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D F Kinane

Publications and source records attributed to D F Kinane.

At least 73 records · Page 4Linked to original sources
PubMed1997

Detection of IgA subclasses and J chain mRNA bearing plasma cells in human dental periapical lesions by in situ hybridization.

Humoral immune responses are implicated in the pathogenesis of human dental periapical lesions. To elucidate whether IgA-associated immune systems play a role in the lesions, the in situ hybridization technique was used to detect J chain mRNA expression, which is correlated with the secretion of dimeric IgA. In addition, IgA subclass mRNA-expressing cells were also investigated by double target in situ hybridization (ISH) methodology using digoxigenin- and biotin-labeled IgA subclass specific oligonucleotide probes. This double target ISH technique involved immunochemical detection with an alkaline phosphatase-conjugated antibody and a peroxidase conjugated avidin-biotin complex system to detect IgA subclass mRNA in the formalin-fixed, paraffin wax embedded periapical tissue sections. Twenty-four biopsy samples (16 periapical granulomas and 8 radicular cysts) were examined. IgA subclass mRNA positive plasma cells were detected in all samples. IgA1 mRNA-expressing cells were predominant both in granulomas and cysts (mean = 75.3 +/- 11.2%, 64.8 +/- 21.3%, respectively), and the IgA1 proportion was higher in granulomas than in cysts, although no significant difference was seen between the two lesions (p = 0.132). J chain mRNA positive cells were very sparsely detected in 21/24 cases. The median percentages of J chain mRNA positive cells/IgA mRNA positive plasma cells (4.7%, range 0.3-13.6%) in cysts were significantly higher than in granulomas (1.3%, range 0-7.7%; p = 0.03). This result supports the hypothesis that dimeric IgA may be more actively produced in radicular cysts than in granulomas. These features are thought to reflect the local activation of the periapical immune system in response to environmental factors and indicate that secretory IgA mediated immune defense systems appear to play little role in these lesions. Our results indicate that the IgA-associated immune response in periapical lesions is more similar to serum or systemic IgA responses than to mucosa-associated immune responses where dimeric IgA predominates.

Adult↗
PubMed1997

IgG and IgA subclass mRNA-bearing plasma cells in periodontitis gingival tissue and immunoglobulin levels in the gingival crevicular fluid.

The humoral immune response, especially the production of IgG and IgA, is considered to have a protective role in the pathogenesis of periodontal disease, but the precise mechanisms are still unknown. In order to determine local IgG and IgA production, we investigated the presence of human IgG and IgA subclass mRNA-bearing plasma cells within periodontal tissue by in situ hybridization using digoxigenin-labelled oligonucleotide probes in 24 gingival biopsy samples (pocket depth > or = 5 mm) which were obtained from eight patients with adult periodontitis. Furthermore, we examined IgG and IgA subclass proteins and digested IgA1 Fab portions in the gingival crevicular fluid (GCF), corresponding to the sites from which the tissues were taken, by ELISA. IgG and IgA subclass mRNA-expressing cells were detected in all serial formalin-fixed/paraffin-embedded gingival tissue sections sampled. Plasma cells showed strong cytoplasmic staining with a high contrast and a good retention of morphology with these probes. IgG1 mRNA-expressing cells were predominant (mean 63%) and IgG2 mRNA-expressing cells were present at around 23% of total IgG plasma cells, while IgG3 and IgG4 mRNA-expressing cells were present to a much lesser extent (3% and 10%, respectively). Similar proportions of IgG subclass proteins in GCF were detected, which were also consistent with 'normal' serum levels. In terms of IgA subclass, IgA1 mRNA-positive cells were predominant (mean 65.1%, P < 0.001). In contrast, IgA2 protein in the GCF samples were detected at higher concentrations than IgA1 (P < 0.001). The ratio of total IgG to IgA mRNA-positive plasma cells was approximately 7.5:1. There was a good correlation between the amounts of IgG subclass proteins in GCF and the number of IgG subclass mRNA-positive cells in the same sites, but not between IgA subclass proteins and the number of IgA subclass mRNA-positive cells. These data suggest that IgG and IgA subclass proteins can be locally produced in the periodontitis gingiva. In addition, as we detected IgA1 Fab fragments in GCF, this is further confirmation that secreted IgA1 protein in GCF may be digested by periodontal bacteria.

Adult↗
PubMed1997

Levels of specific immunoglobulin G to Porphyromonas gingivalis in gingival crevicular fluid are related to site disease status.

