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Biomedical subjects

R Attström

Publications and source records attributed to R Attström.

At least 91 records · Page 5Linked to original sources
PubMed1984

Oral cleanliness and gingival health following oral hygiene instruction by self-educational programs.

The aim of the present study was to determine the motivational effect of using a periodontal self-examination manual prior to a self-instructional manual in oral hygiene and to examine whether instruction provided at a later time than the scaling procedure improves the effect of the instruction. 74 patients with periodontal disease were divided into 3 groups: (1) A group of 23 patients who performed a self-examination of their periodontal condition prior to self-instruction in oral hygiene; (2) a control group of 27 patients who used only the self-instructional oral hygiene manual; and (3) a group of 24 patients who were not given the self-instructional oral hygiene manual before 6 weeks after the baseline examination. All these patients had their teeth scaled at the start of the study and after 3 and 7 months. The effect of the various modes of instruction was evaluated by assessments of plaque and gingival bleeding scores. These parameters were determined at the baseline and after 2 and 6 weeks and 3 and 7 months. The results demonstrated a significant improvement in plaque and gingival bleeding scores following the use of the self-instructional manual in oral hygiene. The use of the periodontal self-examination manual or a delay of the instruction had no additional effect on oral cleanliness. The level of oral hygiene and gingival health achieved at 3 months was maintained in all 3 groups for an additional period of 4 months. After that time, they were divided into 2 other groups depending on whether or not their plaque score was less than 20%. A total of 26 in the group who had a plaque score higher than 20% demonstrated a plaque score of than 20% after having performed the tooth brushing test. 10 of the remaining patients, who still had a plaque score of more than 20% after the tooth brushing test, received additional instruction in oral hygiene which subsequently resulted in improved oral cleanliness after 6 months.

Adult↗
PubMed1983

Evaluation of various feedback mechanisms in relation to compliance by adult patients with oral home care instructions.

The purpose of the present study was to examine the effect on oral hygiene and gingival health of plaque scoring and the performance of a 'tooth brushing test" at each visit during initial periodontal treatment. A total of 63 adult periodontal patients (22-67 years of age) was allocated to 4 matched groups: Brushing test group (B), open scoring group (O), minimal feedback group (M) and control group (C). The oral hygiene instruction for groups B, O and M was provided by handing out a self-educational manual on oral home care, while the patients of control group (C) received a short brochure describing the Bass brushing technique and the use of toothpicks. Feedback on the improvement of oral hygiene performance was delivered to groups B and O by scoring of plaque and gingival bleeding by probing while this feedback was avoided in the 2 other groups (M, C). The patients of group B performed a tooth brushing test at each of 3 visits. After 3 months the plaque scores of groups B (27%) and O (22%) had improved more than those of the 2 other groups (35%). However, the improvement in gingival bleeding scores was similar in all 4 groups (from 55% initially to 17% at 3 months). At later examinations only minor differences in plaque and gingival bleeding scores were recorded between the various groups. The findings show that, irrespective of the mode of instruction, a considerable improvement occurs and that this improvement is not related to open scoring of plaque or the tooth brushing test.

Adult↗
PubMed1983

Histopathology of initial gingivitis in humans. A pilot study.

The present study concerns the inflammatory alterations in the gingival margin during initial gingivitis in 11-13 year old human subjects. At day 0 of the experiment, all participants had clean teeth and healthy gingiva. All active oral hygiene measures were excluded for 4 days. From upper and lower premolars, which were extracted for orthodontic reasons, contralateral gingival biopsies, including the tooth and the adjacent gingiva, were obtained on days 0 and 4. The presence of inflammatory cells in the junctional epithelium and the adjacent connective tissue was determined quantitatively in semi-thin sections. The collagen content of the gingival margin was also determined. From day 0 to day 4 there was only a slight increase in the number of neutrophilic granulocytes in the junctional epithelium and adjacent connective tissue, while a more pronounced increase was found in the number of mononuclear leukocytes. A loss of collagen was noticed in 4 of the subjects, while 2 did not show any changes in collagen content. The inflammatory reaction seen in the present study differs somewhat from that observed in adult humans and adult dogs. The results correspond more to the reaction seen in juvenile dogs.

