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Probing Depth (probing + depth)
Kinds of Probing Depth Selected AbstractsA clinical study evaluating the treatment of supra-alveolar-type defects with access flap surgery with and without an enamel matrix protein derivative: a pilot studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2008Holger Jentsch Abstract Aim: There is evidence that regenerative treatment of intra-bony and mandibular class II furcation defects with access flap and an application of an enamel matrix protein derivative (EMD) can result in a clinical benefit compared with access flap alone. The aim of this pilot study was to check if the results of access flap surgery in suprabony defects are improved by additional application of EMD. Material and Methods: Thirty-nine adult subjects with supra-alveolar-type defects were randomly assigned to a test (n=25) and a control group (n=14). Seventy teeth were treated with EMD; 28 teeth were treated by access flap. Probing depth (PD), clinical attachment level and bleeding on probing were evaluated at baseline and after 12 months. Results: PD of the operated teeth was improved in both groups (p<0.001 to p=0.041) but always better in the test group. The attachment gain was 2.72±1.80 mm at sites with an initial PD 7 mm in the test group and 0.78±0.62 mm in the control group (p=0.004). In the test group the mean attachment gain was 0.97±0.92 mm (p<0.001); the mean reduction of PD was 1.55±0.90 mm (p<0.001). Conclusions: The data suggest a significant clinical benefit of supplementary application of EMD during surgical treatment of periodontitis of supra-alveolar pockets, especially in deeper pockets. [source] Submerged healing following surgical treatment of peri-implantitis: a case seriesJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2007Ann-Marie Roos-Jansåker Abstract Objectives: The aim was to study a regenerative surgical treatment modality for peri-implantitis employing submerged healing. Material and Methods: Twelve patients, having a minimum of one osseointegrated implant with peri-implantitis, with a progressive loss of 3 threads (1.8 mm) following the first year of healing were involved in the study. After surgical exposure of the defect, granulomatous tissue was removed and the implant surface was treated using 3% hydrogen peroxide. The bone defects were filled with a bone substitute (Algipore®), a resorbable membrane (Osseoquest®) was placed over the grafted defect and a cover screw was connected to the fixture. The implant was then covered by flaps and submerged healing was allowed for 6 months. After 6 months the abutment was re-connected to the supra-structure. Results: A 1-year follow-up demonstrated clinical and radiographic improvements. Probing depth was reduced by 4.2 mm and a mean defect fill of 2.3 mm was obtained. Conclusion: Treatment of peri-implant defects using a bone graft substitute combined with a resorbable membrane and submerged healing results in defect fill and clinical healthier situations. [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] Open flap debridement with or without intentional cementum removal: a 4-month follow-upJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2005Antonio Wilson Sallum Abstract Objectives: The aim of this study was to investigate the influence of cementum removal on periodontal repair. Material and Methods: Forty subjects with chronic periodontitis and presenting, at least, two proximal sites in anterior teeth (upper or lower) with probing depth 5 mm were selected. After oral hygiene instructions and ultrasonic supragingival instrumentation, the subjects were randomly assigned for one of the following groups: CIC, scaled with Gracey curettes; CIUS, scaled with ultrasonic device; CDC, calculus deattachment with Gracey curettes and brushing with saline solution; and CDUS, calculus deattachment with ultrasonic device and brushing with saline solution. Full-thickness flaps were reflected and the instrumentation was performed with a clinical microscope. Probing depth (PD), relative gingival margin level (RGML) and relative attachment level (RAL) were registered at five experimental periods: baseline and 30, 60, 90 and 120 days postoperative. Results: All the approaches were able to markedly reduce the PD values from the baseline to the other evaluation periods (p<0.0001). The increase in RGML values was statistically significant only for the CDUS group. There were no statistically significant differences between the baseline and postoperative values in all groups for the RAL changes. The changes in RAL were statistically significant only among the groups CDC and CDUS (p<0.0001). Conclusion: The conventional scaling and root planing and the calculus deattachment were effective in reducing the probing depth values, regardless of the instrumentation method. [source] Occurrence and risk indicators of increased probing depth in an adult Brazilian populationJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2005Cristiano Susin Abstract Background/Aims: There is little information about the occurrence and risk indicators for periodontal diseases in Latin America. The present study describes the prevalence, extent and severity of periodontal probing depth (PPD) and assesses the association between demographic, behavioural and environmental risk indicators and the extent and severity of PPD in this population. Materials and Methods: The target population was urban adults aged 30 years in Rio Grande do Sul state in South Brazil. A representative sample was selected using a multi-stage, probability, cluster sampling strategy and included 853 dentate subjects 30,103 years of age. A full-mouth clinical examination was carried out at six sites per tooth on all permanent teeth, excluding third molars, and was conducted in a mobile examination centre. Results: Approximately 65% and 25% of the subjects and 19% and 5% teeth per subject had PPD 5 and 7 mm, respectively. 31.6%, 33.7% and 34.7% subjects had generalized, localized or no PPD 5 mm, respectively. Probing depth increased in prevalence with increasing age, and leveled off at around 50 years of age and beyond. PPD 5 mm was significantly higher in males than in females, and in non-Whites than in Whites. Cigarette smokers had a significantly higher occurrence of PPD 5 mm than non-smokers, and this relationship was dose dependent. A multivariate model showed that generalized PPD 5 mm was associated with subjects aged 40 years, males, non-Whites and moderate or heavy cigarette smokers (relative risk ratios: 2.0, 2.0, 2.2, 2.4 and 6.8, respectively). Conclusion: Moderate and deep probing depth was a common finding in this urban adult Brazilian population. Older age, male gender, non-White race and moderate and heavy cigarette smoking were significant risk indicators of increased PPD, and these may be useful indicators of periodontal disease high-risk groups. [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] Simultaneous or staged installation with guided bone augmentation of transmucosal titanium implantsCLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2003A 3-year prospective cohort study Abstract: A prospective cohort study of 45 nonsmoking consecutively admitted patients was studied for the treatment outcomes following jaw bone augmentation in conjunction with installment of oral implants. Twenty-eight patients were treated for both bone augmentation and implant treatment simultaneously, while 17 patients were treated with a staged approach with the bone augmentation being performed 6,8 months prior to implant installation. Three months following this, prosthetic reconstructions were incorporated. One year thereafter, baseline data and 3 years after reconstruction, follow-up data were obtained. Moderately low mean scores for the bleeding on probing percentage were found at baseline (24%) and after 3 years of function (17%), while the corresponding values at the implant sites were 40.6% and 52.4%, respectively. However, the modified gingival index (mGI)=2 was found in only 4.8%, and 6.9% at the baseline and 3-year examinations. Peri-implant Probing depth (PPD) and level of attachment mean values did not vary between baseline and follow-up examinations. Only a small proportion of 1.8% yielded PPD=6.0 mm after 3 years of function. Radiographic bone level measurements showed that 18.2% of the implants lost 0.5 mm during the observation period. Seventy percent of the sites were considered completely stable. It was concluded that predictable treatment outcomes resulted for oral implant installation combined with or staged after jawbone augmentation. Only 6.5% of the sites had lost 1.5% crestal bone with the staged approach while 14% of the sites had lost 1.5 mm, when the implants were placed simultaneously. This suggests that the staged approach may have a lower risk for greater amounts of crestal bone loss as the simultaneous approach. In general, crestal bone loss encountered in the present study corresponded very well with that reported following placement of the same implant system into nonaugmented bone. Résumé Une étude prospective chez 45 non-fumeurs a été menée pour étudier le traitement suivant l'épaississement de l'os de la mâchoire en association avec le placement d'implants buccaux. Vingt-huit patients ont été traités pour un épaississement osseux et un traitement implantaire simultané tandis