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PubMed2003

Efficacy of enamel matrix protein applied to spontaneous periodontal disease in two dogs.

Enamel matrix protein (EMP) was applied for regeneration of periodontal tissue in 2 dogs with spontaneous periodontal disease. Case 1 had bony resorption around the root and root apex of the maxillary fourth premolars. Case 2 had vertical resorption of bone between the mandibular first and second molars. A flap was formed in the buccal gingiva, and EMP was applied onto the surface of the exposed root. One or 4 months postoperatively, increased bone level and clinical attachment were recognized. EMP was therefore suggested to be effective to induce regeneration of periodontal tissues in the cases with periodontal disease.

Animals↗

PubMed2005

Position paper: The role of supra- and subgingival irrigation in the treatment of periodontal diseases.

This position paper addresses the role of supra- and subgingival irrigation in the treatment of periodontal diseases. It was prepared by the Committee on Research, Science and Therapy of the American Academy of Periodontology. The document is divided into two portions, consisting of supragingival irrigation and subgingival irrigation. In their respective segments, these treatment techniques are assessed as monotherapies and as adjuncts to conventional treatment. The conclusions drawn in this paper represent the position of the American Academy of Periodontology regarding irrigation therapy in the treatment of periodontal diseases.

Anti-Infective Agents, Local↗

PubMed1990

[Relation between functional-immunological and clinical parameters in juvenile periodontal diseases].

In 57 Moscow adolescents aged 15 to 19 years gingival bleeding and periodontal pocketing was recorded. In addition to this functional parameters of Rheoperiodontography and Polarography were documented and immunological investigations were carried out. The clinical parameters of the test group showed a higher level of periodontal diseases compared with a random selected control group. A correlation between clinical and functional parameters in early periodontal destruction was not detected. This study demonstrates the importance of prevention of periodontal diseases in adolescents.

Adolescent↗

PubMed1976

Relationship of occlusion and periodontal disease: part IX-incisor inclination and periodontal status.

In this study population the following observations have been made: Periodontal destruction, gingival inflammation and mobility were not significantly related to axial inclination of the incisor teeth. Labial gingival recession of the mandibular incisor was related to linguoversion (less than 85 degrees to GoGn). No other associations between incisor inclination and labial or lingual recession were found. Age was not related to either maxillary or mandibular incisor inclination. The periodontal-incisor inclination relationships reported above for periodontal destruction and gingival inflammation were not altered by the factor of age. Study of the secondary influence of incisor inclination on the relationships of selected occlusal factors and periodontal pathosis showed: A. Severe overjet (more than 6mm) had been found to be associated with more periodontal destruction. With severe overjet maxillary incisors in linguoversion (less than 100 degrees to SN) were somewhat healthier than all others. Among the same cases of severe overjet mandibular incisors in labioversion had slightly more disease than all others. B. The absence of a significant correlation between anterior overbite or crowding reported previously was not influenced by incisor inclination. C. Facial alveolar bone thickness, observed clinically, was studied for its relation to periodontal destruction and gingival inflammation. Thick facial alveolar bone was found to be associated with increased pathosis. This finding was not consistent for the maxillary and mandibular incisor and the influence of other factors might be suspected: Incisor inclination had no effect on the bone thickness-periodontal disease findings.

Adolescent↗

PubMed2002

Partial- or full-mouth approaches to assessing the prevalence of and risk factors for periodontal disease in young adults.

BACKGROUND: While partial-mouth recording is often used in epidemiological studies of periodontal disease because of the efficiencies afforded in data collection, there has been no investigation of the extent to which information is lost in studies of young adults using the combined attachment loss (CAL) approach. METHODS: A random sample of 25- and 26-year-olds was periodontally examined at 3 sites per tooth in all 4 quadrants. The analysis obtained full-mouth prevalence estimates for gingival recession (GR), probing depth (PD), and CAL. The half-mouth analyses took 3 forms: 1) estimates from each of the left and right sides were obtained and compared; 2) estimates were obtained separately and compared for quadrants 1 and 3 (upper right and lower left), and quadrants 2 and 4 (upper left and lower right); and 3) estimates were obtained from a diagonal half-mouth count, whereby quadrants 1 and 3 were analyzed for study participants whose identification number was odd, and quadrants 2 and 4 were analyzed for the remainder. The utility of the half-mouth and full-mouth approaches in analytical epidemiology was examined by estimating the strength of the association between periodontitis prevalence and smoking, male gender, and episodic use of dental care. RESULTS: Of the 169 participants examined, 100 (59.2%) were female, 54 (32.0%) were smokers, and 78 (46.2%) were episodic dental visitors. The difference in prevalence estimates obtained from the different methods was considerably greater for GR than for PD and CAL. The unadjusted odds ratio (OR) for the prevalence of 1 or more teeth with > or = mm of CAL among smokers was 2.3 (95% confidence interval [CI] 1.0, 5.3) using the full data set and 2.4 (95% CI 0.9, 6.1) using the diagonal half-mouth approach. Similarly close odds ratios were observed for males and, to a lesser extent, for episodic dental visitors. CONCLUSIONS: Wherever possible, full-mouth data should be collected for descriptive epidemiological studies of periodontal disease, but where resource and time constraints mean that half-mouth examinations must be used, analytical studies of periodontitis should not be unduly affected by the loss of information. However, where the primary focus of the latter is upon gingival recession, the full-mouth design should be used in order to capture all relevant information, and attention should be directed to making economies in other areas of the data collection process.

