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Biomedical subjects

H Rylander

Publications and source records attributed to H Rylander.

At least 19 recordsLinked to original sources
PubMed1998

The effect of supragingival plaque control on the progression of advanced periodontal disease.

The aim of the present trial was to study the effect of meticulous supragingival plaque control on (i) the subgingival microbiota, and (ii) the rate of progression of attachment loss in subjects with advanced periodontal disease. An intra-individual group of sites exposed to non-surgical periodontal therapy served as controls. 12 patients with advanced periodontal disease were subjected to a baseline examination (BL) including assessments of oral hygiene status, gingival condition (BoP), probing depth, clinical attachment level and subgingival microbiota from pooled samples from each quadrant. The assessments were repeated after 12, 24 and 36 months. Following BL, a split mouth study was initiated. The patients received oral hygiene instruction, supragingival scaling and case presentation. 2 quadrants in each patient were identified as "test" and the remaining 2 as "control" quadrants. Subgingival therapy was performed in all bleeding sites in the control quadrants. Oral hygiene instructions and plaque control exercises were repeated once every 2 weeks during the initial 3 months of the study. Thereafter the plaque control program was repeated once every 3 months for the duration of the 3 years. Sites demonstrating loss of clinical attachment > or =2 mm in the test quadrants were treated subgingivally. The results showed that in both test and control quadrants repeated oral hygiene instructions and supragingival plaque removal procedures resulted in low plaque scores throughout the study. The gingival bleeding scores and the frequency of periodontal pockets > or =4 mm was, however, significantly higher in the test quadrants than in the control quadrants. At the end of the 3 year study, the control quadrants showed significantly more reduced (> or =2 mm) pockets than the test quadrants, 265 versus 96. The number of sites in the test quadrants showing probing attachment loss > or =2 mm was more than 4x greater than in the control quadrants (59 versus 13). The microbiological findings indicate a more pronounced reduction only for P. gingivalis in the control quadrants. None of the other 4 marker bacteria consistently reflected or predicted the clinical parameters. The present study shows that only supragingival plaque control fails to prevent further periodontal tissue destruction in subjects with advanced periodontal disease.

Adult↗
PubMed1996

The effect of periodontal therapy in diabetics. Results after 5 years.

The present investigation was performed to study the frequency of recurrence of periodontitis in diabetic subjects, who, prior to the initiation of a 5-year period of monitoring, were treated for moderate to advanced periodontal disease. 20 patients with diabetes, type 1 (IDDM) or type 2 (NIDDM) and 20, sex and age matched, controls with similar amounts of periodontal tissue destruction, were selected for the study. Following a screening examination, all patients were subjected to non-surgical periodontal therapy (oral hygiene instruction, supra- and subgingival scaling). 3 months later, the baseline examination for the study was performed. This included assessments of several parameters such as: number of teeth, plaque, gingivitis, probing pocket depth and probing attachment level. 6 months after the baseline examination, all 40 subjects were recalled for a 2nd examination. Sites which at this 6-month examination exhibited bleeding on probing, and had probing depth > 5 mm, were scheduled for additional surgical therapy (modified Widman flap). Following this selective additional therapy, the main period of monitoring was initiated. During this period, a plaque control program was repeated every 3 months. Re-examinations regarding plaque, gingivitis, probing depth and probing attachment level were performed 12, 24 and 60 months after the baseline examination. The findings from the examinations disclosed that diabetics and non-diabetics alike, treated for moderately to advanced forms of adult periodontitis, during a subsequent 5-year period, were able to maintain healthy periodontal conditions. Thus, the frequency of sites which exhibited signs of recurrent disease was similar in the 2 study groups.

Aged↗
PubMed1995

The influence of the design of two different bioresorbable barriers on the results of guided tissue regeneration therapy. An intra-individual comparative study in the monkey.

The aim of the present study was to compare two bioresorbable barriers to evaluate whether differences in design influence the result of guided tissue regeneration (GTR) therapy. Twenty-four (24) plaque exposed, recession type defects in 4 monkeys were treated. Contralateral defects were randomized for test or control treatment. During a healing period of 6 weeks, gingival recession resulting in device exposure occurred at 3 test and 10 control sites. One control barrier was exfoliated. Histologically, 9 of the 12 test barriers were completely integrated with the surrounding tissues. At 3 test sites, epithelium had migrated apically outside the barrier to a level not exceeding one-third of the height of the device. Seven of the 11 control barriers were enclosed by dentogingival epithelium. The adjacent connective tissue exhibited local inflammatory cell infiltrates (ICT). At the remaining 4 control sites, the epithelial downgrowth as well as the adjacent ICT areas were limited to the coronal 1/3 of the device. New attachment; i.e., new cementum with inserting collagen fibers, averaged 2.2 mm and 0.8 mm at the test and control sites respectively (P < 0.01). Based on the results of the present study, it was concluded that a bioresorbable GTR device, designed to prevent epithelial downgrowth along the barrier surface, has a higher potential to promote new attachment formation than a device which does not have this property.

