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Biomedical subjects

P Gjermo

Publications and source records attributed to P Gjermo.

At least 37 records · Page 2Linked to original sources
PubMed1994

Microbiologic tests in epidemiologic studies: are they reproducible?

Microbiologic assessments are often included in longitudinal studies to elucidate the significance of the association of certain Gram-negative bacteria and the development of periodontal diseases. In such studies, the reliability of methods is crucial. There are several methods to identify putative pathogens, and some of them are commercially available. The purpose of the present study was to compare the reproducibility of four different methods for detecting Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia in order to evaluate their usefulness in epidemiologic studies. The test panel consisted of 10 young subjects and 10 adult periodontitis patients. Subgingival plaque was sampled from sites showing bone loss and "healthy" control sites. The four different methods for detecting the target bacteria were 1) cultivation, 2) Evalusite (a chair-side kit based on ELISA), 3) OmniGene, Inc, based on DNA probes, and 4) indirect immunofluorescence (IIF). The test procedure was repeated after a 1-wk interval and was performed by one examiner. Sites reported to be positive for a microorganism by any of the four methods at one or both examinations were considered to be positive for that organism and included in the analysis. The reproducibility of the four methods was low. The IIF and the cultivation methods showed somewhat higher reproducibility than did the commercial systems. A second test was done for Evalusite, three paper points for sampling being used instead of one as described in the manual. The reproducibility of the second test was improved, indicating that the detection level of the system may influence the reliability.

Adolescent↗
PubMed1994

Chlorhexidine use after two decades of over-the-counter availability.

Chlorhexidine (CHX) is a compound with plaque-inhibiting effects and available only by prescription in the United States. In Norway, however, CHX has been dispensed over-the-counter for over 20 years, and this study was undertaken to evaluate dentists' perceptions regarding its indications, usefulness, and side effects. A written questionnaire was sent to a sample of 10% of dentists registered in Norway, 78% of whom (354) responded. Additionally, representatives from 2% of all dental practices in Norway were contacted by telephone. Fourteen percent (14%) of the respondents reported that they never recommended CHX to their patients. Among those recommending the compound, 85% used it frequently after surgical periodontal procedures; 74% when treating acute gingivitis; 57% following oral surgery in general; and 35% during non-surgical periodontal therapy. It was used also as an adjunct to other treatment routines. Seventy-three percent (73%) reported frequent use of CHX when treating stomatitis and 54% in herpes simplex infections. As to side effects, 77% of the dentists indicated that staining of teeth, restorations, and the tongue was a major concern to patients; 12% reported inconveniences due to the bitter taste; and 6% reported other disturbances such as dryness of the mouth and development of oral ulcerations. The majority (94%) of the dentists recommended mouth rinsing, whereas 6% recommended a gel form. Only 4% of the dentists recommended rinsing with a patient-diluted 0.1% concentration, whereas 96% recommended the standard 0.2% formulation; 88% recommended using CHX mouthwash twice a day or more often.(ABSTRACT TRUNCATED AT 250 WORDS)

Chlorhexidine↗
PubMed1994

Incidence of early periodontitis in a group of young individuals during 8 years: associations with selected potential predictors.

The aim of the present study was to assess the incidence of early radiographic bone loss in a birth cohort over 8 years and to assess possible associations between incidence of bone loss and reported dental behavior, ethnic background, and previous orthodontic treatment. In a case control study comprising a proportion of the study population, the detection of black pigmented Bacteroides and Actinobacillus actinomycetemcomitans and their association with early radiographic bone loss was assessed. At the beginning of the study in 1984, there were 2,767 subjects. In 1992 sets of bite-wing radiographs were obtained from 215 subjects, who also filled out a questionnaire concerning their present and past dental behavior, ethnic background, and orthodontic treatment. Radiographic alveolar bone loss was recorded if the distance from the cemento-enamel junction to the alveolar crest exceeded 2 mm. Thirteen subjects (6%) showed new sites with bone loss over the 8-year period. Subgingival plaque was sampled from these 13 subjects and from 13 control subjects. None of the independent variables could be associated with the observed incidence of radiographic bone loss in this cohort, with the possible exception of the presence of A. actinomycetemcomitans which was detected in about 50% of the new sites with bone loss.