Titers of immunoglobulin G (IgG) directed against Porphyromonas gingivalis in gingival crevicular fluid of 40 periodontitis patients were measured at three sites in each patient (healthy, gingivitis and periodontitis) by enzyme-linked immunosorbent assay. When paired analyses were performed using Wilcoxon signed-rank tests, periodontitis sites were found to have lower median titers than gingivitis sites. Both systemic and locally-produced antibodies contribute to the overall gingival crevicular fluid antibody profile. Albumin, in contrast, is derived only from serum, and thus this protein serves as an indicator of serum contribution to gingival crevicular fluid. Correction was therefore made for systemic input to the gingival crevicular fluid IgG profile by expressing the results per unit of albumin. When this was done, periodontitis sites were also found to have significantly lower antibody levels than gingivitis sites. These findings suggest that a failure of local antibody production or reduction in quantities, by, for example, degradation by bacterial proteases, may contribute to the change from a gingivitis to a periodontitis lesion.

Adult↗
PubMed1997

Crevicular fluid and serum IgG subclasses and corresponding mRNA expressing plasma cells in periodontitis lesions.

Recent reports suggest that specific serum IgG subclasses are a feature of several forms of periodontitis. GCF antibodies are both serum-derived and locally produced by the abundant plasma cells of the diseased periodontal tissue. Previous work has shown that crevicular fluid (GCF) levels of IgG may be reduced in active and deep periodontal pockets when compared to other sites in chronic periodontitis patients (7). These findings, and more recent findings for IgA levels in GCF (5), suggest that GCF immunoglobulins may indicate "high risk" sites for periodontitis. In these studies, the relative distribution of IgG isotypes was not investigated, nor was the relative contribution of local and serum antibodies to the GCF immunoglobulin profile. Therefore, more precise investigation of the tissue distribution of local gingival IgG subclass producing plasma cells and their protein levels in the GCF from the same sites and in serum, was undertaken.

Adult↗
PubMed1997

The effect of smoking on mechanical and antimicrobial periodontal therapy.

The aim of this investigation was to evaluate the effect of smoking on the outcome of periodontal therapy. The study consisted of 54 patients who participated in a 4-group parallel-arm clinical trial on the efficacy of three locally delivered antimicrobial systems as adjuncts to scaling and root planing in the treatment of sites with persistent pocketing after a course of scaling and root planing. These groups included scaling and root planing either alone (S) (n = 3), or in conjunction with the application of 25% tetracycline fibers (S&T) (n = 13), 2% minocycline gel (S&Mi) (n = 14), or 25% metronidazole gel (S&Me) (n = 14). In each patient four pockets > 5 mm with bleeding on probing (BOP) and/or suppuration were studied. The number of subjects who smoked was: 8 (61.5%) in the S&T group, 8 (57.1%) in the S&Mi group, 6 (42.9%) in the S&Me group, and 6 (46.2%) in the S group. The probing depth, attachment level and other clinical parameters were assessed at baseline and 6 weeks after treatments. The clinical results of this comparative study have been previously reported. Regardless of the type of treatment, the change in the probing depth (delta PD) and attachment gain (delta AL) were greater in non-smoker subjects than smoker subjects. delta PD was 1.14 mm versus 0.76 mm (P = 0.019), and delta AL was 0.52 mm versus 0.50 mm at (P = 0.845) for non-smokers and smokers respectively. The analysis of variance using the general linear model (GLM) was used for delta PD and delta AL and took into account the variations in the treatments, number of smoker subjects per group, and baseline probing depth. There was a significant interaction between the "smoking" and the "baseline PD." Further analysis using linear regression indicated that, while there was a significant relationship between the baseline PD and the delta PD or delta AL among the non-smokers, weak and insignificant relationship existed among the smoker subjects. Thus, smoking may have an important role in determining the prognosis of periodontal treatment, particularly in persistent and deep pockets.

Adult↗
PubMed1997

Relationship of diabetes to periodontitis.

Although the relationship between diabetes and periodontal disease has been the subject of much debate, the consensus of recent studies is that diabetic patients have an increased risk of periodontal disease, particularly when metabolic control is poor. This paper reviews recently published studies in this area and concludes that not only is metabolic control a risk factor in disease susceptibility but that it may also influence the outcome of periodontal therapy.

Diabetes Complications↗
PubMed1996

Dentists, pills and pregnancies.

Unplanned pregnancies may occur if antibiotics are prescribed to women using the combined oral contraceptive pill. To investigate awareness of the potential for this interaction among general dental practitioners, the authors designed a cross-sectional questionnaire based study and sent it out to a random sample of GDPs in Scotland.

