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PubMed1992

The ability of gingival crevicular fluid acute phase proteins to distinguish healthy, gingivitis and periodontitis sites.

3 acute phase proteins, from the local gingival inflammatory response, were examined for their ability to distinguish healthy, gingivitis and periodontitis sites. Indirect competitive immunoassays were developed for the quantification of alpha 2-macroglobulin (alpha 2-M) and transferrin (TF), and for alpha 1-antitrypsin (alpha 1-AT), a double antibody sandwich assay was produced. Healthy (25), gingivitis (31) and periodontitis (28) sites were sampled with filter paper strips (2 x 13 mm) and the volume assessed with the Periotron 6000. The samples were eluted in phosphate-buffered saline and analyzed for alpha 2-M, alpha 1-AT and TF. The results were expressed as absolute amounts per sample (ng/30 s) and on a concentration basis (ng/microliter of GCF). Higher GCF absolute amounts of alpha 2-M, alpha 1-AT and TF were consistently obtained from diseased (gingivitis and periodontitis) sites than healthy sites (p less than 0.005). Absolute amounts of GCF alpha 2-M, alpha 1-AT and TF were increased in periodontitis sites over gingivitis sites, although these differences were not statistically significant (p greater than 0.1). When the results were expressed on a concentration basis, alpha 2-M levels from diseased sites were significantly higher than healthy sites (p less than 0.01). In addition, GCF TF concentration was increased in periodontitis compared to healthy sites (p = 0.03).

Enzyme-Linked Immunosorbent Assay↗
PubMed2005

Manual versus powered toothbrushing for oral health.

BACKGROUND: Removing dental plaque may play a key role maintaining oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this. OBJECTIVES: To compare manual and powered toothbrushes in relation to the removal of plaque, the health of the gingivae, staining and calculus, dependability, adverse effects and cost. SEARCH STRATEGY: We searched the Cochrane Oral Health Group Trials Register (to 17/06/2004) and Central Register of Controlled Trials (The Cochrane Library Issue 2, 2004); MEDLINE (January 1966 to week 2 June 2004); EMBASE (January 1980 to week 2 2004) and CINAHL (January 1982 to week 2 June 2004). Manufacturers were contacted for additional data. SELECTION CRITERIA: Trials were selected for the following criteria: design-random allocation of participants; participants - general public with uncompromised manual dexterity; intervention - unsupervised manual and powered toothbrushing for at least 4 weeks. Primary outcomes were the change in plaque and gingivitis over that period. DATA COLLECTION AND ANALYSIS: Six authors independently extracted information. The effect measure for each meta-analysis was the standardised mean difference (SMD) with 95% confidence intervals (CI) using random-effects models. Potential sources of heterogeneity were examined, along with sensitivity analyses for quality and publication bias. For discussion purposes SMD was translated into percentage change. MAIN RESULTS: Forty-two trials, involving 3855 participants, provided data. Brushes with a rotation oscillation action removed plaque and reduced gingivitis more effectively than manual brushes in the short term and reduced gingivitis scores in studies over 3 months. For plaque at 1 to 3 months the SMD was -0.43 (95% CI: -0.72 to -0.14), for gingivitis SMD -0.62 (95% CI: -0.90 to -0.34) representing an 11% difference on the Quigley Hein plaque index and a 6% reduction on the Loe and Silness gingival index. At over 3 months the SMD for plaque was -1.29 (95% CI: -2.67 to 0.08) and for gingivitis was -0.51 (-0.76 to -0.25) representing a 17% reduction on the Ainamo Bay bleeding on probing index. There was heterogeneity between the trials for the short-term follow up. Sensitivity analyses revealed the results to be robust when selecting trials of high quality. There was no evidence of any publication bias. No other powered designs were as consistently superior to manual toothbrushes.Cost, reliability and side effects were inconsistently reported. Any reported side effects were localised and temporary. AUTHORS' CONCLUSIONS: Powered toothbrushes with a rotation oscillation action reduce plaque and gingivitis more than manual toothbrushing. Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses.

Dental Devices, Home Care↗
PubMed1991

Periodontal health of 14-17-year-old US schoolchildren.

This paper describes the findings related to periodontal health in 14-17-year-old children who participated in the National Survey of Oral Health in US Schoolchildren, conducted by the National Institute of Dental Research (NIDR) during 1986-87. Gingivitis was observed in approximately 60 percent of children in this age group. The proportion of examined sites per child with gingivitis, however, was less than 6 percent. Gingivitis was most common in molar areas in the maxilla and incisor areas in the mandible. Supragingival calculus was observed in nearly 34 percent of the children, and subgingival calculus in approximately 23 percent. The proportion of teeth per child with calculus was approximately 8 percent for supragingival and 4 percent for subgingival calculus. Both types of calculus showed a predilection for molars in the maxilla and incisors and cuspids in the mandible. The mean periodontal attachment loss was 0.33 mm. The teeth most frequently affected by attachment loss of 2 mm or more were maxillary molars and bicuspids, followed by mandibular molars and cuspids.

