11±0.53. Beim Vergleich beider Gruppen ergaben sich keine statistisch signifikanten Unterschiede (p>0.05). Des weiteren war die Behandlung der lokalisierten Rezession effektiv und lieferte bei genotyp-positiven und genotyp-negativen Patienten einen ähnlichen Anteil an Wurzeldeckung. Jedoch zeigten mehr genotyp-negative Patienten eine vollständige Rezessionsdeckung als genotyp-positive Patienten. Schlussfolgerungen: Mit den Einschränkungen dieser Studie kann die Schlussfolgerung gezogen werden, dass (1) unabhängig vom vorliegenden Genotyp mit geeigneten präventiven Maßnahmen die parodontale Gesundheit erhalten werden kann und (2) dass unabhängig vom IL-1-Genotyp, die durchschnittliche Reaktion auf die mukogingivale Chirurgie zur Deckung von lokalisierten Gingivarezessionen ähnlich ist. Jedoch wird eine vollständige Deckung häufiger bei genotyp-negativen Patienten erreicht. Résumé But: Un test génétique pour la suscpetibilitéà la maladie parodontale est présenté. Un test positif indique un facteur de risque pour une destruction parodontale plus sévère. La fréquence globale de sujets positifs au génotype semblerait être de 30%. Dans une population mexicaine, une fréquence globale de 26% d'individus positifs pour le génotype a été trouvée. Peu d'études ont apporté la réponse au traitement chez ces individus. Le but de cette investigation a été de mesurer la réponse de la chirurgie muco-gingivale dans une population hispanique parodontalement saine. Matériaux et méthodes: 7 hommes et 15 femmes d'un âge moyen de 45 ans y ont participé. Ils avaient été traités 3 ans auparavant pour des lésions de récession de type I et II en utilisant des greffes de tissu conjonctif. Aucun autre traitement parodontal actif n'avait été requis, sauf pour la maintenance. Une évaluation clinique de toute la bouche a été effectuée comprenant l'estimation de l'inflammation gingivale et les measures de la profondeur de poche au sondage et des niveaux d'attache clinique. Les valeurs moyennes par patient ont été déterminées. Un échantillon sanguin par piqûre du doigt a été récolté en utilisant un papier filtre ADN, qui fût séché et envoyé pour analyse. Résultats: Les résultats ont indiqué que 5 des 22 sujets étaient génotype positif. Ces sujets présentaient les valeurs suivantes: GI 1.13±0.17, PPD 2.48±0.46 mm et CAL 3.38±0.66 mm. Les valeurs chez les sujets génotype négatif étaient: GI 1.06±0.14, PPD 2.38±0.31 mm et CAL 3.11±0.53 mm. Aucune différence statistiquement significative n'a été trouvée lorsque les deux groupes ont été comparés. De plus le traitement des récessions locales était effectif et apportait une quantité semblable de recouvrement chez les deux types de sujets. Cependant davantage de sujets génotype négatif bénéficiaient d'un recouvrement complet de la récession. Conclusions: Dans les limites d l'étude présente: (1) la santé parodontale peut être maintenue avec des mesures préventives quelque soit le génotype présent, (2) la réponse moyenne de la chirurgie muco-gingivale pour recouvrir des récessions gingivales locales est semblable quelque soit le génotype parodontal IL-1, bien qu'un recouvrement complet est plus souvent réalisé chez les sujets génotype négatif. 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