Animals↗
PubMed1994

Periodontal tissue response to a new bioresorbable guided tissue regeneration device: a longitudinal study in monkeys.

This study evaluated periodontal tissue response to a new bioresorbable guided tissue regeneration barrier material following guided tissue regeneration treatment of dehiscence-type defects at 45 teeth in 15 monkeys. The results were clinically and histologically evaluated 6 weeks and 3,6, 12, and 24 months posttreatment. Healing was uneventful and without inflammation or other adverse tissue reactions. Following 6 weeks of healing, the matrix barrier was completely integrated with the surrounding tissues, preventing epithelial downgrowth along the device. There were no inflammatory cell infiltrates adjacent to the material. New attachment (ie, new cementum with inserting collagen fibers) and new supporting bone were found after 6 weeks of healing. The matrix barrier maintained its functional stability for a minimum of 6 weeks. The subsequent slow resorption process of the material occurred without detrimental effects on the surrounding tissues, demonstrating the biocompatibility of the material. The material was completely resorbed after 6 to 12 months. At the final stages of the resorption process, macrophages and multinuclear cells were present within the tissue that replaced the material. The design and the resorption pattern of the matrix barrier are discussed in relation to the regenerative wound healing process.

Animals↗
PubMed1992

Healing-in of root analogue titanium implants placed in extraction sockets. An experimental study in the beagle dog.

The aim of these animal experiments was to characterize and evaluate the healing-in of root analogue titanium implants fitting with high precision to the alveolar wall. Four beagle dogs were used in the study. The roots of the 3rd and 4th mandibular premolars in both quadrants of 3 dogs and in 1 quadrant of 1 dog (dog 4) were extracted after hemisection. Each root was machine-copied to 1 titanium analogue. In dog 4, however, 2 titanium analogues were fabricated from each of the 4 extracted roots. This enabled insertion of analogues also into the contralateral sockets obtained by extraction of the corresponding roots immediately before implant installation, which was undertaken 2 weeks after the first extractions. Thus, in all, 32 analogues were implanted in their respective (or contralateral) sockets following ridge incision and elevation of mucoperiosteal flaps. The analogues were carefully covered by the repositioned flaps. In dog 4, 2 analogues from the immediate sockets and 2 from the 2-week sockets were surgically exposed and supplied with titanium crowns after a healing period of 2 months. The healing after implantation was evaluated by clinical, radiographic and histological measures after 2, 12 or 36 months. Two analogues (6%) were lost due to early (during the 1st week) exposure to the oral cavity. Another 2 analogues (6%) were, although not exposed, encapsulated by soft tissue and were easily removed with a surgical forceps. Twenty-eight analogues (88%) were healed-in by contact between bone and implant (osseointegration).(ABSTRACT TRUNCATED AT 250 WORDS)

Alveolar Process↗
PubMed1988

Computer-assisted densitometric image analysis in periodontal radiography. A methodological study.

A videobased computer assisted densitometric image analysis (CADIA) system to quantify alveolar bone density changes on standardized dental radiographs was tested. An algorithm was used for grey level correction of a subsequent image to the baseline image. Quantitative information regarding positive and/or negative grey level changes were obtained automatically. Comparison of the ability of CADIA to detect surgically induced bone loss with interpretation of digital subtraction images and conventional radiographic interpretation revealed that CADIA was the most sensitive of the 3 methods, followed by interpretation of digital subtraction images which was considerably more sensitive than conventional radiographic interpretation. CADIA was capable of assessing differences in alveolar bone changes due to periodontal surgery between sites exposed to ostectomy/osteoplasty and control sites and sites exposed to periodontal surgery without ostectomy/osteoplasty. Finally, CADIA was capable of assessing differences in remodeling activity over 4-6 weeks after periodontal surgery between 45 surgical sites and 45 control sites. The system offers an objective method to quantitatively follow alveolar bone density changes over time and appears to be the most sensitive of previously described radiographic interpretation techniques.

