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Biomedical subjects

T Eger

Publications and source records attributed to T Eger.

At least 19 recordsLinked to original sources
PubMed2001

Gingivitis in young adults with Actinobacillus actinomycetemcomitans.

High intraoral load of A. actinomycetemcomitans in subjects with no or minimal periodontal disease may induce subtle changes in clinical periodontal conditions. The aim of the present study was to compare, at a site level, clinical conditions in two groups of young adults with plaque-induced gingivitis. In one group, more than 20% subgingival sites harboured cultivable A. actinomycetemcomitans (n=9), whereas in the other group, the organism was present in 20% or fewer subgingival plaque samples (n=8). Whereas no overt differences in clinical conditions could be ascertained, on average, the association between the presence of subgingival plaque and bleeding upon probing was considerably stronger (Mantel-Haenszel's common odds ratio RMH and 95% confidence interval 3.903, 2.951-5.165, P<0.001) in subjects with only a few subgingival sites harbouring A. actinomycetemcomitans as compared to subjects with a widespread intraoral distribution of the organism (R(MH)=1.637, 1.226-2.184, P<0.001). Since the proportion of sites not bleeding upon probing in the presence of supragingival plaque was slightly elevated in these subjects, the present findings may suggest a suppressed inflammatory reaction on supragingival plaque in the presence of a pronounced intraoral load of A. actinomycetemcomitans.

Adolescent↗
PubMed2001

Intraoral distribution of Actinobacillus actinomycetemcomitans in young adults with minimal periodontal disease.

The aim of the present study was to investigate the intraoral distribution of Actinobacillus actinomycetemcomitans in young adults with minor signs of periodontal disease but harboring the organisms in the oral cavity. 17 healthy volunteers, 20 to 27 years of age, participated. Samples from mucosal surfaces of the oro-pharyngeal cavity and saliva (n = 221) as well as subgingival plaque from every tooth (n =477) were selectively cultivated for A. actinomycetemcomitans. Species identity and presence of the leukotoxin encoding gene, ltxA, were checked by multiplex polymerase chain reaction. Moreover, the leukotoxin promoter region was analyzed. No isolate harbored a 530 bp deletion in the promoter region of the leukotoxin gene, signaling minimally toxic strains. 42.1 +/- 30.4% extracrevicular and 34.4 +/- 29.5% subgingival samples were culture-positive. In extracrevicular samples, the organism could easily be recovered from cheek mucosa (62%), saliva (59%) and the palatal tonsils (41%). Mean log-transformed numbers of A. actinomycetecomitans colony forming units (CFU/ml) in culture-positive material ranged between 1.8 from the hard palate and 2.3 from 10 microl saliva. The highest prevalence in subgingival plaque was observed at maxillary 3rd molars (55%) followed by maxillary lateral incisors (50%) and mandibular 3rd molars (41%). Mean log-transformed counts of CFU/ml ranged between 2.2 at maxillary 3rd molars and 3.4 at upper central incisors. When adjusted for jaw, site and tooth type, the odds of isolating higher numbers of the organism were increased with every mm probing depth by a factor of 1.35 (p <0.05). The odds ratio for bleeding on probing was 1.38. Thus, in this young adult population with minor periodontal disease, A. actinomyetemcomitans was mainly associated with some deviation from gingival health. Of concern might be a minority of subjects (29%) with an extremely wide distribution of the organism in the oral cavity.

Adolescent↗
PubMed2001

Failure of root coverage of shallow gingival recessions employing GTR and a bioresorbable membrane.

