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Biomedical subjects

J Egelberg

Publications and source records attributed to J Egelberg.

At least 19 recordsLinked to original sources
PubMed1996

Patterns of attachment loss in advanced periodontitis patients monitored following initial periodontal treatment.

2 main concepts seem to exist for the progression of periodontitis: (1) a slow continuous process of attachment loss; (2) periodic bursts of activity followed by quiescence or remission. This study addresses this problem and presents data for 69 sites having experienced a net loss of probing attachment amounting to > or = 3.0 mm over 42 months. The sites originated from 16 adult patients monitored after nonsurgical treatment of advanced chronic periodontitis. Probing attachment level recordings were obtained every 3rd month. The sequential probing attachment level data for each site were smoothed using cubic splines. Subjective evaluation of the raw and the smoothed data from the study sites suggested that the majority of the sites seemed to lose probing attachment in a continuous fashion, and over periods of 12 months or more. The smoothed curves were subjected to principal components analysis, which allowed the 69 sites to be ordered according to curve similarity. Nonparametric runs test failed to show that the shape of the curves for the sites was significantly associated with any of the following characteristics: patient, tooth type, tooth surface, initial probing depth, bleeding frequency, occurrence of suppuration, or a combination of inflammatory characteristics of sites.

Adult↗
PubMed1996

Reproducibility of clinical caries diagnoses on coronal and root surfaces.

Intra- and interexaminer reproducibility of clinical caries diagnoses was studied using 3 experienced dentists, who independently examined 20 patients twice at an interval of 2-6 weeks. The lesions were classified as one of the following four diagnoses: (1) initial active caries, (2) initial inactive caries, (3) manifest active caries, and (4) manifest inactive caries. For the various diagnoses, signs of cavitation, surface structure and discolouration were used. The reproducibility at a patient level was evaluated using intraclass correlation coefficients and at a surface level using kappa statistics. At a patient level, for the total number of lesions, the intraclass coefficients of correlation varied from 0.55 to 0.77. For the individual diagnoses, total manifest caries showed the highest coefficients of correlation, ranging from 0.73 to 0.92. At a tooth surface level, the kappa values varied from 0.29 to 0.61. The most common shift was that from any type of caries diagnosis to a diagnosis of a sound surface. There was little difference between the results for coronal and root caries and between initial and manifest lesions. Nor was there any difference for buccal + lingual surfaces only compared to all surfaces. Judging from the pattern of change in diagnosis between the repeated examinations, the main source of error seemed to be due to the fact that the lesions observed at one examination were overlooked at the other examination.

Adult↗
PubMed1995

Clinical indicators of probing attachment loss following initial periodontal treatment in advanced periodontitis patients.

16 advanced periodontitis patients were subjected to initial periodontal treatment and monitored every 3rd month during 42 months. Clinical characteristics at baseline and during the 42-month maintenance period were investigated for their association with probing attachment loss over the 42-month period, both on a patient level and on a site level. On a patient level, averaged full-mouth plaque and bleeding on probing scores over the maintenance interval showed little association with probing attachment loss. Little association was also observed for % sites with depth > or = 6 mm at baseline. However, a notable relationship was seen for % sites > or = 6 mm at 3 months. This finding initiated a separation of the 16 subjects into 2 groups based upon % sites > or = 6 mm at 3 months (groups 'high' and 'low'). Site level analyses for these groups showed little association between frequent presence of plaque at the sites over the maintenance interval and probing attachment loss. Frequent bleeding on probing showed limited relationship with attachment loss for group 'low', but an appreciable association for group 'high'. The findings suggest that advanced periodontitis patients with multiple residual probing depths > or = 6 mm at re-evaluation run a greater risk of developing sites with additional attachment loss than patients with few such residual depths. For such higher risk patients, bleeding on probing at maintenance examinations may be a useful indicator of subsequent deterioration at a site level.

Adult↗
PubMed1994

Clinical characteristics of periodontal sites with probing attachment loss following initial periodontal treatment.

Periodontal sites which had undergone probing attachment loss were identified in 16 advanced periodontitis patients subjected to initial periodontal treatment and monitored every 3rd month for 42 months. Many sites with probing attachment loss showed no increase in probing depth and bled on probing at a few of the examinations during maintenance. Others showed increase in depth, frequent bleeding and suppuration. An arbitrary classification of 'questionable periodontitis' sites was used and included sites with the following characteristics: probing depth at 42 months < or = 3.5 mm + bleeding on probing at no more than 5 of the 14 examinations 3-42 months + no suppuration on probing 3-42 months. The % sites in this category ranged from 21-35%, depending upon method used to determine probing attachment loss. Widely varying characteristics of sites identified with probing attachment loss were evident for all surface locations and all subgroups of initial probing depth. From a traditional viewpoint, a significant proportion of the losing sites might not have been afflicted with periodonitis. On the other hand, deterioration does not necessarily have to be coupled with obvious inflammation, particularly following therapy.

