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Biomedical subjects

D F Kinane

Publications and source records attributed to D F Kinane.

At least 91 records · Page 5Linked to original sources
PubMed1996

The effect of subgingival antimicrobial therapy on the levels of stromelysin and tissue inhibitor of metalloproteinases in gingival crevicular fluid.

Recent investigations imply that a key mechanism in the pathogenesis of periodontal disease may be the ability of oral microorganisms to induce production and/or activation of matrix metalloproteinases (MMPs) in the host tissues. It has been suggested that the pharmacologic inhibition of MMP activity could play an important role in achieving a desirable outcome in periodontal therapy. The efficacy of locally delivered antibiotics on the level of gingival crevicular fluid (GCF) stromelysin (SL) and tissue inhibitor of metalloproteinases (TIMP) on sites with a history of a poor response to mechanical treatment was studied. Fifty-two patients with 4 periodontal pockets > or = 5 mm and bleeding on probing were randomized into four groups of 13 patients. One group received scaling and root planing alone and the other three groups received scaling and root planing plus a locally delivered antimicrobial system. These included 25% tetracycline fiber, 2% minocycline gel, and 25% metronidazole gel. The GCF samples taken at baseline and 6 weeks after treatments were analyzed using an enzyme linked immunosorbent assay (ELISA). GCF SL levels significantly decreased after adjunctive tetracycline fiber (paired t-test, P = 0.020) and minocycline gel (paired t-test, P = 0.023) treatments whereas it remained almost unchanged in the other two groups. While the GCF TIMP level did not change significantly in the scaling and root planing alone group, it significantly increased for all three adjunctive antimicrobial treatments (for tetracycline fiber P < 0.001, minocycline gel P = 0.005, metronidazole gel P < 0.001). The use of adjunctive locally delivered antimicrobial systems, particularly the tetracycline family, may offer an advantage in changing the metalloproteinase profile of the GCF to one more compatible with periodontal health.

Administration, Topical↗
PubMed1995

Detection of interleukin-1 beta mRNA-expressing cells in human gingival crevicular fluid by in situ hybridization.

Interleukin-1 beta (IL-1 beta) mRNA-expressing cells in human gingival crevicular washings (GCW) obtained from patients with periodontitis and healthy controls were examined by in situ hybridization. GCW was done at 15 diseased sites [Gingival Index > 1; pocket depth > or = 5 mm] from five patients with adult periodontitis and eight clinically periodontal healthy sites from three volunteers GI < or = 1; PD < or = 3 mm), and then the samples were cytocentrifuged. In situ hybridization using digoxigenin-labelled oligonucleotide probe complementary to human IL-1 beta mRNA showed IL-1 transcripts in both polymorphonuclear leucocytes and mononuclear cells but not in epithelial cells in all GCW samples from diseased and healthy sites. Polymorphs were the predominant leucocytes in diseased and healthy sites, averaging 91.7 +/- 4.6 and 77.0 +/- 10.3%, respectively. The percentages of IL-1 beta mRNA-positive polymorphonuclear leucocytes in GCW samples from diseased and healthy sites were 92.3 +/- 4.7 and 80.9 +/- 10.3%, respectively. The IL-1 beta gene signals in individual cells were quantified in five samples (two healthy and three diseased sites). The mean amounts of IL-1 beta mRNA expression in polymorphonuclear leucocytes was higher than that of mononuclear cells in all samples and there was heterogeneity within the populations of polymorphonuclear and mononuclears cells in their ability to express the IL-1 beta gene. These findings indicate that IL-1 beta may be predominantly produced by polymorphonuclear leucocytes in the gingival crevice of patients with adult periodontitis and periodontally healthy controls.

Adult↗
PubMed1995

Acute-phase proteins and immunoglobulin G against Porphyromonas gingivalis in peri-implant crevicular fluid: a comparison with gingival crevicular fluid.

