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Biomedical subjects

P Gjermo

Publications and source records attributed to P Gjermo.

At least 55 records · Page 3Linked to original sources

The effect of chlorhexidine supplementation in a periodontal dressing.

Most commercial periodontal dressings claiming antibacterial activity lose this activity shortly after application. Chlorhexidine (CH) is an antibacterial agent with long-term activity in the oral cavity owing to its substantiveness and slow-release properties. In a double-blind split-mouth-designed clinical trial the effect of incorporating CH acetate in periodontal dressing was tested on wound healing after gingivectomy. Eleven patients, each needing at least two gingivectomies, constituted the test panel. Wound healing, as assessed by bleeding tendency after removal of dressing 7 days postoperatively was significantly delayed when control dressings were applied as compared with test dressings. Variables with regard to patient comfort also yielded results in favor of the test pack. Incorporation of antibacterial agents with high retention and slow release properties in the mouth in surgical dressings seems advantageous.

Adult↗

Variation in prevalence of radiographic alveolar bone loss in subgroups of 14-year-old schoolchildren in Oslo.

The aim of the present study was to assess the prevalence of radiographic alveolar bone loss, as related to selected background variables in 2767 14-year old schoolchildren. Bone loss was recorded when the distance from the cemento-enamel junction to the alveolar crest exceeded 2 mm. The radiographs were magnified approximately 10 times. 3% of the subjects and 18.5% of the sites were excluded because of indistinct radiographic reference points. Radiographic bone loss was found in 4.5% of the subjects. Horizontal lesions were more prevalent than vertical defects. Most subjects with bone loss had 1 (75%) or 2 (22%) lesions. No subject was diagnosed with juvenile periodontitis kind of lesion. The prevalence of bone loss depended on the variables sex, orthodontic treatment and ethnic background.

Adolescent↗

Clinical management of prepubertal periodontitis in 2 siblings with Papillon-Lefèvre syndrome.

The development of prepubertal periodontitis in Papillon-Lefévre syndrome (PLS) has been studied in 2 siblings, 12 and 8 years of age, since they were 5 and 3 years of age, respectively. Results of the treatment which comprised mechanical and chemical plaque control as well as systemic tetracycline medication, are reported. Extraction of temporary teeth, resulting in edentulousness prior to eruption of permanent teeth in the youngest child seemed to prevent destructive periodontitis from developing in the permanent dentition. After institution of continuous tetracycline medication in the oldest child at the age of 10 years, periodontitis with attachment loss did not occur in new sites. The possible rôle of specific micro-organisms in the progression of PLS-periodontitis is discussed.

Aggressive Periodontitis↗

The effect of 2 teaching programs on the gingival health of 15-year-old schoolchildren.

The present study evaluated the effect of 2 different dental health education programs on schoolchildren's gingival health and identified the subgroups best reached with these programs. The traditional program was the same as the yearly recurrent Dental Health Week (DHW)--comprising an informational package submitted to the teachers. The comprehensive program was in addition to the DHW-package, based on principles in social learning theory and research. Data from 15 schools in 5 municipalities, comprising 1167 students, were used. 1/3 of the children made up a reference group. Each subject was clinically examined 3 weeks before and 3 weeks after the intervention, and rated by using the non-bleeding papillae index (NBP). A questionnaire was completed by each of the 15-year-olds at the time of the second examination. The overall increase in NBP-index scores was from 38.9% to 43.1% in the traditional program and from 45.4% to 52.1% in the comprehensive one. The difference between the programs was not significant. After adjusting for social status variables, sex and initial bleeding, an effect of the comprehensive program appeared (p less than 0.01). The strongest effect of the comprehensive program was found among the schoolchildren with poor initial gingival health. Our findings support the theory of active participation, visualization and involvement of parents.

Adolescent↗

Bacteriophage infection--a possible mechanism for increased virulence of bacteria associated with rapidly destructive periodontitis.

