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M K Jeffcoat

Publications and source records attributed to M K Jeffcoat.

At least 73 records · Page 4Linked to original sources
PubMed1992

Elastase as an indicator of periodontal disease progression.

THIS STUDY SOUGHT TO EVALUATE the ability of gingival crevicular fluid (GCF) elastase to predict attachment and bone loss in human periodontitis. Thirty subjects who were medically healthy and had a history of progressive periodontitis were studied with an automated probe. Five sites in each patient were monitored bi-monthly for a 6-month period for attachment loss. Subtraction radiography was utilized at the beginning and end of the study to monitor bone loss. GCF elastase was measured at 0 month and then bi-monthly by collecting GCF on paper strips impregnated with PMN leukocyte elastase substrate inserted into the gingival crevice for 15 seconds. After 8 minutes of reaction time, the strips were scored relative to fluorescent standards in an ultraviolet view box. Strips were then eluted in methanol and total elastase measured by spectrofluorometry. Total elastase was significantly higher in sites demonstrating progressive attachment loss than in inactive sites (2.81 +/- .29 versus 2.03 +/- .07, P less than 0.0005) and sites demonstrating bone loss (2.32 +/- .17 versus 2.01 +/- .08 P less than 0.05). When considering the joint presence of bone loss and attachment loss of 1.0 mm or greater in the 6-month period following a visual elastase kit score of 2 or greater, the test kit shows a sensitivity and specificity of 82% and 66%, respectively. This study demonstrated that GCF elastase levels are significantly higher in sites demonstrating progressive periodontal attachment and bone loss assessed 6 months later and may serve as a predictor of future bone and attachment loss.

Adult↗
PubMed1992

Radiographic methods for the detection of progressive alveolar bone loss.

Intraoral transmission radiographs have been the primary diagnostic method for the assessment of bone support as well as for the detection and measurement of osseous changes due to periodontitis. The purpose of the present paper is three-fold. The first is to review radiographic techniques for the assessment of periodontal disease progression, presenting the strengths and weaknesses of each method while placing special emphasis on digital subtraction radiography. The second purpose is to present data from a recent study that compared the ability of digital subtraction radiography and automated attachment level probing to detect the same active sites. Thirty periodontitis patients and eight control patients were studied over a 6-month period. The results indicate that when these two sensitive methods for the assessment of progressive periodontitis were used there was concordance between the presence or absence of probing attachment loss and bone loss in 82.1% of the sites. The final goal of this paper is to present future directions for the quantitative analysis of digital radiographic images.

Alveolar Bone Loss↗
PubMed1992

Digital subtraction radiography for the assessment of bone changes in rheumatoid arthritis.

A digital subtraction radiography (DSR) method was developed to assess changes of bony erosions in the hands of patients with rheumatoid arthritis (RA). The method initially was validated in vitro using simulated lesions in cadaver hands. The sensitivity, specificity and accuracy in detecting simulated lesions were 84.6, 100, and 92.3%, respectively. This technique was then pilot tested clinically using 17 patients with RA and 5 controls with no arthritis. All subjects received the nonsteroidal antiinflammatory drug, flurbiprofen, during the 6-month study period. No progressive changes in bone were observed in the control group; however, 18% of the target joints studied in the group with RA showed significant erosive changes (positive or negative) which correlated with the clinical assessment. The results indicate that DSR may be useful in detecting small changes in erosions on hand/wrist radiographs of patients with RA.

Adult↗
PubMed1991

Contrast enhancement as an aid to interpretation in digital subtraction radiography.

An initial study was performed to demonstrate the feasibility of pseudocolor contrast enhancement technique in digital subtraction radiography (DSR). DSR is an electronic image processing technique that has been shown to be of greater diagnostic value in the detection of small periodontal bone lesions than conventional radiography. Pseudocolor enhancement involves selectively assigning a unique color to each shade of gray present in a black-and-white subtracted image. Two image enhancement techniques were developed and tested in a phantom system consisting of extracted teeth set in blocks of plaster mixed with sawdust to simulate trabecular bone. It was found that experimentally induced periodontal lesions were more readily detected by the average clinician in both types of enhanced subtraction images than unenhanced subtractions. Furthermore, both enhancement techniques were of significantly greater diagnostic value for lesions smaller than 1.0 mm (p less than 0.001). The technique that colored an isolated area of interest was significantly more diagnostic at all depths tested (p less than 0.001 at 0.5 and 1.0 mm, and p less than 0.05 at 0.5 mm). Contrast enhancement may be a significant aid to the average clinician for the interpretation of DSR and the detection of small periodontal defects.

Chi-Square Distribution↗
PubMed1991

A periodontal probe with automated cemento--enamel junction detection-design and clinical trials.

An automated periodontal probe has been developed to measure pocket depth and attachment loss in a single measurement under controlled force conditions. A natural anatomic landmark, the cemento-enamel junction (CEJ), is used as a reference for attachment level measurements. The CEJ is detected automatically by immediate digital postprocessing of simultaneous measurements of probe tip acceleration and displacement during probing. Clinical trials in the beagle dog model for naturally occurring periodontitis have shown that the automated probe, when used with 35 g probing force, has a repeatability of 0.16 mm and a bias of 0.09 mm. These results indicate that the automated periodontal probe is capable of attachment level measurements with a high degree of repeatability and validity.

Animals↗
PubMed1991

Use of digital radiography to demonstrate the potential of naproxen as an adjunct in the treatment of rapidly progressive periodontitis.

The effect of the non-steroidal anti-inflammatory drug, naproxen, in reducing periodontal disease activity was assessed in 15 patients with rapidly progressive periodontitis. All patients in this double-blind study were treated with scaling and root planing. Thereafter, 7 patients receiving 500 mg naproxen b.i.d. for 3 months, and 8 patients received placebo. Disease activity was assessed in three ways. First, alveolar bone height was determined using standardized radiography. Second, alterations in alveolar bone metabolism were assessed using 99m-Tc-methylene diphosphonate uptake prior to dosing and 3 months later. Finally, bone loss or gain was detected using digital subtraction radiography. In this study, conventional subtraction images were processed to isolate the area of change and superimpose the change on the original radiograph. This allowed determination of both the direction and location of osseous changes. There was significantly less bone loss as determined by analysis of bone height during the 3-month study in the naproxen-treated patients when compared to the placebo-treated patients (p less than 0.001). Radiopharmaceutical uptake was significantly reduced in the alveolar bone in patients receiving naproxen (p less than 0.03), whereas no significant change was observed in the placebo-treated patients. Furthermore, the subtraction radiographs showed a significant increase in the proportion of teeth demonstrating bone gain in the naproxen-treated group. These findings indicate that naproxen may be a useful adjunct to scaling and root planing in patients with rapidly progressive periodontitis.

Adolescent↗
PubMed1991

Inhibition of alveolar bone loss in beagles with the NSAID naproxen.

The non-steroidal anti-inflammatory drug(NSAID) naproxen was studied in 11 beagle dogs over a 13-month period to determine its effect on the progression of periodontitis. Following a 6-month pretreatment period, 5 dogs received naproxen daily at a dosage of 2.0 mg/kg for 1 month, then 0.2 mg/kg for 6 months. Six control dogs received a gelatin capsule daily as placebo. Standardized radiographs were used to measure the rate of bone loss during the pretreatment and treatment periods. In the control dogs, the rate of bone loss was seen to increase during the treatment period although the increase was not statistically significant. In dogs treated daily with naproxen, the rate of bone loss in the treatment period was significantly less at 4 months of treatment; however, at 7 months the difference, though lower than pretreatment rate, was not significant. When the percent change in rate of bone loss during the overall 7-month treatment period was compared with pretreatment rate, the control dogs demonstrated a 38% increase in rate of bone loss during the treatment period contrasting with a 61% decrease in bone loss rate in naproxen-treated dogs. The data indicate that the non-steroidal anti-inflammatory drug naproxen can significantly inhibit alveolar bone loss in beagles. At 4 months of treatment the rate of bone loss in the naproxen-treated dogs was significantly less than pretreatment, but at 7 months of treatment the rate was no longer statistically significantly less than baseline. This probably reflects a dose response to naproxen treatment for, after 30 days of the treatment period, the naproxen dosage was reduced 10-fold due to tolerance by the beagle.

Alveolar Bone Loss↗
PubMed1991

Detection of periodontal disease activity with a scintillation camera.

The goal of this study was to assess the ability of a scintillation camera method to detect areas of active bone loss due to periodontitis. Technetium 99m methylene diphosphonate was used as the bone-seeking radiopharmaceutical. Bone-seeking radiopharmaceutical uptake (BSRU) was imaged and quantified in alveolar bone regions of interest with a scintillation camera and a computer. Analysis of the sequential radiographs over six months constituted the basis for determination of sites of active disease. The study was composed of two parts. First, 18 subjects, nine with adult periodontitis and nine controls, were enrolled in a cross-sectional study to determine whether the quantitative scintillation amera methodology detected differences in BSRU in periodontitis vs. periodontally healthy patients. Second, the nine patients with periodontitis were studied longitudinally in order to determine whether the BSRU examination was indicative of bone loss subsequently measured radiographically. In the cross-sectional study, the mean uptake ratio for the periodontitis group was significantly higher than that for the control group (1.63 +/- 0.06 and 1.42 +/- 0.04, respectively, p less than 0.01, t test). From the longitudinal study, the mean patient scintillation image uptake ratios were highly correlated with the mean bone loss determined from serial radiographs (p less than 0.01). The accuracy, sensitivity, and specificity of the quantitative gamma camera method for detecting site(s) of active bone loss within the region of interest were assessed relative to the longitudinal radiographic data. The accuracy, sensitivity, and specificity were 85%, 90%, and 79%, respectively. Alveolar bone scintigraphy with a gamma camera and computer may provide a simple and valid technique for the immediate indication of areas of periodontal disease activity.

Adult↗
PubMed1991

Progression of probing attachment loss in adult periodontitis.

Thirty patients with adult periodontitis were monitored using an automated periodontal probe for 6 months in order to determine the prevalence of active sites and the overall pattern of disease progression in active sites. The automated probe is capable of measuring probing attachment levels relative to the cemento-enamel junction with better than 0.2 mm of accuracy. The prevalence of disease activity was dependent on the threshold for probing attachment loss used. When the smallest threshold (0.4 mm) was used the prevalence of active disease was 29%, whereas a large threshold (2.4 mm) detected only 2% active sites. Regression analysis of the active sites revealed that 76% of the sites lost probing attachment consistent with a continuous model for disease progression. A small subset of sites demonstrated either bursts of activity or exacerbations and remissions of disease activity.

Aged↗
PubMed1991

Machines in periodontics.

The use of machines to assist the clinician in the assessment of periodontal support is not new. However, in the past five years great strides have been made in the use of electronics and computers to assist in the performance of routine tasks for the detection and diagnosis of periodontal diseases. The purpose of this paper is to review, compare and contrast three electronic periodontal probes which represent a range of technological complexity. The fundamental principles underlying these instruments and possible roles in practice will be outlined. Other technologies, such as digital subtraction radiography, direct digital radiography and tests for periodontal disease activity, will be briefly addressed.

Diagnosis, Computer-Assisted↗
PubMed1991

A comparison of probing and radiographic methods for detection of periodontal disease progression.

Over the last decade new technology has increasingly been applied to periodontal probing and radiography to result in diagnostic methods with greater resolution, repeatability, and accuracy. The goal of this paper is to discuss these methods with special emphasis on data published within the past year. Moreover, this paper summarizes the state of our current understanding of the usefulness of these methods in patient care and research.

Alveolar Bone Loss↗
PubMed1990

Assessment of adjunctive flurbiprofen therapy in root-form implant healing with digital subtraction radiography.

The goals of these case reports were to (1) apply digital subtraction radiography to the assessment of the healing of root-form implants so that small changes in bone height and density could be detected and (2) to compare the bony support around root-form implants in patients prescribed the non-steroidal anti-inflammatory drug, flurbiprofen, with support in patients who did not receive the flurbiprofen as adjunctive therapy. Titanium root-form implants were surgically placed in four patients who were randomly assigned to receive either 100 mg flurbiprofen twice a day for three months or no flurbiprofen (as controls). Radiographs were taken immediately post-operatively and at four months. Digital subtraction radiography was used to detect sites of bone gain, loss, or unchanged bone around the implant. This four-month pilot study suggests that the non-steroidal anti-inflammatory drug, flurbiprofen, appears to be associated with increased bone density surrounding dental implants, and that digital subtraction radiography may be useful for the evaluation of bone density changes around dental implants.

Bone Density↗
PubMed1989

Altering the progression of human alveolar bone loss with the non-steroidal anti-inflammatory drug flurbiprofen.

The treatment of human periodontal diseases relies on mechanical and antimicrobial suppression of the etiologic bacteria. The ability to alter the progression of periodontitis by additionally blocking host pathways involved in the destructive process is an area of current research. Prostaglandins and other metabolites of arachidonic acid are believed to be important host mediators of the bone resorption of diseases such as periodontitis. We have previously examined the effect of inhibitors of prostaglandin production, non-steroidal anti-inflammatory drugs (NSAIDs), on inhibiting alveolar bone loss in beagles. The present study was designed to examine the effect of the NSAID, flurbiprofen, on slowing the radiographic loss of alveolar bone in the human. Fifty-six individuals with radiographic evidence of alveolar bone loss were recruited for study. Forty-four patients remained in the study for the data analysis of loss of alveolar bone. Following a 6 month baseline pretreatment period to measure the radiographic progression of bone loss, half of the patients were administered flurbiprofen, 50 mg. b.i.d., while half were administered a placebo. All patients received a subgingival scaling and pumice by a hygienist every 6 months. The rate of alveolar bone loss in a 2 year treatment period was compared to the baseline 6 month pretreatment period within and between patient groups. Throughout the study, teeth exhibiting obvious loss of bone were exited from study and treated with conventional mechanical therapy. At the end of the pretreatment period both patient groups had a similar mean rate of alveolar bone loss.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Autoradiographic localization of technetium-99 methylene diphosphonate in growth sites of young mice.

Conflicting reports about the localization of 99mTc-MDP in bone and cartilage are found in the literature. Possible binding sites include hydroxyapatite and non-osteoid matrix such as immature collagen. The present study used autoradiographs of demineralized and non-demineralized growth sites in young mice to demonstrate localization of 99Tc-MDP, and consequently 99mTc-MDP, in mineralizing cartilage and bone. Uptake of the isotope was seen in mineralizing bone and cartilage, associated with the mineral in contrast to the organic phase. The results indicate that bone seeking radiopharmaceutical uptake (BSRU) may detect alterations in the rate of mineralized phase in growth sites and thus has the potential to disclose skeletal growth disorders.

Animals↗