This investigation had 2 aims: 1) to determine the levels of acute-phase proteins and immunoglobulin G (IgG) against Porphyromonas gingivalis in peri-implant crevicular fluid (PICF) and their association with the clinical condition of the peri-implant mucosa; and 2) to compare the inflammatory and immunological responses at implants and teeth as reflected by the gingival crevicular fluid (GCF) and PICF levels of acute-phase proteins and immunoglobulins. Thirty-one partially edentulous subjects were recruited for this study. PICF was sampled from 1 healthy and 1 inflamed site from each patient; GCF was sampled from an additional 21 healthy and 27 inflamed tooth sites of the same patients. GCF and PICF were collected with paper strips (for 30 s) and analysed using enzyme-linked immunosorbent assays for alpha 2-macroglobulin, alpha 1-antitrypsin, transferrin, lactoferrin and IgG against P. gingivalis. This investigation demonstrated that the absolute amounts of the acute-phase proteins and IgG against P. gingivalis are higher in GCF and PICF from inflamed than healthy sites. No significant differences were observed between PICF and GCF components at either healthy or inflamed sites, suggesting that inflammatory and immune events are similar in the peri-implant mucosa and gingiva in humans and that PICF and GCF production is governed by similar mechanisms.

Acute-Phase Proteins↗
PubMed1995

Gingival crevicular stromelysin, collagenase and tissue inhibitor of metalloproteinases levels in healthy and diseased sites.

The ability of stromelysin (SL), fibroblast-type collagenase (FIB-CL) and tissue inhibitor of metalloproteinases (TIMP), to differentiate between healthy, gingivitis and periodontitis sites was investigated. SL and FIB-CL 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 TIMP. 40 patients each provided 3 GCF samples from healthy, gingivitis and periodontitis sites. GCF samples were collected by means of sterile paper strips. GCF samples were eluted into 500 microliters of assay buffer and assays for SL, FIB-CL and TIMP were performed by a sandwich ELISA. The mean amounts of SL and TIMP in diseased sites (gingivitis and periodontitis) were significantly higher than the mean amount of these GCF components in healthy sites (MANOVA p values were: 0.006 for SL and 0.001 for TIMP). GCF SL and TIMP differentiated healthy from diseased sites. Both SL and TIMP showed moderate correlation with clinical indices. FIB-CL was detectable in only 20.8% of all sites and did not correlate with disease status.

Adult↗
PubMed1995

An evaluation of the effects of an Nd:YAG laser on subgingival calculus, dentine and cementum. An in vitro study.

The aim of this study was to evaluate the effects of Nd:YAG laser treatment on subgingival calculus, cementum and dentine, in vitro at different power settings and durations. The study included 2 experiments. In the 1st experiment, 32 extracted teeth with calculus were divided into 8 laser treatment groups. Each tooth was treated on 2, 3 or 4 sites. In the 2nd experiment, 3 extracted cementum covered teeth and 3 extracted root planed teeth with exposed dentine were selected. 1 surface of each tooth was subjected to 8 different laser treatments. In both experiments, all specimens were assessed using scanning electron microscopy. Micrographs were taken from each treated site at x 100 and x 750 magnifications. An arbitrary scale (from 0 to 3) was used to score the degree of damage caused by the laser. Generally, the laser caused greater damage on calculus than either cementum or dentine. Linear regression analysis showed that higher total energy input caused a greater mean damage score on calculus (R2 = 66%, p < 0.001). 3-way analysis of variance showed that for calculus, the power setting, number of pulses per second and the duration of exposure contributed independently to the mean damage score in an additive way. Cementum specimens were not affected by treatment 1 (50 mJ, 10 pps, 1 s), treatment 2 (50 mJ, 10 pps, 5 s), and treatment 5 (50 mJ, 20 pps, 1 s). Dentine specimens were not affected by treatment 1 (50 mJ, 10 pps, 1 s).(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1995

The relationship between elastase and lactoferrin in healthy, gingivitis and periodontitis sites.