Adult↗

PubMed2004

The microbial outcome observed with polymerase chain reaction in subjects with recurrent periodontal disease following local treatment with 25% metronidazole gel.

The aim of this study was to evaluate the microbial outcome in patients with recurrent periodontal disease following treatment with 25% metronidazole gel using the polymerase chain reaction (PCR). Twenty subjects in a maintenance care program but with recurrent periodontal disease participated. Three months after scaling and root planing a total of 40 sites, 2 in each patient, with pocket probing depth of > or = 5 mm were selected. One site randomly selected was treated with 25% metronidazole gel (test) and the other site with a placebo gel (control). A bacterial sample was collected on paperpoint from each test and control site at baseline and 12 weeks after treatment. The following pathogens were analysed and detected with PCR:Actinobacillus actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.) and Prevotella nigrescens (P.n.). At baseline, A.a., P.g. and P.n. were detected in 30, 60 and 70% of all test sites and in 32, 58 and 21% of all control sites. There was a statistically significant difference between the test and control sites for P.n. at baseline. The major difference after treatment with 25% metronidazole gel was the increase of positive control sites for P.g. and P.n. However, there were no statistically significant differences in the occurrence rate of A.a., P.g. and P.n. at test and control sites after treatment. This study has shown that 25% metronidazole gel treatment did not seem to influence the microbial outcome, when PCR was used to analyse the presence/absence of A.a., P.g. and P.n. in this group of subjects with recurrent periodontal disease.

Adult↗

PubMed1989

Environmental influences on the progression of clinical and microbiological parameters of sheep periodontal disease.

The responses of some clinical and microbiological parameters of periodontal disease (PD) in sheep were examined subsequent to transferring animals between PD-affected and PD-free farms. Previously healthy animals showed transient deterioration in some clinical, but not microbiological parameters, which suggests either that a different microbiota to the one studied may be more important in the initiation of the disease, or that sampling did not intercept periods of destructive disease activity in the early lesions. In sheep with established disease, those parameters indicative of periodontitis which included pocket depth and bleeding on probing as well as the proportions of black-pigmented Bacteroides species were not significantly altered by environmental changes. This observation suggests that once the disease is established on PD-affected farms, the hand, some clinical signs of the disease including lengthening and mobility of incisor teeth increased in sheep on the PD-affected farm relative to the PD-free farm. This suggests that the disease may have a complex aetiology.

Animals↗

PubMed1993

Periodontal disease in three siblings with familial neutropenia.

The periodontal status and treatment of three teenagers in a Finnish family with familial neutropenia is described. The mother was also diagnosed with neutropenia. At initial examination, the 15-year-old male and the 10-year-old female had severe periodontitis, whereas the 13-year-old male had oral ulcerations but no significant periodontal disease. The two siblings with periodontitis were treated and followed approximately 5 years. It was concluded that periodontal therapy including scaling, surgery, and use of antimicrobial agents can be successful in patients with familial neutropenia, and that such patients are not necessarily candidates for full mouth extraction. The role of granulocyte colony-stimulating factor in which was used in the treatment of these patients remains to be established.

Adolescent↗

PubMed1998

Periodontal disease in dogs. Etiopathogenesis, prevalence, and significance.

Periodontal disease is very common and often very severe in dogs. It is caused by accumulation of bacterial plaque, particularly Gram-negative anaerobic rods. Tissue destruction results from autodegradation induced by the continuing inflammatory response. Small dogs are particularly at risk. Prevention by retarding accumulation of plaque is the key concept.

Animals↗

PubMed2000

Periodontal disease: diagnosis and management.