que 17 patients ont été traités par une approche de l'épaississement osseux effectuée six à huit mois avant le placement des implants. Trois mois après, les reconstructions prothétiques ont été placées. Une année plus tard les données de l'examen initial, et trois années après la reconstruction les données du suivi, ont été obtenues. Un pourcentage de BOP moyen modérément bas a été constaté lors de l'examen de départ (24%) et après trois années de mise en fonction (17%), tandis que les valeurs correspondantes au niveau des implants étaient respectivement de 41 et 52 %. Cependant, le mGI=2 était constaté seulement dans 5% et 7% lors des examens de départ et après trois ans. Les valeurs moyennes PPD et LA ne variaient pas entre l'examen de départ et les suivis. Seul une petite proportion de 2% avaient un PPD de 6,0 mm après trois années de mise en fonction. Les mesures du niveau osseux radiographique ont montré que 18% des implants perdaient 0,5 mm durant la période d'observation. Septante pour cent des sites étaient considérés complètement stables. Un traitement prévisible se produisait donc pour les implants osseux qu'ils aient été installés en une ou deux étapes. Seul 6,5% des sites avaient perdu 1,5% d'os crestal avec l'approche chirurgicale en une étape tandis que 14% des sites avaient perdu 1,5 mm lorsque les implants étaient placés en même temps que l'épaississement. L'approche en deux étapes pourrait s'accompagner d'un risque inférieur de perte osseuse importante au niveau crestal comparée à l'approche en une étape. En général, la perte osseuse crestale rencontrée dans l'étude présente correspondait très bien avec celle rapportée suivant le placement du même système d'implants dans l'os non-épaissi. Zusammenfassung In dieser prospektiven Kohortenstudie an 45 nichtrauchenden Patienten wurden die Behandlungsresultate nach Kieferkammaugmentation in Zusammenhang mit der Platzierung von oralen Implantaten untersucht. Bei 28 Patienten wurde die Knochenaugmentation und die Implantation in einem Eingriff durchgeführt, während bei 17 Patienten ein gestaffeltes Verfahren angewendet wurde, bei welchem die Knochenaugmentation 6,8 Monate vor der Implantatplatzierung stattfand. Drei Monate nach Implantation wurden die prothetischen Rekonstruktionen eingesetzt. Ein Jahr später wurden die Daten für die Ausgangsuntersuchung erhoben und drei Jahre nach Rekonstruktion wurden die Daten für die Nachuntersuchung aufgenommen. Bei der Ausgangsuntersuchung (24%) und nach drei Jahren in Funktion (17%) wurden relativ tiefe mittlere BOP % Werte gefunden, während die entsprechenden Werte bei den Implantatstellen 40.6% bzw. 52.4% betrugen. Jedoch wurde ein mGI=2 nur bei 4.8% anlässlich der Ausgangsuntersuchung und bei 6.9% bei der Nachuntersuchung gefunden. Die mittleren PPD und LA Werte variierten nicht zwischen der Ausgangs- und Nachuntersuchung. Nur ein kleiner Anteil von 1.8% zeigte eine PPD=6 mm nach drei Jahren in Funktion. Die Messung des radiologischen Knochenniveaus ergab, dass 18.2% der Implantate während der Beobachtungszeit einen Knochenverlust von 0.5 mm zeigten. 70% der Stellen wurde als komplett stabil angesehen. Es wurde die Schlussfolgerung gezogen, dass für die Eingliederung von oralen Implantaten zusammen mit Knochenaugmentation oder in einem gestaffelten Verfahren zu voraussagbaren Behandlungsresultaten führt. Nur 6.5% der Stellen im gestaffelten Vorgehen zeigten einen Knochenverlust von 1.5 mm während bei den gleichzeitig gesetzten Implantaten bei 14% der Stellen ein Knochenverlust von 1.5 mm auftrat. Dies lässt vermuten, dass das gestaffelte Vorgehen ein kleineres Risiko für grössere Knochenverluste haben könnte als das gleichzeitige Vorgehen. Generell betrachtet korrespondierte der in der vorliegenden Studie gesehene Knochenverlust sehr gut mit den Werten, die für das gleiche Implantatsystem nach dem Setzten in nichtaugmentierten Knochen berichtet werden. Resumen Se realizó un estudio prospectivo en serie sobre 45 pacientes no fumadores admitidos consecutivamente acerca de los resultados del tratamiento tras el aumento del hueso mandibular en conjunción con la instalación de implantes orales. Se trataron 28 pacientes para aumento del hueso y tratamiento de implantes simultáneamente mientras que 17 pacientes se trataron con un enfoque por fases con el aumento óseo realizado 6,8 meses antes de la instalación del implante. A los tres meses de esto, se incorporaron las reconstrucciones protésicas. Un año después, se obtuvieron datos de seguimiento, momento inicial y tres años tras la reconstrucción. Se encontró un % de BOP medio moderadamente bajo al inicio (24%) y tras tres años en función (17%), mientras que los valores correspondientes para los lugares de implante fueron 40.6% y 52.4%, respectivamente. De todos modos, el mGI=2 se encontró en solo 4.8%, y 6.9% al inicio y en el examen de los tres años. Los valores medios de PPD y LA no variaron entre el inicio y los exámenes de seguimiento. Solo una pequeña proporción del 1.8% produjo un PPD=6.0 mm tras tres años en función. Las mediciones del nivel radiográfico del hueso mostraron que el 18.2% de los implantes perdieron 0.5 mm durante el periodo de observación. El 70% de los lugares se consideraron completamente estables. Se concluyó que se obtuvieron unos resultados predecibles para instalación de implantes orales combinados con o en fases tras el aumento del hueso mandibular. Solo el 6.5% de los lugares perdió el 1.5% del hueso crestal con el enfoque por fases mientras que el 14% de los lugares perdieron 1.5 mm cuando los implantes se colocaron simultáneamente. Esto sugiere que el enfoque por fases puede tener un menor riesgo para mayores cantidades de perdida de hueso crestal que el enfoque simultaneo. En general, la perdida de hueso crestal encontrada en el presente estudio correspondió con muy buen con aquella informada tras la colocación del mismo sistema de implantes en hueso no aumentado. [source] Surgical treatment of peri-implantitis using a bone substitute with or without a resorbable membrane: a prospective cohort studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2007Ann-Marie Roos-Jansåker Abstract Objectives: The aim of this prospective cohort study was to compare two regenerative surgical treatment modalities for peri-implantitis. Material and Methods: Thirty-six patients having a minimum of one osseointegrated implant, with a progressive loss of bone amounting to 3 threads (1.8 mm) following the first year of healing, combined with bleeding and/or pus on probing, were involved in this study. The patients were assigned to two different treatment strategies. After surgical exposure of the defect, granulomatous tissue was removed and the infected implant surface was treated using 3% hydrogen peroxide. The bone defects were filled with a bone substitute (Algipore®). In 17 patients (Group 1), a resorbable membrane (Osseoquest®) was placed over the grafted defect before suturing. In 19 patients (Group 2), the graft was used alone. Results: One-year follow-up demonstrated clinical and radiographic improvements. Probing depths were reduced by 2.9 mm in Group 1 and by 3.4 mm in Group 2. Defect fill amounted to 1.5 and 1.4 mm, respectively. There was no significant difference between the groups. Conclusion: It is possible to treat peri-implant defects with a bone substitute, with or without a resorbable membrane. [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] 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] Effect of oral hygiene instruction and scaling on oral malodour in a population of Turkish children with gingival inflammationINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 6 2006C. KARA Summary. Aim., Oral malodour affects a large proportion of the population, and may cause a significant social or psychological handicap to those suffering from it. The condition has a positive correlation with the accumulation of bacterial plaque in the oral cavity. The aim of the present study was twofold: first, to determine whether oral malodour and periodontal disease parameters are associated with one another in 150 Turkish subjects (mean age ± SD = 9·1 ± 2·7 years; age range = 7,12 years); and secondly, to investigate the impact of oral hygiene instruction and scaling on oral malodour. Design., The parameters measured included whole-mouth odour judge scoring, halimeter measurements, saliva pH scores, gingival index, plaque index, and probing depth before and after the treatment procedures. Results., Odour judge scores were significantly associated with halimeter findings. However, gingival index, plaque index and probing depth were significantly associated with odour judge scores and halimeter scores. The statistical analysis revealed that periodontal treatments caused a significant reduction (P < 0·001) in volatile sulphur compound formation. Conclusion., These results suggest that, in the population studied, periodontal health and oral malodour are associated with one another. Oral malodour levels were significantly reduced after treating gingival inflammation. Thus, in order to avoid oral malodour in children, oral care should not be neglected. [source] Application of chitosan gel in the treatment of chronic periodontitisJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2007Hakan Ak Abstract Local administration of antibiotics in periodontal therapy can be provided with an appropriate delivery system. The