OBJECTIVES: To compare the relative amounts of elastase (primary polymorphonuclear leucocyte granule constituent) and lactoferrin (secondary PMN granule constituent) in the gingival crevicular fluid (GCF) of healthy, gingivitis and periodontitis sites. DESIGN: This cross-sectional study looked at the two GCF constituents in three categories of disease status within the same subject. MATERIALS AND METHODS: Patients with chronic adult periodontitis were screened and those exhibiting all three types of sites ie periodontally healthy, gingivitis and periodontitis sites were recruited (n=10) and had GCF collected from the three sites. Lactoferrin and elastase were measured in eluates of GCF by enzyme-linked immunosorbent assay. RESULTS: The absolute amount of lactoferrin measured in ng per 30 s samples was significantly lower in healthy and gingivitis sites as compared to periodontitis sites; however this difference failed to reach significance when the concentration of lactoferrin in GCF was used as the analytical unit. No significant differences were found for elastase levels at any sites when expressed as either absolute amounts or concentrations. Secondary granule release, as evidenced by lactoferrin levels, occurs during cell migration and the process is independent of primary granule release, which is thought to correlate with PMN activation. The relationship between granule constituents in the samples showed significant differences, the highest lactoferrin/elastase ratio being at periodontitis sites (P<0.001). CONCLUSIONS: These findings imply a change in the relative amounts of elastase and lactoferrin released at different disease level sites, wth an almost 10-fold increase in the proportion of lactoferrin to elastase in periodontitis sites over healthy and gingivitis sites. This variation in the release by PMNs of primary and secondary granule constituents may indicate alterations in PMN function in different disease environments.

Adult↗
PubMed1995

Initial serum antibody titer to Porphyromonas gingivalis influences development of antibody avidity and success of therapy for chronic periodontitis.

This study assessed the effect of periodontal therapy on specific serum antibody concentration, expressed as titer, and antibody binding strength, expressed as relative avidity. The immune responses to Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans were investigated. Antibody titer was assayed by enzyme-linked immunosorbent assay (ELISA) and relative avidity was measured by thiocyanate elution in 17 adult periodontitis patients before and after therapy. Immunoglobulin G (IgG) avidities (expressed as thiocyanate molarity) to P. gingivalis increased from 1.01 to 1.38 M (P = 0.05) and IgA titers (expressed as ELISA units [EU]) increased from 89 to 237 EU (P = 0.012). There were no significant changes in avidity to A. actinomycetemcomitans, but the titer of all three immunoglobulin classes increased significantly (P < 0.03). More specifically, when patients were divided into subgroups which had originally been either IgG seropositive (i.e., having an IgG titer to this organism > 2 times the control median) or seronegative for P. gingivalis, only patients who were initially seropositive showed a significant increase in antibody avidity (P = 0.026; mean difference, 0.69 M). Patients who were originally seropositive in terms of IgG and IgA titer to P. gingivalis had demonstrably better treatment outcomes in terms of a reduced number of deep pockets and sites which bled on probing (P < 0.05). These findings suggest that periodontal therapy affects the magnitude and quality of the humoral immune response to suspected periodontopathogens, that this effect is dependent on initial serostatus, and that initial serostatus may have a bearing on treatment outcome.

Adult↗
PubMed1994

Cervical marginal fit of proximal amalgam restorations.

This study investigated the relationship between the adaptation, apical location and gap width of the cervical margin of proximal amalgam restorations. Three hundred and seventeen proximal cervical margins were studied in 243 extracted teeth. The restorations were categorized as 'flush fitting'; 'small overhang', or 'large overhang', based on examination with a Cross calculus probe. After trimming the overhangs to make the restorations flush with the tooth surface, the gap width was measured. In addition, the location of the cavity margin was measured relative to the amelocemental junction (ACJ), and the data were further grouped according to whether the restoration finished apical to the ACJ, less than 1.5 mm coronal to it, or more than 1.5 mm coronal to it. All measurements were made with a Reflex Microscope. Analysis of variance with the Scheffé multiple range test indicated that: the mean gap width of large overhanging restorations was significantly greater than that of small overhanging or flush fitting restorations (P < 0.001); the mean gap width of restorations which finished on the root surface was significantly greater than that of those restorations which finished on the enamel surface at more than 1.5 mm from the ACJ (P < 0.002); and large overhanging restorations were located further apically than small overhanging restorations which were, in turn, located further apically than flush fitting restorations (P < 0.0001). Furthermore, discriminant analysis indicated that the location of the cervical margin had more influence on gap width than the presence of an overhang (R2 = 3.6%; P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1994