Adolescent↗
PubMed1982

Teaching plaque control. I. A five-visit versus a two-visit program.

The effects of two series of oral hygiene instruction programs were studied. One of the programs was given as a series of five consecutive 30-min visits during 14 days. The other program contained the same basic components but was scheduled as two 60-min visits. Sixty-nine white-collar employees served as subjects and were divided into three matched groups; two experimental groups (five-visit group, two-visit group) and one control group. The five-visit program as well as the two-visit program significantly reduced the presence of plaque, gingival bleeding and periodontal pockets. No differences could be observed between the results in two experimental groups during the immediate 12-week observation interval or throughout the subsequent 48 months of maintenance care.

Adult↗
PubMed1981

Oral hygiene instruction of adults by means of a self-instructional manual.

The need for improved oral cleanliness in adults presents a large scale resource requirement for professional manpower if oral hygiene instruction is to be accomplished conventionally on an individual basis at the chairside. Therefore a self-instructional manual in oral hygiene measures, to be used by the patients at home, has been designed. The effect on oral hygiene of periodontal patients following instruction by means of this manual has been compared with the effect of one instruction carried out by a dental hygienist as well as with the effect of minimal instruction by the aid of a short brochure. Thirty-seven patients (25--64 years of age) were allocated to three groups matched with regard to baseline scores of dento-gingival plaque, age and sex. Presence of disclosed dento-gingival plaque (Plak-lite) and gingival bleeding on probing were recorded at the start, 1, 2 and 6 weeks, 3 and 6 months. Toothbrushing performance of the patients was evaluated at each visit by a "brushing test". The treatment of all the patients consisted of scaling and polishing of the teeth at the start and after 3 months as well as the patients being supplied with the necessary oral hygiene aids including a lighted mouth mirror, a toothbrush, toothpicks and disclosing tablets. The baseline mean plaque and bleeding scores of 64 and 40% decreased during the first 6 weeks to a level of 20 and 14%. This improvement was maintained during the 6-month study period. Among the three groups no significant differences were observed in oral hygiene and gingival health. The results indicate that an oral hygiene instructional mode relatively independent of professional manpower may be equally effective as one single personal instruction. Furthermore the results suggest that factors other than the instruction per se are important for obtaining improvements in oral home care.

Adult↗
PubMed1981

Ultrastructural estimation of the effect of sucrose and glucose rises on early dental plaque formed on plastic films.

The influence of water, glucose and sucrose rises on early plaque formation has been studied. The amount and structure of dental deposits formed on plastic films were determined on four occasions: no rinsing, water, glucose or sucrose rinses. Five subjects with healthy gingiva developed plaque in 4 h on plastic films applied to the buccal surfaces of premolars and canines, after which period the plastic films with adhering deposits were processed for electron microscopy. Sections were prepared for examination in the light and electron microscope. Some were stained for the demonstration of carbohydrates according to the periodic acid thiocarbohydrazide osmium tetroxide technique. Furthermore, the number of cellular elements collected on the films during the four experiments was calculated and statistically compared. The results in the four groups were identical. The plastic films were covered by a surface coating of acellular material in or on which bacteria, epithelial cells and leukocytes were observed. The microorganisms were almost exclusively Gram-positive cocci. Many bacteria exhibited intracellular polysaccharides. The results indicate that the rinsing procedure does not influence early plaque formation, and that frequent mouthrinses with glucose or sucrose have no detectable effect on plaque growth at this initial stage of bacterial adherence.

Adult↗
PubMed1981

Periodontal status of 14-16 year-old Danish schoolchildren.

The purpose of this study was to determine the prevalence of periodontal disease in teenagers. The survey was conducted on 325 children aged 14, 15 and 16 years, living in Aarhus, Denmark. Pocket depth and loss of attachment was measured in mm at the maxillary and mandibular first molars and incisors. Plaque, calculus and gingival bleeding on probing were recorded. A total of 221 children (68%) had 4-5 mm deep pockets and 19 children (5.8%) had pockets deeper than 5 mm on at least one tooth. Approximately 11% of the subjects showed loss of attachment on at least one tooth. The frequency of surfaces with plaque and gingivitis was high in all three age groups. Plaque, gingivitis, deepened pockets and loss of attachment were most frequently observed on interproximal surfaces. No significant differences were observed between the sexes with regard to periodontal disease.