purpose of this study was to evaluate the clinical effectiveness of chitosan, both as a carrier in gel form and as an active agent in the treatment of chronic periodontitis (CP). The chitosan gel (1% w/w) incorporated with or without 15% metronidazole was prepared and applied adjunctive to scaling and root planing (SRP) in comparison to SRP alone (control group-C), in CP patients. The clinical parameters such as probing depth (PD), clinical attachment level, the amount of gingival recession, plaque index, gingival index, and gingival bleeding time index were recorded at baseline and at weeks 6, 12, and 24. In all groups, significant improvements were observed in clinical parameters between baseline and week 24 (p < 0.05). The reductions in PD values were 1.21 mm for Ch, 1.48 mm for Ch + M, and 0.94 mm for C groups. No complications related to the chitosan were observed in patients throughout the study period. It is suggested that chitosan itself is effective as well as its combination with metronidazole in CP treatment due to its antimicrobial properties. © 2006 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2007 [source] Periodontal disease progression and glycaemic control among Gullah African Americans with type-2 diabetesJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2010Dipankar Bandyopadhyay Bandyopadhyay D, Marlow NM, Fernandes JK, Leite RS: Periodontal disease progression and glycaemic control among Gullah African Americans with type-2 diabetes. J Clin Periodontol 2010; 37: 501,509. doi: 10.1111/j.1600-051X.2010.01564.x. Abstract Aim: To evaluate associations between glycaemic control and periodontitis progression among Gullah African Americans with type-2 diabetes mellitus (T2DM). Materials and Methods: From an ongoing clinical trial among T2DM Gullah, we extracted a cohort previously in a cross-sectional study (N=88). Time from baseline (previous study) to follow-up (trial enrollment, before treatment interventions) ranged 1.93,4.08 years [mean=2.99, standard deviation (SD)=0.36]. We evaluated tooth site-level periodontitis progression [clinical attachment loss (CAL) worsening of 2 mm, periodontal probing depth (PPD) increases of 2 mm and bleeding on probing (BOP) from none to present] by glycaemic control status (well-controlled=HbA1c<7%, poorly-controlled=HbA1c7%) using multivariable generalized estimating equations logistic regression, nesting tooth sites/person. Results: Poorly-controlled T2DM (68.18%) was more prevalent than well-controlled T2DM (31.82%). Proportions of tooth sites/person with CAL progression between baseline and follow-up ranged 0.00,0.59 (mean=0.12, SD=0.12), while PPD and BOP progression ranged 0.00,0.44 (mean=0.09, SD=0.11) and 0.00,0.96 (mean=0.24, SD=0.18), respectively. Site-level PPD at baseline was a significant effect modifier of associations between poorly-controlled T2DM and site-level CAL and PPD progression [adjusted odds ratios (OR) according to poorly-controlled T2DM among PPD at baseline=3, 5 and 7 mm, respectively: CAL progression=1.93, 2.64, and 3.62, PPD progression=1.98, 2.76, and 3.84; p<0.05 for all]. Odds of site-level BOP progression were increased (OR=1.24) for poorly-controlled T2DM, yet the results were not significant (p=0.32). Conclusions: These findings from a distinct, homogenous population further support the clinical relevance of identifying patients with poor glycaemic control and periodontitis, particularly among those with disparities for both diseases. [source] 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] Saliva concentrations of RANKL and osteoprotegerin in smoker versus non-smoker chronic periodontitis patientsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2008Nurcan Buduneli Abstract Objectives: To compare the salivary receptor activator of NF- ,B ligand (RANKL) and osteoprotegerin (OPG) concentrations in smokers versus non-smokers with chronic periodontitis. Material and Methods: Whole saliva samples were obtained from 67 untreated chronic periodontitis patients, of whom 34 were smokers, and from 44 maintenance patients, of whom 22 were smokers. Full-mouth clinical periodontal measurements were recorded. Saliva cotinine, sRANKL and OPG concentrations were determined by ELISA. Statistical analysis was performed using the Mann,Whitney U test, Bonferroni's correction for multiple comparisons and Spearman's correlations. Results: Untreated smokers exhibited significantly higher values of clinical periodontal recordings than untreated non-smokers (all p<0.05). Salivary cotinine level correlated with clinical attachment level (p=0.023). Smoker versus non-smoker maintenance groups showed no significant differences in clinical parameters. There were significant differences in sRANKL and OPG concentrations between untreated and maintenance groups (all p<0.01). Salivary OPG concentration was significantly lower (all p<0.01) and the sRANKL/OPG ratio was higher (all p<0.01) in smokers than in non-smokers. OPG concentration correlated positively with probing depth, clinical attachment level and bleeding on probing (all p<0.005) and negatively with pack-year, and cotinine level (p<0.05). Conclusion: Salivary RANKL and OPG concentrations are suggested to be affected by smoking as not only the untreated but also the treated smokers exhibited higher RANKL and lower OPG concentrations than non-smokers. [source] Relationship between betel quid additives and established periodontitis among Bangladeshi subjectsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2008Rahena Akhter Abstract Aim: To determine the relationship between betel quid chewing additives and established periodontitis in Bangladeshi subjects. Material and Methods: A total of 864 subjects participated in this study. Among them, 140 pairs of sex- and age-matched case subjects and control subjects were selected. A case was defined as a person who had at least two sites with a clinical attachment level (CAL)6 mm and at least one site with probing depth (PD)5 mm. Subjects who did not fulfill these criteria were considered as controls. Information on sociodemographic variables, psychological stress, dental health behaviour, smoking and betel quid chewing habits was obtained. Results: Multiple logistic regression analysis showed that current betel quid chewers had greater probabilities of having established periodontal disease than did non-chewers (odds ratio=3.97, p<0.05). Mean PD, mean CAL, mean percentage of bleeding on probing and number of missing teeth were significantly higher in chewers of betel quid with tobacco and masala than in chewers of betel quid without such additives adjusting for age, sex, smoking habit, body mass index, dental visit pattern, stress and plaque index. Higher frequency and longer duration of betel quid chewing showed a significant relation to an increase in periodontal parameters. Conclusion: The results indicate that betel quid additives might significantly enhance periodontitis in the population studied. [source] Two-year clinical results following treatment of peri-implantitis lesions using a nanocrystalline hydroxyapatite or a natural bone mineral in combination with a collagen membraneJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2008Frank Schwarz Abstract Objectives: The aim of the present case series was to evaluate the 2-year results obtained following treatment of peri-implantitis lesions using either a nanocrystalline hydroxyapatite (NHA) or a natural bone mineral in combination with a collagen membrane (NBM+CM). Material and Methods: Twenty-two patients suffering from moderate peri-implantitis (n=22 intra-bony defects) were randomly treated with (i) access flap surgery (AFS) and the application of NHA, or with AFS and the application of NBM+CM. Clinical parameters were recorded at baseline and after 12, 18, and 24 months of non-submerged healing. Results: Two patients from the NHA group were excluded from the study due to severe pus formation at 12 months. At 24 months, both groups revealed clinically important probing depth (PD) reductions (NHA: 1.5±0.6 mm; NBM+CM: 2.4±0.8 mm) and clinical attachment level (CAL) gains (NHA: 1.0±0.4 mm; NBM+CM: 2.0±0.8 mm). However, these clinical improvements seemed to be better in the NBM+CM group (difference between groups: PD reduction: 0.9±0.2 mm; CAL gain: 1.0±0.3 mm). Conclusion: Both treatment procedures have shown efficacy over a period of 24 months, however, the application of NBM+CM may result in an improved outcome of healing. [source] Five-year results of a prospective, randomized, controlled study evaluating treatment of intra-bony defects with a natural bone mineral and GTRJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2007Anton Sculean Abstract Background: Treatment with a natural bone mineral (NBM) and a guided tissue regeneration (GTR) has been shown to promote periodontal regeneration. However, until now there are only very limited data on the long-term clinical results following this regenerative technique. Aim: To present the 5-year results of a prospective, randomized, controlled clinical study evaluating the treatment of deep intra-bony defects either with open flap debridement (OFD) and a combination of an NBM and GTR (test) or OFD alone (control). Methods: Nineteen patients diagnosed with advanced chronic periodontitis, and each of whom displayed one intra-bony defect, received randomly the test or the control treatment. Results