The aim of the present study was to compare the postsurgical outcome of two different modes of surgical root coverage of predominantly shallow, Class I or II, gingival recessions. Fourteen facial recessions in nine patients were subjected to a coronally repositioned flap in combination with a bioresorbable membrane, and 14 sites in 13 patients were treated with a connective tissue graft employing an envelope technique. Immediately before surgery and after 6 and 12 months, gingival dimensions as well as root coverage and attachment gain were assessed. At baseline, mean recession depths amounted to 2.77+/-1.67 mm and 2.49+/-1.07 mm for patients treated with a bioresorbable membrane and a free connective tissue graft, respectively. Acceptable and stable root coverage of 81% to 82% of baseline recession depth and 78% of its width was achieved by grafting. In contrast, guided tissue regeneration (GTR) resulted in only 50% coverage of recession depth and, after 12 months, only 11% of its width (P < 0.01). Logistic regression revealed that the odds of obtaining success, ie, at least 80% root coverage, were 3.3 times greater in cases treated with a connective tissue graft (P < 0.05). In addition, the odds ratio was 2.3 in cases of recessions below 2.5 mm compared to deeper recessions and 2 at canines compared to premolars. It was concluded that shallow recessions in the 1.5 to 3.5 mm range should not be treated with GTR. In these situations, predictable results are achieved with free connective tissue grafts employing an envelope technique.

Absorbable Implants↗
PubMed2000

Site-specific association between supragingival plaque and bleeding upon probing in young adults.

The aim of the present study was to consider supragingival plaque as a risk factor for gingivitis in a group of young adults without destructive periodontal disease. A total of 127 subjects, 17 to 30 years of age, participated. Periodontal probing depth, clinical attachment level as well as bleeding upon probing and supragingival plaque was assessed at 6 sites of every tooth present. The individual odds ratios between plaque and bleeding ranged between 0.237 and 66.6. 23% volunteers had an odds ratio of below 1.2. Only 15% individuals presented with an attributable risk of supragingival plaque for bleeding upon probing of 50% or more. Overall, the odds of bleeding, adjusted for periodontal probing depth, was increased by 67% in the presence of plaque. Large differences were observed at different teeth with the highest odds ratio at mandibular premolars with 2.557 (95% confidence interval 2.033-3.216) and the lowest at maxillary molars with 1.355 (1.161-1.732). It was concluded that there was high interindividual and intraindividual variation of the relative risk for bleeding in the presence of plaque. The observed low overall relative risk has important consequences in educational and health care programmes since the risk of supragingival plaque which is actually attributable for the observed bleeding on probing may be rather small.

Adolescent↗
PubMed2000

Dynamics of mucosal dimensions after root coverage with a bioresorbable membrane.

BACKGROUND: So far, the clinical effects of the placement of a resorbable membrane for guided tissue regeneration have not been studied in humans in great detail. The dynamics of the resorptive processes, in particular, appear to be rather speculative. In the present longitudinal study, specific alterations of the dimensions of the dentogingival mucosa were explored after surgical root coverage by using a bioresorbable membrane and a coronally-repositioned flap. METHODS: The study population consisted of 14 patients with a total of 31 predominantly shallow, Miller class I, II or III recessions. The thickness of the masticatory and lining mucosa before and after surgical intervention was measured with an ultrasonic device. RESULTS: Mean (+/-sd) recession depth and width were 2.85+/-1.29 and 4.46+/-1.14 mm, respectively. After 12 months, 51+/-29% of the recession depth (p<0.001) and 13+/-35% of its width (n.s.) were covered. Root coverage seems to be rather defect-type sensitive with best results obtained at canines with relatively shallow recessions. Mucosal thickness was considerably increased after surgery with a gradual decrease during the following 9 months. Thus, thickness of the marginal tissue rose from 0.82+/-0.27 mm to 1.49+/-0.54 mm 3 months after placement of the membrane (p<0.001). After 12 months, a mean thickness of 1.03+/-0.40 mm was observed (p<0.001). Even more pronounced alterations were noted for the alveolar lining mucosa with a threefold increase of thickness 3 months after surgery and a gradual decrease to about 1 mm after 12 months. CONCLUSIONS: The present results point to the considerable space making capacity of the bioresorbable membrane which probably allows for the ingrowth of a granulation tissue derived from the underlying structures. The gradual decline in mucosal thickness between months 6 and 9 after surgery may be paralleled by the maturation of the granulation tissue while complete resorption of the membrane had been accomplished.