Adolescent↗
PubMed1981

Radiographic and clinical examination of periodontal status of first molars in 15-16-year-old Danish schoolchildren.

The prevalence of alveolar bone loss was investigated in 2813, 15- and 16-year-old Danish schoolchildren using bitewing radiographs. The interproximal spaces of the mesial and distal aspects of the first molar teeth were examined. Only defects with depths of more than 2 mm were considered periodontal bone loss. Radiographic evidence of bone resorption was found in 48 children. When evaluated clinically, 42 out of the 48 children with radiographic signs of bone loss demonstrated clinical loss of attachment. Only four children (0.1%) had the characteristic radiographic features of juvenile periodontitis. Loss of attachment of more than 2 mm was observed in these children.

Adolescent↗
PubMed1980

Influence of optimal and excluded oral hygiene on early formation of dental plaque on plastic films. A quantitative and descriptive light and electron microscopic study.

The influence of oral hygiene on early plaque formation has been studied. The amount and structure of dental deposits formed on plastic films were determined at two occasions with or without a preceding period of effective oral hygiene. Six human subjects developed plaque during 4 hours on plastic films applied to the buccal surfaces of premolars and cuspids. The plastic films with adhering deposits were processed for electron microscopy. In presence of healthy gingiva, the plastic films were covered by a surface coating of acellular material in or on which bacteria, epithelial cells and leukocytes were observed. The microorganisms were almost exclusively Gram-positive cocci. When plaque formation was preceded by a week of excluded oral hygiene, the deposits collected on the same teeth exhibited a threefold increase in the number of bacteria. The relative composition of the flora was altered, as evidenced by a higher number of Gram-negative cells as well as the occurrence of rods and filamentous organisms. The results indicate that neglect of oral hygiene favors an earlier establishment of a complex bacterial flora at the dento-gingival region of the buccal surfaces of premolars and cuspids.

Adult↗
PubMed1979

Periodontal self-examination. A motivational tool in periodontics.

The institution of proper oral hygiene procedures and habits is a learning process. This paper describes a self-instructing periodontal self-examination program to be used in the initial phase of periodontal treatment. The program was designed in an effort to facilitate learning by taking the teaching conditions into consideration. The program tries to utilize the patient's curiosity and need for activity and to involve the patient himself in an effort to make the patient apprehend the relevance of subject matter. The program also allows for an individualized learning speed of the patient. The self-examination program was tested on 108 periodontal patients (19-75 years of age) and the patients' findings were compared to those made by a dentist. Questionnaires before and after the self-examination were used in the evaluation of opinions of the patient. The present study showed that the patients were able to perform the self-examination without individual professional guidance. A rather close correlation was noted between findings made by the patient and the dentist. Furthermore, the program was well accepted and appreciated by the patients according to their answers on the questionnaires.

Activities of Daily Living↗
PubMed1979

Histologic characteristics of experimental gingivitis in the juvenile and adult beagle dog.

An earlier study (Matsson & Attström 1979) revealed an unexplained difference between juvenile and adult dogs in the propensity to develop clinical signs of gingivitis. The aims of the present investigation were to depict the structural composition of clinically normal gingiva and to analyze the histologic changes in the gingiva during plaque development in juvenile and adult dogs. Six beagle dogs were used. Two periods of discontinued oral hygiene were studied, the first at 3 and the second at 12 months of age. Biopsies were sampled on days 0, 4, 7, 14, 21 and 28 of each period. Sections from the biopsies were analyzed at two levels of magnification. Compared to adult dog gingiva, juvenile gingiva seemed to display: 1) a thicker keratinized layer of the oral epithelium, 2) a junctional epithelium that structurally resembles the oral epithelium, 3) a cuticular structure at the surface of the junctional epithelium, 4) a limited mononuclear inflammatory cell response during experimental gingivitis, and 5) a delayed establishment of an infiltrated connective tissue portion during experimental gingivitis. In addition, during experimental gingivitis, subgingival plaque formed along the tooth surfaces to a lesser extent in the juvenile stage compared to adult dogs.

Age Factors↗