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Biomedical subjects

R Attström

Publications and source records attributed to R Attström.

At least 19 recordsLinked to original sources

The effect of delmopinol rinsing on dental plaque formation and gingivitis healing.

The aim of this study was to investigate a possible dose-response effect of delmopinol hydrochloride, on the development of plaque and on the healing of gingivitis. 64 healthy male volunteers, aged 18-40 years with healthy gingivae and clean teeth, participated. During a 2-week period, the participants refrained from all oral hygiene and rinsed 2x daily with a placebo solution. On day 14 of the study, they received professional toothcleaning, and were randomly assigned to 4 groups. For the following 2 weeks, they rinsed 2x daily for 1 min with 10 ml of 0.05% (15 subjects), 0.1% (17) or 0.2% (16) delmopinol, respectively. 16 subjects rinsed with 0.2% chlorhexidine. No oral hygiene procedures were performed during the test period. On days 0, 14 and 28, gingival bleeding index and the presence of stainable plaque were determined. Periodic identical photographs were used for planimetric determination of buccal plaque extension. No significant difference for the reduction in gingival bleeding index was found between 0.2% delmopinol and chlorhexidine rinsing. The mean plaque index showed its most significant reduction on lingual surfaces of both upper and lower jaws when rinsing with 0.2% delmopinol. Mean plaque extension was reduced by 23% for 0.05%, 39% for 0.1% and 55% for 0.2% delmopinol. A significant dose-response effect for 0.05%, 0.1% and 0.2% delmopinol was found for gingival bleeding index, plaque index and plaque extension. The results show that delmopinol favors the healing of gingivitis and reduces plaque formation.

Adolescent

Gingivectomy versus flap surgery: the effect of the treatment of infrabony defects. A clinical and radiographic study.

The aim of this paper was to compare the short-term results of gingivectomy (GV) and modified Widman flap (MWF) surgery in the treatment of infrabony defects. 14 patients with 68 bilateral infrabony defects were selected. At baseline, and 3 and 6 months postoperatively, assessments of oral hygiene, gingival conditions, bleeding on probing, probing pocket depth and attachment level, were recorded. Conventional radiograps were obtained in a way that assured a reproducible projection geometry. In a split-mouth design, one jaw quadrant was randomly treated with GV, while the contralateral with a MWF. The changes of the bone tissue were assessed by means of conventional and subtraction images by 2 observers. The interobserver agreement of the conventional and subtraction technique was studied. The majority of the sites demonstrated a significant improvement in gingival conditions and a reduction in bleeding. For both treatments, probing depths were reduced by an average of 3 mm, while a mean of 1.22-1.35 mm of probing attachment gain was obtained. The GV resulted in slightly more gingival recession (1.90 mm) than the MWF (1.60 mm). The radiographic examination demonstrated gain of bone in 7 defects treated with GV and in 9 defects treated with MWF. This study demonstrated that pockets associated with infrabony defects can be successfully treated by both treatment modalities. Furthermore, bone gain can occur after treatment but not in a predictable manner.

Adolescent

The effect of supragingival plaque control on the composition of the subgingival flora in periodontal pockets.

The effect of mechanical supragingival plaque control on the composition of the subgingival microflora in untreated 4-6 mm deep periodontal pockets was investigated. 13 subjects with chronic periodontitis were recruited for the study. Periodontally-diseased sites were subjected to professional plaque control 3 x weekly for a period of 3 weeks. Contralateral sites received no prophylaxis and served as controls. No instructions in oral hygiene procedures were given to the patients who maintained their habitual oral hygiene regime during the observation period. Clinical examination and darkfield microscopic analysis of bacterial samples were performed every week. The PlI scores for the experimental sites were reduced markedly, while those for the control sites remained stable throughout the observation period. No changes in the other clinical parameters were detected during the study. The composition of the subgingival microflora at the control sites did not change during the experimental period. In contrast, at the test sites, the proportion of spirochetes+motile rods decreased continuously. This decrease reached statistical significance at the end of the experiment. The results indicate that at periodontally diseased sites with an established subgingival ecosystem, supragingival plaque removal may influence the composition of the subgingival microflora.