Adolescent↗
PubMed1994

CPITN as a basic periodontal examination in dental practice.

Diagnosis of a disease or condition in an individual may be defined as a conclusion which is reached following an evaluation of clinical, radiographic, laboratory and anamnestic information obtained by examination. No index designed for epidemiological purposes can be substituted for the careful process of reaching a diagnosis in an individual. However, in spite of arguments against its validity in this respect, CPITN has been suggested as a simple and quick screening tool for use in general dental practice. Several studies support this notion and that CPITN may assist in: assessing the goals for treatment, estimating the time and cost requirements, evaluating the results, and being useful in communication between dentists, specialists and auxiliary personnel. Modifications of CPITN for use with individuals have been launched in several countries which dentists and periodontists find useful and acceptable.

Communication↗
PubMed1993

Contemporary use of agents in the control of progressive periodontitis.

Mechanical treatment of periodontitis is effective in most cases. However, there are cases which respond poorly and in which chemotherapy may be appropriate. Topical antibacterials applied supragingivally have limited or no effect upon established periodontitis caused by subgingival plaque. Subgingival application of antibacterial agents have in some studies shown a certain effect upon the inflammatory response particularly when applied in addition to conventional mechanical treatment. Long term results are not convincing. Speculation that some forms of periodontitis may be regarded as specific infections have led to the use of antibiotics in the treatment of such conditions. The drugs most often recommended are tetracyclines and imidazoles, and there are reports indicating arrest or retardation of further disease progression when they are applied as an adjunct to conventional mechanical treatment. Recently, local application of antibiotics in slow release devices has been claimed to be effective in combating periodontitis. Data presented so far have mostly shown reduced inflammation, while the effect upon the progression of the disease remains largely unknown. There seems to be general agreement that use of antibiotics in some cases of periodontitis is advantageous, but only if it is used as an adjunct to scaling and root planing.

Anti-Infective Agents↗
PubMed1992

Comparison of the effectiveness of three different methods in detection of changes in gingivitis in the primary dentition.

The pattern of distribution and development of gingivitis is different in children and adults. Also the anatomy in the primary dentition is different from that in the permanent dentition. Indices to measure gingival inflammation and changes in this condition have been designed for the permanent dentition and may not necessarily perform adequately in the primary dentition. The purpose of the present study was to assess the association between indices commonly used in adults and to compare their ability to detect changes in gingivitis in children. The correlation between the Gingival Index and percent bleeding units (scores 2 and 3) was r = 0.93, while provoked bleeding from the interdental area correlated only weakly with the two. However, the non-bleeding papilla index seemed to more effectively detect changes in the gingival condition induced by professional cleaning. Since gingivitis usually is less severe in the primary dentition than in the permanent dentition, it may be of importance to use an index with high sensitivity in studies where effect of interventions is to be evaluated in children.

Child↗
PubMed1992

Changes in radiographic bone level in orthodontically treated teenagers over a 4-year period.

In 1984 the prevalence of subjects with radiographic bone loss was assessed in all 14-year-old schoolchildren in Oslo (n = 2767). An overrepresentation of subjects with bone loss was found among those undergoing orthodontic treatment. The aim of the present study was to assess the effect of orthodontic treatment on the prevalence and incidence of radiographic bone loss during the following 4-yr period. Bitewing radiographs from 1984, 1986, and 1988 of a sample of 438 subjects from the original population constituted the study material. Bone loss was recorded if the distance from the alveolar crest to the cementoenamel junction exceeded 2 mm. 111 subjects (25.3%) had received orthodontic treatment. In 1984, 18 of them (16.2%) exhibited bone loss. The corresponding figure for the 327 non-treated children was 14 (4.3%). The incidence of subjects with new tooth sites with bone loss among those with a record of previous orthodontic treatment was 1.1% and 3.2% in the periods 1984-86 and 1986-88, respectively. Among those who had never received such treatment the incidence figures were 3.2% in the period 1984-86 and 2.0% in the last period. The results indicated that the majority of the bone loss observed during or immediately after termination of orthodontic treatment was transient in nature.

