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Biomedical subjects

E C Morrison

Publications and source records attributed to E C Morrison.

51 records · Page 3Linked to original sources
PubMed1984

Metronidazole in periodontitis. I. Clinical and bacteriological results after 15 to 30 weeks.

The statistical association of certain anaerobic organisms such as black pigmented bacteroides (BPB) species and spirochetes with clinical signs of active periodontitis, i.e. bleeding upon probing and bone loss, suggests that the lesions may actually reflect a "specific infection" involving these or unidentified species. All the known oral species of BPB and spirochetes are anaerobes which suggests that antimicrobial treatment directed specifically against anaerobes might be effective in periodontal therapy. In this report, the short-term results of metronidazole treatment plus mechanical debridement in patients with extensive periodontal disease and of a double-blind clinical study in which metronidazole plus mechanical debridement is compared to placebo plus mechanical debridement are described. The findings indicate that 1 week of systemic metronidazole can optimize the clinical reduction of pockets and increase the apparent attachment in periodontitis patients who receive concurrent mechanical debridement of their root surfaces. In patients with extensive clinical involvement, metronidazole resulted in a significant reduction in the number of sites exhibiting pocket depths and attachment loss greater than or equal to 7 mm. When metronidazole plus mechanical debridement was compared with placebo plus mechanical debridement in a double-blind study, the metronidazole patients exhibited a significant improvement in those sites initially greater than or equal to 7 mm. The beneficial effect of the metronidazole was associated with a significant and sustained reduction of certain anaerobic organisms such as Bacteroides gingivalis and the large spirochetes. These data indicate that treatment aimed specifically toward the anaerobic component of the plaque flora can be associated with impressive clinical improvements 15 to 30 weeks after the initiation of treatment.

Alveolar Process↗
PubMed1982

Oral hygiene and maintenance of periodontal support.

The role of personal plaque control in periodontal maintenance care was studied in 78 patients who had undergone periodontal therapy and were on 3-month recall for prophylaxis over 8 years. Variations in pocket depth and attachment levels were related to individuals with plaque scores above and below the median. The results also were analyzed by comparing the 25% of the sample having the lowest plaque scores with the 25% having the highest scores over 7 years of maintenance care. Students t test was used. It was found that personal oral hygiene as expressed in plaque scores was not critical for maintenance of post-treatment pocket depth and attachment levels in patients with professional tooth cleaning every 3 months. The initial post-treatment reductions in pocket depth and variations in attachment levels were more favorable in patients with good than with poor oral hygiene, but, these differences were not significant after 3 to 4 years of maintenance care.

Dental Plaque↗
PubMed1982

Effect of periodontal treatment on tooth mobility.

The purpose of this study was to compare tooth mobility at different time periods during periodontal treatment and to relate changes in mobility to each method of treatment. Ninety-three patients (2421 teeth) with moderate to severe periodontitis were scored: (1) at initial examination, (2) 1 month following scaling, root planing, instruction in oral hygiene and preliminary occlusal adjustment, (3) 1 month after treatment with pocket elimination or reduction, curettage, modified Widman flap or scaling and root planing by the periodontist, and (4) 1 and 2 years following completed periodontal treatment. After initial nonsurgical treatment there was a significant decrease in tooth mobility. Tooth mobility increased temporarily after pocket reduction surgery but was not altered following curettage, modified Widman flap or scaling and root planing. Two years post-treatment there was a trend toward further decrease in tooth mobility with professional tooth cleaning every 3 months.

Dental Scaling↗
PubMed1981

Treatment of periodontal infections due to anaerobic bacteria with short-term treatment with metronidazole.

In the present report, five selected periodontal patients were treated for 1 week with metronidazole. Two of the patients had their teeth scales and root-planed the week they received metronidazole. Prior to treatment, B. asaccharolyticus accounted for 41% of the cultivable isolates and the spirochetes averaged 29% of the microscopic count in plaque removed from each of four pockets per patient. The presence of these elevated proportions of periodontopathic bacteria combined with the presence of periodontal pockets and attachment loss suggested that the patients were in a state of an active infectious process involving primarily anaerobic bacteria. If this be the case, then antimicrobial therapy directed against these anaerobes wih metronidazole was indicated. The 1-week treatment with metronidazole significantly reduced the proportions of these organisms for up to 6 months after treatment. Coincident with these findings was an improvement in the clinical parameters, especially in those sites that initially had greater than 5 mm pocket or attachment loss. These sites showed a 2 mm or more reduction in pocket depth and an almost 2 mm gain in apparent attachment that was evident 6 months after treatment. The results obtained were in only five patients. However, the magnitude of improvement suggests that antimicrobial therapy directed against anaerobic organisms may be a valuable adjunct to periodontal therapy.