We have recently isolated several groups of bacteriophages infecting Actinobacillus actinomycetemcomitans from periodontal lesions in patients with rapidly destructive periodontitis. Bacteriophage infection of these bacteria in these patients was restricted to periodontal pockets showing radiographic evidence of recent bone loss and suggests an association between phage-infected A. actinomycetemcomitans and active periodontal disease. On the basis of the biological activity of bacteriophages we propose a working hypothesis to explain the mechanism by which a phage may increase bacterial virulence in periodontal disease.

Actinobacillus↗

Chemotherapy in juvenile periodontitis.

Juvenile periodontitis has been described as a separate entity among the human periodontal diseases. Several forms of the disease based on the number and types of involved teeth as well as the age of the patient have been reported. The present review deals with the "classical" localized juvenile periodontitis (LJP). The etiology of LJP has been explained according to 3 theories: (1) a genetic (hereditary) defect in the host defense mechanism; (2) a specific infection; (3) a combination of 1 and 2. In all 3 alternatives, bacterial infection is the direct cause of the breakdown of the tissues. This is supported by reports of success following therapy aimed at eliminating the microbial challenge. Arguments favoring the use of chemotherapeutic agents as an adjunct to mechanical debridement, or instead of it, as well as arguments against such use are discussed. The conclusion seems to be dependent on which of the 3 theories of etiology the arguments are related to. If antibiotics are to be used, the choice of drug would depend on the sensitivity of the suspected pathogen(s). At present tetracycline seems to be the one suggested by most authors, but routine use of antibiotics in the treatment of LJP does not seem necessary and is not recommended.

Aggressive Periodontitis↗

Radiographic quantification of alveolar bone level changes. A 2-year longitudinal study in man.

The "random burst" theory has recently been proposed as an explanation of the pattern of periodontal disease progression. The theory predicts that the progression of bone loss at individual sites is not dependent upon previous bone loss and age. A longitudinal radiographic study was designed to test this hypothesis, and to describe the changes in bone level over 2 years in a group of 180 subjects (18-68 years of age) who were not under systematic periodontal treatment. The results indicated that 94% of the sites did not show significant changes in the alveolar bone level during the observation period. The mean annual bone loss for the total population was 0.11 mm. By regressing longitudinal bone loss upon age, it was shown that the rate of bone loss increased rapidly between 33 and 56 years of age while a different pattern was shown for the age intervals 18-32 and 57-68 years. Also, the rate of bone loss increased with increasing initial bone loss. This was less evident in the oldest age group. It was concluded that the progression of bone loss in the present material is consistent with a "burst" theory. However, the progression did not occur randomly with regard to previous loss of alveolar bone and time.

Adolescent↗

Periodontal conditions, remaining teeth and oral hygiene habits in a group of Vietnamese refugees in Norway.

Since 1975, about 3500 Vietnamese refugees have come to Norway. The purpose of the present study was to report on remaining teeth and periodontal conditions in a population of 200 adolescent and adult Vietnamese refugees. The mean number of remaining teeth ranged from 27.8 in the youngest age group to 24.6 in the oldest. This number of teeth is slightly lower than reported from Norwegian populations, but similar to other Asian populations. Almost all index teeth showed dental plaque, and subgingival calculus was observed in 9 of 10 teeth after the age of 20. Gingival bleeding was seen on all index sites of 26.5% of the subjects and all subjects above the age of 40 had gingivitis adjacent to one or more index teeth. There was a progression of probeable pocket depths with increasing age. In the oldest age group, 72.7% had pockets between 3.5 mm and 5.5 mm. The data indicated that if optimal conditions should be obtained, substantial resources would be required. In populations with limited resources and with relatively few subjects with severe periodontal breakdown, it is suggested that an identification of subjects "at risk" to be dentally handicapped through loss of teeth, should be a priority.

Adolescent↗

Comparison between standardized periapical and bitewing radiographs in assessing alveolar bone loss.

