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Leukocyte esterase and protein levels in saliva, as indicators of gingival and periodontal diseases in children.

PURPOSE: This study was to determine if dip stick assays of children's saliva for leukocyte esterase or protein (Serim Research Corporation, Elkhart, Ind) reflect the presence or severity of gingival or periodontal diseases in children. METHODS: The study included 13 children with periodontitis [study group] and a control group of 17 children without periodontitis. The saliva leukocyte esterase and protein values (scales from 1 to 4) were tested with dip stick analyses. The gingival (GI) and plaque indices (PI) presence and number of sites with periodontitis, demographic data, systemic condition, caries prevalence, and the presence of dental restorations were recorded and their relationship to leukocyte esterase or protein values were analyzed. RESULTS: Most children had a protein value of 2 or 3 or a leukocyte esterase value of > or = 3. Significant differences in the distribution of protein values by the presence/absence of periodontitis (chi-square, P<0.001), or the number of sites with periodontitis by protein value (chi-square, P=.005; ANOVA, P=.03) were evident; No. 4 protein values were found only in children with periodontitis, and No. 2 and No. 3 protein values were mostly found in children without it. CONCLUSIONS: Dip stick protein analysis of saliva of children has the potential to differentiate children with periodontitis or with fewer periodontal lesions.

Aggressive Periodontitis↗

Epidemiology of gingivitis.

In recent years, tremendous strides have been made in understanding the etiology of gingivitis. This increase in knowledge has come, for the most part, from basic research in oral microbiology, immunology, histology and pathology. Over the past decade, less progress has been made in further refining the epidemiological relationships between gingivitis and various host and environmental factors. The major restraint has been the great difficulty in reliably measuring gingival inflammation. This problem has resulted in great inter- and intra-study variation in diagnosing the prevalence and severity of gingivitis in human populations. Consequently, it is almost impossible to estimate longitudinal trends in gingivitis and it is nearly as difficult to make comparisons among different population groups studied by different examiners. Nevertheless, by focusing on the most apparent and robust epidemiological relationships, an instructive overview of the epidemiology of gingivitis can be gained. A number of host and environmental factors have been studied in relation to gingivitis and some of these will be reviewed. With respect to age, there is general concensus that marginal gingivitis begins in early childhood, increases in prevalence and severity to the early teenage years, thereafter subsiding slightly and leveling off for the remainder of the second decade of life. Gingivitis during the adult period is much more difficult to characterize due to paucity of data. Estimates of the general prevalence of adult gingivitis vary from approximately 50 to 100% for dentate subjects. In terms of gingivitis prevalence, the dentate elderly do not deviate appreciably from the general adult pattern. When adjusted for cohort effects, gingival disease appears to be on the decline.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Observations and concepts of the oral health consequences of tobacco use of Finnish periodontists and dentists.

The observations of Finnish periodontists and other dentists, and their concepts of the oral health consequences of tobacco use as well as their counseling on tobacco use, were surveyed from November 1987 to January 1988. A questionnaire was mailed to all 61 Finnish periodontists and to 535 other dentists; 37 periodontists (61%) and 432 of the other dentists (80%) responded. The periodontists enquired about and advised on smoking significantly more frequently than did the other dentists; 71% of the periodontists often or always enquired about, and 62% advised their patients on smoking. 31% of all dentists had patients who were users of smokeless tobacco, and 62% of those dentists had often or always advised the users to quit. Nearly all dentists had seen some tobacco-caused effects. Periodontists reported more frequently than the other dentists that they had observed more periodontitis, impaired healing of periodontitis and more changes in the oral mucosa in smokers compared with non-smokers. The majority of those who had seen users of smokeless tobacco had noticed changes in the oral mucosa and in the color of the gingiva. The majority of all dentists believed that heavy smoking may impair the host response in the periodontium, with periodontists believing in this more strongly than other dentists.

Adult↗

Prevalence of gingival stippling in children.