Adolescent↗
PubMed1992

Antibiotic prescribing practices among Norwegian dentists.

There is scarce information on antibiotics prescription habits among dentists in general. The present investigation was undertaken to study some patterns of antibiotics prescription among Norwegian dentists. A total of 459 dentists (approximately 10% of Norwegian dentists) were randomly selected, and to each was mailed a letter describing the survey, accompanied by a questionnaire about age, type of practice, educational background and pattern of prescription of antibiotics. 78% of the dentists responded to these questions. The results indicate that during a typical week, 32% did not prescribe antibiotics, whereas 5% wrote greater than 5 prescriptions. The mean weekly number of prescriptions per dentist was 2.04. Periodontists and oral surgeons prescribed antibiotics significantly more often than did general practitioners and other disciplines. In addition, those with research and/or teaching experience seemed to prescribe significantly more often than those without. More than 1/3 of the sample indicated that they may prescribe antibiotics when treating periodontal diseases. Compared with other disciplines, periodontists prescribed such drugs significantly more often when treating periodontitis, but significantly less often in acute gingivitis, stomatitis and herpes simplex infections. Moreover, 22% of the dentists might prescribe antibiotics when the patient is in pain, 73 and 38% in cases of abscesses with or without generalized malaise, 2.5% in endodontic therapy, 60% to prevent general complications, and 68% for prophylactic use if the patient revealed a history of endocarditis. Norwegian dentists are somewhat restrictive in their prescription of antibiotics, but they mostly prescribe the correct drugs for the different conditions.

Anti-Bacterial Agents↗
PubMed1992

Association between detection of oral Actinobacillus actinomycetemcomitans and radiographic bone loss in teenagers. A 4-year longitudinal study.

The aim of the present study was to assess a possible association between radiographic bone loss and presence of Actinobacillus actinomycetemcomitans on the site and subject level over time. Forty-six teenagers with registered radiographic bone loss and 8 controls participated in the study, which began in 1984. In 1986 and 1988 new sets of bite-wing radiographs were obtained and examined for bone loss. Subgingival plaque was sampled from both diseased and contralateral healthy sites in the same individual. Only 15 of the 46 originally diseased sites persisted with bone loss in 1986, and 60% of these sites harbored A. actinomycetemcomitans. Of the 31 "healed" sites, 29% contained A. actinomycetemcomitans. The difference was statistically significant at P less than 0.05. Six of the contralateral healthy sites had developed bone loss during these 2 years and 50% of them contained A. actinomycetemcomitans, while 35% of the remaining contralateral sites harbored A. actinomycetemcomitans. The difference was not statistically significant (P greater than 0.05). The difference between patients with and without persistent bone loss regarding presence of A. actinomycetemcomitans was statistically significant in 1986; however, none of the observed differences were statistically significant in 1988. A. actinomycetemcomitans was found 2 to 3 times more frequently in patients with radiographic bone loss at all examinations than in "healthy" subjects. Detection of A. actinomycetemcomitans on the site level appeared to be a poor predictor of future radiographic bone loss.

Adolescent↗
PubMed1991

An in vivo model for the identification of serum proteins in the acquired subgingival pellicle.

The present study describes an in vivo model for the collection of the subgingival pellicle adsorbed to tooth surface, and the identification of some serum proteins within this layer. Clean dentin slabs were prepared from freshly extracted teeth, and then placed subgingivally for 2 h. The dentin slabs with their adsorbed pellicle layer were processed for transmission electron microscopy. Thin sections were made from the specimens, and treated with antisera to human immunoglobulins and albumin. The reactions were visualized by means of protein A-gold complex, which allowed semiquantification of the serum proteins. The indicator proteins were all identified within the pellicle material, but their amounts and distribution varied. Albumin demonstrated higher amounts in the pellicle layer than other proteins, followed by IgA, IgG, and IgM in descending order. The model described seems useful for studying the acquired subgingival pellicle under varying degrees of disease and health.

Adult↗
PubMed1991

Factors influencing the assessment of treatment needs.

Epidemiologic surveys have provided data for health planning by estimating prevalence and incidence of diseases in populations. New ways of presenting epidemiologic data on periodontal diseases have changed our understanding of their extent and severity, and conversion of prevalence data into treatment need estimates has proved difficult. Furthermore, new concepts of the pathogenesis of periodontal diseases have questioned the validity of epidemiologic methods currently used. Treatment need assessments vary considerably between studies even when prevalence data from the same populations are similar. This may be due to lack of described goals for periodontal health. Various aspects of the concept of need for treatment are discussed. It is suggested that periodontal treatment need on a population level is defined as the intervention needed in order to change the existing periodontal condition to the described goal. Thus, treatment need assessments will have to include descriptive epidemiologic data as well as defined periodontal health goals. It is recommended that goals are described in terms compatible with the indicators used in the epidemiologic description of the disease status.

Europe↗
PubMed1991

Antibacterial dentifrices. Clinical data and relevance with emphasis on zinc/triclosan.

The present review concerns the effect on plaque and gingivitis of some antibacterial dentifrices. The difficulties of including cationic agents in conventional dentifrice formulations are briefly discussed. The focus is on 2 recently introduced dentifrices with triclosan as the active ingredient. One aims at providing a slow release reservoir of triclosan in the oral cavity by delivering the substance dissolved in a lipophilic copolymer. 3-month results indicate a modestly improved effect on plaque and gingivitis compared to that of triclosan alone. Long-term studies are needed before conclusions on the clinical relevance can be drawn. The other dentifrice on the market utilises the principle of additive effects by combining triclosan and zinc citrate in the formulation. The combination appears to be more effective against plaque and gingivitis than either compound alone. Studies of up to 1 year duration indicate that the level of oral hygiene and gingival health obtained through an initial period of motivation and oral hygiene instruction can be maintained by regular use of the test dentifrice, while most subjects in the control group returned to pre-experimental levels. Microbiological monitoring indicates no major shifts in plaque ecology nor any development of resistant bacteria, and adverse side-effects have not been observed. It is concluded that the new approaches to chemical plaque control may be beneficial to the population at large, and thus of great clinical relevance.

Anti-Bacterial Agents↗
PubMed1990

Changes in periodontal disease indicators in 35-year-old Oslo citizens from 1973 to 1984.

Periodontal disease indicators were evaluated according to the periodontal treatment need system (PTNS) in random samples of 35-year-old citizens of Oslo in 1973 and 1984. The study indicated that although periodontal disease was a common finding in both samples, there was a significant reduction in score C (indicating need for complex periodontal treatment) in 1984 compared to 1973. Whereas 37.9% of the subjects showed inflamed pockets deeper than 5 mm (score C) in 1973, only 22.9% scored C in 1984 (non-Caucasians excluded). This reduction was most pronounced in females. The mean number of C-quadrants in subjects needing complex periodontal treatment was also reduced from 2.0 in 1973 to 1.7 in 1984. Further analyses of the 1984 sample showed that the mean number of C-quadrants was significantly lower in subjects with low OHI-S scores and in regular dental visitors, whereas sex, years at school, toothbrushing frequency, interdental cleaning habits, previous periodontal therapy, self-experienced need for treatment, health attitude or smoking habits, did not seem to influence the prevalence of score C.