Approximately 50% of all adults in the United States have some form of gingivitis, and 80% have experienced some degree of periodontitis. Despite the use of fluoride, a critical element in the prevention of periodontal disease, many children and adults still suffer needlessly from this "silent" destroyer of the gum tissue and its underlying bone structures. This article highlights the prevalence, pathophysiology, classifications, health risk factors and clinical management of clients with periodontal diseases. Regardless of the health care setting, the advanced practice nurse plays a critical role in the prevention, early diagnosis and intervention of periodontal disease.

Adult↗

PubMed1997

Cell-mediated immune system regulation in periodontal diseases.

The adaptive immune system consists of humoral and cell-mediated immunity. T-lymphocytes are the key components of cell-mediated immunity. CD4+ helper T-lymphocytes facilitate B-cells to differentiate and produce specific antibodies, whereas CD8+ cytotoxic T-lymphocytes kill virally infected cells. Periodontal diseases have been associated with a variety of imbalances in the regulation of immune responses. Changes in the ratios of peripheral blood CD4+ and CD8+ T-lymphocytes, depressed proliferative responses of peripheral blood lymphocytes, and increased frequency of CD45RO+ memory T-lymphocytes in diseased tissues have been reported in individuals with various forms of periodontal disease. While some studies have shown an increased frequency of gamma delta + T-cells in periodontal lesions, the role of gamma delta + T-cells in periodontal disease remains controversial. The ability of putative periodontopathic bacteria selectively to stimulate certain V beta-expressing T-cells is intriguing and could determine whether a CD4+ Th1 or a CD4+ Th2 cell response is elicited. The prominence of a particular subset of helper T-cells within the periodontal lesion could be a reflection of the stage and activity of the disease, or the types of bacteria present. Regardless, longitudinal studies of the involvement of T-cell subsets and cytokines in periodontal disease are clearly needed.

Antigens, Bacterial↗

PubMed1999

Comparison of periodontal disease in patients with clefts of palate and patients with unilateral clefts of lip, palate, and alveolus.

OBJECTIVE: Long-term health of the stomatognathic system as well as esthetic aspects are the therapeutic goals in patients with orofacial clefts. The aim of this study was to analyze the periodontal condition of patients with cleft palate (CP) and cleft lip, palate, and alveolus (CLP) and to determine the differing degrees and localization of periodontal disease. DESIGN: In 30 patients with unilateral cleft lip, palate, and alveolus and 30 patients with cleft palate (CP), periodontal lesions were identified and classified according to the Community Periodontal Index of Treatment Needs (CPITN) and pathological mobility of teeth was noted. The state of oral hygiene was recorded by the Approximal Plaque Index. RESULTS: In general, poor oral hygiene was found in all patients. Patients with CLP were classified as CPITN code 0 in 0%, codes 1 and 2 in 7%, code 3 in 43%, and code 4 in 50% of cases. Patients with cleft palate showed code 0 in 0%, codes 1 and 2 in 30%, code 3 in 45%, and code 4 in 25% of cases. In this study, periodontal disease was found in patients with cleft palate to a similar extent to that in the general population, whereas patients with cleft lip, palate, and alveolus had a predisposition to deep periodontal destruction of teeth adjacent to the cleft. The registration of pathological mobility of teeth and resulting loss of attachment corresponded to the periodontal disease classification according to the CPITN. CONCLUSION: A critical periodontal situation was found in patients with unilateral cleft lip, palate, and alveolus. In contrast, patients with cleft palate exhibited a similar periodontal situation to that found in the general population, with additional damage that may be attributed to orthodontic treatment.

Adolescent↗

PubMed1989

[The sign of induced bleeding in the evaluation of individual susceptibility to periodontal disease. Experimental study in diabetic and non-diabetic patients].

The most recent hypotheses on the pathogenesis of periodontal disease have underlined the great importance exerted by individual susceptibility to the disease. The ability of a high ratio between bleeding index and plaque index as a way of identifying subjects at risk has been investigated, the values of this ratio being compared in a group of diabetic patients and in a group of non-diabetics with periodontal lesions of similar extent. The results obtained confirmed those of other Authors, testifying to the good capability of the bleeding/plaque ratio to identify patients with a high risk of developing advanced forms of periodontal disease.

Adult↗

PubMed1986

Proteases and their inhibitors in chronic inflammatory periodontal disease.