Adult↗
PubMed1994

Treatment of mandibular class III periodontal furcation defects. Coronally positioned flaps with and without expanded polytetrafluoroethylene membranes.

Twenty-six mandibular class III furcation defects were treated in 26 subjects using a regenerative therapy that included citric acid root conditioning, placement of freeze-dried decalcified bone allograft and coronally positioned flaps secured by crown-attached sutures. In addition to this therapy, expanded polytetrafluoroethylene (ePTFE) membranes were placed in 14 of the 26 defects. The effect of these therapies was evaluated after 52 to 60 weeks through a series of soft and hard tissue probing measurements including residual furcation classification. For both treatments, mean improvements were observed for furcal probing attachment levels, furcal bone levels, and defect volumes. However, only a few of these through-and-through defects had become closed as judged by a panel of 3 independent examiners. Four defects in each of the 2 treatment groups had changed from Class III to Class I/II or Class II/II evaluated with the soft tissue in place. One defect treated without membrane and 3 defects treated with membranes had changed from Class III to Class II as recorded after reflection of the soft tissues at re-entry. Little difference was observed between defects treated with and without membranes. Further studies with larger sample sizes and longer observation times are needed to fully evaluate these regenerative procedures and their potential for healing Class III furcation defects.

Adult↗
PubMed1993

Treatment of periodontal furcation defects. Coronally positioned flap with or without citric acid root conditioning in class II defects.

A total of 27 mandibular, buccal class II furcation defects were treated in 16 subjects using a coronally positioned flap procedure, with or without citric acid conditioning of the root surfaces. The effect of the therapies was evaluated from a series of soft and hard tissue measurements. Mean improvements were slightly greater for acid treated than for non-acid treated defects. However, none of the mean differences reached statistical significance, indicating that citric acid conditioning may not be a necessary part of the regenerative, coronally positioned flap procedure in mandibular furcations.

Acid Etching, Dental↗
PubMed1993

Marginal bone loss in the primary dentition of patients with juvenile periodontitis.

118 patients with juvenile periodontitis (JP), diagnosed when the patients were 13-19 years old, were studied retrospectively with respect to radiographic marginal bone loss in the primary dentition, experienced when the patients were 5-12 years old. 168 other 13-19 year old patients without any signs of bone loss in the permanent teeth were used as a reference group. The JP patients were classified into 2 groups according to the number of sites with bone loss in the permanent dentition: JP group I having 1 site with bone loss (n = 45) and JP group II having > or = 2 sites with bone loss (n = 73). It was found that 35 patients (52%) of JP group II displayed 1 or more sites with bone loss in the primary dentition during the age of 5-12 years. The corresponding numbers for JP group I and the reference group were 9 (20%) and 8 (5%) respectively. These findings indicate that juvenile periodontitis, at least in some individuals, may have its onset already in the primary dentition.

Adolescent↗
PubMed1991

Periodontal repair in dogs. Effect of heparin treatment of the root surface.

Studies on periodontal repair to denuded root surfaces have suggested that initial clot adhesion to the root surface may be important for the nature of subsequent healing. To study this hypothesis, circumferential periodontal defects, approximately 5 mm in vertical dimensions, were surgically created and immediately treated around the mandibular premolars in 4 beagle dogs. Prior to wound closure, the root surfaces were treated with either the anticoagulant heparin or with saline. Tissue blocks were obtained at sacrifice 4 weeks after surgery. Histometric analysis showed that connective tissue repair to the root surface averaged 50% of the defect height for heparin-treated teeth as compared to 95% for saline-treated teeth. Junctional epithelium amounted to an average of 33% of the defect height in heparin-treated teeth in contrast to 5% following saline treatment. It can be concluded that heparin treatment of the root surface compromises connective tissue repair, confirming clot adhesion as one prerequisite for connective tissue repair of periodontal defects.

Alveolar Bone Loss↗
PubMed1991

Periodontal repair in dogs: effect of root surface treatment with stannous fluoride or citric acid on root resorption.

