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Biomedical subjects

R R Nissle

Publications and source records attributed to R R Nissle.

17 recordsLinked to original sources
PubMed1992

A randomized trial of occlusal adjustment in the treatment of periodontitis patients.

The purpose of the randomized clinical trial was to test; (1) the influence of occlusal adjustment (OA) in association with periodontal therapy on attachment levels, pocket depth, and tooth mobility, (2) whether OA was of greater significance in non-surgically treated periodontal defects, and (3) whether initial tooth mobility or disease severity had an affect on post-treatment attachment levels following OA. After hygienic-phase therapy, 50 patients received OA/No OA according to random assignment; 22 patients received an OA and 28 were not adjusted. 2 months after OA, either modified Widman flap surgery or scaling and root planing by a periodontist were done according to random assignment within each patient in a split-mouth design. Following active treatment patients were maintained with prophylaxis done every 3 months and scored annually. For the analysis of this two-year data, a repeated measures analysis of variance was performed using attachment level change and pocket depths as outcome indicators. There was significantly greater gain of clinical periodontal attachment in patients who received an OA compared to those who did not. Both the surgically and non-surgically treated sides of the mouth responded similarly to OA. There was no affect of OA on the response in pocket depth, nor did initial tooth mobility or initial periodontal disease severity influence the response to OA.

Adult↗
PubMed1987

4 modalities of periodontal treatment compared over 5 years.

The purpose of the present study was to assess in a clinical trial over 5 years the results following 4 different modalities of periodontal therapy (pocket elimination or reduction surgery, modified Widman flap surgery, subgingival curettage, and scaling and rool planing). 90 patients were treated. The treatment methods were applied on a random basis to each of the 4 quadrants of the dentition. The patients were given professional tooth cleaning and oral hygiene instructions every 3 months. Pocket depth and attachment levels were scored once a year. 72 patients completed the 5 years of observation. Both patient means for pocket depth and attachment level as well as % distribution of sites with loss of attachment greater than or equal to 2 mm and greater than or equal to 3 mm were compared. For 1-3 mm probing depth, scaling and root planing, as well as subgingival curettage led to significantly less attachment loss than pocket elimination and modified Widman flap surgery. For 4-6 mm pockets, scaling and root planing and curettage had better attachment results than pocket elimination surgery. For the 7-12 mm pockets, there was no statistically significant difference among the results following the various procedures.

Clinical Trials as Topic↗
PubMed1982

Oral hygiene and maintenance of periodontal support.

The role of personal plaque control in periodontal maintenance care was studied in 78 patients who had undergone periodontal therapy and were on 3-month recall for prophylaxis over 8 years. Variations in pocket depth and attachment levels were related to individuals with plaque scores above and below the median. The results also were analyzed by comparing the 25% of the sample having the lowest plaque scores with the 25% having the highest scores over 7 years of maintenance care. Students t test was used. It was found that personal oral hygiene as expressed in plaque scores was not critical for maintenance of post-treatment pocket depth and attachment levels in patients with professional tooth cleaning every 3 months. The initial post-treatment reductions in pocket depth and variations in attachment levels were more favorable in patients with good than with poor oral hygiene, but, these differences were not significant after 3 to 4 years of maintenance care.

Dental Plaque↗
PubMed1982

Effect of periodontal treatment on tooth mobility.

The purpose of this study was to compare tooth mobility at different time periods during periodontal treatment and to relate changes in mobility to each method of treatment. Ninety-three patients (2421 teeth) with moderate to severe periodontitis were scored: (1) at initial examination, (2) 1 month following scaling, root planing, instruction in oral hygiene and preliminary occlusal adjustment, (3) 1 month after treatment with pocket elimination or reduction, curettage, modified Widman flap or scaling and root planing by the periodontist, and (4) 1 and 2 years following completed periodontal treatment. After initial nonsurgical treatment there was a significant decrease in tooth mobility. Tooth mobility increased temporarily after pocket reduction surgery but was not altered following curettage, modified Widman flap or scaling and root planing. Two years post-treatment there was a trend toward further decrease in tooth mobility with professional tooth cleaning every 3 months.

Dental Scaling↗
PubMed1981

Four types of periodontal treatment compared over two years.

Results of various modalities of periodontal therapy were studied in 90 subjects (mean age 45 years) with moderate to severe periodontitis. Initial measurements of pocket depth and clinical attachment levels were compared with measurements obtained after the initial hygienic phase of the treatment and measurements of the same areas 1 and 2 years after four different types of periodontal treatment had been applied on a randomized basis to each of the four quadrants of the dentition. These treatments were: (1) surgical pocket elimination or reduction, (2) modified Widman flap surgery. (3) subgingival curettage, (4) scaling and root planing only. The patients were recalled for prophylaxis every 3 months, and rescored annually. One-way analysis of variance and Scheffe's method were used to test the hypothesis of equal treatment effects. The results were analyzed both with initial pocket depth as the baseline and with pocket depth at the hygienic phase as the baseline using a grouping of pockets 1 to 3 mm, 4 to 6 mm, and greater than or equal to 7 mm. For the 1 to 3 mm pockets there was a slight reduction in depth at the hygienic phase, with only minor changes after the various modalities of treatment over 2 years. However, significant losses of attachment after all modalities of periodontal therapy, including scaling alone, were observed at both the 1-year an 2-year intervals. For pockets 4 to 6 mm deep, the main reduction in pocket depth occurred at the hygienic phase, but the pockets also were reduced by further treatment, most by pocket elimination and modified Widman surgery. However, this reduction in pocket depth after surgery had no beneficial influence on maintenance of the attachment level, which actually was maintained best by scaling alone. For deep pockets greater than or equal to 7 mm, significant reduction in pocket depth occurred both at the hygienic phase and 1 to 2 years after treatment, with the greatest initial reduction after pocket elimination surgery. However, again there was no significant difference in attachment results among the four methods.