Absorbable Implants↗
PubMed2000

Thickness of masticatory mucosa.

BACKGROUND: The aim of the present study was to assess thickness of all parts of the masticatory mucosa by using an ultrasonic measuring device. METHODS: A total of 40 periodontally healthy subjects, 19 to 30 years old, took part. Thickness of masticatory mucosa was measured at a maximum of 149 sites in each proband. RESULTS: Female volunteers had significantly thinner mean masticatory mucosa than males (p<0.01). Mean thickness of facial gingiva ranged between 0.7 mm at canines in the maxilla and central incisors in the mandible and 2.3 mm at 3rd molars in the mandible. In the mandible, thickness of lingual gingiva ranged between 0.9 mm at lateral incisors and 2.3 mm at 3rd molars. Interdental gingiva ranged between 1.0 mm 2.1 mm. With 3 mm or more, on average, palatal masticatory mucosa was thickest in the 3rd molar region and at 2nd premolars at more central locations. 2 regions with comparatively thin palatal mucosa of about 2 mm were identified, namely (i) at central and lateral incisors and (ii) at the prominence of the palatal roots of 1st and 2nd molars. The thickest tissue with more than 4 mm, on average, was observed in the tuberosity and retromolar regions. CONCLUSIONS: Considerable intra- as well as interindividual variation of thickness of masticatory mucosa could be observed. According to differences in thickness of facial and interdental gingiva, it appears that lining is also an important function of the gingiva in reducing and smoothing the pronounced convexities of the dentoalveolar, i.e., skeletal, complex.

Adult↗
PubMed2000

Masticatory mucosa in subjects with different periodontal phenotypes.

AIMS: The aim of the present investigation was to study thickness of masticatory mucosa and gingival width in subjects with different periodontal phenotypes. METHODS: Periodontal phenotypes were defined with the aid of cluster analysis of standardised parameters including mean gingival thickness and width as well as ratio of crown width to its length at maxillary canines, lateral and central incisors of 40 young adults with healthy periodontal conditions. RESULTS: 3 groupings could be observed. Clusters A1 and A2 comprised 75% of all subjects. They were characterised by thin gingiva and a slender tooth form. Clusters A1 and A2 were differentiated by gingival width. Cluster B comprised 11 subjects with relatively thick and wide gingiva and a quadratic tooth shape. In general, characteristics of the frontal sextant in the maxilla were also found in other parts of the dentition. Thus, mean thickness of masticatory mucosa as well as gingival width and crown form differed significantly among clusters. In addition, cluster B subjects had a significantly greater mean periodontal probing depth. Multiple linear regression analysis was employed to identify significant factors influencing palatal mucosal thickness. Women had considerably thinner palatal mucosa than men. Furthermore, cluster affiliation had a significant influence on thickness of palatal mucosa. Thickest tissue was found in the premolar region, whereas the mucosa over the root prominence of the first molar represented an anatomical barrier for graft harvesting. CONCLUSIONS: Thickness of masticatory mucosa strongly depends on gender and the periodontal phenotype.

Adult↗
PubMed1999

Absence of an especially toxic clone among isolates of Actinobacillus actinomycetemcomitans recovered from army recruits.

