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Biomedical subjects

T F Flemmig

Publications and source records attributed to T F Flemmig.

At least 19 recordsLinked to original sources
PubMed2002

In-dental-office screening for diabetes mellitus using gingival crevicular blood.

BACKGROUND: Diabetes mellitus (DM) is undiagnosed in approximately 1/2 of the patients actually suffering from the disease. In addition, the prevalence of DM is more than 2x as high in patients with periodontitis when compared to periodontally healthy subjects. Thus, a high number of patients with periodontitis may have undiagnosed DM. AIM: The purpose of this pilot study was to evaluate, whether blood oozing from gingival tissues during routine periodontal examination can be used for determining glucose levels. 32 non-diabetic and 13 diabetic patients with moderate to severe periodontitis were enrolled and subjected to routine clinical periodontal examination. Periodontal pocket probing was performed using a standard force. Blood oozing from gingival tissues of anterior teeth following periodontal pocket probing was collected with the stick of a glucose self-monitoring device (Elite(R) 2000, Bayer Diagnostics GmbH, Munich). As control, fingerstick capillary blood was taken. Statistical analysis was performed by Pearson's correlation coefficient. RESULTS: The patient blood glucose levels ranged from 3.57 mmol/l to 18.01 mmol/l and the values of blood samples taken from gingiva or finger tip showed a very high intrapatient correlation (r=0.98; p<0.0001). CONCLUSION: The results suggested that blood oozing during routine periodontal examination may be used for diabetes mellitus screening in a dental office setting.

Adult↗
PubMed2000

Heterogeneity of the prtC gene of Porphyromonas gingivalis.

In this study, the nucleotide sequences of the prtC genes of six clinical Porphyromonas gingivalis isolates obtained from patients with periodontitis and from reference strain 53977 were determined. All analyzed genes were heterogeneous in their nucleotide composition and differed in up to 13 nucleotides. Moreover, substantial differences were found in comparison to prtC of reference strain 53977. The prtC genes of 45 Porphyromonas gingivalis isolates were amplified by polymerase chain reaction (PCR) and the PCR products were also digested with restriction endonucleases Tsp509I, NlaIII and DraII (PCR-restriction fragment-length polymorphism). Nine different restriction pattern combinations were observed, with four being most frequent (28.9%, 26.7%, 17.8% and 11.1%). The data presented here demonstrates that prtC genes are heterogeneous in their nucleotide sequence and therefore may be used as a target for molecular epidemiological studies. The observed heterogeneity of prtC genes may be a result of microevolution processes.

Bacterial Proteins↗
PubMed2000

Lack of antimicrobial effect on periodontopathic bacteria by ultrasonic and sonic scalers in vitro.

BACKGROUND: The purpose of this study was to assess the antimicrobial effects of a sonic and ultrasonic scaler generally used for subgingival scaling on gram-negative and gram-positive periodontopathic bacteria. METHOD: Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Campylobacter rectus, or Peptostreptococcus micros were suspended in Schaedler's broth medium and treated by a sonic or a magnetostrictive ultrasonic scaler for 30 s and 150 s in vitro. Bacterial suspensions treated by an ultrasonic cell disruptor served as a positive control and untreated bacterial suspensions served as a negative control. Following sonication, samples were serially diluted, streaked on blood agar plates and incubated for 2-5 days at 37 degrees C. RESULTS: Treatment by the sonic or ultrasonic scaler for up to 150 s did not reduce the viability of any of the tested periodontal pathogens. Compared to untreated controls, the viability of A. actinomycetemcomitans and P. gingivalis was significantly (p<0.05) reduced only following ultrasonication with the cell disruptor after 30 s (0.72 and 0.54 log CFU/ml, respectively) and of A. actinomycetemcomitans, P. gingivalis, C. rectus, and P. micros after 150 s (1.98, 1.34, 1.95 and 1.98 log CFU/ml, respectively). CONCLUSION: The data of the study may indicate that the assessed sonic and ultrasonic scaler used for subgingival debridement do not result in killing of the tested periodontal pathogens.

Colony Count, Microbial↗
PubMed1999

Protective effect of serum antibodies against a 110-kilodalton protein of Actinobacillus actinomycetemcomitans following periodontal therapy.

Thirty-four adult patients with untreated periodontitis were randomly assigned to receive full mouth scaling alone or scaling with an adjunctive antimicrobial therapy, both followed by supportive periodontal therapy. At 24 months, specific serum immunoglobulin A (IgA), IgG and IgG subclass antibody reactivities against a 110-kDa protein of Actinobacillus actinomycetemcomitans were assessed by Western blot. In patients harboring A. actinomycetemcomitans intraorally, the IgG4 antibody reactivity against the 110-kDa protein of A. actinomycetemcomitans was associated with significantly increased survival rates of teeth and of sites not exhibiting 2 mm or more of probing attachment loss. The same trend was found for IgG3 and IgG2 antibody reactivities, but it was statistically insignificant. No association with clinical treatment outcome was observed for IgA, IgG and IgG1 antibody reactivities. The results indicated that systemic IgG4 antibody reactivity against the 110-kDa protein of A. actinomycetemcomitans may have a protective effect against periodontal disease progression in patients harboring A. actinomycetemcomitans and receiving periodontal therapy.

Adult↗
PubMed1999

Interleukin-1 haplotype and periodontal disease progression following therapy.

The purpose of this study was to assess the prognostic value of the IL-1 haplotype on the progression of periodontal disease following therapy. 48 adult patients with untreated periodontitis harboring Actinobacillus actinomycetemcomitans and/or Porphyromonas gingivalis were randomly assigned to receive full-mouth scaling alone (control) or in combination with systemic metronidazole plus amoxicillin and supragingival irrigation with chlorhexidine digluconate (test). All patients received supportive periodontal therapy at 3 to 6 months intervals. In 33 patients, lymphocyte DNA was analyzed for polymorphism in the IL-1A gene at position -889 and IL-1B gene at position +3953. Overall, 16 of 33 patients (7 of 17 test and 9 of 16 control) carried the IL-1 haplotype. 2 years following initial periodontal therapy, no differences in the survival rates of sites or teeth not exhibiting probing attachment loss of 2 mm or more compared to baseline, were found between patients who tested positive (85% sites, 53% teeth) and patients who tested negative (89% sites, 56% teeth) for the IL-1 haplotype. The results indicated that the IL-1 haplotype may be of limited value for the prognosis of periodontal disease progression following non-surgical periodontal therapy.

Adult↗
PubMed1999

Simultaneous detection of Bacteroides forsythus and Prevotella intermedia by 16S rRNA gene-directed multiplex PCR.

In a 16S rRNA gene-directed multiplex PCR, Prevotella intermedia- and Bacteroides forsythus-specific reverse primers were combined with a single conserved forward primer. A 660-bp fragment and an 840-bp fragment that were specific for both species could be amplified simultaneously. A total of 152 clinical samples, subgingival plaque and swabs of three different oral mucosae, from 38 periodontitis patients were used for the evaluation.

Adult↗
PubMed1999

Clonal infection with Actinobacillus actinomycetemcomitans following periodontal therapy.

Mechanical debridement results in a shift of the bacterial composition in the periodontal pocket on the species level. It is unknown, however, whether a clonal change within a species could lead to the emergence of strains with different levels of virulence. Therefore, in the present study, the genetic variability of Actinobacillus actinomycetemcomitans was assessed and strains identified which were associated with periodontal disease progression following periodontal therapy, i.e., refractory periodontitis. Twenty adult patients with untreated periodontitis and subgingival colonization of A. actinomycetemcomitans were randomly assigned to receive full-mouth scaling alone or scaling with an adjunctive antimicrobial therapy. Both groups received supportive periodontal therapy at 3, 6, 9, 12, 18, and 24 months. Subgingival plaque samples were taken at every visit; venous blood was obtained at 24 months only. A. actinomycetemcomitans isolates were typed by the RAPD method, and antibody reactivity against outer membrane proteins was assessed by immunoblot analysis. Eleven distinct RAPD patterns were found in 18 patients completing the study. All patients harbored only one A. actinomycetemcomitans genotype, and within each patient this genotype persisted throughout the 24-month observation period. No differences in the expression of antibody reactivity against outer membrane proteins were found between strains isolated at baseline and at 24 months. Three genotypes were associated with reduced survival rates of teeth without probing attachment loss of 2 mm or more. The results indicated that (i) most patients harbored only one A. actinomycetemcomitans genotype; (ii) the genotype persisted following therapy; and (iii) only some genotypes were associated with refractory periodontitis.

Adult↗
PubMed1999

Periodontitis.

The purpose of this review was to assess the scientific and clinical bases for the proposed classification of periodontitis. The clinical and histopathological signs and the etiology of periodontitis were described. Cross-sectional studies were analyzed to determine when onset of periodontitis most frequently occurs in adults. In addition, the progression rates of periodontitis have been assessed from longitudinal studies. No clinical, histopathological, or microbiological features could be identified that would characterize different disease entities of chronic periodontitis. The prevalence, extent, and severity of periodontitis were found to increase continually with higher age and there was no age when onset of disease would most likely occur. The rate of periodontitis progression varies largely between patients and there is no natural threshold for distinguishing various rates of disease progression. The incidence of periodontitis unresponsive to treatment depends on pretreatment progression rate, extent and severity of disease, tooth type, smoking, high levels of putative periodontal pathogens, a deficient immune response, and the type of therapy provided. There is no scientific basis for the classification "adult periodontitis" and "refractory adult periodontitis." Extensive clinical examinations are required for the diagnosis of "rapidly progressive adult periodontitis." It appears unrealistic that these examinations can be performed routinely in clinical practice. Therefore, the classification proposed by the Organizing Committee to define adult, rapidly progressive, and refractory periodontitis as specific disease entities was replaced with a simplified classification of periodontitis based on the scientific data available.

Acute Disease↗
PubMed1999

Combined systemic and local antimicrobial therapy of periodontal disease in Papillon-Lefèvre syndrome. A report of 4 cases.

4 patients, 2 pairs of siblings, suffering from Papillon-Lefèvre syndrome were treated for periodontal disease. Following extraction of hopeless teeth, the children received scaling and adjunctive systemic antibiotics (metronidazole and amoxicillin for 7 to 10 days). In addition, they performed supragingival pulsated jet irrigation with 0.06% chlorhexidine digluconate 1 x daily. In 2 siblings, A. actinomycetemcomitans was suppressed subgingivally below detectable levels, pocket probing depths were reduced to 4 mm or less, and plaque and bleeding indices were low. No further disease progression was seen over a 3-year-period. Another female patient also showed clinical improvement and suppression of subgingival A. actinomycetemcomitans and B. forsythus up to the 9-month-follow-up, while her sister showed further attachment loss over the course of 4 years. The present case reports indicated that in some patients suffering from Papillon-Lefèvre syndrome periodontal disease may be arrested by means of (i) oral hygiene instruction, (ii) extraction of severely diseased teeth, (iii) scaling, (iv) systemic antibiotics and (v) long-term antimicrobial irrigation.

Aggregatibacter actinomycetemcomitans↗
PubMed1998

Differential effects of systemic metronidazole and amoxicillin on Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in intraoral habitats.

48 adult patients with untreated periodontitis harboring subgingival Actinobacillus actinomycetemcomitans and/or Porphyromonas gingivalis were randomly assigned to receive full mouth scaling alone (control) or scaling with systemic metronidazole plus amoxicillin and supragingivai irrigation with chlorhexidine digluconate (test). Subgingival plaque and swab samples from tongue, tonsils, and buccal mucosa were taken at baseline, 10 days and 3, 6, 9, and 12 months. A. actinomycetemcomitans was detected in the oral cavity, i.e., subgingival plaque and/or mucous membranes, less frequently in test patients compared to controls at 9 and 12 months (p<0.01), whereas, the intraoral detection frequency of P. gingivalis was significantly reduced only 10 days following therapy (p<0.001). At any time after therapy, A. actinomycetemcomitans was not detected intraorally in 5 of 10 (50%) test and 1 of 13 (8%) control patients harboring this pathogen at baseline; P. gingivalis was not detected in only 1 of 18 (6%) test and none of the 17 control patients harboring this pathogen at baseline. Although the data indicated that the assessed antimicrobial therapy may suppress A. actinomycetemcomitans from the entire oral cavity below detectable levels over a minimum of 12 months, P. gingivalis persisted or reoccurred.

Administration, Oral↗
PubMed1998

The effect of working parameters on root substance removal using a piezoelectric ultrasonic scaler in vitro.

This study assessed defect depth and volume resulting from root instrumentation using a piezoelectric ultrasonic scaler with a slim scaling tip in vitro. Combinations of the following working parameters were analyzed: lateral forces of 0.5 N, 1 N, and 2 N; tip angulations of 0 degrees, 45 degrees, and 90 degrees; power settings of low, medium and high; and instrumentation time of 10 s, 20 s, 40 s, and 80 s. Defects were quantified using a 3D optical laser scanner. Overall, lateral force had the greatest influence on defect volume compared to instrument power setting and tip angulation (beta-weights 0.49 +/- 0.04, 0.25 +/- 0.04, and 0.14 +/- 0.04, respectively). The effects on defect depth were highest for tip angulation followed by lateral force and instrument power setting (beta-weights 0.48 +/- 0.04, 0.34 +/- 0.04, and 0.25 +/- 0.04, respectively). Interestingly, at all power settings, the highest defect volume and depth by far were found after combining 45 degrees tip angulation with 2 N of lateral force. The efficacy of the assessed piezoelectric ultrasonic scaler may be adapted to the various clinical needs by adjusting the lateral force, tip angulation, and power setting. To prevent severe root damage it is crucial to use the assessed scaler at a tip angulation of close to 0 degrees.

Dental Instruments↗
PubMed1998

Differential clinical treatment outcome after systemic metronidazole and amoxicillin in patients harboring Actinobacillus actinomycetemcomitans and/or Porphyromonas gingivalis.

48 adult patients with untreated periodontitis harboring subgingival Actinobacillus actinomycetemcomitans and/or Porphyromonas gingivalis as assessed by PCR were randomly assigned to receive full-mouth scaling alone (control) or scaling with systemic metronidazole plus amoxicillin and supragingival irrigation with chlorhexidine digluconate (test). In patients harboring A. actinomycetemcomitans intraorally at baseline, the adjunctive antimicrobial therapy resulted in a significantly higher incidence of probing attachment level (PAL) gain of 2 mm or more compared to scaling alone over 12 months (p<0.05). In addition, suppression of A. actinomycetemcomitans in subgingival plaque below detectable levels was associated with an increased incidence of PAL gain. In contrast, patients initially harboring P. gingivalis but not A. actinomycetemcomitans in the oral cavity showed a significantly higher incidence of PAL loss following adjunctive antimicrobial therapy compared to scaling alone (p<0.05). When the presence of pathogens at baseline was disregarded in the analysis, adjunctive antimicrobial therapy did not significantly enhance clinical treatment outcome. The results indicated that adults with untreated periodontitis harboring A. actinomycetemcomitans may benefit from the adjunctive antimicrobial therapy for a minimum of 12 months, whereas, the regimen may adversely affect the clinical treatment outcome of patients harboring P. gingivalis but not A. actinomycetemcomitans.

Adult↗
PubMed1998

Long-term maintenance of alveolar bone gain after implantation of autolyzed, antigen-extracted, allogenic bone in periodontal intraosseous defects.

This randomized controlled trial assessed the long-term maintenance of alveolar bone gain after implantation of autolyzed, antigen-extracted, allogenic (AAA) bone. AAA bone is a demineralized freeze-dried bone allograft processed after previously described methods. In each of 14 patients, AAA bone was implanted into the intraosseous defect of 1 tooth (test); a second tooth with an intraosseous defect was treated by modified Widman flap surgery alone (control). All patients were offered supportive periodontal therapy at 3- to 6-month intervals following treatment. Clinical measurements were taken prior to surgery, 6 months, and 3 years following surgery. Of the 14 patients enrolled, 11 patients completed the 6-month and 8 patients the 3-year examination. In test teeth, bone gain was significantly greater compared to control teeth at 6 months (2.2+/-0.5 mm and 1.2+/-0.5 mm, respectively) and 3 years (2.3+/-0.7 mm and 1.1+/-0.8 mm, respectively) (P < 0.05). Also, more probing attachment was gained in test compared to control teeth at 3 years (2.0+/-0.7 mm and 0.8+/-0.5 mm, respectively; P < 0.05). At 3 years, Porphyromonas gingivalis was detected in 3 test and 2 control teeth by polymerase chain reaction, whereas no Actinobacillus actinomycetemcomitans was found. Due to the low detection frequency, there was no clear correlation between the maintenance of alveolar bone during supportive periodontal therapy and subgingival infection with P. gingivalis. The data indicated that alveolar bone gain after implantation of AAA bone may be maintained over a minimum of 3 years in patients receiving periodontal supportive therapy.

Adult↗
PubMed1998

Working parameters of a magnetostrictive ultrasonic scaler influencing root substance removal in vitro.

This study assessed defect depth and volume resulting from root instrumentation using a magnetostrictive ultrasonic scaler with a slim scaling tip (P 12) in vitro. Combinations of the following working parameters were analyzed: lateral forces of 0.5 N, 1 N, and 2 N; tip angulations of 0 degrees, 45 degrees, and 90 degrees; power settings of low, medium, and high; and instrumentation time of 10, 20, 40, and 80 seconds. Defects were quantified using a 3-dimensional optical laser scanner. Lateral force had the greatest influence on defect volume compared to tip angulation and power setting (beta-weights 0.53+/-0.04, 0.17+/-0.04, and 0.19+/-0.04, respectively). Lateral force and tip angulation had similar effects on defect depth, but both effects were greater compared to power setting (beta-weights 0.43+/-0.04, 0.49+/-0.04, and 0.19+/-0.04, respectively). The various combinations of the assessed working parameters showed synergistic effects resulting in a wide range of defect depths (14.1+/-1.7 microm to 410.5+/-51.1 microm) and volumes (0.0084+/-0.0057 mm3 to 1.3+/-0.079 mm3). Severe root damage (defect depth >50 microm) at 40 seconds instrumentation time occurred under most combinations of lateral force, angulation, and power settings. The only exceptions were combinations of: 1) 0 degrees angulation, 0.5 N and 1 N lateral force at any power setting and 2) 45 degrees angulation, 0.5 N lateral force at low and medium power setting. The efficacy of the assessed magnetostrictive ultrasonic scaler may be adapted to the various clinical needs by adjusting the lateral force, tip angulation, and power setting.

Dental High-Speed Equipment↗
PubMed1997

Working parameters of a sonic scaler influencing root substance removal in vitro.

This study assessed defect depth and volume resulting from root instrumentation using a KaVo Sonic-flex Lux 2000 L sonic scaler with a slim scaling tip (Perio-Tip no. 8) in vitro. Combinations of the following working parameters were analyzed: lateral forces of 0.5 N, 1 N, and 2 N; tip angulations of 0 degree, 45 degrees, and 90 degrees; and instrumentation time of 10 s, 20 s, 40 s, and 80 s. Defects were quantified using a three-dimensional optical laser scanner. Instrumentation time had an almost linear impact on defect depth and volume. Although lateral force (beta-weight 0.55 +/- 0.062) had a greater influence on defect volume than tip angulation (beta-weight 0.29 +/- 0.062), their effects on defect depth were similar (beta-weight 0.43 +/- 0.052 and 0.50 +/- 0.052, respectively). The combination of force and angulation showed synergistic effects resulting in a wide range of defect depths (21.9 +/- 0.96 microns to 174 +/- 28.8 microns, at 40 s) and volumes (0.056 +/- 0.019 mm3 to 0.68 +/- 0.10 mm3 at 40 s). Severe root damage (> 50 microns/40 s) did not occur at any combination of 0.5 N lateral force and/or 0 degree tip angulation. By adjusting lateral force and tip angulation, the efficacy of the assessed sonic scaler may be adapted to various clinical needs.

Dental Instruments↗
PubMed1997

Controlled local delivery of tetracycline HCl in the treatment of periimplant mucosal hyperplasia and mucositis. A controlled case series.

The purpose of this controlled case series was to assess the adjunctive efficacy of controlled topical tetracycline HCl application in the treatment of infection associated periimplant mucositis or mucosal hyperplasia. Eight patients with at least 2 endosseous implants showing clinical signs of periimplant mucosal hyperplasia or mucositis were enrolled. All implants received supra- and subgingival scaling, with half of the implants receiving adjunctive controlled local delivery of tetracycline HCl (test). Control implants did not receive any other therapy aside from scaling. Clinical parameters were assessed at baseline, 4, and 12 weeks. Scaling plus controlled local delivery of tetracycline HCl markedly reduced periimplant mucosal hyperplasia in 4 of 5 test implants and demonstrated a trend towards a reduction of bleeding on probing scores. Scaling alone had no effect on mucosal hyperplasia in the 2 control implants presenting with this condition nor bleeding on probing scores. In both groups, plaque index scores were slightly reduced at 4 weeks but returned to baseline values at 12 weeks, whereas pocket probing depths, clinical attachment levels, and probing bone levels remained unchanged during the course of the trial. The observed trends suggest that scaling plus controlled local delivery of tetracycline HCl may have beneficial effects. Randomized controlled trials employing a sample size high enough to reach sufficient statistical power are needed to definitively assess the efficacy of controlled local tetracycline HCl delivery on periimplant diseases.

Administration, Topical↗
PubMed1996

Adjunctive controlled topical application of tetracycline HCl in the treatment of localized persistent or recurrent periodontitis. Effects on clinical parameters and elastase-alpha1-proteinase inhibitor in gingival crevicular fluid.

35 patients receiving regular supportive periodontal therapy (SPT) and showing signs of localized persistent or recurrent periodontitis were enrolled in the study. Within 1 week after SPT, each patient had a tetracycline HCl loaded ethylene vinyl acetate co-polymer fiber placed into the periodontal pocket of 1 randomly selected tooth with persistent or recurrent periodontitis (test); the fiber was removed after 9.5+/-2.0 days. A non-adjacent tooth with persistent or recurrent periodontitis in a separate quadrant, which received no further treatment, served as a control. A total of 28 patients completed the 6-month study. Compared to control teeth, in test teeth at 6 months significantly (p<0.01) lower scores were found for gingival index, pocket probing depths, and PMN elastase-alpha1-proteinase inhibitor concentrations in gingival crevicular fluid. With the exception of plaque index scores, test teeth demonstrated significant reductions from baseline to 6 months in all parameters (p<0.05). Conversely, all parameter measurements in control teeth, except bleeding on probing, showed no significant difference between baseline and 6-month values. The results suggest that the use of controlled topical application of tetracycline HCl may improve periodontal health and reduce the risk of disease progression in localized persistent or recurrent periodontitis. Moreover, the effects of this application appear to be sustained for at least 6 months.

Administration, Topical↗