Adolescent↗
PubMed2000

The in vivo expression of the collagenolytic matrix metalloproteinases (MMP-2, -8, -13, and -14) and matrilysin (MMP-7) in adult and localized juvenile periodontitis.

Periodontal inflammation is characterized by irreversible degradation of periodontal ligament collagen fibers leading to loss of tooth attachment. Cultured gingival keratinocytes and fibroblasts express, in vitro, various matrix metalloproteinases (MMPs) which can degrade fibrillar collagens. We hypothesized that several MMPs are also synthesized in vivo by sulcular epithelium, and analyzed the collagenolytic MMPs (MMP-2, -8, -13, and -14) and matrilysin (MMP-7) in gingival tissue specimens and gingival crevicular fluid from adult and localized juvenile periodontitis patients by in situ hybridization, immunohistochemistry, and Western immunoblotting. MMP-2, -7, -8, and -13 were expressed in gingival sulcular epithelium. MMP-7 and -13 were also located in fibroblasts and macrophages, and MMP-8 in neutrophils. MMP-8- and -13-positive cells/mm2 were higher in periodontitis gingiva when compared with healthy control tissue (p < 0.01). In periodontal diseases, gingival sulcular epithelium expresses several, rather than a single, collagenolytic MMPs, and this proteolytic cascade is evidently responsible for the tissue destruction characteristic of adult and juvenile periodontitis.

Adolescent↗
PubMed1997

[Benign focal melanotic lesions of the oral mucosa: a clinicopathologic study of 41 cases].

41 patients with benign focal melanotic lesions on the oral mucosa were studied. The results showed that among the patients, 27 were female and 14 male, the mean age was 33 years old, and the most common site was the lip and gingiva. Clinically, the lesions were focal and well-defined, the size was about 0.6 cm in diameter. Histologically, 21 cases were pigmented nuvus on the oral mucosa (18 cases with nevocellular nevus and 3 cases with the common blue nevus), 2 cases were junctional change, 5 cases were the lentigo simplex, and 13 cases were oral melanotic macule. The characteristics of the oral melanotic macule and the junctional change were discussed.

Adolescent↗
PubMed1991

[Stomatological problems related to pregnancy. A statistical study].

Pregnancy is related to particular dental issues, such as the increased incidence of diseases( gingivitis, caries, epulis), the fluoride supplementation, and the limits of diagnostics and therapy. Moreover, the mysterious halo surrounding pregnancy often makes the dentist uneasy. In order to objectively evaluate the implications of pregnancy in dentistry, we distributed a form to 100 pregnant women. The results of the form showed that 53 of them had gingival bleeding, 22 had toothache, 19 had caries but that just 12 of them had gone to the dentist because of dental troubles while 54 had not gone at all. Among the pluri-gravidae, all the women with dental diseases in their previous pregnancies had them again in their current pregnancy but nonetheless only some had undergone a dental check-up. The dentists did not show any uneasiness, as they performed tooth extractions in 5 women, endodontics in 2 women and fillings in 11 women. Just 4 out of 100 women had taken a fluoride supplementation. We deem advisable a stronger collaboration between physician, gynecologist and dentist in order to resolve specialist problems and to make pregnant women more aware of the need for dental follow-ups and fluoride supplementations.

Adult↗
PubMed1989

Oral flora of mongrel and beagle dogs with periodontal disease.

The plaque flora was studied in adult mongrel and beagle dogs with periodontal disease. Gingival plaque from maxillary premolars was removed and cultured on various growth media. The flora in all dogs was composed of mostly anaerobic gram negative rods. Bacteroides asaccharolyticus was found in the highest proportion of plaque samples from mongrel dogs, and decomposed hydrogen peroxide suggesting catalase activity. Fusobacterium nucleatum was found in higher proportion in the plaque of beagle dogs as compared to B. asaccharolyticus. With the increasing numbers of obligative anaerobic gram negative organisms such as B. asaccharolyticus, the proportions of Streptococcus, Enterococcus and Staphylococcus decreased in the dogs with periodontal disease. The salivary flora was different from the plaque flora of the dogs with periodontal disease. It was constant regardless with the disease. The salivary flora of beagle dogs with the healthy gingiva was different from that of mongrel dogs. Enterococcus, Lactobacillus, Eubacterium and black-pigmented Bacteroides (BPB, mainly B. asaccharolyticus) were higher proportion in the flora of beagle dogs as compared to mongrel dogs, while Fusobacterium, Enterobacteriaceae, yeast and molds were lower in the flora. The results reveal that B. asaccharolyticus and F. nucleatum are common pathogens and uniquely contribute to the development of gingival inflammation in dog.

Animals↗