Actinobacillus actinomycetemcomitans is a major periodontal pathogen which is associated with early-onset and adult periodontitis. The organism has been shown to be widely distributed among dentate, healthy individuals as well. It has been demonstrated that A. actinomycetemcomitans shows great genetic diversity. An especially virulent clone of the organism (JP2-like) with a specific 530-base pair (bp) deletion in the promoter region of the leukotoxin gene has been isolated from localized juvenile periodontitis patients and related subjects of African and African-American origin. The aim of the present study was to examine the presence of this specific clone employing specific oligonucleotide primers in a polymerase chain reaction among 51 isolates of A. actinomycetemcomitans recovered from 201, 18- to 25-year-old recruits with no or minor periodontal disease. In addition, clinical isolates from 37 periodontitis patients were analyzed as well as reference strains ATCC 29524, NCTC 9710, Y4 and JP2. Primers amplifying a specific 285-bp amplification product in the ltxA region of the leukotoxin gene and a specific 547-bp amplification product of 16 S rRNA were used to genetically confirm identification of the organisms. Primers amplifying sequences in the leukotoxin promoter region were used to identify the deletion. Species specific primers definitively identified all A. actinomycetemcomitans isolates. No isolates from army recruits or the reference strains displayed the deletion in the leukotoxin promoter region. However, in the periodontitis group, a 24-year-old individual from Ghana with localized juvenile periodontitis was identified with an intraoral infection with highly toxic A. actinomycetemcomitans (JP2-like). Present results confirm previous observations of absence of a highly toxic clone of A. actinomycetemcomitans among periodontally healthy and diseased Caucasians as well as a possible presence in localized juvenile periodontitis in individuals of African origin.

Adolescent↗
PubMed1999

Ultrasonic determination of thickness of masticatory mucosa: a methodologic study.

OBJECTIVE: The aim of the present study was to assess the reliability and validity of ultrasonic measurements of thickness of the masticatory mucosa. STUDY DESIGN: Eleven periodontally healthy subjects took part. Thickness of the buccal gingiva was assessed midbuccally and interdentally. In the maxilla, the palatal mucosa was measured at every tooth midpalatally, between the first and second molars, and between the second and third molars at each of 3 defined locations 4 mm apart. In the mandible, thickness of the lingual gingiva was measured midlingually as well as interdentally between the first and second molars and between the second and third molars. Thickness of the retromolar mucosa was also assessed. All 1,293 measurements were repeated after 24 hours. Validity of measurements was tested in a porcine model. RESULTS: Mean (+/- standard deviation) thickness of the midbuccal and midlingual gingiva was 0.99+/-0.52 mm; the measurement error was 0.26 mm. Measurements were well correlated (Pearson's r = .74, P<.001). Mean thickness of the papillary gingiva was 1.19+/-0.53 mm; the measurement error was 0.37 mm (r = .58, P<.001). A lower reliability was observed for palatal measurements of mucosal thickness; mean thickness was 2.36+/-0.87 mm, and measurement error was 0.54 mm (r = .64, P<.001). The validity of measurements was excellent in the 0.5-4.5 mm range. CONCLUSIONS: Differences in reliability of ultrasonic assessments of mucosal thickness in different parts of the oral cavity may depend on the difficulties of repeatedly measuring at the same location, on varying thickness of the tissues, and on expression of palatal rugae. These problems might be resolved by averaging multiple measurements.

Adult↗
PubMed1999

Furcation diagnosis.

One of the most important and at present unsolved problems in clinical periodontology is the predictable successful treatment of periodontitis-affected furcations of multirooted teeth. Since several therapeutic approaches are proposed, i.e., conservative, resective or regenerative, a proper diagnosis of these lesions is demanding. The aim of the present article is to review the current information on the impact of a proper diagnosis of a furcational lesion as well as tooth morphology on decision making with regard to different treatment modalities and to emphasize the need for a detailed clinical, radiographical and intraoperative diagnosis of the furcation lesion beyond the usually performed diagnosis of the degree of furcation involvement.

Bicuspid↗
PubMed1999

Clonal diversity of Actinobacillus actinomycetemcomitans isolates from young adults with minimal periodontal disease.