Absorptiometry, Photon↗
PubMed1988

Changing concepts of periodontal treatment: surgical and non-surgical.

Periodontal disease can be successfully treated by non-surgical procedures including supra- and subgingival scaling and root planing with hand or ultrasonic instruments. This non-surgical treatment is recommended for the initial management of all cases with the institution of a plaque control programme. Such management should be the basis of all periodontal therapy. The results obtained are mainly dependent on the skillfulness of the operator and the morphology of the pockets as well as upon patient related factors. Additional treatment, i.e. periodontal surgery, may be necessary if resolution of subgingival inflammation is not obtained. Pocket elimination by the use of surgical procedures (gingivectomy, flap operation with bone surgery) may be preferred in regions of the mouth where the aesthetic result is unimportant and where the removal of alveolar bone does not jeopardize the periodontal support of neighbouring teeth. In situations with deep infrabony pockets especially in anterior regions and in furcation areas a reconstructive surgical technique is the therapy of choice. Recent research in the field of guided tissue regeneration may, in the future, change the traditional approach to periodontal surgery.

Female↗
PubMed1987

Prevalence of periodontal disease in young diabetics.

In the present study, the frequency of sites exhibiting gingival inflammation and periodontal tissue breakdown was assessed in one group of 46 individuals (19-25 years old; test group T) who had suffered from diabetes mellitus (Type 1) for 10 years or more, and in another group of 41 non-diabetic controls (18-26 years old; control group C). Each individual was examined regarding oral hygiene status, gingival conditions, probing depths, probing attachment levels and gingival recessions. The interproximal marginal bone level was assessed in bitewing radiographs. No significant differences were found between the 2 groups regarding their oral hygiene status, frequency of sites with probing depths of greater than 3 mm and the position of the interproximal alveolar bone margin. The mean distance between the cemento-enamel junction (CEJ) and the interproximal bone crest was in group T, 0.91 +/- 0.14 (SD) mm and in group C, 0.95 +/- 0.18 (SD) mm. About 80% of the individuals in both groups were free from signs of marginal bone loss and only 1 subject in each group had greater than 6 sites with definitive bone loss. The group of diabetic patients had higher frequencies of inflamed buccal/lingual gingival units, gingival recessions and sites with attachment loss of greater than or equal to 2 mm. Most of the sites (85%) with attachment loss were located at the buccal and lingual surfaces. There were no significant correlations between the periodontal variables and the duration of diabetes, insulin dosage and HbA1 level. Individuals with both retinopathy and nephropathy had significantly more gingival inflammation than diabetic individuals without complications.

Adolescent↗
PubMed1987

Histologic characteristics of clinically healthy gingiva in adolescents.

Gingival biopsies from healthy buccal gingival units in 10 young individuals (12-14 yr) were analyzed morphometrically. The connective tissue was generally characterized by a dense collagenous network, apart from a well defined zone subjacent to the smooth and noninfiltrated junctional epithelium. This zone, which constituted on average 10% of the connective tissue volume, was less dense than the remaining part of the connective tissue and devoid of well defined collagen fiber bundles. This zone could also harbor clusters of inflammatory cells, mainly mononuclear cells, surrounded by non-infiltrated collagen-poor connective tissue. In the noninfiltrated collagen-dense mid-portion of the gingival connective tissue small areas of infiltrates could be found, the composition of which resembled that of the infiltrated areas subjacent to the junctional epithelium.

Adolescent↗
PubMed1987

Periodontal status and bruxism. A comparative study of patients with periodontal disease and occlusal parafunctions.

This study investigated a possible association between bruxism and severity of periodontal disease. Subjects consisted of 51 patients (mean age 47.3 years) referred to the Department of Periodontology for treatment of moderate to severe periodontal disease (Perio-group) and 40 patients (mean age 48.9 years) referred to the Department of Stomatognathic Physiology for treatment of symptoms related to bruxism (Bruxism-group). Examination of the two groups included measurements of the alveolar bone height, probing attachment level, tooth mobility, and attrition of teeth. A questionnaire was also used to gain information on the patient's awareness of bruxism and tooth mobility. Awareness of clenching and/or grinding was reported by 57% of patients in the Bruxism-group and 24% of patients in the Perio-group. The perio-patients reported significantly higher frequency of tooth mobility than did the bruxism-patients. Alveolar bone loss, attachment loss, and tooth mobility were significantly more pronounced in the Perio-group than in the Bruxism-group. The Bruxism-group showed a higher frequency of tooth attrition than the Perio-group. Periodontal disease and bruxism seldom occurred in the same individual, and the results indicate that the two phenomena are in general not closely associated.