Readability and alveolar bone level were compared in 455 sets of standardized radiographs each consisting of four periapical (PA) and two bitewing (BW) films. BW radiographs showed significantly higher proportions of unreadable sites in the canines and the mesial surface of first premolars (P less than 0.0001), while PA radiographs exhibited significantly higher proportions of unreadable sites in the distal surface of second molars (P less than 0.0001). Alveolar bone level was assessable in a total of 10016 sites, and the comparison showed identical readings in 82% of the sites. In the maxilla, a significantly higher proportion of sites exhibited larger bone loss measurements (P less than 0.0001) and more sites with significantly higher mean values (P less than 0.005) in BW than in PA films. Mandibular sites showed the opposite trend. The majority of the sites revealed a Pearson's correlation coefficient (r) ranging between 0.60 and 0.82. No significant difference between mean bone loss measurements in the two types of radiographs for all the sites was found. It was concluded that the two radiographic techniques may be used interchangeably in epidemiologic studies.

Adolescent↗

Chemical and morphological studies of the acquired pellicle formed subgingivally on dentin in vivo.

The morphological appearance and chemical composition of the subgingival pellicle were studied, using Auger analysis and scanning and transmission electron microscopy. A pellicle was formed on pieces of dentin (2 X 2 X 1 mm), prepared from freshly extracted teeth after root planing. The dentin slabs were inserted for 2 h into healthy gingival sulci. Control slabs cemented supragingivally were used for comparison. The results confirmed the presence of an organic film on the surface of all slabs. Auger analysis of the organic film showed the presence of Ca in the supragingival integument but not in the subgingival integument. The subgingival pellicle was in all cases thicker than the supragingival pellicle. The transmission and scanning electron microscopy observations confirmed the presence of a film essentially free of bacteria on the subgingival specimens and also indicated a possible morphological difference between the supra- and sub-gingival pellicle.

Dental Deposits↗

Prevalence of bone loss in a group of Brazilian teenagers assessed on bite-wing radiographs.

Bite-wing radiographs were used to assess periodontal disease in 304 Brazilian 15-year-old schoolchildren from a population with a low socioeconomic status. The criterion for destructive periodontitis was a distance from the cementoenamel junction to the alveolar crest greater than 2 mm. 90 subjects were excluded, mainly due to missing first molars. Bone loss was diagnosed in 28% of the subjects. More males than females were affected. 50% of all lesions were observed adjacent to first molars. The juvenile periodontitis type of lesion was found in 8 subjects. It was concluded that in young populations bite-wing X-rays seem to be valuable in screening for individuals with incipient bone loss as well as for identification of subjects with juvenile periodontitis. In community programs regular use of this kind of roentgen examination is therefore recommended.

Adolescent↗

Periodontal bone loss in 15-year-old Norwegians.

The prevalence of marginal bone loss was determined on bite-wing radiographs in 2,409 15-year-old schoolchildren living in the country of Buskerud, Norway. Radiographs were collected from all dentists in the area participating in the Public Dental Service. A distance exceeding 2 mm from the cementoenamel junction to the alveolar crest was recorded as bone loss. Bone loss around one or more teeth was found in 11.3% of the subjects. More males than females were affected, with prevalences of 13.7 and 9.0%, respectively. Most of the lesions were observed adjacent to the maxillary first molars. Overt infrabony pockets were found in only a very few cases (0.5%). A clinical examination of 31 of the subjects could not distinguish those with and those without bone loss. The present study has demonstrated that alveolar bone loss is a common finding in 15-year-old school children. It is concluded that bite-wing roentgenograms may be useful in the detection of early bone lesions in young individuals.

Adolescent↗

Comparison of the effect of chlorhexidine and CuSO4 on plaque formation and development of gingivitis.

Recent studies have shown that several metal ions inhibit plaque formation and reduce the acidogenicity of dental plaque. The aim of the present study was to compare the effect on plaque and gingivitis of 2.2 mM CuSO4 with an equimolar solution of chlorhexidine in a modified experimental gingivitis model. The study was performed according to a double-blind cross-over design. Before each experimental period the GI was recorded and the participants' teeth were scaled and polished to remove all supragingival deposits. All mechanical oral hygiene was suspended during the experimental periods. The mean PII after rinsing with chlorhexidine, CuSO4 and water was 0.29, 0.79 and 1.25, respectively. The corresponding GI values were 0.57, 0.83 and 1.02. All differences were statistically significant. The results showed that CuSO4 inhibits plaque formation and development of gingivitis, but not to the same degree as chlorhexidine.

