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PubMed1988

Evaluation of four modalities of periodontal therapy. Mean probing depth, probing attachment level and recession changes.

Eighty-two periodontally involved patients were treated in a split mouth design such that one quadrant received coronal scaling (CS), root planing (RP), modified Widman surgery (MW), and flap with osseous resection surgery (FO). The therapy was performed in three phases: Phase I: the teeth previously designated to receive RP, MW, and FO were thoroughly root planed and the teeth designated to receive CS were scaled with no subgingival instrumentation, plaque control was initiated and reinforced for the entire mouth; Phase II: the designated teeth received MW or FO surgery; and Phase III: maintenance therapy every three months. The CS teeth received coronal scaling and polishing during maintenance appointments, while RP, MW, and FO teeth received supragingival instrumentation, subgingival instrumentation and polishing. Clinical measurements were taken initially, four weeks post-Phase I, 10 weeks post-Phase II, and after each of two years of maintenance care. All therapy modalities resulted in a decrease of mean probing depth with the FO producing the greatest decrease followed by MW, RP, and CS. The deeper the initial probing depth, the greater was the mean reduction of probing depth. FO created a loss of mean probing attachment in the 1 to 4 mm category. RP and MW produced the greatest gain of mean probing attachment in the 5 to 6 mm category. RP, MW, and FO produced similar gains in the greater than or equal to 7 mm category. FO created the most gingival recession followed by MW, RP, and CS.

Adult↗
PubMedDate not supplied

[Prevalence of dental caries, gingivitis and periodontal disease in pregnant diabetic women].

OBJECTIVE: To determine the difference in the prevalence of dental caries, gingivitis, and periodontal disease among non-diabetic, type-II diabetic and pregnant diabetic women. MATERIAL AND METHODS: In the period from June 1993 to January 1994, a cross-sectional study was carried out at the Instituto Nacional de Perinatología among 160 pregnant women; eighty non-diabetic women were included in the control group, while 40 type-II diabetic and 40 gestational diabetic women conformed the study group. In each patient the following variables were recorded: age, week of pregnancy, the Simplified Oral Hygiene Index, the Decayed, Missing and Filled Teeth Index, the Gingival Index, and the Extent and Severity Index. Statistical analysis was carried out using Analysis of Variance and the Multiple Range Test, with a 95% confidence internal. RESULTS: All of the groups had similar prevalences of dental caries (100%). Type-II diabetic women showed a higher prevalence of gingivitis (42.5%) than non-diabetic (36.25%) and gestational diabetic (10%) women, but the differences were not statistically significant between the non-diabetic and type-II diabetic women. Type-II diabetic women had a statistically significant higher prevalence of periodontal disease (12.5%) than the women in the other groups. CONCLUSIONS: It is very important to establish proper metabolic control and a fitting oral hygiene in pregnant diabetic women, since type-II diabetes was shown to be associated with a higher prevalence of periodontal disease. Besides, gestational diabetes is likely to pose a high risk of periodontal disease in the absence of preventive measures.

Adult↗
PubMed2000

In vitro antimicrobial susceptibilities of three Porphyromonas spp and in vivo responses in the oral cavity of cats to selected antimicrobial agents.

OBJECTIVES: To determine in vitro susceptibility of Porphyromonas gingivalis, P salivosa and P circumdentaria to seven antimicrobial agents by agar dilution and Epsilometer test methods and to assess the effectiveness of these antimicrobial agents in reducing the numbers of each Porphyromonas spp in the oral cavity of 16 domestic cats. DESIGN: A two-part prospective study involving in vitro antimicro-bial studies using Porphyromonas spp obtained from naturally occurring feline infections and in vivo antimicrobial response studies using client-owned cats with naturally occurring periodontal disease. PROCEDURE: Isolates (n = 25) of three feline Porphyromonas spp from the oral cavity and oral-associated disease were tested for their in vitro susceptibility to amoxycillin, amoxycillin-clavulanate, benzylpenicillin, clindamycin, doxycycline, erythromycin and metronidazole, using agar dilution and Epsilometer test methods. Digoxigenin-labelled whole chromosomal DNA probes directed against P gingivalis VPB 3492, P circumdentaria NCTC 12469T and P salivosa VPB 3313 were used to quantify organisms taken from two sample sites at the gingival margins of these cats prior to, and 5 days after, treatment with one of four commonly used antimicrobial products (amoxycillin-clavulanate, clindamycin, doxycycline or spiramycin-metronidazole). The response to treatment was assessed clinically for each cat. RESULTS: All isolates were susceptible in vitro to all seven antimicrobial agents using both methods. The numbers of P gingivalis were not reduced at the gingival sample sites by administration of amoxycillin-clavulanate for 5 days, although this treatment reduced the numbers of P salivosa and P circumdentaria to below detection levels in six of eight and two of three of sample sites, respectively; clinical improvement was not observed in cats treated with amoxycillin-clavulanate. Treatment with clindamycin, doxycycline or spiramycin-metronidazole resulted in clinical improvement and a marked reduction of all Porphyromonas isolates at the sample sites. CONCLUSION: The Epsilometer test is a simple and accurate method for determining the minimum inhibitory concentration for P gingivalis, P salivosa and P circumdentaria. All strains were susceptible in vitro to all the antimicrobial agents tested although clinical improvement of gingival disease was not noted with amoxycillin-clavulanate when given for 5 days at usual doses. This appears to be the first report of the disparity between the in vivo and in vitro susceptibility of oral bacterial strains to amoxycillin-clavulanate in the veterinary dental literature. This also appears to be the first report in which clinical and microbiological responses to commonly used antimicrobial agents for periodontal disease in cats has been documented and quantified. It was shown that treatment with clindamycin, spiramycin-metronidazole or doxycycline not only produced a substantial reduction in the number of Porphyromonas spp (in the majority of cases to below detection levels), but also resulted in substantial clinical improvement. This would indicate that these antimicrobial agents are useful adjunctive therapy to mechanical debridement in domestic cats.