This study evaluated healing, with emphasis on root resorption, following root surface treatment with 1% aqueous stannous fluoride (SnF2), saturated citric acid (CA), or saline control (C) in conjunction with periodontal flap surgery. Supraalveolar periodontal defects were surgically created and immediately treated in the mandibular premolars in 6 beagle dogs. The defect height approximated 5 to 6 mm from the reduced alveolar bone to the cemento-enamel junction. Root treatments were rotated between experimental teeth within jaw quadrants and duplicated in left and right quadrants in the dogs. Flaps were raised to cover most of the crowns of the teeth and sutured. The dogs were sacrificed 12 weeks after surgery and tissue blocks with teeth and adjacent structures were processed for histometric analysis. SnF2-treated teeth healed with significantly longer junctional epithelium, less connective tissue repair to the root surface, and less bone regeneration than CA and C-treated teeth. New cementum formation was limited in all treatment groups. Root resorption was observed in almost all teeth exhibiting connective tissue repair, however to a lesser amount and not as frequent in SnF2 treated teeth due to limited connective tissue repair. No differences were found in amount and frequency of root resorption in CA and C-treated teeth. An inhibitory effect on root resorption of SnF2 could not be disclosed in this experiment, however, it may be concluded that CA treatment of the root surface in conjunction with reconstructive periodontal flap surgery does not seem to enhance root resorption.

Alveolar Process↗
PubMed1990

Connective tissue repair in circumferential periodontal defects in dogs following use of a biodegradable membrane.

A biodegradable polylactic acid membrane was evaluated for its ability to enhance periodontal regeneration. In 8 Labrador dogs, circumferential defects were created around the maxillary 1st premolars. The defects were combination "1-wall vertical and horizontal". A membrane was adjusted to cover the defect on one side of the jaw, while the contralateral tooth served as control without membrane. After 3 months, healing was evaluated histologically. The results demonstrated that the amount of connective tissue repair with newly formed cementum approximated 50% of the defect height for both test and control groups. Thus, no advantage to the use of membrane was found, which is contradictory to the findings of our previous dog study using the same biodegradable membrane. The possible reasons for this difference in results are discussed relative to suggested mechanisms for membrane effects in periodontal regeneration.

Alveolar Process↗
PubMed1990

Effect of root debridement on the elimination of Actinobacillus actinomycetemcomitans and Bacteroides gingivalis from periodontal pockets.

The aims of this 6-month longitudinal study were: (1) to investigate to what extent root debridement of pockets in adult periodontitis will reduce the subgingival presence of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis and some other bacterial groups; (2) to relate the microbiological results following debridement to clinical measurements of healing. 16 patients and a total of 111 periodontally involved sites with probing depth greater than or equal to 6 mm served for the study. Duplicate subgingival microbial samples and duplicate clinical recordings were obtained 1 week apart at baseline and at 6 months following supra- and subgingival debridement. The results demonstrated reductions of the mean total viable counts and reductions of the mean counts of several of the cultured groups of micro-organisms coupled with significant improvements of mean clinical measurements. B. gingivalis was eliminated from a majority of infected subgingival sites. A. actinomycetemcomitans, on the other hand, still remained after therapy in a high proportion of sites initially infected with this microorganism. Subgingival persistence of A. actinomycetemcomitans appeared to be associated with a reduced healing response following debridement. Further studies are needed to clarify why A. actinomycetemcomitans is poorly eliminated following debridement. Also, the long-term clinical significance of the subgingival perseverance of A. actinomycetemcomitans needs to be elucidated.

Actinobacillus↗
PubMed1990

On the inability of root debridement and periodontal surgery to eliminate Actinobacillus actinomycetemcomitans from periodontal pockets.

In a previous study, we observed that root debridement was inefficient in eliminating Actinobacillus actinomycetemcomitans from adult periodontitis lesions. The present report describes the effects on A. actinomycetemcomitans of subsequent treatments of 6 patients that had at least 2 separate sites still harboring A. actinomycetemcomitans 6 months following debridement. 1 site or more in each individual was treated with renewed root debridement and at least 1 other site was treated by surgical excision of the gingival tissue. The results indicated that retreatment with either repeated root debridement or with surgical excision of the gingival tissue was not more effective in eliminating A. actinomycetemcomitans than initial debridement. The possible reasons for this limited therapeutic effect on the subgingival presence of A. actinomycetemcomitans are discussed.

Actinobacillus↗
PubMed1990

5-year follow up of periodontal intraosseous defects treated by root planing or flap surgery.