Adult↗
PubMed1996

An evaluation of the Nd:YAG laser in periodontal pocket therapy.

The aim of this study was to determine whether the Nd:YAG laser energies of 50 and 80 mJ at 10 pulses per second (pps) were capable of improving the clinical parameters associated with periodontal disease. These energy settings were chosen as previous work indicated that higher values would damage root surfaces and that 80 mJ had an in-vitro bactericidal effect. Eighty periodontally affected sites in teeth scheduled for extraction from 11 patients with adult periodontitis were randomly placed in one of the following four treatment groups: 1. laser treatment at 50 mJ, 10 pps for 3 minutes; 2. laser treatment at 80 mJ, 10 pps for 3 minutes; 3. scaling and 4. untreated control. Probing depth, bleeding on probing (BOP), plaque index, gingival index and gingival crevicular fluid (GCF) volume were measured at baseline and week 6. Baseline subgingival microbiological samples were collected, then repeated immediately after treatment and at week 6 to assess the total anaerobic colony forming units (CFU). Only the scaling group showed a significant reduction in pocket depth and BOP (P < 0.001). The microbial samples taken immediately after scaling and laser at 80 mJ and 10 pps treatments showed a significant reduction in total CFU compared with the baseline (P < 0.01), which was sustained only in the scaling group until week 6. Electron microscopy did not reveal any heat damage on the root surfaces. This study demonstrated that application of Nd:YAG laser pulses of 50 mJ and 80 mJ failed to improve the clinical and microbiological parameters of periodontal disease.

Adult↗
PubMed1996

Effects of treatment on gingival crevicular collagenase, stromelysin and tissue inhibitor of metalloproteinases and their ability to predict response to treatment.

Fibroblast collagenase (FIB-CL) and stromelysin (SL) are members of a family of enzymes which are capable of degrading most of the extracellular matrix macromolecules. Extracellular control of these enzymes is performed by tissue inhibitor of metalloproteinases (TIMP). During healing, inflammation and normal tissue turnover, levels of MMPs and TIMP will change. The effect of treatment on the levels of FIB-CL, SL and TIMP as well as their ability, at baseline, to predict the outcome of therapy was investigated. 21 patients each provided 8 gingival crevicular fluid (GCF) samples from sites with probing depths > or = 4 mm. Clinical recordings and GCF sampling were performed at 3 time points. Assays for SL, FIB-CL and TIMP were performed by a sandwich ELISA. Attachment level changes were detected by the "tolerance method". The ability of the GCF constituents to predict the response to treatment was assessed by comparing pre-treatment levels between sites which did or did not show attachment gain after therapy. Although no GCF constituents could reliably predict the response to treatment, SL reduced significantly (p = 0.029) after the hygiene phase of therapy. In addition, both SL and TIMP levels showed a highly significant reduction at follow-up visit (p = 0.003 and p = 0.005 respectively). Thus, SL and TIMP levels are reduced by treatment, but these GCF proteins do not appear to have an ability to predict treatment outcome from baseline.

Adult↗
PubMed1996

Matrix metalloproteinases and their inhibitors in gingival crevicular fluid and saliva of periodontitis patients.

Matrix metalloproteinases (MMPs) and serine proteinases seem to be related to tissue destruction in periodontitis. The presence of MMPs in gingival crevicular fluid (GCF) and saliva, however, has not been studied comprehensively with the enzyme-linked immunosorbent assay (ELISA)-technique. We therefore examined the levels of MMP-1, -3, -8 and -9, and their endogenous inhibitor, tissue inhibitor of matrix metalloproteinases (TIMP-1), in GCF and saliva of patients with adult periodontitis (AP) and localized juvenile periodontitis (LJP). Elevated levels of MMP-1 were detected in LJP GCF compared to AP and control GCF. Elevated levels of TIMP-1 were also detected in LJP GCF in comparison to AP and control GCF. Higher MMP-8 levels were detected in AP GCF compared to LJP and control GCF. The relative low levels of MMP-3 were present in all studied GCF samples. Elevated levels of MMP-8 were further detected in saliva of AP compared to LJP and the controls. Both MMP-1 and TIMP-1 were detected in all studied saliva samples, but not significant differences were detected between the studied groups. Our ELISA-results confirm that (i) PMN MMP-8 and MMP-9 are the main collagenase and gelatinase in AP GCF, whereas GCF collagenase in LJP seems to be of the MMP-1-type; (ii) only low levels of TIMP-1, endogenous MMP-inhibitor, are present in AP GCF, which emphasises the importance of doxycycline as a possible adjunctive drug in the treatment of AP patients; (iii) tests based on specific antibodies against PMN MMPs, especially MMP-8, might serve as a reliable method of measuring and monitoring enzyme levels in GCF from different periodontitis patients.