Adult

Guided tissue regeneration in the treatment of infrabony defects on maxillary premolars. A pilot study.

The present study evaluated clinically and radiographically the short-term results of the healing of infrabony defects at maxillary premolars treated according to guided tissue regeneration (GTR). 9 patients with bilateral presence of infrabony defects with or without furcation involvements at maxillary premolars were selected. At baseline assessments of plaque and gingival indices, bleeding, probing pocket depth and attachment level, and furcation measurements were recorded. Conventional radiographs were obtained in a way that assured a reproducible projection geometry. One premolar was randomly treated with GTR and the contralateral with open debridement. Clinical and radiographic examinations were performed again 6 months postoperatively. The bone tissue changes were assessed by means of conventional radiographs and subtraction images. Sites treated by both procedures demonstrated an improvement of gingival conditions and a reduction of pocket depths. A statistically significant attachment gain was obtained for the test (mean 1.2 mm), but not for the control sites (mean 0.6 mm). The differences, though, were not significant between the test and control sites. Limited improvement in furcation closure was recorded. The radiographic examination demonstrated loss of bone tissue in four sites treated with GTR. The findings suggest that the regeneration of the periodontal soft and bone tissues was not significantly enhanced with the GTR therapy.

Adult

The effect of topical metronidazole therapy on experimentally-induced periodontitis in the beagle dog.

The present study was performed to assess the effect of topical metronidazole therapy on ligature-induced periodontitis in beagle dogs. 6 beagle dogs with experimentally-induced periodontitis on the mandibular 2nd, 3rd and 4th premolars were treated with metronidazole 10% dental paste 2 x daily for 4 weeks in an open placebo-controlled study using a split-mouth design. Recordings of probing pocket depth, bleeding on probing and gingival index were performed before commencement of treatment and repeated weekly during the 4-weeks treatment period. Concurrently, samples for microbiological analysis were collected from 2 of the dogs. The results demonstrated that probing pocket depth, bleeding on probing and gingival index had improved significantly in the metronidazole-treated side compared with the placebo-treated side. Black pigmented Bacteroides spp. and Spirochetes, present in all samples before treatment, were eliminated from the metronidazole-treated side after the 1st week of treatment and throughout the treatment period, whereas they were present in all samples from the placebo-treated side. The result of the present study demonstrates that topical application of metronidazole in a dental paste, improves the clinical features of the experimentally-induced periodontitis and eliminates some of the micro-organisms associated with the disease.

Animals

3 regimens of topical metronidazole compared with subgingival scaling on periodontal pathology in adults.

This report presents the findings from an open randomized multicentre clinical trial designed to compare the clinical efficacy of scaling with application of 3 different preparations/dose frequencies of topical metronidazole in the treatment of adult periodontitis. The 4 treatments were: (A) metronidazole 25% dental gel administered 1 x a week for 2 weeks; (B) metronidazole 15% dental gel applied 1 x a week for 2 weeks; (C) metronidazole 15% dental gel applied 2 x a week for 2 weeks; (D) subgingival scaling, performed 1 x only. A split mouth design was used. Patients were included in the study if they had at least 1 tooth in each quadrant with a pocket depth > or = 5 mm in at least 1 of 4 sites. A total of 61 patients from 4 centres were entered into the study. The efficacy parameters were probing pocket depth and bleeding on probing. Follow-up visits for recording of clinical efficacy were made at 2, 4, 6 and 12 weeks after the end of metronidazole treatment. All 3 antibiotic treatments (A, B, C) reduced the symptoms of periodontal pathology and yielded results comparable to those seen after subgingival scaling (D). When using a topical drug therapy, it seems important to use a preparation that requires as few applications as possible. The best candidate for drug therapy would therefore be treatment (A) metronidazole 25% applied 1 x a week for 2 weeks.