were evaluated at baseline, at 1 and at 5 years following therapy. Results: No statistically significant differences in any of the investigated parameters were observed at baseline between the two groups. At 1 year after therapy, the test group showed a reduction in mean probing depth (PD) from 9.1±1.1 to 3.7±0.8 mm (p<0.001) and a change in mean clinical attachment level (CAL) from 10.4±1.3 to 6.4±1.2 mm (p<0.001). At 5 years, mean PD and CAL measured 4.3±0.8 and 6.7±1.6 mm, respectively. At 5 years, both PD and CAL were statistically significantly improved compared with baseline (p<0.001) without statistically significant differences between the 1- and 5-year results. In the control group, mean PD was reduced from 8.9±1.3 to 4.9±1.2 mm (p<0.001) and mean CAL changed from 10.6±1.4 to 8.8±1.5 mm (p<0.01). At 5 years, mean PD and CAL measured 5.6±1.1 and 9.1±1.3 mm, respectively, and were still statistically significantly improved compared with baseline (p<0.01). No statistically significant differences were found between the 1- and 5-year results. The test treatment, at both 1 and 5 years, yielded statistically significantly higher CAL gains than the control one (p<0.01). Compared with baseline, at 5 years a CAL gain of 3 mm was found in nine defects (90%) of the test group but in none of the defects treated with OFD alone. Conclusions: It was concluded that (i) treatment of intra-bony defects with OFD+NBM+GTR may result in significantly higher CAL gains than treatment with OFD, and (ii) the clinical results obtained after both treatments can be maintained over a period of 5 years. [source] Open flap debridement with or without intentional cementum removal: a 4-month follow-upJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2005Antonio Wilson Sallum Abstract Objectives: The aim of this study was to investigate the influence of cementum removal on periodontal repair. Material and Methods: Forty subjects with chronic periodontitis and presenting, at least, two proximal sites in anterior teeth (upper or lower) with probing depth 5 mm were selected. After oral hygiene instructions and ultrasonic supragingival instrumentation, the subjects were randomly assigned for one of the following groups: CIC, scaled with Gracey curettes; CIUS, scaled with ultrasonic device; CDC, calculus deattachment with Gracey curettes and brushing with saline solution; and CDUS, calculus deattachment with ultrasonic device and brushing with saline solution. Full-thickness flaps were reflected and the instrumentation was performed with a clinical microscope. Probing depth (PD), relative gingival margin level (RGML) and relative attachment level (RAL) were registered at five experimental periods: baseline and 30, 60, 90 and 120 days postoperative. Results: All the approaches were able to markedly reduce the PD values from the baseline to the other evaluation periods (p<0.0001). The increase in RGML values was statistically significant only for the CDUS group. There were no statistically significant differences between the baseline and postoperative values in all groups for the RAL changes. The changes in RAL were statistically significant only among the groups CDC and CDUS (p<0.0001). Conclusion: The conventional scaling and root planing and the calculus deattachment were effective in reducing the probing depth values, regardless of the instrumentation method. [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] Occurrence and risk indicators of increased probing depth in an adult Brazilian populationJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2005Cristiano Susin Abstract Background/Aims: There is little information about the occurrence and risk indicators for periodontal diseases in Latin America. The present study describes the prevalence, extent and severity of periodontal probing depth (PPD) and assesses the association between demographic, behavioural and environmental risk indicators and the extent and severity of PPD in this population. Materials and Methods: The target population was urban adults aged 30 years in Rio Grande do Sul state in South Brazil. A representative sample was selected using a multi-stage, probability, cluster sampling strategy and included 853 dentate subjects 30,103 years of age. A full-mouth clinical examination was carried out at six sites per tooth on all permanent teeth, excluding third molars, and was conducted in a mobile examination centre. Results: Approximately 65% and 25% of the subjects and 19% and 5% teeth per subject had PPD 5 and 7 mm, respectively. 31.6%, 33.7% and 34.7% subjects had generalized, localized or no PPD 5 mm, respectively. Probing depth increased in prevalence with increasing age, and leveled off at around 50 years of age and beyond. PPD 5 mm was significantly higher in males than in females, and in non-Whites than in Whites. Cigarette smokers had a significantly higher occurrence of PPD 5 mm than non-smokers, and this relationship was dose dependent. A multivariate model showed that generalized PPD 5 mm was associated with subjects aged 40 years, males, non-Whites and moderate or heavy cigarette smokers (relative risk ratios: 2.0, 2.0, 2.2, 2.4 and 6.8, respectively). Conclusion: Moderate and deep probing depth was a common finding in this urban adult Brazilian population. Older age, male gender, non-White race and moderate and heavy cigarette smoking were significant risk indicators of increased PPD, and these may be useful indicators of periodontal disease high-risk groups. [source] Dental nomograms for benchmarking based on the study of health in Pomerania data setJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2004C. Schwahn Abstract Aim: Benchmarking is a means of setting goals or targets. On an oral health level, it denotes retaining more teeth and/or improving the quality of life. The goal of this pilot investigation was to assess whether the data generated by a population-based study (SHIP 0) can be used as a benchmark data set to characterize different practice profiles. Material and Methods: The data collected in the population-based study SHIP (n=4310) in eastern Germany were used to generate nomograms of tooth loss, attachment loss, and probing depth. The nomograms included twelve 5-year age strata (20,79 years) presented as quartiles, and additional percentiles of the dental parameters for each age group. Cross-sectional data from a conventional dental office (n=186) and from a periodontology unit (n=130, Greifswald) in the study region as well as longitudinal data set of a another periodontology unit (n=135, Kiel) were utilized in order to verify whether the given practice profile was accurately reflected by the nomogram. Results: In terms of tooth loss, the data from the conventional dental office agree with the median from the nomogram. For attachment loss and probing depth, some age groups yielded slight but not uniform deviations from the median. Cross-sectional data from the periodontology unit Greifswald showed attachment loss higher than the median in younger but not in older age groups. The probing depth was uniformly less than the median and tended toward the 25th percentile with increasing age. The longitudinal data of the Unit of Periodontology in Kiel showed a pronounced trend towards higher percentiles of residual teeth, meaning that the patients retained more teeth. Conclusion: The profile of the Pomeranian dental office does not deviate noticeably from the population-based nomograms. The higher attachment loss of the Unit of Periodontology in Greifswald in younger age strata clearly reflects their selection because of periodontal disease; the combination of higher attachment loss and decreased probing depth may reflect the success of the treatment. The tendency of attachment loss towards the median with increasing age may indicate that the Unit of Periodontology in Greifswald does not fulfill its function as a special care unit in the older subjects. The longitudinal data set of the Unit of Periodontology in Kiel impressively reflects the potential of population-based data sets as a means for benchmarking. Thus, nomograms can help to determine the practice profile, potentially yielding benefits for the dentist, health insurance company, or , as in the case of the special care unit , public health research. [source] Five-year results following treatment of intrabony defects with enamel matrix proteins and guided tissue regenerationJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2004Anton Sculean Abstract Background: Treatment with enamel matrix proteins (EMD) or guided tissue regeneration (GTR) has been shown to enhance periodontal regeneration. However, until now there are limited data on the long-term results following these treatment modalities. Aim: The aim of the present clinical study was to present the 5-year results following treatment of intrabony defects with EMD, GTR, combination of EMD and GTR, and open flap debridement (OFD). Material and Methods: Forty-two patients, each of whom displayed one intrabony defect of a probing depth of at least 6 mm, were randomly treated with one of the four treatment modalities. The following parameters were evaluated prior to surgery, at 1 year and at 5 years after: plaque index, gingival index, bleeding on probing, probing pocket depth (PPD), gingival recession, and clinical attachment level (CAL). No statistically significant differences in any of the