Actinobacillus actinomycetemcomitans is a major periodontal pathogen which is associated with both early-onset periodontitis and adult cases refractory to conventional periodontal therapy, although the organism has also been shown to be widely distributed among dentate healthy individuals. The observed disease status may be associated with a variation in virulence of different strains or clones. The aim of the present study was to analyse genotype distribution as assessed by an arbitrarily primed polymerase chain reaction (AP-PCR) among 51 isolates of A. actinomycetemcomitans recovered from more than 200 young adult recruits with no or minor periodontal disease. In addition, isolates from 25 periodontitis patients as well as reference strains were genotyped. Primers amplifying (i) a specific sequence in the ltxA region, (ii) a specific 16S rRNA sequence and (iii) sequences in the leukotoxin promoter region were used to verify species identity of the strains. Three random oligonucleotide primers were employed to analyse genomic polymorphisms of the organism by means of PCR. A total of 19 genotypes could be distinguished, which were grouped by cluster analysis into 5 major clusters based on genetic similarity and a complete linkage sort. Whereas 3 clusters assembled A. actinomycetemcomitans genotypes isolated from both healthy subjects and periodontitis patients, one cluster containing 4 different genotypes exclusively comprised isolates from healthy or gingivitis subjects. Another cluster with 2 genotypes consisted of strains originating from periodontitis patients (p < 0.05). One strain characterized by a specific 530 bp deletion in the promoter region of the leukotoxin region was identified in a Ghanese patient with localized juvenile periodontitis. It was concluded that there is considerable clonal diversity of A. actinomycetemcomitans strains isolated from healthy or periodontally diseased subjects, and that genetically closely related groups might be associated with health or disease.

Actinobacillus Infections↗
PubMed1999

Prevalence of Mycobacterium avium in slaughter pigs in The Netherlands and comparison of IS1245 restriction fragment length polymorphism patterns of porcine and human isolates.

A significant increase in the incidence of caseous lesions in the lymph nodes of slaughter pigs prompted a large-scale investigation in five slaughterhouses in The Netherlands. In total, 158,763 pigs from 2,899 groups underwent gross examination. At least one pig with caseous lesions in the submaxillary and/or mesenteric lymph nodes was observed in each of 154 of the 2,899 groups examined (5%). In total, 856 pigs (0.5%) were affected. As many as five pigs in each of 141 of the 154 positive groups (91.5%) had lymph node lesions. Greater numbers of pigs with affected lymph nodes were found in 13 groups (8.5%). Four pigs had lesions in the kidneys, liver, or spleen. Acid-fast bacteria were detected by microscopic examination of 121 of 292 Ziehl-Neelsen-stained smears of caseous lesions (41%). In a follow-up study, Mycobacterium avium complex (MAC) bacteria were isolated from 219 of 402 affected lymph nodes (54.2%). Ninety-one of the isolated strains were analyzed by restriction fragment length polymorphism (RFLP) typing with insertion sequence IS1245 as a probe. All but 1 of these 91 strains contained IS1245 DNA, indicating that pigs in The Netherlands carried almost exclusively M. avium bacteria and no other bacteria of MAC. Only one pig isolate exhibited the bird-type RFLP pattern. MAC isolates from 191 human patients in The Netherlands in 1996 were also typed by RFLP analysis. Computer-assisted analysis showed that the RFLP patterns of 61% of the human isolates and 59% of the porcine isolates were at least 75% similar to the RFLP patterns of the other group of strains. This indicates that pigs may be an important vehicle for M. avium infections in humans or that pigs and humans share common sources of infection.

Animals↗
PubMed1999

Root coverage employing an envelope technique or guided tissue regeneration with a bioabsorbable membrane.

BACKGROUND: Different treatment modalities have been described for root coverage in cases of gingival recession. The aim of the present study was to evaluate the postsurgical outcome of 2 modes of surgical root coverage of predominantly shallow, Class I or II, gingival recessions. METHODS: Fourteen buccal recession sites in 13 patients were treated with free connective tissue grafts employing a modified envelope technique; 14 sites in 9 patients were subjected to a coronally repositioned flap in combination with a bioabsorbable membrane. Immediately before surgery as well as after 6 months, gingival dimensions, i.e., width and thickness, as well as root coverage and attachment gain, were assessed to the next 0.1 mm employing a caliper, an ultrasonic device, and a pressure calibrated, computerized periodontal probe. RESULTS: At the outset, mean recession depths amounted to 2.48+/-1.06 and 3.00+/-1.95 mm for patients treated with a free connective tissue graft and a bioabsorbable membrane, respectively. With the former technique, 80+/-24% root surface could be covered after 6 months, while the latter resulted in only 45+/-40% coverage. The contrast in reduction of recession width was even more pronounced (77+/-35% versus 18+/-37%). In both groups, an increase of gingival thickness of 0.6 to 0.7 mm was noticed. CONCLUSIONS: Small recessions may be covered more predictably with the modified envelope technique. 751.