Humoral immune responses to Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans in adult periodontitis and rapidly progressive periodontitis.

The relationships between various forms of periodontal disease and the avidities of serum antibodies of all 3 immunoglobulin (Ig) classes (IgG, IgM and IgA) to Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans were investigated. Twenty-four patients with untreated adult periodontitis and twelve untreated patients diagnosed as suffering from the early-onset form of periodontitis, rapidly progressive periodontitis, were studied. The latter group were matched for age and sex to healthy controls. Antibody titres were measured and avidity (expressed as molarity) was further assayed using the thiocyanate elution method. Avidity has previously been shown to relate to the biological function of antibody. IgM avidities to P. gingivalis were lower in the rapidly progressive periodontitis group than in the adult periodontitis group (0.54 M vs 0.74 M). IgG avidities tended to be lower in the former than in the latter group (0.58 M vs 0.92 M). In accordance with other workers, seropositivity was defined as an immunoglobulin titre more than twice the median level of control sera. Only 2 of the rapidly progressive periodontitis group were seropositive. Interestingly, the seronegative rapidly progressive periodontitis patients were significantly different (0.53 M vs 0.92 M). The data that patients with various forms of periodontal disease appear to produce antibodies of differing avidity to P. gingivalis suggest that the quality of the humoral immune response to suspected periodontopathogens may have a bearing on the aetiology of periodontal disease.

Adult↗
PubMed1994

Acute-phase proteins in gingival crevicular fluid during experimentally induced gingivitis.

The dynamics of four acute-phase proteins were investigated in gingival crevicular fluid (GCF) during the course of a 21 day experimental gingivitis study. These acute-phase proteins were the protease inhibitors alpha 2-macroglobulin (alpha 2-M) and alpha 1-antitrypsin (alpha 1-AT) and the iron-binding proteins transferrin (TF) and lactoferrin (LF). 6 healthy volunteers ceased all oral hygiene procedures for 3 weeks. GCF was sampled at seven day intervals from two sites per subject by paper strips for 30 s during the experimental gingivitis period and for two additional weeks after the reinstitution of oral hygiene. The mainly serum derived alpha 2-M, alpha 1-AT and TF exhibited very similar dynamics which reflects their common origin in GCF. Their levels increased significantly from baseline and remained high for at least one week after the reinstitution of oral hygiene measures (repeated measures MANOVA; alpha 2-M: p = 0.015; alpha 1-AT: p = 0.012; TF: p = 0.02). This probably reflects increased vascular permeability in the gingivae and, to a lesser degree, local production by gingival inflammatory cells. In contrast to the serum derived acute-phase proteins, the neutrophil derived LF rose significantly from baseline (repeated measures MANOVA; p = 0.001) but dropped rapidly after the reinstitution of oral hygiene measures. This could be because dental plaque was removed and thus neutrophil chemotactic agents in the crevice were decreased.

Acute-Phase Proteins↗
PubMed1993

Local and systemic antibody response to putative periodontopathogens in patients with chronic periodontitis: correlation with clinical indices.

