[The importance of the sulcus fluid flow rate on early recognition of gingival diseases].
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PURPOSE: The purpose of this study was to evaluate the relationship between volatile sulfur compounds (VSC) and gingival health status and to determine if volatile sulfur compounds can detect early dental plaque-induced gingival disease. METHODS: A split-mouth design with randomly selected quadrants of the mandibular arch enabled 39 participants to serve as their own controls. At baseline and at three subsequent appointments (days 7, 14, and 21) gingival inflammation (GI), bleeding on probing (BOP), and sulfide levels (SUL) were measured using the Gingival Index and the Diamond Probe/Perio 2000 System. For three weeks, participants refrained from brushing and flossing one randomly selected quadrant of the mandibular arch. The Pearson correlation test was used to determine the relationship between sulfide concentrations and gingival health. The Wilcoxon signed rank test was used to compare the differences in mean GI, BOP, and SUL scores between the hygiene side (H) and the non-hygiene side (NH). RESULTS: Data suggest that SUL correlate positively to GI and BOP on both sides; however, the strength of the correlation was stronger for the NH side. A comparison of mean GI, BOP, and SUL scores revealed a statistically significant difference between sides for all three parameters from baseline to day 21, except for SUL on day 14. CONCLUSIONS: Based on study outcomes, the Diamond Probe/Perio 2000 System demonstrated the ability to detect sites with elevated SUL; therefore, SUL may be a useful adjunctive indicator of early plaque-induced gingivitis. In addition, data revealed a moderate correlation between SUL levels and gingival inflammation on the NH sides. Whether sulfur by-product is a contributor to the disease process, or merely a correlate, is inconclusive.
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Cell adhesion molecules are involved in recognition and effector aspects of the host response, including the control of migration of leukocytes into inflammatory sites. In this study we have demonstrated that the distribution of three cell-surface molecules involved in cell interactions, ICAM-1, LFA-3 and HLA-DR is distinct and different in healthy and diseased gingival tissue. ICAM-1 was consistently expressed by junctional epithelial cells in healthy gingiva and by pocket epithelium in diseased gingiva but was not detectable on the majority of keratinocytes in external gingival epithelium. ICAM-1 was also expressed by endothelial cells of gingival blood vessels and a subset of leukocytes in the infiltrated connective tissue in both healthy and diseased gingiva. HLA-DR and LFA-3 were also expressed by epithelial cells and endothelial cells but in patterns which were distinctly different from ICAM-1.
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Patients who have undergone irradiation for head and neck tumors commonly have xerostomia. Loss of the protective constituents normally found in saliva leaves patients at greater risk for development of significant dental pathologic disorders, including gingival and periodontal disease. Periodontal disease and tooth extractions are currently accepted as etiologic factors for the development of osteoradionecrosis. This double-blind crossover trial was conducted to assess the efficacy of a dentifrice containing salivary peroxidase elements in the reduction of gingivitis in a population of patients with irradiated cancer. Subjects were instructed to brush with the dentifrice provided. Plaque and gingival index values were obtained and statistically compared with baseline values. A weak positive effect was found between use of the dentifrice and a reduction in gingival inflammation. Patient compliance was a limiting factor in this treatment effect. The results suggest possible efficacy for the dentifrice in augmenting traditional measures of postradiation oral health maintenance.
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