Adult↗
PubMed1980

Tooth mobility and periodontal therapy.

Data collected as part of an 8-year longitudinal study on periodontal therapy involving 82 patients and 1974 teeth were analyzed to determine if tooth mobility influenced the result of treatment. For each patient, pocket depth, attachment level and tooth mobility were scored clinically at the initial appointment, and once a year for 8 years following periodontal therapy. The treatment consisted of scaling, oral hygiene instruction, occlusal adjustment, periodontal surgery (curettage, modified Widman or pocket elimination), followed by recall prophylaxes every 3 months. Tooth mobility data on a scale of 0--3 were related to changes in attachment levels for three grades of severity of periodontal disease, based on initial pocket depth (1--3 mm, 4--6 mm, and 7 + mm). Mean patient attachment changes were calculated from teeth in the same severity category for each patient. The data were analyzed by one-way analysis of variance and Scheffe's multiple comparison procedure to test the hypothesis of equal effects of tooth mobility on the results of the treatment for the three severity groups over 8 years. The results indicate that there is a statistically significant relationship between original tooth mobility and the change in level of attachment following treatment. Pockets of clinically mobile teeth do not respond as well to periodontal treatment as do those of firm teeth exhibiting the same initial disease severity.

Humans↗
PubMed1980

Results of periodontal therapy related to tooth type.

Certain teeth or groups of teeth are prone to develop more severe periodontal destruction than other teeth in the same individuals. A test was made to assess if these same teeth or groups of teeth also respond less favorably to periodontal therapy than other teeth. Data from a longitudinal study of periodontal therapy for 78 patients over 8 years were analyzed with regard to effect of tooth types on treatment results. The response to periodontal treatment was only marginally related to tooth type with the most favorable responses in the maxillary and mandibular anterior teeth and the least favorable responses in the maxillary molars and bicuspids. Although a number of these differences were significant statistically, the actual values were too small to be of appreciable clinical significance. The overall prognosis for treatment of periodontal pockets apparently is good for all tooth types and this observation applies to moderate as well as to deep pockets.

Bicuspid↗
PubMed1977

Short term results of three modalities of periodontal treatment.

Short term data were obtained from 74 patients who recieved comprehensive periodontal treatment using a split mouth approach to test three variables; subgingival curettage, pocket elimination surgery, and modified Widman flap procedure. The patients initially had an average interproximal loss of attachment of 3.2 mm and an average interproximal pocket depth of 3.9 mm. Evaluation of the data indicate that after 4 to 6 weeks: 1. All three surgical procedures reduce pocket depths. In order of effectiveness they are: pocket elimination surgery, modified Widman flap, and subgingival curettage. 2. Pocket elimination surgery reduces pockets more than subgingival curettage on the buccal, lingual and interproximal, and more than the modified Widman flap on the lingual. The modified Widman flap procedure reduces pockets more interproximally than subgingival curettage. 3. Subgingival curettage results in a gain of attachment interproximally, and on the lingual side, while the modified Widman flap resulted in a gain of attachment interproximally only. 4 Pocket elimination surgery resulted in a loss of attachment buccally. 5 Subgingival curettage results in a more favorable postoperative attachment level on all surfaces than did pocket elimination surgery.

Adult↗
PubMed1975

Radiographs in clinical periodontal trials.

Fifty-eight patients were selected from an ongoing study of periodontal therapy at The University of Michigan. Pre-and post-treatment series of full mouth radiographs obtained by conventional paralleling long cone technique were available. Mesial and distal radiographic bone height was scored using the technique developed by Björn et al. A total of 1416 teeth were scored from the itial radiographs, and subsequently at one, two, three, and four years after the treatment. Radiographic bone height scores were compared with level of attachment and pocket depth scores for the same teeth at the same time. Statistical significance and correlation coefficients were derived using computer analysis of the data. The data were analyzed using three different data groupings: individual teeth, patient means, and half-mouth treatment methods. High positive correlations were found between initial measurements of radiographic bone height and attachment level as well as pocket depth. The correlations between changes in measurements of radiographic bone height and attachment level after treatment were markedly lower but are statistically significant. A highly significant correlation between radiographic bone heights and measurements of attachment level also appeared in follow-up data one to four years after treatment. The method of data grouping resulted in different correlation coefficients. Highest correlations were found if the data were pooled for patients. Lowest correlations were found if the data for individual teeth were analyzed. When the data were combined to produce patient scores, sample variation is reduced and correlations increase in magnitude. The generally high correlations between radiographic bone height and attachment level scores before and after treatment tend to confirm the fact that radiographic assessment of alveolar bone height using the method of Björn et al. can provide fairly accurate assessment of interproximal periodontal support.

Alveolar Process↗
PubMed1975

Results following three modalities of periodontal therapy.

Three methods for treatment of periodontal pockets (subgingival curettage, modified Widman flap surgery, and pocket elimination) were applied as a clinical trial to 82 patients. Follow up results over one to five years after the initial treatment are reported. The variations in attachment levels and pocket depth were analyzed statistically as related to methods of treatment and yearly time intervals following the initial treatment. The most favorable results regarding gain or maintenance of attachment levels and reduction of pocket depth were observed interproximally. Subgingival curettage provided the greatest gain in attachment level up to three years postoperatively, but after four to five years there was no significant difference in results following the three methods. The most significant loss of attachment and return of pocket depth occurred on the buccal aspects of the teeth, and the results were not significantly different for the three methods except at the first year of follow up when the attachment level was maintained best after curettage.

Adult↗