Adolescent↗
PubMed1996

Analysis of immunoglobulin-synthesizing cells in human dental periapical lesions by in situ hybridization and immunohistochemistry.

Immunoglobulin (Ig) kappa (kappa) and lambda (lambda) light chain mRNA-expressing cells were investigated by in situ hybridization (ISH) to assess the local humoral immune response in human dental periapical lesions. Twenty-seven biopsy samples (17 periapical granulomas and 10 radicular cysts) were examined. Both types of light chain mRNA-positive cells were detected in formalin-fixed/paraffin-embedded tissue sections in all samples. Plasma cells showed weak to strong cytoplasmic staining with both probes and background staining was negligible. The ISH methodology is specific and sensitive in detecting Ig light chain mRNAs and retains cell morphology well. kappa to lambda ratios showed moderate variability for both granulomas and cysts (mean = 1.66 +/- 0.85 SD, 1.47 +/- 0.51, respectively). There was no significant difference in light chain distribution between granulomas and cysts. Ig kappa and lambda light chain proteins were also studied by immunohistochemistry (IHC) but the results were disappointing due to excessive background staining. This study confirms that Ig is locally produced in periapical lesions and that the ISH method localises Ig light chain-containing cells better than IHC. The wide variability in kappa/lambda ratio may support the concept of non-specific multibacterial infection in these lesions.

Adult↗
PubMed1996

Detection of stable and active periodontitis sites by clinical assessment and gingival crevicular acute-phase protein levels.

The aim of the present study was to investigate whether incipient periodontal disease breakdown could be associated with changes in gingival crevicular fluid (GCF) acute-phase protein levels. In addition, the potential of clinical indices to act as predictors of significant attachment level (AL) change was investigated. AL measurements were taken at baseline and 3 months using the Florida Probe stent handpiece from a total of 384 sites in 38 patients. The average standard deviation of duplicate AL measurements was 0.423. When the tolerance method was used to detect significant AL change, 3.9% of the sites lost attachment. When a less stringent criterion of AL change of > or = 1 mm was used 9.9% of the sites lost attachment during the 3-month period. With the exception of probing depth, baseline clinical parameters failed to predict AL change. Fourteen active periodontitis sites that demonstrated significant attachment loss were paired to stable periodontitis sites within the same patient. The levels of four acute-phase proteins, namely alpha 2-macroglobulin (alpha 2-M), alpha 1-antitrypsin (alpha 1-AT), transferrin (TF) and lactoferrin (LF), and also albumin (Alb) were assessed in the same gingival crevicular fluid sample using sandwich ELISAs. Results were expressed either as ng/30 s and ng/microgram Alb. Acute-phase protein levels in GCF failed to differentiate between active and stable periodontitis sites at baseline. In conclusion, the degree of gingival inflammation of the tissues adjacent to the crevice/pocket seems to influence the levels of protease inhibitors and iron-binding proteins in GCF to a greater extent than probing attachment loss.

Acute-Phase Proteins↗
PubMed1996

In situ localization of cell synthesis and proliferation in periodontitis gingiva and tonsillar tissue.

OBJECTIVE: Previous work indicates that large numbers of B and T cells accumulate in the periodontal soft tissues although we know little about cellular synthetic activity and proliferation in this site. The aim of this study was to examine lymphocytic cell synthetic activity and proliferation in periodontitis gingiva and compare this to a known site of leucocyte proliferation, namely the oropharyngeal tonsils. MATERIALS AND METHODS: Messenger RNA (mRNA) and 28S ribosomal (28S rRNA) expressing cells in formalin-fixed/paraffin-embedded gingival and tonsillar tissue sections were detected by in situ hybridisation (ISH) using poly-deoxyribothymidine and 28S probes respectively. In addition S-phase proliferating and cycling cells were also detected by ISH with histone probes and by Ki-67 immunohistochemistry. Ten gingival biopsy samples were obtained from adult periodontitis patients and five tonsillar biopsies from tonsillectomy patients. RESULTS: Both mRNA and 28S rRNA-expressing cells were detected in all the samples tested. Plasma cells showed the strongest signal for the two probes and slight to moderate staining could be seen in epithelium, fibroblasts and endothelial cells. In contrast, gingival lymphocytes were either weakly stained or were unstained for these probes of synthetic activity. In tonsils, most lymphocytes in germinal centres showed moderate staining and mantol zone cells were much more weakly stained. In gingival samples, histone mRNA-expressing and cycling (Ki-67) cells were detected in 4/10, 10/10 cases respectively. These positive cells were mainly basal and suprabasal epithelial cells and a few mononuclear cells, whereas most germinal centre lymphocytes (B cells) were positive for this probe. The number of Ki67 positive cells was greater than histone mRNA bearing cells both in gingiva and tonsillar tissue. In contrast, mantol zone cells (mainly T cells) were sparsely stained by probes of cell proliferation. CONCLUSION: These results indicate that local proliferation of B cells does not occur in periodontitis gingiva in contrast with tonsillar tissue, although plasma cells showed strong synthetic activity in both tissues. T cells did not appear to proliferate greatly nor undergo active synthesis in either of these tissues. These findings substantiate previous hypotheses that specific leucocytes predominate in the gingival tissue through selective homing rather than by local proliferation.