parameters were observed at baseline between the four groups. Results: The sites treated with EMD demonstrated a mean CAL gain of 3.4±1.1 mm (p<0.001) and of 2.9±1.6 mm (p<0.001) at 1 and 5 years, respectively. The sites treated with GTR showed a mean CAL gain of 3.2±0.8 (p<0.001) at 1 year and of 2.7±0.9 mm (p<0.001) at 5 years. The mean CAL gain at sites treated with EMD+GTR was 3.0±1.0 mm (p<0.001) and 2.6±0.7 mm (p<0.001) at 1 and 5 years, respectively. The sites treated with OFD demonstrated a mean CAL gain of 1.6±1.0 mm (p<0.001) at 1 year and 1.3±1.2 mm (p<0.001) at 5 years. At 1 year, the only statistically significant difference between the four different treatments was found in terms of PPD reduction and CAL gain between EMD and OFD (p<0.05). However, at 5 years there were no statistically significant differences in any of the investigated parameters between the four different treatments. Conclusion: Within the limits of the present study, it may be concluded that the short-term clinical results following treatment with EMD, GTR, EMD+GTR, and OFD can be maintained over a period of 5 years. [source] Polymer-assisted regeneration therapy with Atrisorb® barriers in human periodontal intrabony defectsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2004Lein-Tuan Hou Abstract Aim: This study compared clinical results of 40 periodontal osseous defects treated by two types of absorbable barrier materials. Material and Methods: Thirty patients (23 males and seven females) suffering from moderate to advanced periodontitis (with comparable osseous defects) were randomly assigned to receive either Atrisorb® barrier (n=22; group A) or Resolut XT® barrier (n=18; group B) therapy. Periodontal phase I treatment and oral hygiene instruction were performed before periodontal surgery. Papillary preservation, partial thickness flap, citric acid root conditioning, and decortication procedures were applied during the operation. Bone defects were filled with demineralized freeze-dried bone allograft and minocycline mixture (4:1 ratio). Postoperative care included 0.10% chlorhexidine rinse daily and antibiotic medication for 2 weeks. Clinical assessments including probing depth (PD), clinical attachment level (CAL), gingival recession (GR), plaque index (PlI), gingival index (GI), and radiographic examinations were taken at the baseline, preoperatively and at 3 and 6 months after regenerative surgery. Results: Six months following therapy, both Atrisorb® and Resolut XT® groups had achieved comparable clinical improvement in pocket reduction (3.9 versus 4.4 mm), attachment tissue gain (clinical attachment gain; 3.5 versus 3.6 mm), and reduction in the GI and in the PlI. Within-group comparisons showed significant attachment gain and pocket reduction between baseline data and those at both 3 and 6 months postoperatively (p<0.01). There were no statistically significant differences in any measured data between groups A and B. Conclusions: The results of this study indicate that a comparable and favorable regeneration of periodontal defects can be achieved with both Atrisorb® and Resolut XT® barriers. Further long-term study and histologic observations of tissue healing are needed to evaluate whether Atrisorb® is promising for clinical use. [source] Periodontal attachment loss over 14 years in cleft lip, alveolus and palate (CLAP, CL, CP) subjects not enrolled in a supportive periodontal therapy programJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2003Giovanni E. Salvi Abstract Objectives: (i) To assess the overall and (ii) cleft-associated rate of periodontal disease (PD) progression in subjects with cleft lip, alveolus and palate (CLAP) and (iii) to compare these rates with those of subjects with cleft lip (CL) and cleft palate (CP). Material and methods: Twenty-six subjects not enrolled in a supportive periodontal therapy (SPT) program were examined in 1979, 1987 and 1993. PD progression was assessed as increase in pocket probing depth (PPD in mm) and probing attachment loss (PAL in mm). Results: Extensive plaque accumulation and high frequencies of gingival units bleeding on probing were observed at all three examinations. A statistically significant increase in mean PPD of 0.57±0.21 mm (SD) in both groups as well as a statistically significant loss of PAL of 1.85±0.23 mm (SD) in the CLAP group and of 1.72±0.21 mm (SD) in the CL/CP group occurred over the observation period (p<0.05). In subjects with CLAP, statistically significant increases in PPD and loss of PAL were recorded over time at sites adjacent to the cleft as well as at control sites (p<0.05). Over 14 years, however, PPD increased 1.72±1.08 mm (SD) at cleft sites versus 0.72±1.14 mm (SD) at control sites (p<0.05), and PAL amounted to 3.19±1.35 mm (SD) at cleft sites versus 2.41±1.52 mm (SD) at control sites (p<0.05). Conclusion: Both the CLAP and the CL/CP subjects are at high risk for PD progression if no SPT program is provided. This also suggests that alveolar cleft sites in subjects with high plaque and gingival inflammation scores underwent more periodontal tissue destruction than control sites over a 14-year period. Zusammenfassung Ziele: 1. Beurteilung der gesamten und 2. der mit der Spalte assoziierten Progressionsrate der Parodontalerkrankung (PD) bei Patienten mit Lippen-Kiefer-Gaumenspalten (CLAP) und 3. der Vergleich dieser Progressionsraten mit denen von Patienten mit Lippenspalten (CL) sowie Gaumenspalten (CP). Material und Methoden: 26 Patienten, die nicht an einem SPT-Programm teilnahmen wurden in 1979, 1987 und 1993 untersucht. Die PD-Progression wurde über die Zunahme der Sondierungstiefe (PPD in mm) und den klinischen Attachmentverlust (PAL in mm) beurteilt. Ergebnisse: Bei allen drei Untersuchungszeitpunkten wurde eine ausgedehnte Plaqueakkumulation und eine große Häufigkeit von Gingivabereichen, die bei Sondierung bluteten beobachtet. Während der Beobachtungsperiode fand in beiden Gruppen ein statistisch signifikanter Anstieg der mittleren PPD von 0.57±0.21 mm (SD) als auch ein statistisch signifikanter Attachmentverlust von 1.85±0.23 mm (SD) in der CLAP-Gruppe sowie von 1.72±0.21 mm (SD) in der CL/CP-Gruppe statt (p<0.05). Bei den Patienten mit CLAP wurde im Laufe der Zeit sowohl an den Parodontien neben der Spalte als auch an den Kontrollstellen (p<0.05) ein statistisch signifikanter Anstieg der PPD und Attachmentverlust registriert. Während der 14 Jahre jedoch nahm die PPD an Stellen mit Spalte um 1.72±1.08 mm (SD) zu im Gegensatz zu den Kontrollstellen (p<0.05) wo dieser Wert 0.72±1.14 mm (SD) betrug. Für den Attachmentverlust lag dieser Wert bei 3.19±1.35 mm (SD) an den Stellen mit Spalte im Gegensatz zu den Kontrollstellen (p<0.05) mit 2.41±1.52 mm (SD). Schlussfolgerung: Wenn keine parodontale Erhaltungstherapie zur Verfügung gestellt wird haben beide Personen, die mit CLAP und die mit CL/CP ein hohes Risiko hinsichtlich der Parodontitisprogression. Dies läßt annehmen, dass bei Personen mit viel Plaque und ausgeprägter Entzündung der Gingiva, die Stellen mit Kieferspalten während einer 14-jährigen Zeitperiode eine stärkere Zerstörung der parodontalen Gewebe erfahren als die Kontrollstellen. Résumé Les buts de cette étude ont été de suivre la progression du taux de la maladie parodontale associée au bec de lièvre (CLAP) et de comparer ces taux avec ceux de sujets ayant lèvre fendue (CL) et palais fendu (CP). Vingt-six sujets non-soumis à un programme parodontal de maintien (SPT) ont été examinés en 1979, 1987 et 1993. La progression PD a été enregistrée telle une augmentation de la profondeur au sondage (PPD en mm) et une perte d'attache au sondage (PAL en mm). Une énorme accumulation de plaque dentaire et de très hautes fréquences dans les nombres d'unités gingivales avec saignement au sondage ont été observées lors des trois examens. Une augmentation statistiquement significative dans la moyenne PPD de 0.57±0.21 mm (SD) dans les deux groupes ainsi qu'une perte significative de PAL de 1.85±0.23 mm (SD) dans le groupe CLAP et de 1.72±0.21 mm (SD) dans le groupe CL/CP apparaîssaient durant cette période d'observation (p<0.05). Chez les sujets avec CLAP, les augmentations statistiquement significatives de PPD et la perte de PAL ont été enregistrées avec le temps sur les sites adjacents au bec de lièvre ainsi qu'au niveau des sites contrôles (p<0.05). Sur les quatorze années, cependant, PPD augmentait de 1.72±1.08 mm (SD) au niveau des sites bec de lièvre vs 0.72±1.14 mm (SD) au niveau des contrôles (p<0.05), et PAL s'élevait à 3.19±1.35 mm (SD) au niveau des sites bec de lièvre vs 2.41±1.52 mm au niveau des contrôles (p<0.05). Tant les sujets CLAP que les CL/CP étaient à haut risque pour la progression PD si un programme SPT n'était pas suivi. Ceci suggère également que les sites alvéolaires associés au bec de lièvre avec des scores de plaque et de gingivite importants s'accompagnaient de plus de destruction que les sites contrôles sur une période de quatorze années. [source] Periodontitis and perceived risk for periodontitis in elders with evidence of depressionJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2003G. R. Persson Abstract Background: Depression and periodontitis are common conditions in older adults. There is some evidence that these two conditions may be related. Aims: To study a population of dentate elders and assess the prevalence of depression, self-assessment of risk for