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At least 91 records · Page 5Linked to original sources
PubMed2000

Local delivery of antimicrobial agents for the treatment of periodontal diseases.

Periodontitis is an inflammatory disease of the supporting tissues of the teeth caused by groups of specific microorganisms. Aggressive forms of periodontitis can be localized or generalized. The concept that localized problem sites may be treated by local drug delivery appears attractive as the antimicrobial agent is delivered within periodontal pockets and the therapy is targeted on specific pathogenic microorganisms. Local delivery of antimicrobial agents using controlled release systems should be considered as adjunctive to mechanical debridement for the treatment of localized forms of periodontal destruction. This article reviews various types of delivery systems evaluated in practical periodontal therapy. Despite the large number of studies showing an enhanced effectiveness of local antibiotherapy, there are insufficient comparative data to support any of the local delivery system.

Animals↗
PubMed1998

Treatment of periodontal disease.

Periodontal surgery is used to control advanced lesions affecting the support for teeth. The choice between conservative treatment and surgical treatment is a technical issue, but client compliance plays an important role. Excision surgical techniques (e.g., gingivectomy) and incisional surgical techniques (e.g., flap surgery) are described in this article. Postoperative, recall, and retreatment programs are explored.

Animals↗
PubMed2005

Functional implication of the hydrolysis of platelet endothelial cell adhesion molecule 1 (CD31) by gingipains of Porphyromonas gingivalis for the pathology of periodontal disease.

Periodontitis is a response of highly vascularized tissues to the adjacent microflora of dental plaque. Progressive disease has been related to consortia of anaerobic bacteria, with the gram-negative organism Porphyromonas gingivalis particularly implicated. The gingipains, comprising a group of cysteine proteinases and associated hemagglutinin domains, are major virulence determinants of this organism. As vascular expression of leukocyte adhesion molecules is a critical determinant of tissue response to microbial challenge, the objective of this study was to determine the capacity of gingipains to modulate the expression and function of these receptors. Given the potential multifunctional role of platelet endothelial cell adhesion molecule 1 (PECAM-1) in the vasculature, the effect of gingipains on PECAM-1 expression by endothelial cells was examined. Activated gingipains preferentially down-regulated PECAM-1 expression on endothelial cells compared with vascular cell adhesion molecule 1 and endothelial-leukocyte adhesion molecule 1, but the reduction in PECAM-1 expression was completely inhibited in the presence of the cysteine proteinase inhibitor TLCK (Nalpha-p-tosyl-l-lysine chloromethyl ketone). Endothelial monolayers treated with activated gingipains demonstrated progressive intercellular gap formation that correlated with reduced intercellular junctional PECAM-1 expression as determined by Western blotting and immunofluorescence microscopy. This was accompanied by enhanced transfer of both albumin and neutrophils across the monolayer. The results suggest that degradation of PECAM-1 by gingipains contributes to increased vascular permeability and neutrophil flux at disease sites.

Adhesins, Bacterial↗
PubMed2000

Vascular remodelling in chronic inflammatory periodontal disease.

Periodontitis is a chronic inflammatory disease of the highly vascularised supporting tissues of the teeth. Little is known about the vascular changes in untreated advanced periodontitis. Using confocal immunofluorescence microscopy and morphometry, we defined and quantified vascular remodelling in this lesion. In the connective tissue subjacent to the altered epithelium lining of the periodontal pocket, there was a significant increase in the numerical density of vascular profiles, primarily accounted for by vessels > or = 25 microm in diameter. In addition, vascular basement membranes were thickened and there was accumulation of non-vascular basement membrane remnants. We investigated the distribution of major angiogenic growth factors in periodontitis using immunohistochemistry. Basic fibroblast growth factor, although consistently associated with blood vessels, showed no regional variation in its distribution. In contrast, there was a marked regional variation in the intensity of immunostaining for vascular endothelial growth factor, with significantly reduced staining of the pocket epithelium. The changes in the vascularity of the periodontal connective tissues in untreated advanced periodontitis may be, in part, a consequence of altered expression of angiogenic activity by the epithelium. In turn, this may reflect the epithelial response to microbial flora in the microenvironment of the periodontal pocket.