Adult↗
PubMed1996

Putative periodontal pathogens, antibody titres and avidities to them in a longitudinal study of patients with resistant periodontitis.

OBJECTIVE: To study changes in antibody titres and antibody avidities to putative periodontal pathogens in patients with resistant periodontitis and to compare these findings with the result of culture of these pathogens. SUBJECTS AND METHODS: Patients meeting strict clinical criteria in whom periodontal therapy had failed to prevent disease progression were studied microbiologically and immunologically over a 75-week period. Particular reference was made to the isolation of Actinobacillus actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) together with changes in antibody titres and avidities to these organisms between baseline examination and week 75. RESULTS: Pg was eliminated following antibiotic treatment but metronidazole and amoxycillin therapy failed to remove Aa in all cases. Antibody avidities to these pathogens were higher in patients than in matched controls but no change in avidity was noted during the course of treatment. Most antibody titres were not significantly higher in patients than in controls. CONCLUSIONS: Continued disease progression characterised these patients who, nevertheless, mounted an immune response to the periodontal pathogens but this appeared to be inadequate to stop the disease.

Adult↗
PubMed1996

Index of Oral Cleanliness (I.O.C.). A new oral hygiene index for use in clinical audit.

Although plaque control influences orthodontic treatment planning, treatment progress and outcome, current national orthodontic clinical audit software does not include an assessment of oral hygiene. This paper presents the development of the Index of Oral Cleanliness, a new simple rapid measure of oral hygiene, and describes its validation and reliability by comparison with the Silness and Loe plaque index in an unselected group of adolescents. It is concluded that the Index of Oral Cleanliness provides a valid quantitative method of scoring oral hygiene, with advantages for use in routine clinical practice.

Adolescent↗
PubMed1996

Comparison of 3 periodontal local antibiotic therapies in persistent periodontal pockets.

The aim of this study was to evaluate the efficacy of 3 commercially available periodontal systems for local delivery of antibiotics as adjuncts to scaling and root planing in treatment of sites with persistent periodontal lesions following a course of scaling and root planing. Fifty-four patients with 4 pockets > or = 5 mm and bleeding on probing and/or suppuration were randomized in 4 treatment groups including: scaling and root planing plus application of 25% tetracycline fiber (S + Tet) (13 patients), scaling and root planing plus application of 2% minocycline gel (S + Min) (14 patients), scaling and root planing plus application of 25% metronidazole gel (S + Met) (14 patients), and scaling and root planing alone (S) (13 patients). Clinical measurements were taken at baseline and 6 weeks after the end of treatment periods. All treatments were applied using the distributors' recommended protocols and resulted in significant improvement in probing depth, attachment level, bleeding on probing and the modified gingival index (MGI) scores. The improvements in clinical parameters were greater in all three adjunctive treatment groups than scaling and root planing alone. The mean probing depth reductions were: S + Tet = 1.35 mm, S + Met = 0.95 mm, S + Min = 0.87 mm and S = 0.60 mm. The probing depth reduction was significantly greater in the scaling plus tetracycline fiber group than the scaling and root planing alone group (P = 0.002). The difference between groups in improvement of attachment level or bleeding on probing was not significant Scaling plus tetracycline fiber treatment resulted in the greatest reduction in the MGI scores which was significantly greater than all other groups. While the frequency of sites with suppuration was markedly reduced following all treatments, it reached zero in the scaling plus tetracycline fiber group. No serious adverse effects were observed or reported for any treatment. While all three locally applied antimicrobial systems seem to offer some benefit over scaling and root planing alone, a treatment regimen of scaling and root planing plus tetracycline fiber replacement gave the greatest advantage in the treatment of persistent periodontal lesions at least during the 6-week period following treatment.

Administration, Topical↗