Adult↗
PubMed1987

Mandibular dysfunction and periodontitis. A comparative study of patients with periodontal disease and occlusal parafunctions.

Fifty-one patients (mean age, 47.3 years) with moderate to severe periodontal disease and 40 patients (mean age, 48.9 years) with symptoms related to bruxism (occlusal parafunctions such as grinding and/or clenching of the teeth) were compared with regard to periodontal conditions and signs and symptoms of mandibular dysfunction. The bruxists reported more symptoms of pain and dysfunction of the masticatory system than the periodontal patients. The clinical dysfunction index was significantly higher among the bruxists, while there was a similarity between the groups in the variation of occlusal conditions, except for occlusal wear, which was more pronounced in the bruxist group. Attrition was in general positively correlated to alveolar bone height. This correlation was stronger (and statistically significant) for the canines than for other teeth. Attrition was negatively correlated to tooth mobility. It is concluded that patients with moderate to severe periodontal disease and patients with bruxism/occlusal parafunctions are distinctly different with regard to signs and symptoms of mandibular dysfunction. The results support the opinions that there is no or only weak correlation between periodontal disease and bruxism, and between bruxism and occlusal status.

Adult↗
PubMed1985

Longitudinal study of dental caries in individuals in Jönköping, Sweden, aged 15 years in 1973 and 20 years in 1978.

The aim of this investigation was to study caries development between the ages of 15 and 20 yr in the same individuals. Data concerning 100 adolescents constituted the basic material. Eighty subjects could be re-examined 5 yr after the first examination. The mean number of teeth per subject was 27.1 both in 1973 and in 1978. Four subjects (4%) in 1973 and three subjects (2.4%) in 1978 showed no decayed and/or filled proximal tooth surfaces. The prevalence of intact tooth regions was higher in the mandible than in the maxilla. Only one of the 73 subjects who were free from caries in the mandibular incisor/canine region at the basic examination developed new carious lesions in this region during the next 5-yr period. Analysis of the frequency distribution of the different caries diagnostic groups revealed that 32 subjects (40%) showed no change during the 5-yr period while 47 (58.7%) now belonged to a higher caries prevalence group. 3538 (80.7%) proximal surfaces were diagnosed as intact at the basic examination. The number of intact surfaces 5 yr later was 3107 (70.9%). In individuals with low and high numbers of decayed and/or filled surfaces, respectively, there was a tendency towards a more pronounced individual caries progression in the group that showed the highest caries prevalence at the basic examination than in the group showing a low caries prevalence.

Adolescent↗
PubMed1983

The effect of different levels of polishing of amalgam restorations on the plaque retention and gingival inflammation.

This study was performed to elucidate the effect of different levels of polishing of amalgam restorations as part of the treatment of patients with gingivitis and/or incipient periodontitis on plaque retention and gingival inflammation. The results indicate that contouring of restorations and removal of marginal overhangs using diamond tips and conventional finishing burrs is sufficient to permit adequate tooth cleaning and that further polishing using rubber discs, rubber tips and polishing pastes does not result in further improvement of gingival health.

Adult↗
PubMed1982

New attachment following surgical treatment of human periodontal disease.

The present experiment was undertaken to test the hypothesis that new connective tissue attachment may form on a previously periodontitis involved root surface provided cells originating from the periodontal ligament are enabled to repopulate the root surface during healing. A mandibular incisor with advanced periodontal disease of long standing (the distance between the cemento-enamel junction and the alveolar bone crest was 9 mm) was subjected to periodontal surgery using a technique which during healing prevented the dentogingival epithelium and the gingival connective tissue from reaching contact with the curetted root surface. Preference was hereby given to the periodontal ligament cells to repopulate the previously diseased root surface. After 3 months of healing a block biopsy containing the incisor and surrounding tissue was sampled. The histological analysis revealed that new cementum with inserting principal fibers had formed on the previously diseased root surface. This new attachment extended in coronal direction to a level 5 mm coronal to the alveolar bone crest. This finding suggests that new attachment can be achieved by cells originating from the periodontal ligament and demonstrates that the concept that the periodontitis affected root surface is a major preventive factor for new attachment is invalid.