periodontitis and tooth loss, in relation to periodontal disease status. Material and methods: Data were obtained from 701 older subjects (mean age 67.2 years (SD±4.6), of whom 59.5% were women. Self-reports of a diagnosis of depression, scores of the Geriatric Depression Scale (GDS), and self-assessment of risk for future tooth loss and periodontitis were compared with a diagnosis of periodontitis based on probing depth, and bone loss assessed from panoramic radiographs. Other systemic diseases and smoking habits were also determined and studied in relation to depression. Results: A history of depression was reported by 20% of the subjects. GDS scores 8 were reported by 9.8% of the elders. Periodontitis was identified in 48.5% of the subjects. Depression was associated with heart attack (p<0.05), stroke (p<0.01), high blood pressure (p<0.02), all combined cardiovascular diseases (p<0.001), chronic pain (p<0.01), osteoarthritis (p<0.001), and osteoporosis (p< 0.001) but not with periodontitis (p=0.73). Subjects with depression had a higher self-reported risk score for future tooth loss (p<0.02). No group difference emerged for self-perceived risk for periodontitis. Logistic regression analysis demonstrated that a past history of tooth loss (p<0.001), self-perceived risk for periodontitis (p<0.02), the number of years with a smoking habit (p<0.02), and male gender (p<0.02) were associated with a diagnosis of periodontitis but neither measure of depression could be included in an explanatory model for periodontitis. Conclusions: Evidence of depression (self-report or by GDS) is not associated with risk for periodontitis in older subjects but is associated with tooth loss and chronic conditions associated with pain. Zusammenfassung Hintergrund: Depression und Parodontitis sind gewöhnliche Bedingungen bei älteren Erwachsenen. Es gibt einige Evidenz, dass diese zwei Bedingungen miteinander in Beziehung stehen könnten. Ziel: Studium einer älteren bezahnten Population und Feststellung der Prävalenz der Depression, Selbstbestimmung des Risikos für Parodontitis und Zahnverlust in Beziehung zum parodontalen Erkrankungsstatus. Material und Methoden: Die Daten wurden von 701 älteren Personen erhalten (mittleres Alter 67.2 Jahre, SD+4.6), von denen 59.5% Frauen waren. Die Selbstberichte zur Diagnose Depression, Scorewerte einer geriatrischen Depressionsskala (GDS) und Selbstbeobachtung des Risikos eines zukünftigen Zahnverlustes und der Parodontitis wurden mit der Diagnose Parodontitis verglichen, die auf der Sondierungstiefe und dem Knochenverlust, gemessen an Panoramaaufnahmen, beruhte. Andere systemische Erkrankungen und Rauchen wurden auch bestimmt und in Beziehung zur Depression studiert. Ergebnisse: Eine Depression wurde von 20% der Personen berichtet. GDS Werte 8 wurden bei 9.8% der Älteren berichtet. Parodontitis wurde bei 48.5% der Personen identifiziert. Depression war verbunden mit Herzattacken (p<0.05), Schlaganfall (p<0.01), Bluthochdruck (p<0.02), allen kombinierten kardiovaskulären Erkrankungen (p<0.001), aber nicht mit Parodontitis (p=0.73). Personen mit Depression hatten ein höheres selbst berichtetes Risiko für zukünftigen Zahnverlust (p<0.02). Keine Gruppendifferenzen tauchten für das selbst berichtetes Risiko für Parodontitis auf. Die logistische Regressionsanalyse demonstrierte, dass vergangener Zahnverlust (p<0.001), selbst erkanntes Risiko für Parodontitis (p<0.02), die Anzahl der Jahre mit Zigarettenrauchen (p<0.02) und das männliche Geschlecht (p<0.02) mit der Diagnose Parodontitis verbunden waren, aber keine Messung der Depression konnte in das erklärende Modell für Parodontitis eingebunden werden. Schlussfolgerungen: Die Evidenz für Depression (selbst berichtet oder mit Hilfe des GDS) ist nicht verbunden mit dem Risiko für Parodontitis bei älteren Personen, aber ist verbunden mit Zahnverlust und chronischen mit Schmerz verbundenen Bedingungen. Résumé Contexte: La dépression et la parodontite sont des conditions banales chez les adultes âgés. Il existe quelques preuves de la relation entre ces deux conditions. Buts: étudier une population de sujets âgés et dentés et mettre en évidence la prévalence de la dépression, l'évaluation personnelle de risque de développement d'une parodontite et de perte dentaire en relation avec l'état de maladie parodontale. Matériels et méthodes: Des données furent obtenues chez 701 sujets âgés (age moyen 67.2 ans (SD±4.6), dont 59.5%étaient des femmes. Le rapport personnel de diagnostique de dépression, les scores de l'échelle gériatrique de dépression (GDS), et l'évaluation personnelle de risque de future perte dentaire et de parodontite furent comparés avec un diagnostique de parodontite fondé sur la profondeur au sondage et la mise en évidence de perte osseuse sur des radiographies panoramiques. D'autres maladies systémiques et le tabagisme furent aussi déterminés et étudiés en relation avec la dépression. Résultats: Un historique de dépression fut reporté chez 20% des sujets. Des scores de GDS 8 furent reportés par 9.8% des personnes âgés. Une parodontite fut identifiée chez 48.5% des sujets. La dépression était associée avec une attaque cardiaque (p<0.05), congestion cérébrale (p<0.01), hypertension (p<0.02), toute maladie cardiaque confondue (p<0.001), douleur chronique (p<0.01), arthrite osseuse (p<0.001), et ostéoporose (p< 0.001) mais pas avec la parodontite (p=0.73). Les sujets atteints de dépression avait un score de risque auto-rapporté de future perte dentaire plus important (p<0.02). Aucune différence des groupes n'émergeait pour l'auto-perception d'un risque de parodontite. Une analyse de régression logistique démontrait qu'un historique préalable de perte dentaire (p<0.001), un risque auto-perçu de parodontite (p<0.02), la durée de tabagisme (p<0.02), et l'appartenance au sexe masculin (p<0.02) étaient associés avec un diagnostique de parodontite mais aucune mesure de dépression ne pouvait être incluse dans un modèle d'explication de parodontite. Conclusions: la mise en évidence de la dépression (auto-rapportée ou par GDS) n'est pas associée avec un risque de parodontite chez des personnes âgés mais avec la perte dentaire et des conditions chroniques associées avec la douleur. [source] Meta-analysis of the effect of scaling and root planing, surgical treatment and antibiotic therapies on periodontal probing depth and attachment lossJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2002Hsin-Chia Hung Abstract Objective: This paper reports a meta-analysis of studies that have investigated the effect of scaling and root planing on periodontal probing depth and attachment loss. Material and methods: The criteria used for inclusion of studies were as follows: root planing and scaling alone was one of the primary treatment arms; patients or quadrants of each patient were randomly assigned to study groups; 80% of patients enrolled were included in first year follow-up examinations; periodontal probing depth and attachment loss were reported in mm; the sample size of each study and substudy was reported. Sample size was used to weight the relative contribution of each study since standard errors were not reported by many studies and sample size is highly correlated with standard error and therefore statistically able to explain a substantial portion of the standard error on studies that use similar measures. Results: The meta-analysis results show that periodontal probing depth and gain of attachment level do not improve significantly following root planing and scaling for patients with shallow initial periodontal probing depths. However, there was about a 1-mm reduction for medium initial periodontal probing depths and a 2-mm reduction for deep initial periodontal probing depths. Similarly, there was about a 0.50-mm gain in attachment for medium initial periodontal probing depth measurements and slightly more than a l-mm gain in attachment for deep initial periodontal probing depth measurements. Surgical therapy for patients with deep initial probing depths showed better results than scaling and root planing in reducing probing depths. When patients were followed up over 3 years or more, these differences were reduced to less than 0.4 mm. Antibiotic therapy showed similar results to scaling and root planing. However, a consistent improvement in periodontal probing depth and gain of attachment is demonstrated when local antibiotic therapy is combined with root planing and scaling. Zusammenfassung Metaanalyse des Effekts von Scaling und Wurzelglätten, chirurgischer Behandlung und Antibiotikatherapien auf parodontale Sondiertiefe und Attachment-Verlust Zielsetzung: Der vorliegende Artikel beschreibt eine Metaanalyse von Studien, in denen die Wirkung von Scaling und Wurzelglätten auf parodontale Sondiertiefe und Attachment-Verlust untersucht wurden. Material und Methodik: Die Kriterien für die Aufnahme in die Studie waren wie folgt: 1) Wurzelglätten und Scaling allein war einer der primären Behandlungsverfahren; 2) Patienten oder Quadranten einzelner Patienten wurden auf Studiengruppen zufallsverteilt; 3) 80% der aufgenommenen Patienten waren in den Follow-up-Untersuchungen nach einem Jahr eingeschlossen; 4) parodontale Sondiertiefe und Attachment-Verlust wurden in mm berichtet; und 5) der Probenumfang jeder einzelnen Studie und Unterstudie wurde berichtet. Der Probenumfang wurde zur Gewichtung des relativen Beitrages jeder einzelnen Studie