Gingival stippling is a characteristic of the healthy attached gingiva and its diminution or loss has been considered as a sign of gingival disease. The clinician however, must take in consideration that its pattern and extent varies in different mouth areas, among persons and with age. Reports on the prevalence of stippling in children are few and inconsistent. Therefore, the purpose of the present study was to describe the prevalence of gingival stippling in children of various ages. Fifty-five high quality anterior oral color slides of children (25 girls and 30 boys) aged 1 to 10 years, were examined for the presence of stippling. The average age of the study population was 5.1 years (S. E. = 0.3). The overall prevalence of stippling was 56.4%. Analysis of the differences between boys and girls in age (t-test) or the prevalence of stippling (Chi square) did not indicate statistical significance (p>0.05). Stippling was evident from 3 years of age and thereafter, with no particular trend of change with age. Stippling was found in 47.2% of the maxillary areas, in 41.7% of the mandibular areas and in 26.1% in both arches of the same child. The differences in distribution of stippling by gender and arch were not statistically significant (Chi square, p>0.05). In conclusion, gingival stippling was found to be a normal characteristic in 56.3% of 3 to 10-year-old children, without significant differences in prevalence related to arch, gender or age.

Child↗

[Modified bridge flap. Three-year control study].

Gingival recessions in the upper jaw were covered by a modified bridging flap and follow-up examinations were carried out over three years. After one year the covering result was 72% and after three years 66%.

Gingival Diseases↗

[The importance of periodontal evaluation in orthodontics].

The orthodontist is in fact a periodontal-therapist since his aim is to move the teeth with and through the periodontal tissues. It is most important for the orthodontist to be able to determine at the initial clinical examination what are the various periodontal risk factors. When the pathology is obvious with inflammation, periodontal pockets, gingival hyperplasia, edema of the papillae, gingival recessions, the need for periodontal treatment is manifest. But many times, the periodontal evaluation is complicated by the presence of slight variations of the quality of the marginal tissue that represent a risk of developing periodontal defects during the orthodontic treatment. The aim of this presentation is to put forward the importance of the periodontal evaluation during the initial examination of the patient so that, if necessary, an adequate periodontal therapy can be initiated to stabilize the periodontal tissues and thus improves the esthetical outcome.

Dental Plaque↗

Prevalence and distribution of gingivitis and dental caries in children aged 6-12 years in Brisbane primary schools.

A study of caries experience and gingivitis prevalence in 6-, 9- and 12-yr-old children attending primary schools in Brisbane was undertaken in November/December 1983. Children from high socioeconomic level (SEL) schools exhibited lower dmft and DMFT scores at all ages. At age 6 yr the proportion of children with caries-free primary dentitions was for high SEL Schools 70%, for middle SEL schools 52% and for low SEL Schools 23%. At 12 yr DMFT scores were 1.8 (high), 2.1 (middle) and 3.3 (low). Similar differences in gingivitis prevalence occurred, children from high SEL schools displaying a much lower proportion of bleeding sites than those from middle and low SEL schools. For selection of children at "high risk" to gingival disease for intensive prevention programmes, an increased emphasis on probing techniques is indicated to achieve diagnostic consistency.

Australia↗

Periodontal diseases: a review.

Periodontal diseases are a collection of disorders that may affect patients throughout life. The most common form of periodontal disease, gingivitis, which affects only the soft tissues, is seen in children, adolescents, and adults. Periodontitis, which destroys the bone supporting a tooth, is found more commonly in adults over the age of thirty-five but may be present in a variety of forms in children after three years of age. These diseases are caused by bacterial plaque but may be modulated by systemic diseases, immunologic compromise, heredity, and other contributing factors. Periodontal pathoses may be an indication of an underlying systemic condition such as leukemia or human immunodeficiency virus infection. The standard treatment of periodontal diseases is the control of intraoral plaque. This may be accomplished using mechanical, chemotherapeutic, and surgical means.

Humans↗

Clinical appearance of lesions associated with the use of loose and portion-bag packed Swedish moist snuff: a comparative study.

The aim of this study was to register and compare clinical oral mucosal lesions and gingival recessions associated with the use of two different smokeless tobacco products, loose snuff and portion-bag packed snuff. Selected for the study were 252 men (mean age 36.3 yr) of whom 184 (mean age 36.0 yr) used exclusively loose snuff and 68 (mean age 36.9 yr) exclusively portion-bag snuff. Oral mucosal lesions were registered according to a four-grade clinical scale. There was a significantly larger proportion of less pronounced lesions, Degrees 1 and 2, among the users of portion-bag snuff compared with the users of loose snuff. This was also valid when differences in consumption data were considered. Smokeless tobacco-associated gingival recessions were found in 42 (23.5%) subjects among the users of loose snuff and in 2 (2.9%) subjects among the users of portion-bag snuff. The results of this study support previous preliminary assessments that clinical changes of the oral mucosa and the gingival margin are less pronounced among those who use portion-bag snuff than among those who use loose snuff.

Adolescent↗