Absorbable Implants↗
PubMed1998

Gingival dimensions after root coverage with free connective tissue grafts.

Traumatic injury in the presence of a thin and narrow zone of gingival tissue may lead to gingival recession. Especially in class I and II recessions, root coverage may be accomplished with connective tissue grafts. In order to prevent recurrent recession, altering gingival dimensions width and thickness might be of advantage. In the present study, dimensions of gingiva were followed for 1 year after root coverage with connective tissue grafts. The study population consisted of 18 patients with a total of 28 class I or II recessions. Gingival width and depth of the recession were measured with a caliper, and thickness of the marginal tissue with an ultrasonic device. Periodontal probing depth was determined with a pressure-controlled electronic probe. Mean (+/-sd) recession depth at baseline was 3.1+/-1.4 mm. After 12 months, coverage amounted to 74+/-30%. Width of gingiva rose from 2.1+/-1.0 mm to 3.2+/-1.4 mm, whereas thickness was increased from 0.8+/-0.3 mm to 1.5+/-0.7 mm, on average. No significant alteration of periodontal probing depth was observed but a mean gain of clinical attachment of 1.7+/-1.1 mm was ascertained. In a multiple regression analysis, recession depth and presence of the recession in the maxilla, but not tooth type significantly influenced relative root coverage (R2=0.34, p<0.01). Attachment gain after surgery depended on baseline attachment loss and was negatively influenced by smoking. The present results point to the possibility of doubling gingival thickness after root coverage with connective tissue grafts.

Adult↗
PubMed1998

Alteration of gingival dimensions in a complicated case of gingival recession.

This case report describes possible etiology, treatment, and 2-year outcome of a complicated case of gingival recession in the mandibular anterior dentition. Deep, cleftlike Miller Class I and II recessions at both mandibular canines and all incisors were treated using subperiosteal connective tissue grafts and coronally repositioned flaps. During surgery it was noted that the facial aspects of the roots had lost bone near the apex. After surgery profound alterations of gingival dimension occurred. Mean gingival thickness increased from 0.87 +/- 0.20 mm to 258 +/- 0.65 mm, and width of keratinized tissue increased from 1.34 +/- 0.79 mm to 4.80 +/- 0.97 mm. Periodontal probing depths increased from 1.06 +/- 0.33 mm to 2.74 +/- 0.81 mm, and depth of the recessions was reduced by 56% +/- 5%. Gingival thickness and periodontal probing depth remained stable over the 2 years of observation. Gingival width decreased and the mucogingival border moved a mean 2.5 mm coronally. Creeping attachment resulted in a 74% +/- 24% coverage of recession after 2 years and a gain in clinical attachment of 1.79 +/- 1.56 mm. The present observations point to long-lasting, continuous alterations in the mucogingival region following periodontal surgery in a case of cleftlike Class II recession.

Adult↗
PubMed1997

Gingival phenotypes in young male adults.