herangezogen, da von vielen Studien keine Standardabweichungen berichtet wurden und der Probenumfang mit der Standardabweichung stark korreliert ist. Daher lässt sich auf dem Weg über den Probenumfang ein wesentlicher Teil der Standardabweichung bei Studien mit ähnlichen Messparametern statistisch erklären. Ergebnisse: Die Ergebnisse der Metaanalyse zeigten, dass die parodontale Sondiertiefe und die Zunahme des Attachment-Niveaus nach Scaling und Wurzelglätten bei Patienten mit ursprünglich geringen Sondiertiefen keine signifikanten Verbesserungen liefern. Bei ursprünglich mittleren parodontalen Sondiertiefen konnte jedoch eine Reduktion von 1 mm, bei ursprünglich tiefen parodontalen Sondiertiefen eine Reduktion von 2 mm beobachtet werden. Dementsprechend wurde eine Zunahme des Attachment-Niveaus bei ursprünglich mittleren parodontalen Sondiertiefen von 0,5 mm eine sowie eine Zunahme von etwas mehr als 1 mm bei ursprünglich tiefen parodontalen Sondiertiefen verzeichnet. Die chirurgische Behandlung bei Patienten mit ursprünglich beträchtlicher Sondiertiefe lieferte bei der Reduktion der Sondiertiefe bessere Ergebnisse als Scaling und Wurzelglätten. Wenn sich Patienten über 3 Jahre oder länger einem Follow-up unterzogen, liessen sich diese Differenzen auf unter 0,4 mm reduzieren. Darüber hinaus kann jedoch eine konsistente Verbesserung der parodontalen Sondiertiefe und Zunahme des Attachment-Niveaus erreicht werden, wenn eine lokale Antibiotikatherapie mit Scaling und Wurzelglätten kombiniert wird. Résumé Méta-analyse de l'influence du détartrage et du surfaçage radiculaire, du traitement chirurgical et des traitements antibiotiques sur la profondeur de poche au sondage et la perte d'attache But: Ce rapport présente une méta-analyse des études qui ont porté sur l'influence du détartrage et du surfaçage radiculaire sur la profondeur de poche au sondage et la perte d'attache. Matériaux et méthodes: Les critères d'inclusion dans les études étaient les suivants: 1) le détartrage et le surfaçage radiculaire constituaient l'un des premiers moyens de traitement utilisés; 2) les patients ou les quadrants de chaque patient ont été répartis dans les groupes d'étude de façon aléatoire; 3) 80% des patients enrôlés ont fait l'objet d'examens de suivi durant un an; 4) la profondeur de poche au sondage et la perte d'attache ont été mesurés en mm; 5) la taille de l'échantillon a été relevée pour chaque étude et sous-étude. La taille de l'échantillon a été utilisée pour évaluer la contribution relative de chaque étude. En effet, de nombreuses études ne mentionnaient pas les erreurs standard, alors qu'il existe une corrélation étroite entre la taille de l'échantillon et l'erreur standard et qu'elle permet donc d'expliquer statistiquement une part substantielle de l'erreur standard dans les études qui se basent sur des mesures similaires. Résultats: Les résultats de la méta-analyse montrent que la profondeur de poche au sondage et le gain d'attache ne s'améliorent pas de façon significative suite au détartrage et surfaçage radiculaire chez les patients dont les profondeurs de poche au sondage initiales étaient faibles. Il y avait toutefois une réduction d'environ 1 mm des profondeurs de poche au sondage initiales moyennes, et une réduction de 2 mm des profondeurs de poche au sondage initiales élevées. De façon similaire, on a observé un gain d'attache d'environ 0,50 mm pour les mesures des profondeurs de poche au sondage initiales moyennes et un gain d'attache légèrement supérieur à 1 mm pour les mesures des profondeurs de poche au sondage initiales élevées. Chez les patients à profondeur de poche au sondage initiale élevée, le traitement par chirurgie s'est avéré plus efficace que le détartrage et le surfaçage radiculaire pour réduire la profondeur au sondage. Lorsque les patients faisaient l'objet d'un suivi durant trois ans ou plus, ces différences s'abaissaient jusqu'à moins de 0,4 mm. Le traitement antibiotique a donné des résultats similaires à ceux obtenus par détartrage et surfaçage radiculaire. Une amélioration régulière de la profondeur de poche au sondage et du gain d'attache a toutefois été observée lorsque le traitement antibiotique local est combiné au détartrage et surfaçage radiculaire. [source] Effect of a controlled-release chlorhexidine chip on clinical and microbiological parameters of periodontal syndromeJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2002Daniela C. Grisi Abstract Aim: The aim of this study was to evaluate the effectiveness of a controlled-released chlorhexidine chip (CHX) as adjunctive therapy to scaling and root planing (SRP) in the treatment of chronic periodontitis. Material and methods: Twenty patients with at least four sites with probing depth ,,5 mm and bleeding on probing were selected. This randomized single-blind study was carried out in parallel design. The control group received SRP alone, while the test group received SRP plus CHX chip. The clinical parameters, Plaque Index (PlI), Papillary Bleeding Score (PBS), Bleeding on Probing (BOP), Gingival Recession (GR), Probing Depth (PD) and Relative Attachment Level (RAL), and the microbiological parameter BANA test were recorded at baseline and after 3, 6 and 9 months. Results: Both groups presented significant improvements in all parameters analyzed over the study period. There were no statistically significant differences between the two groups for any parameter analyzed after 9 months, except for BOP, which was significantly reduced in the control group. The mean reductions on PD and RAL were 2.4 mm and 1.0 mm for the control group and 2.2 mm and 0.6 mm for the test group, respectively. Conclusion: The CHX chip did not provide any clinical or microbiological benefit beyond that achieved with conventional scaling and root planning, after a 9-month period. Zusammenfassung Wirkung eines Chlorhexidin-Chips mit kontrollierter Wirkstoff-Freisetzung auf klinische und mikrobiologische Parameter parodontaler Erkrankungen Zielsetzung: Das Ziel der vorliegenden Studie war die Evaluierung der Wirksamkeit eines Chlorhexidin-Chips mit kontrollierter Wirkstoff-Freisetzung (CHX) als Adjunktivtherapie zu Zahnsteinentfernung (Scaling) und Wurzelglätten (Root planing) bei der Behandlung einer chronischen Parodontitis. Material und Methodik: Zur Teilnahme an der Studie wurden zwanzig Patienten mit mindestens vier Stellen mit einer Sondiertiefe von ,5 mm und Blutung bei der Sondierung ausgewählt. Diese randomisierte einfach-blinde Studie wurde mit Parallelgruppenaufbau durchgeführt. Die Kontrollgruppe erhielt ausschliesslich SRP, die Testgruppe dagegen erhielt SRP plus den CHX-Chip. Zu Baseline und nach 3, 6 und 9 Monaten wurden die klinischen Parameter Plaque-Index (PlI), Papillarblutungs-Score (PBS), Blutung bei Sondierung (BOP), Gingivaretraktion (GR), Sondiertiefe (PD), Relatives Attachmentniveau (RAL) und die mikrobiologischen Parameter (BANA-Test) verzeichnet. Ergebnisse: Beide Gruppen zeigten signifikante Verbesserungen aller analysierten Parameter über den Studienzeitraum. Nach 9 Monaten konnten mit Ausnahme von BOP, was in der Kontrollgruppe eine signifikante Reduktion zeigte, keine statistisch signifikanten Unterschiede zwischen den beiden Gruppen für die untersuchten Parameter festgestellt werden. Die durchschnittlichen Reduktionen bei PD und RAL waren 2,4 mm und 1,0 mm in der Kontrollgruppe und 2,2 mm bzw. 0,6 mm in der Testgruppe. Schlussfolgerung: Nach einer 9-monatigen Behandlungszeit konnten mit dem CHX-Chip zusätzlich zu dem durch konventionelles Scaling und Wurzelglätten erzielten klinischen und mikrobiologischen Nutzen keine weiteren Vorteile erzielt werden. Résumé Influence d'une capsule de chlorhexidine à libération contrôlée sur les paramètres cliniques et microbiologiques de la maladie parodontale But: Le but de cette étude était d'évaluer l'efficacité d'une capsule de chlorhexidine (CHX) à libération contrôlée comme thérapie complémentaire au détartrage et au surfaçage radiculaire (scaling and root planing, SRP) dans le traitement de la parodontite chronique. Matériaux et méthodes: Vingt patients avec au moins quatre sites présentant une profondeur au sondage ,5 mm et un saignement au sondage ont été sélectionnés. Cette étude randomisée en simple aveugle a été conduite en parallèle. Le groupe contrôle a uniquement bénéficié de SRP, tandis que le groupe test a reçu SRP plus une capsule CHX. Les paramètres cliniques, l'indice de plaque (plaque index, PlI), l'indice de saignement papillaire (papillary bleeding score, PBS), la saignement au sondage (bleeding on probing, BOP), la récession gingivale (gingival recession, GR), la profondeur au sondage (probing depth, PD), le niveau d'attache relatif (relative attachment level, RAL) et les paramètres microbiologiques (test BANA) ont été enregistrés à la base puis après 3, 6 et 9 mois. ésultats: Les deux groupes présentaient une amélioration significative de tous les paramètres analysés au cours de la période d'étude. Entre les deux groupes, il n'y avait de différence statistiquement significative pour aucun des paramètres analysés au bout de 9 mois, sauf pour le BOP qui était considérablement réduit dans le groupe contrôle. Les baisses moyennes de PD et RAL valaient respectivement 2,4 mm et 1,0 mm pour le groupe contrôle, et 2,2 mm et 0,6 mm pour le groupe test. Conclusion: A l'issue d'une période de 9 mois, la capsule CHX n'a apporté aucun bénéfice clinique