Connective Tissue↗
PubMed1982

Longitudinal study of periodontal status in individuals aged 15 years in 1973 and 20 years in 1978 in Jönköping, Sweden.

The aim of this investigation was to study the periodontal status at the ages of 15 and 20 years in the same individuals. Gingival and periodontal data from 100 adolescents in 1973 constituted the basic material. Eighty subjects could be reexamined in 1978. The mean number of teeth per subject was 27.1 both in 1973 and in 1978. Three individuals in 1973 and two in 1978 had no bleeding gingival units. There was a decrease between 1973 and 1978 in the number of subjects with a high number of inflamed gingival units. The buccal and lingual surfaces also showed lower prevalence of gingivitis, while the proximal surfaces showed a slight increase in prevalence. The prevalence of surfaces with plaque in 1978 was decreased for buccal and lingual surfaces but slightly increased for proximal surfaces. Sixty-six individuals in 1973 and 71 in 1978 had no pocketing. Altogether 75 tooth surfaces with pocketing were diagnosed in 1973 and 21 in 1978. Most of the pockets were located at the proximal surfaces of the molars. Four individuals with infrabony defects in one to two sites were found in 1973 and five in 1978. No progression of the bony defects found in 1973 seemed to have occurred during the 5-year period. In spite of the frequent proximal areas with gingivitis, very few 20-year-olds showed signs of marginal bone loss, which indicates that gingivitis does not necessarily lead to destructive periodontitis in young people.

Adolescent↗
PubMed1981

Manifestations and treatment of periodontal disease in a patient suffering from cyclic neutropenia.

A case of severe periodontitis in a young man suffering from cyclic neutropenia is reported. The periodontal status as evaluated from oral radiographs at the age of 13 reveals advanced periodontal breakdown around the molars and the incisors in both jaws. At the age of 21, when clinical examination was performed, all teeth were found to be periodontally involved. The treatment was divided into three phases: (1) a causative treatment phase (oral hygiene phase) aimed at achieving the highest possible level of oral cleanliness, (2) a corrective phase including periodontal surgery and prosthetic rehabilitation and (3) a maintenance phase aimed at prevention of recurrence of periodontal disease. The oral hygiene phase was markedly extended both in time (2 years) and intensity. Several reexaminations were carried out during the course of this phase to evaluate the patient's ability to exercise proper plaque control and the response of the tissues to treatment. The progression of the periodontal disease could be arrested and the prosthetic treatment indicated was successfully performed. Following the corrective treatment phase a maintenance care program was designed including frequent recall appointments in order to prevent disease recurrence. Four years after active treatment no further periodontal breakdown could be observed as evaluated from pocket depth, attachment level and bone height measurements. The result of the treatment of this patient shows that treatment, designed to eliminate plaque infection, is effective also in an individual with defective host defense against bacterial infections, but the demand on the patient's cooperation must be extraordinary high as well as the demand on the effectiveness of the maintenance care program.

Adult↗
PubMed1981

Prevalence and distribution of gingivitis-periodontitis in children and adolescents. Epidemiological data as a base for risk group selection.

The aim of the present study is to analyze the prevalence and distribution of gingivitis and periodontitis in children and adolescents and thereby try to find guidelines for developing preventive programmes and selection of risk individuals. Gingival and periodontal data from 500 children, 100 children in each of the following age groups, 3, 5, 10, 15 and 20 years, constituted the material. About 50 per cent of the 3-year-olds and more or less all the children in the older age groups had visible plaque. The corresponding figures concerning gingival inflammation were 35 per cent of the 3-year-olds and 65 - 97 per cent of the older children and the adolescents. Pathologically deepend pockets were found in 17 per cent in the 15-year-olds and in 21 per cent in the 20-year-olds. Four individuals in the 15- and 20-year old groups showed clear signs of periodontitis. When the distribution of gingival inflammation and periodontal disease within the respective age groups was studied it was frequently found that a small number of children showed pronounud symptoms of disease. When the distribution of gingival inflammation within the dentition was analyzed it was found that in the primary dentition the highest prevalence of gingivitis was found at the lingual surfaces of the lower molars and the buccal surfaces of the upper molars. In the permanent dentition the highest prevalence of gingivitis was found on the molars of the upper and lower jaw. The prevalence of gingivitis increased on the proximal surfaces with increasing age. Concerning pathologically deepend pockets the occurrence in the 15-20-year-olds was restricted to the mesial surface of the first permanent molars.

Adolescent↗