This article reviews the current knowledge of the sources, function and interactions of proteolytic enzymes and their inhibitors in chronic inflammatory periodontal disease. Proteolytic tissue degradation is a typical phenomenon in chronic inflammatory periodontal disease. The proteolytic enzymes can be both host- and bacteria-derived. The proteases of the inflammatory cells are aimed for digestion of bacteria, enhanced locomotion through connective tissue, demarcation of the site of infection and tissue remodeling. Uncontrolled release of proteases in inflammation causes self-digestion and tissue destruction. The potential of the bacterial proteases in degradation of connective tissue is not yet known. Biochemical and immunologic mediators of inflammation are released by proteolytic reactions. Immunoglobulin-cleaving proteases present a specific mechanism in perturbation of host defenses. The 2 main protease inhibitors in serum, alpha-1-antitrypsin and alpha-2-macroglobulin, are also present in the gingival tissue fluid guarding the function of proteases. It has been suggested, although not confirmed, that deficiency in serum protease inhibiting capacity could be correlated with susceptibility to periodontal disease. Mucous secretions contain local low molecular weight protease inhibitors, but their possible rôle in saliva is not known. Bacteria-derived, antiproteolytic short peptides may prove to be useful in pharmacological control of tissue destruction at inflammatory sites.

Adult↗

PubMed2002

[Classification of aggressive form of periodontal diseases].

An attempt at objective evaluation of currently used classifications of periodontal diseases is made. The first classification of aggressive forms of periodontitis was offered in 1983. Classifications of 1982, 1992, 1999, and 2001 also reflect the clinical forms of atypical periodontitis.

Gingivitis↗

PubMed2003

Potential role of vascular endothelial growth factor, interleukin-8 and monocyte chemoattractant protein-1 in periodontal diseases.

Host-mediated immunoinflammatory pathways activated by bacteria lead to destruction of the periodontal connective tissues and alveolar bone. The objective of this study was to elucidate the activation of the inflammatory processes in periodontal disease by quantitative assessment of cytokines and periodontopathogens. Gingival crevicular fluids (GCF) and subgingival plaque samples were collected from patients with chronic periodontitis and gingivitis and from periodontally healthy sites. Vascular endothelial growth factor (VEGF), monocyte chemoattractant protein-1 (MCP-1), and interleukin 8 (IL-8) in GCF were analyzed by enzyme-linked immunosorbent assay. Periodontopathogens, including Bacteroides forsythus, Campylobacter rectus, Porphyromonas gingivalis and Prevotella intermedia, were analyzed by immunofluorescence and dark-field microscopy. There was significantly more VEGF and IL-8 in chronic periodontitis and gingivitis sites than in periodontally healthy sites. There were significant positive correlations between the concentrations and total amounts of VEGF and IL-8 in chronic periodontitis and gingivitis sites, and between the levels of periodontopathogens and the total amounts of VEGF, MCP-1 and IL-8. These data indicate that inflammatory processes induced by periodontopathogens and the activation of certain cytokines (VEGF, MCP-1, IL-8) in periodontal diseases may be relevant to host-mediated destruction in chronic periodontitis.

Adult↗

PubMed2000

Survey of radiographic practices for periodontal disease in UK and Irish dental teaching hospitals.

OBJECTIVES: To assess current radiographic practices in dental teaching hospitals for the management of patients with periodontal diseases. METHODS: All 17 dental teaching hospitals in UK and Ireland were sent a questionnaire on radiographic equipment and radiograph selection currently used for assessment of patients with destructive periodontal diseases. Opinions were recorded for advantages and disadvantages of the most frequently used radiographic views. RESULTS: A 100% response rate was achieved. All hospitals used panoramic and specific periapical radiographs as one of their radiographic regimes for patients with periodontal disease. Fifty-three per cent of respondents most frequently took panoramic and selected periapical radiographs. Twenty-four per cent took full mouth periapical radiographs (FMPAs) most frequently and 18% took a panoramic radiograph alone. Twenty-four per cent of hospitals operated a protocol for selection of radiographs for periodontal patients. CONCLUSIONS: The most commonly used views taken to assess periodontal status are panoramic radiographs with selected periapicals. Few hospitals operate a protocol for prescribing radiographs.

Attitude of Health Personnel↗

PubMed1995

Understanding diagnostic testing for periodontal diseases.

Probability computations are used to characterize new periodontal diagnostic tests and are an integral facet of risk assessment for periodontal diseases. However, misinterpretation of these data can result in confusion and erroneous conclusions regarding the relationship of test results to the presence or absence of disease in a subject, or to episodes of periodontal destruction at specific sites. This paper was written to provide clinicians with a primer to help in understanding calculations used to evaluate diagnostic tests and risk assessment.

Decision Making↗