ou microbiologique supérieur à celui obtenu par détartrage et surfaçage radiculaire conventionnels. [source] Comparison of the validity of periodontal probing measurements in smokers and non-smokersJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2001A. J. Biddle Abstract Aim: To determine whether the reduced inflammation and bleeding and increased fibrosis reported in tobacco smokers affect the validity of clinical probing measurements by altering probe tip penetration. Method: A constant force probe was used to measure probing depths and sound bone levels at six sites on 64 molar teeth (384 sites) in 20 smoking and 20 non-smoking patients from grooves made with a bur at the gingival margin prior to extraction. Connective tissue attachment levels were measured from the grooves with a dissecting microscope following extraction. Data were analysed using robust regression with sites clustered within subjects. Results: Sites in smokers showed more calculus but less bleeding than sites in non-smokers (p<0.05). The mean clinical probing depth was not significantly different (smokers: 5.54 mm, confidence intervals=4.81 to 6.28; non-smokers: 6.05 mm, ci=5.38 to 6.72). The corresponding post-extraction pocket depth measurements (smokers: 4.95 mm, ci=4.30 to 5.61; non-smokers: 5.23 mm, ci=4.49 to 5.96) were less than clinical probing depth in sites from both smokers and non-smokers (p<0.01). However, the proportional difference was less in smokers (p<0.05), particularly in deeper pockets, indicating that clinical probe tip penetration of tissue was greater in non-smokers. Regression analysis indicated that the presence of calculus and bleeding also influenced the difference in clinical probe penetration (p<0.05). Conclusion: Clinical probing depth at molar sites exaggerates pocket depth, but the probe tip may be closer to the actual attachment level in smokers due to less penetration of tissue. This may be partly explained by the reduced inflammation and width of supra-bony connective tissue in smokers. These findings have clinical relevance to the successful management of periodontal patients who smoke. Zusammenfassung Ziel: Bestimmung, ob die reduzierte Entzündung und Blutung und verstärkte Fibrosierung, die bei Rauchern berichtet wird, die Gültigkeit der klinischen Messung der Sondierungstiefen durch Veränderung der Penetration der Sondenspitze beeinflußt. Methoden: Eine konstante Sondierungskraft wurde genutzt, um die Sondierungstiefen und das Knochenniveau (sounding) an 6 Flächen von 64 Molaren (384 Flächen) bei 20 Rauchern und 20 Nichtrauchern von einer Furche, die mit einem Fräser in der Höhe des gingivalen Randes vor der Extraktion angelegt wurde, zu messen. Das Niveau des bindegewebigen Attachments wurde von der Furche mit einem trennenden Mikroskop nach der Extraktion gemessen. Die Daten wurden unter Nutzung einer robusten Regission mit den Flächen in den Personen zusammengefaßt analysiert. Ergebnisse: Die Flächen von Rauchern zeigten mehr Zahnstein, aber weniger Blutung als die Flächen von Nichtrauchern (p<0.05). Die mittleren Sondierungstiefen unterschieden sich nicht signifikant (Raucher: 5.54 mm, Konfidenzinterval (ci)=4.81 zu 6.28; Nichtraucher: 6.05 mm, ci=5.38 zu 6.72). Die korrespondierenden Taschenmessungen nach der Extraktion (Raucher: 4.95 mm, ci=4.30 zu 5.61; Nichtraucher: 5.23 mm, ci=4.49 zu 5.96) waren geringer als die klinischen Messungen sowohl bei den Flächen bei Rauchern als auch bei Nichtrauchern (p<0.01). Jedoch war die proportionale Differenz bei Rauchern geringer (p<0.05), besonders bei tiefen Taschen, was zeigt, daß die Penetration der Sonde ins Gewebe bei der klinischen Messung bei Nichtrauchern größer war. Die Regressionsanalyse zeigte, daß das Vorhandensein von Zahnstein und Blutung die Differenz in der klinischen Sondenpenetration beeinflußte (p<0.05). Zusammenfassung: Die klinische Sondierung an Molarenflächen überschätzt die Taschentiefe, aber die Sondenspitze liegt bei Rauchern näher am wirklichen Stützgewebelevel aufgrund der geringeren Gewebepenetration. Dies mag teilweise durch die reduzierte Entzündung und die Breite des supra-alveolären Bindegewebes bei Rauchern erklärt werden. Diese Ergebnisse haben klinische Bedeutung bei der erfolgreichen Behandlung von rauchenden parodontalen Patienten. Résumé But: L'objectif de cette étude est de déterminer si la diminution de l'inflammation et du saignement, ainsi que l'augmentation de la fibrose rapportées chez les fumerus affecte la validité des mesures de sondage parodontal en modifiant la pénétration de la sonde. Methode: Une sonde a pression constante a été utilisée pour mesurer la profondeur au sondage et pour sonder le niveau osseux sur les 6 sites de 64 molaires (384 sites) chez 20 patients fumeurs et 20 patients non-fumeurs à partir de rainures faites à la fraise au niveau de la gencive marginale avant extraction. Les niveaux d'attache du tissus conjonctif furent mesurés à partir de la rainure sous microscope de dissection après extraction. Les données furent analysées par régression avec les sites groupés par patients. Résultats: Les sites des fumerus montraient plus de tartre mais moins de saignement que les sites des non-fumeurs (p<0.05). La profondeur moyenne de sondage clinique n'était pas significativement différente (fumeurs: 5.54 mm, interval de confiance=4.81 à 6.28; non-fumeurs: 6.05 mm, ci=5.38 à 6.72). Les mesures de profondeur de poche correspondantes aprés extraction (fumeurs: 4.95 mm, interval de confiance=4.30 à 5.61; non-fumeurs: 5.23 mm, ci=4.49 à 5.96) ètaient moindre que les profondeurs de sondage clinique des sites des fumeurs et des non-fumeurs ensemble (p<0.01). Cependant, la différence proportionnelle était moindre chez les fumeurs (p<0.05), particulièrement pour les poches profondes, ce qui indique que la pénétration tissulaire de la pointe de la sonde était plus importante chez les non-fumeurs. L'analyse de régression indique que la présence de tartre et le saignement influencent aussi la différence clinique de pénétration (p<0.05). Conclusion: La profondeur clinique de sondage sur des sites molaires exaggère la profondeur de poche, mais la pointe de la sonde pourrait être plus proche de l'actuel niveau d'attache chez les fumeurs en raison de la moindre pénétration des tissus. Cela peut être partiellement expliqué par l'inflammation réduite et l'épaisseur du tissus conjonctif supra-osseux chez les fumeurs. Ces résultats ont une signification clinique pour la bonne gestion des patients fumeurs atteints de maladies parodontales. [source] Prevalence of Actinobacillus actinomycetemcomitans and clinical conditions in children and adolescents from rural and urban areas of central ItalyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2000Michele Paolantonio Abstract Background: The aim of this study was to report on the prevalence of Actinobacillus actinomycetemcomitans (Aa) and the periodontal clinical conditions in children and adolescents from a rural area of central Italy compared with the ones from an urban area of the same region. Method: The study population consisted of 780 systemically healthy children, aged 6,14 years inhabiting the county of Chieti. 505 children attended 3 primary and 2 secondary schools from a rural area whereas 275 individuals attended 1 primary and 1 secondary school from the city of Chieti. The 2 provincial areas present a great difference in socioeconomic level and cultural background. Clinical examination consisted of recording the % of gingival sites positive for the presence of plaque (Pl+), bleeding on probing (BOP+), mean probing depth (PD) from each primary or permanent tooth fully erupted in the oral cavity. Loss of periodontal attachment (AL+) was evaluated only in interproximal sites. AL+ subjects were distinguished in juvenile periodontitis (JP) prepubertal periodontis and early periodontitis (EP) patients. 8 gingival sites were microbiologically sampled in each subject and cultured, after pooling, for the presence of Aa. Results: 30.3% of rural subjects, were positive for the presence of Aa, the difference from urban children (16%) being statistically significant (p=0.01) irrespective of gender and age. Aa showed a significantly (p=0.006) higher mean proportion in subgingival plaque samples from rural children (0.13% versus 0.02%). Loss of periodontal attachment in at least one site was found in 18 rural children (3.56%) (3 JP; 15 EP) and 2 urban girls (0.72%) (1 JP; 1 EP). No significant differences for AL were observed within the rural group according to the gender and age differentiation. In the urban group, both AL+ subjects were Aa+, while among children from rural areas all 3 JP and 13 EP subjects were Aa+. Rural subjects evidenced significantly worse clinical parameters with respect to urban children (% Pl+ sites: p=0.000; % BOP+ sites: p=0.010; mean PD: p=0.000.) The relative risk for AL+ sites was significantly greater (2.42) in rural subjects harboring Aa in subgingival plaque. Similarly, the presence of Aa in subgingival plaque was related to a greater risk of more than 50% of BOP+ gingival sites in both rural and urban subjects (1.45 and 8.40, respectively). Conclusions: Results of this study suggest that Aa colonization in children and adolescents from central Italy is affected by socioeconomic and cultural factors; these factors also affect the periodontal condition of the subjects. [source] | ||||||||||||||||||||||||||||