Adolescent↗
PubMed1981

Four types of periodontal treatment compared over two years.

Results of various modalities of periodontal therapy were studied in 90 subjects (mean age 45 years) with moderate to severe periodontitis. Initial measurements of pocket depth and clinical attachment levels were compared with measurements obtained after the initial hygienic phase of the treatment and measurements of the same areas 1 and 2 years after four different types of periodontal treatment had been applied on a randomized basis to each of the four quadrants of the dentition. These treatments were: (1) surgical pocket elimination or reduction, (2) modified Widman flap surgery. (3) subgingival curettage, (4) scaling and root planing only. The patients were recalled for prophylaxis every 3 months, and rescored annually. One-way analysis of variance and Scheffe's method were used to test the hypothesis of equal treatment effects. The results were analyzed both with initial pocket depth as the baseline and with pocket depth at the hygienic phase as the baseline using a grouping of pockets 1 to 3 mm, 4 to 6 mm, and greater than or equal to 7 mm. For the 1 to 3 mm pockets there was a slight reduction in depth at the hygienic phase, with only minor changes after the various modalities of treatment over 2 years. However, significant losses of attachment after all modalities of periodontal therapy, including scaling alone, were observed at both the 1-year an 2-year intervals. For pockets 4 to 6 mm deep, the main reduction in pocket depth occurred at the hygienic phase, but the pockets also were reduced by further treatment, most by pocket elimination and modified Widman surgery. However, this reduction in pocket depth after surgery had no beneficial influence on maintenance of the attachment level, which actually was maintained best by scaling alone. For deep pockets greater than or equal to 7 mm, significant reduction in pocket depth occurred both at the hygienic phase and 1 to 2 years after treatment, with the greatest initial reduction after pocket elimination surgery. However, again there was no significant difference in attachment results among the four methods.

Adult↗
PubMed1980

Short-term effects of initial, nonsurgical periodontal treatment (hygienic phase).

Longitudinal studies have reported the effect of various modalities of periodontal surgery on pocket depth and attachment levels related to pretreatment measurements. However, possible changes in these measurements as a result of scaling, oral hygiene improvements and occlusal adjustment during the hygienic phase were not considered. The purpose of the present study was to examine the short-term effect of treatment of the hygienic phase in 90 patients with some pockets extending 4 mm or more apically to the CEJ. Pretreatment pocket depths and attachment levels related to the CEJ were measured by a thin probe in five sites at all 2,355 teeth in the sample. Scaling, root planing, instruction in oral hygiene and occlusal adjustment were completed during four to six sessions for each patient. Four weeks after completion of the hygienic phase, all variables were recorded. Mean measurements for pocket depths 1-3 mm, 4-6 mm, and greater than or equal to 7 mm prior to treatment were compared to their posttreatment scores. Pocket depth decreased significantly for pockets extending 4 mm or more apically to the FGM. For pockets 4-6 mm there was a mean difference in pocket depth of 0.96 +/- 0.47 mm (P < .0001) between pretreatment and posttreatment observations. For pockets 7 mm or greater the mean difference was 2.22 +/- 1.35 mm (P < .0001). Reduction in depth of pocket and improvement in attachment levels were related to the initial level of severity. Pocket reduction was in part due to the improvement in attachment levels. This study has demonstrated that the clinical severity of periodontitis is reduced significantly 1 month following the hygienic phase of periodontal therapy, and that need for surgical pocket treatment cannot be assessed properly until completion of the hygienic phase of treatment.

Adult↗
PubMed1980

Tooth mobility and periodontal therapy.

Data collected as part of an 8-year longitudinal study on periodontal therapy involving 82 patients and 1974 teeth were analyzed to determine if tooth mobility influenced the result of treatment. For each patient, pocket depth, attachment level and tooth mobility were scored clinically at the initial appointment, and once a year for 8 years following periodontal therapy. The treatment consisted of scaling, oral hygiene instruction, occlusal adjustment, periodontal surgery (curettage, modified Widman or pocket elimination), followed by recall prophylaxes every 3 months. Tooth mobility data on a scale of 0--3 were related to changes in attachment levels for three grades of severity of periodontal disease, based on initial pocket depth (1--3 mm, 4--6 mm, and 7 + mm). Mean patient attachment changes were calculated from teeth in the same severity category for each patient. The data were analyzed by one-way analysis of variance and Scheffe's multiple comparison procedure to test the hypothesis of equal effects of tooth mobility on the results of the treatment for the three severity groups over 8 years. The results indicate that there is a statistically significant relationship between original tooth mobility and the change in level of attachment following treatment. Pockets of clinically mobile teeth do not respond as well to periodontal treatment as do those of firm teeth exhibiting the same initial disease severity.