Specific immunoglobulin G (IgG), IgA and IgM antibody titres to Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans were measured by enzyme-linked immunosorbent assay in serum and gingival crevicular fluid at 5 sites in each of 20 chronic periodontitis patients. Specific serum antibody titres correlated with mean gingival crevicular fluid titres. The 3 immunoglobulin subclass responses (IgA, IgG and IgM) to P. gingivalis correlated. A comparison of sites with probing depth < 4 mm and > or = 4 mm showed that the latter group had significantly lower gingival crevicular fluid IgG titres to P. gingivalis. Sites with a gingival index of 3 had significantly lower gingival crevicular fluid IgG titres to this organism than those with a gingival index of less than 3. These findings support the concept that the humoral immune response is protective, as chronic periodontitis patients with greater pocket depths and more gingival inflammation had paradoxically lower antibody titres to suspected periodontopathogens.

Adult↗
PubMed1993

Lactoferrin in the gingival crevice as a marker of polymorphonuclear leucocytes in periodontal diseases.

This study examined lactoferrin (LF) levels in gingival crevicular fluid (GCF) and set out to test the hypothesis that LF could act as a marker of crevicular polymorphonuclear leucocytes (PMN). Therefore, 2 experiments were conducted: (a) to quantify total LF (ng/30 s sample) in GCF; (b) to correlate LF levels (ng/microliters) and PMN numbers (PMNs/microliters) in gingival crevicular washings (GCW). GCF was collected from 71 sites in a total of 22 patients. These sites were classified on the basis of clinical indices of gingivitis (GI) and pocket depth (PD) into three clinical groups: 'healthy', 'gingivitis' and 'periodontitis'. GCWs were obtained from an additional 63 sites in 21 patients. LF in GCF and GCWs was assayed by a sandwich ELISA. Total leucocyte and differential counts were performed on the GCWs. GCF LF (ng/30 s) correlated positively with GI (r = 0.418, p < 0.001), PD (r = 0.415, p < 0.001) and GCF volume (r = 0.624, p < 0.001). Gingivitis (n = 21) and periodontitis sites (n = 24) demonstrated significantly higher (p < 0.05) total GCF LF than healthy (n = 26) sites. In GCWs LF (ng/microliters) showed stronger correlations with clinical indices (GI: r = 0.452, PD: r = 0.513, p < 0.001) than did PMN numbers (PMNs/microliters) (GI: r = 0.279, PD: r = 0.388, p < 0.05). LF correlated strongly with PMNs in GCWs (r = 0.531, p < 0.001) and provides a simple and effective marker of crevicular PMN numbers.

Adult↗
PubMed1993

Dental disease, fibrinogen and white cell count; links with myocardial infarction?

Plasma fibrinogen and white blood cell count were compared in fifty patients aged 25-50 years with periodontal disease and in fifty age-matched controls with relatively healthy periodontal tissues. Patients had significantly higher levels of fibrinogen and white cell count, and dental indices correlated significantly with these two cardiovascular risk factors on multivariate analyses. We suggest that inflammatory dental disease may be a determinant of fibrinogen level and white cell count in the general population, and that fibrinogen and white cell count may be two mediators of the link between dental disease and myocardial infarction.

Adult↗
PubMed1993

Relative avidity of serum antibodies to putative periodontopathogens in periodontal disease.

ELISA was used to determine both the avidity and titre of IgG, IgA and IgM antibodies to the gram-negative anaerobe, Porphyromonas gingivalis, in twenty periodontitis patients enrolled in a longitudinal study of attachment loss and eleven non-periodontitis affected subjects. The avidity and titre of IgG antibodies to Actinobacillus Actinomycetemcomitans were also examined. A cross-sectional analysis of the longitudinal patients at baseline and non-periodontally affected controls confirmed earlier findings that IgG and IgA antibody titres to P. gingivalis were higher in periodontitis patients than in individuals who were not periodontally affected. In this cross-sectional analysis, IgG antibody avidities to P. gingivalis were not found to be significantly higher in periodontitis than in control subjects (p = 0.065). However, indications of the potential prognostic value of antibody avidity was demonstrated by the higher IgM avidities to P. gingivalis in patients who did not experience attachment loss during the three-month monitoring period than in those who did (p = 0.0005).

Adult↗
PubMed1992

Bioassay of interleukin 1 (IL-1) in human gingival crevicular fluid during experimental gingivitis.