Adult

Rinsing with delmopinol 0.2% and chlorhexidine 0.2%: short-term effect on salivary microbiology, plaque, and gingivitis.

The aim of this short-term study was to compare the effect of delmopinol HCl 0.2% and chlorhexidine digluconate 0.2% rinses on the development of dental plaque, the healing of experimental gingivitis, and the salivary microbiology. As part of a larger study protocol, 45 healthy males enrolled in an oral hygiene program to upgrade their oral health. For this portion of the study, participants had their teeth professionally cleaned on day 0. The participants then abstained from standard mechanical oral hygiene procedures, but applied a placebo solution twice daily for 2 weeks. At the end of this period the subjects received a second professional cleaning and were then assigned to 2 treatment groups: Group 1 rinsed with 10 ml of delmopinol HCl 0.2% and Group 2 rinsed with 10 ml of chlorhexidine digluconate 0.2% for 1 minute twice daily for the next 2 weeks and continued to refrain from mechanical oral hygiene procedures. At the end of the placebo and active treatment periods 1) saliva samples were taken and cultivated on a series of media; 2) the degree of gingivitis was assessed with gingival crevicular fluid (GCF) and gingivitis index (GI); and 3) the plaque index was assessed and the stainable buccal plaque extension was analyzed planimetrically. No changes in the salivary microbiological counts were detected for the subjects rinsing with delmopinol. Subjects rinsing with chlorhexidine showed significant reductions of anaerobes, aerobes, and S. mutans in saliva. The amounts of GCF and GI were reduced largely to the same extent in both treatment groups. Mean plaque extension was reduced by 52% after delmopinol and 88% after chlorhexidine rinsing.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

The effect of 1% chlorhexidine gel delivered with toothpicks on proximal dental plaque. A pilot study.

The aim of this study was to determine the effect of 1% chlorhexidine gel delivered with toothpicks on interproximal dental plaque. Seven follow-up patients participated in two treatment periods of 1 week each, separated by a normal oral hygiene period of one week. The study had double-blind design. The plaque index by Silness and Löe (Acta Odontol Scand 22: 121-135, 1964) was scored on mesial, distal, buccal and lingual surfaces of each tooth after plaque disclosure, with an aqueous solution of erythrosine and the measurements were performed by the same examiner, at the initial visit and at the end of every experimental week. The ability to use toothpicks was checked and upgraded to the individual need. The participants were instructed to carry out their normal oral hygiene procedures, with placebo gel or 1% chlorhexidine gel delivered interproximally with toothpicks once daily. No significant differences in the measurement of plaque were noted between placebo gel and 1% chlorhexidine gel at interproximal areas. After treatment with 1% chlorhexidine gel, the mean distribution of plaque score 0 was increased significantly (P < 0.05), from 30.7 sites (52%) to 42 sites (71.1%) when all sites are taken into account and compared to the placebo period. 1% Chlorhexidine gel delivered by toothpick on interproximal areas had a limited effect on reduction of dental plaque.

Aged

Effect of the pre-brushing rinse, Plax, on dental plaque formation.

The aim of this double-blind cross-over study was to investigate plaque accumulation after the use of the pre-brushing rinse Plax, compared to placebo. 10 volunteers underwent 2 treatment periods of 1 week, separated by a wash-out period of 1 week. At the start of each study period, professional tooth-cleaning was performed. On days 2, 4, and 7 of each treatment period, periodic identical photographs after plaque disclosure were taken for planimetric analyses of plaque extension on canines, premolars. During each treatment period, the subjects were supervised when rinsing twice daily for 30 seconds with 15 ml of placebo or Plax, followed by brushing. The subjects performed a standardized poor brushing technique without toothpaste. No significant differences were noted between placebo and Plax for plaque extension on days, 2, 4 and 7. The results show that buccal plaque growth is equal after 2x daily rinsing with Plax and placebo in subjects performing a poor oral hygiene.

Adult

Clinical evaluation of pulp and dentine sensitivity after supragingival and subgingival scaling.