Adult↗
PubMed1990

Associations between six DNA probe-detected periodontal bacteria and alveolar bone loss and other clinical signs of periodontitis.

The purpose of the present study was to assess the associations between the presence and amounts of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, B. intermedius, Eikenella corrodens, Wolinella recta, and Fusobacterium nucleatum in the periodontal pocket and the degree of alveolar bone loss and other clinical signs of periodonitis, such as probing pocket depth, attachment level, and presence of bleeding on probing at the same site. The study material comprised 16 subjects with or without approximal sites showing longitudinal alveolar bone loss who were selected from a group of 142 subjects monitored radiographically over the past 4 years. In this group 105 sites were examined, of which 58 showed recent alveolar bone loss greater than or equal to 1 mm. Subgingival plaque was collected with absorbent paper points and hybridized with 32P-labeled DNA probes specific for the above-mentioned bacteria. The amount of each bacterial species was correlated with the degree of bone loss over time and the three clinical measurements by means of Spearman rank correlation. A. actinomycetemcomitans showed poor correlations with all three clinical signs of periodontal inflammation, whereas B. gingivalis and W. recta demonstrated significant positive correlations with the three clinical measurements and with attachment level and pocket depth, respectively. In addition, the amount of A. actinomycetemcomitans, B. gingivalis and W. recta showed significant positive correlation with the extent of alveolar bone loss at the site. In contrast, the amounts of B. intermedius, E. corrodens, and F. nucleatum showed negative correlations with all four measurements.(ABSTRACT TRUNCATED AT 250 WORDS)

Actinobacillus↗
PubMed1989

Validity of CPITN's hierarchical scoring method for describing the prevalence of periodontal conditions.

CPITN has been a frequently used index in periodontal epidemiology during the last decade. It was originally designed to describe treatment needs in populations. For this purpose, it was decided to record only the worst periodontal condition around each index tooth. Such a recording procedure can be regarded as a hierarchical scoring method. Recently, CPITN has been used and recommended for describing the prevalence of periodontal conditions. For this purpose, the index should give a valid estimate of the true periodontal conditions of the index tooth, and not only a recording of the worst condition. The aim of the present study was to test whether the hierarchical assumption of CPITN concerning treatment needs was valid for describing the prevalence of periodontal conditions in a Scandinavian population. The study population comprised 3330 persons from a rural and an urban area in the county of Trøndelag, Norway. The clinical recording was carried out so that it was possible to analyze the indicators both hierarchically and non-hierarchically. The results showed that nearly all the CPITN indicators scored hierarchically gave a correct estimate of the prevalence of bleeding in the population. CPITN codes 3 and 4 overestimated the prevalence of calculus. The degree of overestimation varied by age and tooth type. Most overestimation of calculus occurred on molar teeth with pockets 3.5-5.5 mm and for individuals 13-14 yr of age. There was almost no overestimation of calculus for those aged 65 yr and above.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Pattern of caries experience in permanent molars in a 15-year-old African population.

Some epidemiologic studies from Africa report higher DMF values in second than in first molars. It is generally accepted that the maturation of dental enamel influences the susceptibility of teeth to caries. The purpose of the present study was to test the hypothesis that DMF values of second molars will be higher than those of first molars if the first molars have reached a high degree of maturation before being exposed to increased cariogenic challenge. The study was carried out in a group of 15-year-old students attending secondary schools in Botswana (n = 287). The results showed that in children who assumingly had had a traditional diet during childhood the DMF values were higher in second molars than in first molars. In children who grew up in a more urbanized setting, the results were opposite. The observed differences were due to differences in caries experience in first molars only. The DMF values of second molars did not vary among the groups. Oral hygiene, sugar consumption and knowledge level at age 15 seemed to have no effect upon the caries pattern studied. It is concluded that the results support the hypothesis tested.

Adolescent↗