The cytokine IL-1 was demonstrated in crevicular fluid during a 14- and 21-day experimental gingivitis in healthy human volunteers. A sensitive and specific bioassay allowed detection of biologically active IL-1 at levels ranging from 0.18 ng/microliters at baseline to 1.70 ng/microliters in inflamed gingiva. Levels of IL-1 increased rapidly with plaque accumulation and in advance of the subsequent gingival inflammation, peaking within 7 days of the start of gingivitis. As changes in IL-1 were detected before clinically recognizable gingival changes, IL-1 may have potential as an early marker of gingival inflammatory changes.

Adult↗
PubMed1992

The ability of gingival crevicular fluid acute phase proteins to distinguish healthy, gingivitis and periodontitis sites.

3 acute phase proteins, from the local gingival inflammatory response, were examined for their ability to distinguish healthy, gingivitis and periodontitis sites. Indirect competitive immunoassays were developed for the quantification of alpha 2-macroglobulin (alpha 2-M) and transferrin (TF), and for alpha 1-antitrypsin (alpha 1-AT), a double antibody sandwich assay was produced. Healthy (25), gingivitis (31) and periodontitis (28) sites were sampled with filter paper strips (2 x 13 mm) and the volume assessed with the Periotron 6000. The samples were eluted in phosphate-buffered saline and analyzed for alpha 2-M, alpha 1-AT and TF. The results were expressed as absolute amounts per sample (ng/30 s) and on a concentration basis (ng/microliter of GCF). Higher GCF absolute amounts of alpha 2-M, alpha 1-AT and TF were consistently obtained from diseased (gingivitis and periodontitis) sites than healthy sites (p less than 0.005). Absolute amounts of GCF alpha 2-M, alpha 1-AT and TF were increased in periodontitis sites over gingivitis sites, although these differences were not statistically significant (p greater than 0.1). When the results were expressed on a concentration basis, alpha 2-M levels from diseased sites were significantly higher than healthy sites (p less than 0.01). In addition, GCF TF concentration was increased in periodontitis compared to healthy sites (p = 0.03).

Enzyme-Linked Immunosorbent Assay↗
PubMed1992

Endothelial cell leukocyte adhesion molecule-1 (ELAM-1) and intercellular adhesion molecule-1 (ICAM-1) expression in gingival tissue during health and experimentally-induced gingivitis.

The changes in vascular adhesion molecule expression and numbers of infiltrating leukocytes during a 21-day experimental gingivitis episode were investigated immunohistochemically. Monoclonal antibodies to ELAM-1 (1.2B6), ICAM-1 (6.5B5), CD3 (OKT3-pan-T cell) and neutrophils (PMN-elastase) were used to identify positive vessels and leukocytes within gingival biopsies taken on d 0, 7, 14 and 21. Vascular endothelium expressed ELAM-1 and ICAM-1 both in clinically 'healthy' tissue (d 0) and in experimentally inflamed tissue (d 7 to 21). Positive vessels were found mainly in the connective tissue subjacent to the junctional epithelium where the highest numbers of T cells and neutrophils were also seen. Although T cells were found in all tissue areas studied, neutrophils were largely concentrated in the junctional epithelium and the subjacent connective tissue but were absent from the oral epithelial region. As the experimental gingivitis developed, the number of T cells or neutrophils in the different tissue regions did not change significantly although the most intense vascular ICAM-1 and ELAM-1 staining redistributed to the CT adjacent to the junctional epithelium. A prominent feature was the intense ICAM-1 positive staining of the junctional epithelium and its absence in the closely adjacent oral epithelium, in both clinically 'healthy' and inflamed tissue. The gradient of ICAM-1 in junctional epithelium, with the strongest staining on the crevicular aspect plus the vascular expression of ELAM-1 and ICAM-1 in both clinically 'healthy' and inflamed tissue may be crucial processes which direct leukocyte migration towards the gingival crevice.

Analysis of Variance↗