Humans↗
PubMed1980

Results of periodontal therapy related to tooth type.

Certain teeth or groups of teeth are prone to develop more severe periodontal destruction than other teeth in the same individuals. A test was made to assess if these same teeth or groups of teeth also respond less favorably to periodontal therapy than other teeth. Data from a longitudinal study of periodontal therapy for 78 patients over 8 years were analyzed with regard to effect of tooth types on treatment results. The response to periodontal treatment was only marginally related to tooth type with the most favorable responses in the maxillary and mandibular anterior teeth and the least favorable responses in the maxillary molars and bicuspids. Although a number of these differences were significant statistically, the actual values were too small to be of appreciable clinical significance. The overall prognosis for treatment of periodontal pockets apparently is good for all tooth types and this observation applies to moderate as well as to deep pockets.

Bicuspid↗
PubMedDate not supplied

Treatment of peri-implantitis using guided bone regeneration and bone grafts, alone or in combination, in beagle dogs. Part 1: Clinical findings and histologic observations.

The purpose of this study was to evaluate and compare the treatment of ligature-induced peri-implantitis using guided bone regeneration and two bone grafts alone and in combination. Mandibular premolars and first molars were extracted from four beagle dogs and after 3 months of healing, three Brånemark implants were placed on each side of the mandibles. Following abutment connection 3 months later, experimental peri-implantitis was induced by tying plaque-retentive ligatures around all abutments. Ligatures and abutments were removed after 3 months, and bony defects measured and treated with either: (1) debridement only; (2) debridement plus resorbable hydroxyapatite; (3) debridement plus canine freeze-dried demineralized bone; (4) debridement plus guided bone regeneration; (5) debridement plus resorbable hydroxyapatite and guided bone regeneration; or (6) debridement plus canine freeze-dried demineralized bone and guided bone regeneration. Pretreatment and 4-month-posttreatment comparison revealed a significant but variable degree of clinically appreciable hard tissue fill with all treatment procedures. Guided bone regeneration procedures resulted in the greatest fill, followed by bone grafts alone and flap debridement. There was no significant difference between guided bone regeneration and both guided bone regeneration/graft combinations; therefore, guided bone regeneration procedures appear to be a predictable treatment for plaque-induced peri-implant defects.

Alveolar Bone Loss↗
PubMedDate not supplied

Treatment of peri-implantitis using guided bone regeneration and bone grafts, alone or in combination, in beagle dogs. Part 2: Histologic findings.

The aim of this study was to histologically evaluate and compare the treatment of ligature-induced peri-implantitis using guided bone regeneration, two bone grafts alone, or guided bone regeneration combined with one of the two bone graft materials. Mandibular premolars and first molars in seven beagle dogs were extracted. After placement of Brånemark implants and connection of abutments, experimental peri-implantitis was induced. Flap surgery was performed, abutments were removed, and implant surfaces were treated with an air-powder abrasive unit. Bony defects were randomly treated with either (1) debridement only; (2) debridement plus resorbable hydroxyapatite; (3) debridement plus canine demineralized freeze-dried bone; (4) debridement plus guided bone regeneration; (5) debridement plus resorbable hydroxyapatite and guided bone regeneration; or (6) debridement plus canine demineralized freeze-dried bone and guided bone regeneration. Four months after surgery, a flap was elevated and the barriers were removed. One month later, the animals were sacrificed, and the implants with their supporting peri-implant tissues were processed for histologic evaluation. Guided bone regeneration procedures resulted in the greatest amount of new bone formation, followed by bone grafts alone, and flap debridement. There was no significant difference between guided bone regeneration and both guided bone regeneration/graft combinations in terms of bone regeneration; however, the guided bone regeneration/graft combinations resulted in a greater amount of "reosseointegration" than all of the other treatments. Therefore, the combination of guided bone regeneration with either demineralized freeze-dried bone or resorbable hydroxyapatite appears to be the treatment of choice for plaque-induced peri-implant defects.

Animals↗