Intraosseous, periodontal defects in 12 subjects initially treated by root planing alone (21 defects) or by flap surgery (21 defects) were monitored during a 5-year postoperative interval. Maintenance therapy during this interval was limited to reinforcement of oral hygiene and tooth polishing every 6 months. No subgingival instrumentation was performed at the defect sites. Longitudinal clinical measurements demonstrated that surgically-treated lesions responded with somewhat more reduction of probing depth and more gain of probing bone level than root-planed lesions. Mean gains of probing attachment level were similar for the 2 treatments. Some relapse of the clinical conditions could be observed towards the end of the 5-year observation interval compared to the results at year 1 and year 2. However, the majority of defects subjected to either treatment showed 60-month recordings of probing attachment and probing bone levels equal to or slightly improved compared to those at baseline. Counts from cultures of subgingival, microbial samples were obtained at 42, 48 and 60 months. No significant difference between the 2 therapies was observed for the investigated groups of micro-organisms.

Adult↗
PubMed1990

Reproducibility of microbiological samples from periodontal pockets.

Duplicate microbiological samples, were taken 1 week apart using the paper point technique from a total of 112 untreated periodontal pockets greater than 6 mm deep in 16 adult periodontal patients. Duplicate samples were also obtained from these sites 6 months following a therapy of oral hygiene instruction and supra- and subgingival debridement. The reproducibility of the total viable counts and the reproducibility of the proportions of various groups or species of microorganisms were studied from these duplicate samples. The results demonstrated an acceptable degree of reproducibility for the recovery of Actinobacillus actinomycetemcomitans and Bacteroides gingivalis. For the total viable counts and for the other investigated bacterial groups, including Bacteroides intermedius, unacceptable levels of reproducibility were observed.

Actinobacillus↗
PubMed1990

Antimicrobial irrigation of periodontal furcation lesions to supplement oral hygiene instruction and root debridement.

The purpose of the present study was to evaluate the effects of subgingival irrigations with tetracycline as a supplement to mechanical plaque control and root debridement on clinical conditions of periodontal furcation pockets. 20 subjects with molar teeth having furcation pockets of varying depths and different grades of furcation involvement served for the study. Following oral hygiene instruction and root debridement at baseline, test teeth were irrigated subgingivally by a professional with a solution of 50 mg/ml of tetracycline, and control teeth with saline every 2nd week for 3 months. Records of dental plaque, bleeding on probing, probing depth and probing attachment level were obtained at 0, 1, 2, 3, 6, 9 and 12 months. The results failed to demonstrate any significant differences between test and control teeth for any of the subgroups of furcation sites at any observation interval. It is suggested that future studies may need to be performed over longer periods of time, and that the antimicrobial agents may need to be administered in vehicles, which provide prolonged periods of active subgingival concentrations.

Debridement↗
PubMed1990

Scores of plaque, bleeding, suppuration and probing depth to predict probing attachment loss. 5 years of observation following nonsurgical periodontal therapy.

The purpose of the present study was to determine the diagnostic value of clinical scores of supragingival plaque, bleeding, suppuration and probing depth to predict probing attachment loss in patients on maintenance following nonsurgical periodontal therapy. Non-molar teeth in 39 subjects were monitored and the above scores were repeatedly obtained throughout 5 years of observation following initial treatment. Probing attachment loss between 0-60 months was determined by a combination of linear regression analysis and end-point analysis. The results revealed that all the investigated scores were associated with probing attachment loss. This association was demonstrated by improved diagnostic predictability along with increased frequency or magnitude of the various scores. Also, the diagnostic predictability improved with increase in length of time for recording of the scores. The diagnostic predictability of either accumulated plaque scores and accumulated bleeding scores reached a maximum of about 30%. Residual probing depth greater than or equal to 7 mm reached a predictability of around 50% and increase in probing depth greater than or equal to 1.0 mm reached about 80% after 60 months. Thus, of the clinical scores investigated, increase in probing depth was found to be most valuable in predicting probing attachment loss.

Adult↗
PubMed1990

Diagnostic predictability of scores of plaque, bleeding, suppuration and probing depth for probing attachment loss. 3 1/2 years of observation following initial periodontal therapy.

Recordings of supragingival plaque, bleeding, suppuration and probing depth were obtained for 42 months following initial periodontal therapy. Scores accumulated after various time intervals during monitoring were studied for their predictive value in revealing probing attachment loss as determined by regression analysis during the 0-42 month period. Accumulated plaque scores demonstrated low predictability. Accumulated bleeding scores showed modest predictive values. Suppuration on probing was not a frequent finding during the observation interval and also had modest predictive power. Increase in probing depth compared to baseline and deep residual probing depth had modest predictability after 3 and 12 months, but showed increasing accuracy in revealing probing attachment loss over later time intervals. After a few years of maintenance, increase in probing depth, particularly if combined with high frequency of bleeding on probing, showed the highest predictive value for probing attachment loss of the scores examined.

Adult↗