Animals↗
PubMed1989

Use of smokeless tobacco in a group of professional baseball players.

This paper describes the smokeless tobacco use practices and oral health problems of members of a minor league professional baseball team. Seventeen of 25 ball-players reported current use of smokeless tobacco. Gingival recession and lesions in the oral mucosa were more common in smokeless tobacco users than nonusers. Reported use of smokeless tobacco was greater during baseball season than in the off-season. Of the 19 current and past users, 15 reported first using smokeless tobacco after entering professional baseball. To discourage the use of smokeless tobacco by professional athletes, teams should stop accepting free samples and do a better job educating players about health consequences associated with use.

Adult↗
PubMed1977

A comparison of the continuous and interrupted suturing techniques.

This investigation compared the efficacy of interrupted and continuous suturing for primary closure of the apically positioned flap. Twenty-two flap procedures were performed on contralateral sites in 10 patients. The 11 sites where interrupted suturing was used had a degree of presurgical periodontal involvement which was similar to that in the 11 contralateral sites where continuous suturing was used. At postsurgical assessment visits, after 3 months and 6 months, gingival health status was evaluated for both groups. Recession, residual pocket depth and loss of attachment were also measured. Analysis of the data for each of these parameters indicated no statistically significant difference between the two groups. However, the overall clinical impression was that interrupted suturing provided better flap adaptation.

Adult↗
PubMed1988

The laterally positioned flap.

The laterally positioned flap has shown itself to be the most predictable and esthetically successful procedure in the treatment of mucogingival defects such as gingival/periodontal recessions and root exposures. It is of utmost importance that the biologic principles of wound healing, which have been discussed in the literature and this article, should be adhered to prior to, during, and after the surgical procedure.

Animals↗
PubMed1975

Amyloidosis: a rational approach to diagnosis by intraoral biopsy.

Amyloidosis and its oral manifestations are briefly described. The techniques for antemortem tissue diagnosis of amyloidosis are reviewed and evaluated. In screening for amyloidosis, biopsy of specific oral lesions (when present) is recommended instead of the traditional biopsy of normal-appearing gingiva. This approach is illustrated with four cases. Although rectal biopsy is generally accepted as the screening technique of choice, it is suggested that intraoral biopsy be considered as an easier, safer, more comfortable, and possibly more fruitful technique. It is advocated that in cases of both documented and suspected amyloidosis both intraoral and rectal biopsies should be performed in order to help provide documentation of the most useful technique for routine screening.

Aged↗
PubMed1987

Periodontal status of mandibular incisors following excessive proclination. A study in adults with surgically treated mandibular prognathism.

The present study was undertaken to examine whether excessive proclination of mandibular incisors results in gingival retraction. In patients with surgically treated mandibular prognathism, 29 with more than 10 degrees proclination of mandibular incisors and 33 with minimal change in incisor inclination during presurgical orthodontic phase were selected. A total of 21 and 19 patients, respectively, could meet for a clinical follow-up examination including Visible Plaque Index, Gingival Bleeding Index, probing pocket depth, and length of supracrestal connective tissue attachment. Study models and intraoral color slides were also made. The mean postoperative times at this examination were 7.8 (SD 2.5) and 8.1 (SD 2.8) years, respectively. Clinical crown height was measured on the study models taken before and after appliance therapy, at the 3-year postoperative control (check) and at the follow-up examination. The number of teeth with recession was determined from the color slides taken at the same intervals; the thickness of the symphysis was measured on the cephalograms taken before treatment. The results demonstrated significantly more increase in clinical crown height and significantly more teeth developing recession both during appliance therapy and during the period from removal of appliance to the 3-year postoperative control in the patients with excessive proclination than in the patients with minimal change in incisor inclination. The correlation coefficient between width of symphysis and increase in clinical crown height in patients with excessive proclination was statistically significant. Only minimal changes were observed from 3 years postoperatively to the follow-up examination. No differences in clinical measurements were observed between the groups and bone dehiscences were not found.

Adult↗
PubMed1990

Relationship of gingival bleeding, gingival suppuration, and supragingival plaque to attachment loss.

This study evaluated the relationship between the presence of gingival bleeding, gingival suppuration, and supragingival plaque at 3 month appointments to the incidence of probing attachment loss during a 2-year period of maintenance therapy. The data included in this report were taken during the second and third year of maintenance from 75 periodontal patients who had previously received active therapy in an ongoing longitudinal study. The diagnostic sensitivity, specificity, and positive and negative predictive values were calculated for different frequencies of positive responses for each clinical parameter in relation to sites demonstrating greater than or equal to 2 mm probing attachment loss. Gingival bleeding and plaque were not prognosticators and gingival suppuration was a weak prognosticator of attachment loss during a 2 year maintenance period.

Dental Plaque↗
PubMed1986

Periodontal emergencies.

Discomfort manifesting in the gingival tissues prompts patients to seek emergency treatment. Several clinical entities should be included in the differential diagnosis. Accurate diagnosis and appropriate therapy is essential to resolving the problem.

Emergencies↗