In a previous study on 42 young adult, periodontally healthy subjects without any attrition, abrasion or crown restoration, gingival thickness (GTH) was determined at facial aspects of premolars, canines and incisors by a novel ultrasonic device. GTH strongly depended on periodontal probing depth, width of gingiva (WG), and tooth type. Whereas the ratio of crown width to its length (CW/CL) was not identified as an explanatory variable, a significant influence of the subject was ascertained. The aim of the present study was to extend these analyses in order to identify subjects with different morphological characteristics of gingiva, i.e., gingival phenotypes. When employing cluster analysis on standardized parameters mean GTH, WG and CW/CL of upper canines, lateral and central incisors, 3 clusters were identified. Cluster A comprised 2/3 of subjects, displaying "normal" GTH, WG and CW/CL. Cluster B (n = 9, 21%) had a significantly thicker and wider gingiva, and a more quadratic form of upper front teeth. A 3rd cluster (cluster C, n = 5, 12%) was identified showing "normal" GTH, high CW/CL, but a narrow zone of keratinized tissue. Some characteristics of gingival phenotype of the upper front tooth region were also found at upper premolars (WG, CW/CL) but in general not at mandibular teeth. Present results clearly indicate evidence for the existence of different gingival phenotypes. Clinical relevance of these observations has to be tested in longitudinal studies.

Adult↗
PubMed1997

A longitudinal study of Actinobacillus actinomycetemcomitans in army recruits.

During recruiting examinations 201 recruits, 18-25 yr old, were examined for subgingival and extracrevicular Actinobacillus actinomycetemcomitans. The organism was isolated in 55 subjects, most often at low levels. Cluster analysis revealed 3 clusters with no (A, n = 86) or minor (B, n = 92) periodontal disease and low DMF-S, as well as established periodontitis, increased D + DF-S and high DMF-S (C, n = 22). When leaving the 12-months' service, 105 recruits were re-examined (54 cluster A, 41 cluster B, 9 cluster C subjects, 1 recruit who was not clustered). An increase of periodontal probing depth (PPD) of > or = 3 mm at 1 or more sites occurred in 33 subjects: 9 (17%) in cluster A, 16 (39%) in cluster B, 7 (78%) in cluster C and in the not-clustered recruit. Considerable variation in frequency distributions of PPD alterations was observed, therefore significant (p < 0.1) mean increase (1-sample t-test) and skew g1 (S-statistic) were additionally considered to define an "active" case. A total of 7 recruits (6.7%) met the criteria. Logistic regression analysis revealed a significant influence of self-reported smoking habits on activity status. Thus, heavy smokers (> 20 cigarettes/d) had a 14-fold higher risk (p = 0.030) for developing or progressing periodontitis compared to non- or light smokers (< 10 cigarettes/d). In particular, cluster B recruits appeared to have a lower risk (p = 0.11) for developing periodontitis than cluster C recruits (established periodontitis, high DMF-S). A. actinomycetemcomitans was isolated in 29 recruits (27.6%) at baseline and 30 recruits (28.6%) after 12 months. Presence of the organism was not a risk factor for periodontitis. However, in active subjects, significantly more samples were only A. actinomycetemcomitans-positive at re-examination compared to inactive recruits. It was concluded that smoking is a significant risk factor for periodontitis. Subjects with established periodontitis tend to deteriorate further. A. actinomycetemcomitans seems not to increase the risk for developing or progressing periodontitis in this age group. Longer studies involving larger populations are needed to confirm these observations.

Adolescent↗
PubMed1997

The overall significance of regenerative procedures in the treatment of furcations.

A retrospective study examined the frequency of a feasible or remotely possible indication for regenerative therapy of furcation involvement in a large group of periodontally diseased patients. The judgment about the feasibility of the indication was mainly based on results of current randomized controlled clinical trials with regard to tooth type and location of the furcation lesion. Data from 558 patients treated by two periodontists, one experienced and one in training, were analyzed. Furcation involvement of at least one multirooted tooth was found in 40% and 63% of the two dentists' patients. In only 20% and 27% of their patients was there a potential indication for regenerative furcation treatment. Of 1,134 furcation lesions, 180 (15.9%) were conceivably suitable for this procedure. Only 17 sites with a feasible or remotely possible indication were treated in that way. In most cases, conventional furcational treatment (flap surgery with scaling and root planing) was performed.

Adolescent↗