Adult↗
PubMedDate not supplied

Implications of diabetes mellitus and periodontal disease.

The dental profession is acutely aware of oral health problems associated with diabetes mellitus and clinical manifestations indicative of occult forms of the disease. Periodontal disease is common in patients with diabetes, and its effective management in diabetic patients requires cooperation involving the patient, physician, diabetes educator, dentist, and other allied health care providers. While these patients categorically appear more prone to diseases affecting the supporting tissues of the teeth, preservation of functional dental integrity can be attained by effective control of contributing systemic and local factors. This paper will discuss periodontal disease, its relationship to diabetes, proposed mechanisms of interaction, and management of periodontal disease in the diabetic patient.

Adolescent↗
PubMed1989

[Research into actual conditions and preventive care in periodontal disease. Relationship between questionnaire results and periodontal disease in youth].

The purpose of this study was to determine the prevalence of periodontal disease and the relationship between the results of questionnaire concerning periodontal disease and the actual periodontal condition in youth. The examination was carried out in three parts. In the first part, a questionnaire was conducted on 3,886 junior and senior high school students (12 to 18 years of age) living in Kawagoe, Japan. The questionnaire was composed by of items concerning habits of oral hygiene, periodontal symptoms, understanding of periodontal disease and history of diagnosis by dentist of periodontal disease. Secondary, mass intraoral examination was carried out on all objects. The examination covered gingival inflammation, periodontal probing depth, calculus, dental plaque, dental caries and malalignment. Lastly, we examined the relationship between the results of periodontal examination and questionnaire with the original periodontal classification. The following results were obtained: 1. As an example of items in questionnaire, 83.1% brushed their teeth more than two times daily. The understanding of oral hygiene concerning dental caries was improved, but concerning periodontal disease was still poor. 2. The symptom most frequently reported was gingival bleeding during tooth brushing (18.4%). 3. The percentage of persons with periodontal disease (moderate gingival inflammation and periodontal pocket 4 mm or deeper) was of the highest frequency at 13 years old. The proportion of males increased with the advanced state of periodontal disease. 4. A significant correlation was found (chi 2-test: alpha less than 0.001) between advanced state of periodontal disease and a decrease in tooth brushing time per day. 5. A significant correlation was found between the advance of periodontal disease and gingival bleeding on tooth brushing (chi 2-test: alpha less than 0.001). Similarly, a correlation was found between the advance of periodontal disease and gingival swelling (chi 2-test: alpha less than 0.001). 6. A significant correlation was found (chi 2-test: alpha less than 0.001) between the advance of periodontal disease and aggravation of condition of dental plaque, calculus, dental caries and malalignment.

Adolescent↗
PubMed1992

Microbiology of healthy and diseased periodontal sites in poorly controlled insulin dependent diabetics.

A group of poorly-controlled insulin dependent diabetes mellitus (IDDM) patients were examined in a cross-sectional design for total microbial levels, microbial incidence, and the percent levels of selected periodontal microorganisms. These organisms were selected on the basis of prior reports that associated them with either periodontal disease or health. One periodontally-healthy and one periodontally-diseased site were examined in each IDDM patient. Increased levels of the periodontal pathogens Prevotella intermedia, P. melaninogenica spp., Bacteroides gracilis, Eikenella corrodens, Fusobacterium nucleatum and Campylobacter rectus (formerly Wolinella recta) were found at the periodontal diseased sites. Increased prevalence of the organisms P. intermedia, P. melaninogenica spp., and C. rectus were found at the diseased sites. A significantly higher percentage of P. intermedia was found at the sites exhibiting deep pockets and attachment loss.

Adult↗