Adult↗

Application of the Community Periodontal Index of Treatment Needs (CPITN) in a population of young Brazilians.

Recently WHO has launched an index for assessing the periodontal treatment needs of a population in terms of resources required. This Community Periodontal Index of Treatment Needs was applied in 308 Brazilian 15-yr-old schoolchildren from a population with a high prevalence of periodontitis. The results showed that all subjects needed some kind of care. Totally, 4133 time units were required. Most of the time needed was for motivation and instruction in oral hygiene, and scaling. Several individuals assigned for complex treatment due to pockets deeper than 5.5 mm showed no signs of radiographic bone loss, and in the cases with bone loss, the lesions were few and small. The CPITN therefore seemed to overestimate the need for treatment in this young population. To overcome this problem, it was suggested that complex treatment should not be included in planning of systematic periodontal care for young populations, and that subjects with true periodontal lesions should be given priority in community programs.

Adolescent↗

Study of tooth loss in an adolescent Brazilian population.

Data concerning tooth loss in developing countries may indicate the dental health status in young people and serve as baseline data for evaluation of future dental health programs. The study population consisted of 304 schoolchildren (145 males, 159 females) from Belo Horizonte, M.G. Brazil. The mean age was 14.5, ranging from 13 to 16 yr. The number of teeth already lost and teeth indicated for extraction were assessed from two posterior bitewing radiographs and one frontal color photo which were obtained from all participants. The results showed that 2/3 of the studied population had lost one or more permanent teeth. The average number of missing teeth was 1.8 in both males and females. Of the various teeth, the mandibular first molars had most frequently been lost. Differences between the sexes concerning amount and pattern of lost teeth were small.

Adolescent↗

Associations between gingivitis, pocket depths, and radiographic bone loss in interproximal areas in young adults.

Fifty-five 15-yr-old Brazilian students were selected on the basis of presence or absence of radiographic bone loss. One hundred and fourteen sites were selected, representing areas with and without bone loss, with varying degrees of inflammation and pocket depths. The association between the parameters were evaluated on a site by site basis. Areas with deep pockets more often showed severe inflammation and bone loss than did areas with shallow pockets. However, deep pockets often occurred where no bone loss could be detected radiographically. In this age group clinical assessments seem to overestimate the prevalence of destructive periodontitis, and should be supplemented with radiographic examination for screening purposes and for identification of risk subjects.

Adolescent↗

Effect of chlorhexidine mouthrinses on concentration of IgA in expectorates.

Secretory IgA is usually found in high concentrations in the mucin layer of the oral mucosa. Chlorhexidine (CH) has been shown to precipitate mucin and may thus reduce the amount of IgA available in the oral cavity. Two human experiments were performed using single radial immunodiffusion (SRID) for quantitation of IgA in expectorates after mouthrinses. CH mouthrinses eluted significantly more IgA from the oral cavity than did water. However, regular CH rinses for 1 week did not seem to reduce significantly the amount of IgA the could be extracted by water of CH. The present study did not support the suggestion that CH mouthrinses may reduce the IgA dependent defence mechanisms in the oral cavity.

Adult↗

The treatment of periodontal disease in the mixed dentition.

Treatment of periodontal disease in children comprises: 1. Dental health education emphasizing the role of oral hygiene in the prevention of periodontal disease. Inter-dental cleaning procedures should be taught to children as early as possible. 2. Early diagnosis of disease. Severe gingivitis indicates a poor oral hygiene and proper treatment will be to teach the patient daily plaque control procedures. Early diagnosis of destructive periodontitis may be performed on bite-wing X-rays. 3. Removal of sub- and supragingival plaque and plaque retentive factors as calculus and overhanging margins of restorations. If necessary, periodontal surgery may be performed in order to get access to deep subgingival plaque. This may particularly be the case when treating juvenile periodontitis. 4. Establishment of a plaque control programme preferably performed by the individual patients. If required, professional toothcleaning at adequate intervals must be instituted in order to prevent recurrence of disease after treatment. 5. Establishment of a maintenance schedule for regular dental examination so that recurrence of the disease can be detected and dealt with as soon as possible.

Adolescent↗