The exposure of dentinal tubules by the removal of root cementum on scaling procedures has been proposed to be a source of pulp injury and to cause dentine hypersensitivity. The aim of this study was to evaluate the sensitivity of the pulp and dentine after supragingival and subgingival scaling. Eleven patients with periodontally diseased mandibular incisors were selected. The subjects were divided into two groups according to marginal bone loss. The pulp sensitivity was evaluated by an electric pulp test. Dentine sensitivity was evaluated with two forms of controlled stimulations (probe and air-jet) and with a questionnaire. No changes in pulp sensitivity were found after scaling, but a clinically significant increase in dentine sensitivity to probe and/or air stimuli was observed in 6 patients. Five of these were also sensitive to daily life stimuli. A natural mechanism of desensitization seemed to have occurred two weeks after subgingival debridement. This study showed that supragingival and subgingival scaling might cause a more or less transient occurrence of dentine hypersensitivity.

Adult

A new experimental model for studies of local inflammatory reactions.

The aim of the present study was to develop and evaluate a method for studies of the early phase of the local inflammatory reaction, based on continuous diffusion of an inflammatory inducing agent. 25 rats were used. Four sterile teflon tablets were implanted subcutaneously in the back of each animal. After 3 weeks, when a connective tissue capsula had formed, the tablets were replaced by two test tablets, containing 35 micrograms lipopolysaccaride, one placebo and one teflon tablet. Five rats were sacrificed on day 0, 4, 7, 14, 21, respectively, and biopsies comprising tablet and surrounding tissue were harvested and exposed to routine histologic treatment. The number of leucocytes was assessed in four defined areas adjacent to each tablet. During the first seven days an increase in the number of leucocytes was seen in the tissues adjacent to test tablets. After 14 and 21 days the number of leucocytes was still high but lower as compared to day 7. In the tissues bordering the placebo and teflon tablets only few inflammatory cells were found. The results suggest that the tested method is suitable for studies of local inflammatory reactions during a 21 day period in experimental animals.

Animals

[Treatment of various frequently occurring periodontal problems].

Some clinical factors of importance for handling of periodontal problems are discussed in this paper by means of case reports. Severe but localised alveolar bone loss, treatment of narrow or missing attached gingiva and periodontal abscess formation are briefly described.

Aged

Postgraduate training centre in dentistry in Sweden.

The Swedish government closed down the dental school of Lund because too many dentists were produced. In this article Professor Attström explains why postgraduate courses were started in spite of the closing of the school.

Dentists

Supra-alveolar periodontal healing of auto- and allotransplanted teeth in monkeys.

Although intra-alveolar healing of allotransplanted teeth often shows pathological changes due to rejection of the tooth graft, previous clinical findings seem to indicate that the supra-alveolar part of the allografts heals differently, which is of significant prognostic value. The aim of the present study was to determine the healing of the cervical part of the periodontium of auto- and allotransplanted mature teeth in monkeys. In 4 adult, immunologically unmatched, green vervet monkeys 16 mature permanent maxillary and mandibular incisors were extracted, endodontically treated and either auto- or allotransplanted; 8 untreated neighbouring incisors served as controls. Block biopsies including part of the tooth and the adjacent vestibular tissues were obtained after a healing period of 8 weeks. The biopsies were decalcified in EDTA and embedded in Epon. In semi-thin section (1.5 microns) the morphology of the supra-alveolar periodontal tissues was analysed in the light microscope. The orientation of the connective tissue fibres close to the root surface was found to be more parallel to the root surface of allotransplants compared with autografts, while in the control teeth the fibres were generally oriented perpendicular to the root surface. Resorption of the root was seldom found in the supra-alveolar portions of any of the transplanted teeth. The junctional epithelium had migrated slightly apically onto the root surfaces of allotransplanted teeth. The gingival connective tissue adjacent to allotransplanted teeth showed a significantly increased number of lymphocytes compared with autografts and controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance