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Biomedical subjects

T F Flemmig

Publications and source records attributed to T F Flemmig.

51 records · Page 3Linked to original sources
PubMed1994

Neutrophil lysosomal nonoxidative microbicidal proteins in early-onset periodontitis.

The purpose of this study was to evaluate whether the reduced microbicidal activity of polymorphonuclear leukocytes (neutrophils) in patients with early-onset periodontitis is associated with a deficiency of nonoxidative microbicidal proteins. Neutrophils from 10 patients with early-onset periodontitis and 8 healthy control subjects were assessed for elastase isozymes 1 through 4, cathepsin G isozymes 1 through 4 and defensins (HNP-1, HNP-2 and HNP-3) using cationic and acid urea polyacrylamide gel electrophoresis. The results showed that both the total content and the relative distribution of elastase and cathepsin G isozymes was normal in neutrophils of patients with early-onset periodontitis. However, the HNP-3 content was significantly reduced in neutrophils from patients with generalized early-onset periodontitis. These findings indicate that the impaired microbicidal activities of neutrophils in patients with early-onset periodontitis does not appear to be based on an elastase or cathepsin G abnormality in neutrophils. Due to the high variability of HNP-1 + 2 and HNP-3 in neutrophils of control subjects, the reduced HNP-3 content in neutrophils probably plays a minor role in the pathogenesis of generalized early-onset periodontitis.

Adult↗
PubMed1991

Gingival enhancement in fixed prosthodontics. Part I: Clinical findings.

This study assessed the efficacy of a 0.12% chlorhexidine gluconate (CHX) rinse on the enhancement and maintenance of gingival health in patients receiving fixed prosthodontic treatment. Thirty patient participants in this examiner blind study were randomly assigned into two groups, one control and another group using CHX 15 ml b.i.d. in addition to normal oral hygiene. The medication was used for 2 weeks prior to crown preparation, 3 weeks during provisional crown placement, and 2 weeks after definitive crown cementation. Plaque and gingivitis indices were measured initially and at the three aforementioned points during the 7-week period. The plaque index for the control group decreased by 0.26 units; CHX decreased by 0.63 units at 7 weeks. The gingival index of the control group decreased by 0.37 units; CHX decreased by 0.87 units. Adjunctive use of chlorhexidine with fixed prosthodontic procedures significantly reduced plaque levels and significantly improved gingival health compared with the control patients. Fixed prosthodontic procedures alone decreased plaque levels and increased gingival health.

Adult↗
PubMed1991

Gingival enhancement in fixed prosthodontics. Part II: Microbiologic findings.

This study assessed the changes of the subgingival/marginal microflora during fixed prosthodontic procedures and evaluated the effect of adjunctive rinsing with 0.12% chlorhexidine on the subgingival/marginal microflora during fixed prosthodontic treatment. Thirty patients scheduled for fixed prosthodontics were randomly assigned to either rinsing with 15 ml of tap water b.i.d. (control) or rinsing with 15 ml of 0.12% chlorhexidine gluconate b.i.d. (experimental). Subgingival and marginal plaque was analyzed at baseline, before crown preparation (2 weeks), before crown cementation (5 weeks), and 2 weeks after cementation (7 weeks). The fixed prosthodontic procedures alone altered the subgingival and marginal microbiota toward a more health-associated flora. Adjunctive rinsing twice daily with 0.12% chlorhexidine had a significantly greater effect in reducing putative periodontal pathogens compared with the control regimen. This medication was a useful adjunct to regular oral hygiene during fixed prosthodontic procedures by permitting the establishment and maintenance of a microflora compatible with periodontal health.

Adult↗
PubMed1991

Rapid antimicrobial resistance screening method for Bacteroides intermedius.

The purpose of the study was to validate a rapid resistance screening (RRS) method for antimicrobial susceptibility testing of a selected periodontopathic microorganism using the standard broth dilution method as a control. Twenty-five subgingival plaque samples from gingivitis or periodontitis sites were plated on Trypticase soy agar supplemented with 5% rabbit blood with antibiotic discs (RRS method) and without (control). The antibiotics tested were: Augmentin, clindamycin, erythromycin, metronidazole, penicillin G and tetracycline hydrochloride. Bacteroides intermedius isolated from both groups of plates were placed onto antibiotic supplemented Trypticase soy broth. The antibiotic susceptibilities of B. intermedius isolated from the plates with antibiotic discs and the standard broth method were compared. The results showed high sensitivity and predictability for the RRS method compared with the control. The percentage of agreement was: 100% for Augmentin 30 micrograms, clindamycin 2 micrograms and tetracycline 30 micrograms; 96% for erythromycin 15 micrograms, metronidazole 80 micrograms and penicillin 10 IU; 92% for penicillin 2 IU; 88% for erythromycin 2 micrograms and 84% for tetracycline 5 micrograms. The results of this study document the feasibility of the RRS method for testing antimicrobial resistance of whole samples if its efficacy can be demonstrated for other bacteria. This method may be a quick and useful test for the periodontal practitioner in determining the antibiotic susceptibility of periodontal plaque pathogens.

Adult↗
PubMed1991

Prevalence and severity of periodontal disease in patients with inflammatory bowel disease.

Previous reports have demonstrated that oral mucosa and periodontal lesions occur in patients suffering from inflammatory bowel disease (Crohn's disease [CD] and ulcerative colitis [UC]). It is unknown whether periodontal disease is an occasional or regular finding in these patients. The purpose of this study was to assess the prevalence and severity of periodontal disease in patients with inflammatory bowel disease (IBD). The periodontal status of 107 consecutive patients seeking treatment for inflammatory bowel disease was assessed. Examination of the mid- and mesiobuccal aspects of one quadrant on one jaw and the contralateral quadrant of the opposite jaw revealed the 93.5% of the CD patients and 95.1% of UC patients had at least one site with probing attachment loss of 2 mm or greater, and a mean probing attachment loss 1.4 +/- 0.9 mm and 1.5 +/- 1.0 mm, respectively. We found that 28.3% of CD patients and 29.5% of UC patients possessed at least 1 site with a pocket probing depth of 4 mm or greater; the mean pocket probing depth in these patients was 2.4 +/- 0.2 mm and 2.3 +/- 0.2 mm, respectively. Compared with the assessment of Oral Health of United States Adults, IBD patients revealed a 11.9% higher prevalence (P less than or equal to 0.01) but 0.6 mm lower severity (P less than or equal to 0.01) of periodontal disease. The magnitudes of these differences suggest no clinical implications for the management of periodontal disease in IBD subjects.

Adolescent↗
PubMed1991

Differential killing of Actinobacillus actinomycetemcomitans and Capnocytophaga spp. by human neutrophil granule components.

The purpose of this study was to determine whether granule fractions of human neutrophils differentially kill Actinobacillus actinomycetemcomitans and Capnocytophaga spp. Granule extracts were subjected to gel filtration, and seven fractions (designated A through G) were obtained. Under aerobic conditions at pH 7.0, representative strains of A. actinomycetemcomitans were killed by fraction D and variably by fraction B. In contrast, the Capnocytophaga spp. were killed by fractions C, D, F, and G. Fractions A (containing lactoferrin and myeloperoxidase) and E (containing lysozyme) exerted little bactericidal activity under these conditions. Anaerobiosis had little effect on the bactericidal activity of fractions D and F but inhibited that of fractions B and C. Electrophoresis, zymography, determination of amino acid composition, and N-terminal sequence analysis revealed that fraction C contained elastase, proteinase 3, and azurocidin. Fraction D contained lysozyme, elastase, and cathepsin G. Subfractions of C and D containing elastase (subfraction C4), a mixture of elastase and azurocidin (subfraction C5), and cathepsin G (subfraction D9) were found to be bactericidal. The bactericidal effects of fraction D and subfraction D9 against A. actinomycetemcomitans was not inhibited by heat inactivation, phenylmethylsulfonyl fluoride, or N-benzyloxycarbonylglycylleucylphenylalanylchloromethyl ketone. We conclude that (i) A. actinomycetemcomitans and Capnocytophaga spp. were sensitive to the bactericidal effects of different neutrophil granule components, (ii) both were sensitive to the bactericidal effects of neutral serine proteases, and (iii) the killing of A. actinomycetemcomitans by cathepsin G-containing fractions was independent of oxygen and neutral serine protease activity.

Actinobacillus↗
PubMed1991

Clinical and microbiological patterns of adults with periodontitis.

Although current data suggest that periodontitis may actually be multiple diseases each with varying responses to therapy, little evidence exists to support this theory in adult patients. This report describes the design and initial findings of a longitudinal field trial involving the diagnosis and treatment of adult and refractory periodontitis patients in private practice. Adult patients (N = 221) who met specific clinical criteria were selected from the private practices of 22 periodontists. Clinical characteristics were recorded and subgingival plaque samples were sent to microbiology laboratories at either UCLA or The University of Texas Health Science Center at San Antonio (UTHSCSA). Samples were processed according to protocols standardized between the 2 centers. Five different combinations of the initial clinical and microbial findings were evaluated for patterns in the data by means of cluster analysis. Plaque, bleeding on probing, bone loss scores, probing depth distributions, and microbial findings produced multiple cluster solutions. Solutions involving 6 clusters explained 39.4% to 76.4% of the variation between patients and produced ratios for variation between clusters to variation within clusters of 5.2 to 15.3. The optimal cluster solution incorporated both clinical and microbial findings, with some clusters characterized by high plaque and moderate bleeding on probing and bone loss, whereas others had low plaque but high bleeding on probing and bone loss. Microbial findings of each cluster exhibited distinct patterns with some clusters having a high prevalence (83% to 100%) of specific target bacterial species while other clusters had an absence of these species.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Clinical and microbiological effects of subgingival and gingival marginal irrigation with chlorhexidine gluconate.

Recent interest in the local delivery of antimicrobial and anti-inflammatory agents has stimulated interest in the efficacy of various treatment regimens. Chlorhexidine gluconate (CHX) delivered daily by home-applied marginal irrigation as a 0.04% solution in combination with a single professional irrigation of 0.12% CHX was tested over a 3-month period. Sixty periodontal maintenance patients each having at least 2 pockets greater than or equal to 4 mm probing depth, and bleeding on probing were assigned to either Group 1: one professional subgingival 0.12% CHX (Peridex) irrigation (Perio Pik) followed by adjunctive daily home marginal 0.04% CHX irrigation (Pik Pocket); Group 2: one professional subgingival 0.12% CHX irrigation followed by adjunctive daily home marginal water irrigation; Group 3: one professional subgingival water irrigation followed by adjunctive daily home marginal water irrigation; or Group 4: control. At baseline and 3 month visits, subgingival plaque samples were taken from 2 sites per patient. Cultural microbiological analysis was performed using non-selective and selective media. Plaque Index, Gingival Index, pocket probing depths, and gingival recession were assessed. Scaling and root planing (supportive periodontal treatment) was provided for each patient followed by subgingival irrigation as outlined above. At 3 months the Gingival Index and pocket probing depths were both significantly reduced (P less than .05) in all irrigation groups compared to baseline. There were no significant changes in clinical parameters in the control group from baseline to 3 months. In Group 1 the GI was significantly reduced (P less than .05) compared to Group 4 at 3 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Supragingival irrigation with 0.06% chlorhexidine in naturally occurring gingivitis. I. 6 month clinical observations.

The purpose of this study was to assess the efficacy of supragingival irrigation with 0.06% chlorhexidine gluconate (CHX) on naturally occurring gingivitis. The relative benefit of CHX irrigation in comparison with CHX rinsing, water irrigation, and normal oral hygiene was evaluated. In a blind, placebo-controlled 6-month study 222 patients were assigned to one of four groups: Group 1: Once daily irrigation with 300 ml water followed by irrigation with 200 ml 0.06% chlorhexidine gluconate (experimental); Group 2: Twice daily rinsing with 15 ml 0.12% chlorhexidine (positive control); Group 3: Once daily irrigation with 500 ml water (irrigation control) and Group 4: Sodium fluoride dentifrice for normal oral hygiene only (negative control). All groups used the same sodium fluoride dentifrice for tooth brushing. At baseline, 3 months, and 6 months patients were examined for Gingival Index (GI), Bleeding on Probing (BOP), Plaque Index (PLI), Pocket probing depth (PD), Calculus Index (CI), and stain. After the baseline visit all patients received a supra- and subgingival oral prophylaxis. At 6 months GI and BOP were significantly (P less than or equal to 0.05) reduced by adjunctive CHX irrigation (42.5% and 35.4%, respectively), CHX rinse (24.1% and 15.0%), and water irrigation (23.1% and 24.0%) compared to tooth brushing alone. Plaque was significantly (P less than or equal to 0.05) reduced only by CHX irrigation (53.2%) and CHX rinse (43.3%) while calculus and staining were significantly (P less than or equal to 0.05) increased in the two chlorhexidine groups (276.4% (irrigation) and 273.2% (rinse)). Although significant (P less than or equal to 0.05), pocket probing depth reduction was minimal after CHX irrigation (4.6%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Effects of subgingival irrigation on bacteremia following scaling and root planing.

The purpose of this study was to determine the effects of professional subgingival irrigation, together with subsequent patient administered home marginal irrigation, on the incidence of bacteremia after scaling and root planing (Sc/RP). A total of 60 periodontal maintenance patients were assigned to either Group 1: subgingival irrigation, with 0.12% CHX and daily marginal irrigation with 0.04% CHX; Group 2: subgingival irrigation with 0.12% CHX and daily marginal irrigation with water; Group 3: subgingival and daily marginal irrigation with water; Group 4: Non-irrigation (control). Patients entered the study after receiving a thorough periodontal maintenance appointment including a complete examination, Sc/RP, and standard oral hygiene instruction. Blood samples were taken at the 3-month visit before and after Sc/RP. Microbiological culturing was done using the Septi-Chek system, selective and non-selective media. Results from 54 patients showed that bacteremia was detected prior to Sc/RP in 2 patients and after Sc/RP in 10 patients. No significant effect by treatment regimens on post Sc/RP bacteremia could be detected. The organisms isolated included Eubacterium lentum, Propionibacterium acnes, Streptococcus species, Neisseria species, Candida albicans, Staphylococcus species, and un-identified Gram-negative rods.

Adult↗
PubMed1990

Irrigation with 0.06% chlorhexidine in naturally occurring gingivitis. II. 6 months microbiological observations.

In an examiner blind positive/negative controlled 6-month study, the efficacy of supragingival irrigation with 0.06% chlorhexidine gluconate on the marginal and subgingival microflora in naturally occurring gingivitis was evaluated. The 222 patients enrolled in the study were assigned to one of four groups: Group 1: Once daily irrigation with 300 ml water followed by irrigation with 200 ml 0.06% chlorhexidine gluconate (experimental); Group 2: Twice daily rinsing with 15 ml 0.12% chlorhexidine (positive control); Group 3: Once daily irrigation with 500 ml water (irrigation control) and Group 4: Sodium fluoride dentifrice for normal oral hygiene only (negative control). All groups received the same sodium fluoride dentifrice for tooth brushing. All patients received a supra- and subgingival oral prophylaxis after baseline examination and at the end of the investigation. Plaque samples were analyzed from 105 patients at baseline, 93 patients at 3 months and 88 patients at 6 months. The 6-months results demonstrated that, when compared with tooth brushing alone, adjunctive supragingival irrigation with 0.06% chlorhexidine gluconate was most effective by significantly reducing (P less than or equal to 0.008) both log10 CFU and % of Gram-negative anaerobic rods and black-pigmented Bacteroides. Chlorhexidine rinse also significantly (P less than or equal to 0.008) reduced log10 CFU of black-pigmented Bacteroides at 6 months. Both chlorhexidine regimens significantly (P less than or equal to 0.008) increased the % of Gram-positive facultative cocci compared to water irrigation at 3 months. Water irrigation had a limited effect on any of the assessed bacterial groups (log10 CFU and %).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Immunological aspects of periodontal diseases. Prospects for diagnosis and therapy].

Achievements in bacteriology and immunology have significantly contributed to the understanding about the etiology and pathogenesis of periodontal diseases. Studies have demonstrated that interactions between bacteria and the immune system play a central role in the etiology of periodontal disease. In the immune system four components can be distinguished according to their function in the periodontium. These include a) the secretory system; b) the polymorphonuclear leukocytes, antibody and complement system; c) lymphocytes and monocytes; d) the immunoregulatory system. Polymorphonuclear leukocytes are of utmost importance for the maintenance of periodontal health. In neutrophil defects severe periodontal diseases are frequently found. Prepubertal periodontitis, juvenile periodontitis and rapidly progressing periodontitis are examples for the periodontal manifestation of neutrophil defects. Therapy of periodontal disease that is related to immune defects requires a modified treatment plan. Efforts are being made to extend the diagnosis, prevention and therapy of periodontal diseases. Presently, biochemical, immunological and microbiological methods are being evaluated for their clinical applicability. Preliminary results indicate that, in the future, biochemical markers in the gingival crevicular fluid may be used for the diagnosis of active sites. Therapy may be enhanced by the administration of non-steroidal anti-inflammatory drugs and specific antimicrobials. However, before these methods can be applied in clinical periodontics, further long-term studies are needed.

Adult↗
PubMed1988

Periodontal considerations of implants and implant associated microbiota.

The scientific and clinical acceptance of the success of osseointegrated dental implants has been firmly established, but the relationships between clinical observation and periimplant pathogenesis is not well understood. Data and concepts regarding the diagnostic value of traditional periodontal evaluation parameters, such as pocket probing depth, bleeding on probing, attachment loss, gingival and plaque indices, and the amount of attached gingiva are discussed. The microbiologic characterization of plaque associated with various implant systems reveals many similarities and some differences compared to natural teeth. An hypothesis for the "periodontal" etiology of implant failure is proposed. The maintenance of edentulous and partially edentulous patients with implants is discussed.

Dental Implantation, Endosseous↗