Biomedical subjects
J D Manson
Publications and source records attributed to J D Manson.
The prevention of periodontal disease.
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Gingival inflammation and bone loss in periodontal disease.
Fifty subjects between 27 and 43 years of age were studied to determine the relationship between the severity of gingival inflammation, the amount of bone loss and the plaque score in interproximal sites. The results indicate moderately good correlations between Gingival Index or Plaque Index and percentage bone loss. However a low correlation was found between the amount of crevicular fluid and percentage loss. Gingival Index and Plaque Index were well correlated. It was also found that when patients were divided into two age groups, younger and older than 35 years, the older individuals studied had more bone loss interproximally compared with the younger despite comparable amounts of plaque or gingival inflammation. The data suggest that both severity and longevity of the inflammation may play a role in determining the rate of alveolar bone resorption.
The responsibility of the general dental practitioner in periodontal care.
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General anaesthesia for periodontal surgery.
A technique is described in which full-mouth periodontal surgery is carried out under general anaesthesia. The use of an endotracheal tube with inflatable cuff allows good visibility and access to all parts of the mouth unhampered by a throat pack; access is further improved by sloping the operating table foot-down. A system of haemorrhage control is used involving a combination of procedures: smooth anaesthetic induction and controlled carbon dioxide levels; intravenous injection of a fibrinolytic inhibitor (epsilon amino-caproic acid); foot-down tilt to the operating table and infiltration with local analgesic solution. The advantages and disadvantages of the technique are discussed.
Juvenile periodontitis (periodontosis).
Juvenile periodontitis, characterized by early age of onset, rapid rate of periodontal tissue destruction and selective tooth involvement in the absence of commensurate aetiological factors, is recognized as a distinct clinical entity. The present paper describes the clinical findings and some immunological characteristics in a group of thirty-four patients under the age of thirty. Clinical aspects studied included the influence of sex, race, family history and general health. Immunological findings relating to the level of immunoglobulins in serum and saliva, lymphocyte transformation in response to veillonella, bacteroides, fusobacterium and actinomyces species and to ultrasonicated plaque, and the inhibition of macrophage migration by these antigens. Differences were shown to exist between those patients below the age of 22 years and the group aged 23-29 years.
Subgingival plaque and loss of periodontal attachment in periodontosis as observed in autopsy material.
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Bone morphology and bone loss in periodontal disease.
A clinical study of the distribution of different types of bone defects in chronic periodontitis was carried out on 30 patients. An analysis of 176 defects suggests that their distribution reflects the original morphology of the alveolar bone. The role of function as a determinant of that morphology is examined. While there appears to be a relationship between functional stress and the phylogenesis of the bone, there is no direct relationship between function and ontogenesis. A study of growth remodelling of the mandible in several animals indicates that the pattern of activity is dictated by a drive to achieve a mature form which is the expression of the genetic endowment. Normal function and normal muscle stress are part of the environment in which complete growth can take place, but they do not appear to play a more active role in determining the form of growth; abnormal function does not allow normal growth to take place. The relationship between functional stress and the morphology and activity of the mature bone is not clear. Osteoporosis of age, as measured by the metacarpal index in 101 patients with chronic periodontitis, did not appear to be significantly related to the bone loss score. However, in 54 females patients, aged 35-45 years, a significant correlation was found between the metacarpal index and a "rapidity of bone loss" score.