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At least 19 recordsLinked to original sources

PubMed1979

Periodontal therapy in humans. I. Microbiological and clinical effects of a single course of periodontal scaling and root planing, and of adjunctive tetracycline therapy.

The present results showed that maarked and long-lasting changes in the subgingival microflora associated with periodontal disease could be achieved by a single course of periodontal treatment. Immediately following therapy, the total number of subgingival organisms decreased 10- to 100-fold and the proportions of cultivable Gram negative organisms and anaerobic organisms generally decreased 3- to 4-fold or more. After treatment, most periodontal pockets were populated by a scant microflora predominated by facultative Actinomyces and Streptococcus species. The kinetics of the subgingival bacterial recolonization revealed that the total cell counts and the proportions of spirochetes and Capnocytophaga species did not reach their pretreatment levels even after 6 months. Other Gram negative anaerobic species returned to pretreatment proportions after 3 to 6 months. Several Gram positive species exhibited higher posttreatment than pretreatment proportions throughout the 6 months study. The microbiological shifts paralleled significant changes in the clinical status of the periodontal tissues. Following therapy, the periodontal pocket depths decreased generally 1 to 4 mm, the gingival inflammatory index, the gingival fluid flow, and the suppurative index were generally lower, and nine of 33 test pockets examined showed apposition of alveolar bone. The microbiological and clinical changes described were exhibited by two patients treated with periodontal scaling and root planing alone and by two patients treated with the adjunctive use of systemic tetracycline therapy. In two other patients, mechanical periodontal therapy only slightly reduced the total number of subgingival organisms and the proportions of spirochetes and other Gram negative anaerobic rods. A shift in the subgingival microbial composition was achieved in these two patients after tetracycline therapy. The following model for treatment of periodontal disease is proposed: (1) Conventional therapy including thorough periodontal scaling and root planing; (2) Monitoring the subgingival flora and the clinical course; and (3) Use of antimicrobial therapy in refractory cases. Further studies are needed to develop means for rapid identification of refractory patients, and to determine the optimal antimicrobial agent, the optimal route of administration, and the optimal dosage regime.

Actinomyces↗

PubMed1978

Effect of experimentally induced marginal periodontitis and periodontal scaling on the dental pulp.

Experimental breakdown of the periodontal attachment apparatus was produced in six young adult monkeys to study the effect on the tissue of the dental pulp by (1) periodontitis, (2) scaling and plaque accumulation on exposed root dentin. Periodontal tissue breakdown was induced by the placement of ligatures around the neck of 92 permanent teeth. Subsequent plaque formation caused marked loss of periodontal tissue support, which after a period of 5--7 months amounted to 30--40% of the root length. One group of teeth received no further treatment. Other teeth were subjected to scaling and root planing. Following treatment, plaque was allowed to accumulate for 2, 10, and 30 days on the freshly planed root dentin surfaces. Histologic examination revealed that in comparison to teeth with normal periodontal conditions, 57% of the teeth exposed to periodontitis exhibited pathologic pulp tissue alterations. Secondary dentin formation and/or inflammatory cell infiltrates were observed within localized areas of the pulp subjacent to root surfaces exposed to periodontal tissue destruction. The changes within the pulp were of "mild" nature and only one tooth displayed signs of total pulp necrosis. Lateral canals communicating with both the pulp cavity and the exposed root surface were never detected. Teeth subjected to scaling and subsequent plaque accumulation in comparison with teeth with periodontitis alone exhibited no obvious aggravation or increased incidence of pathologic pulp reactions. The findings show that in the monkey (1) periodontal destruction limited to the cervical half of the root and (2) plaque accumulation on exposed root dentin does not cause severe alteration in the pulp of the roots involved.

Animals↗

PubMed1978

The natural history of periodontal disease in man. The rate of periodontal destruction before 40 years of age.

This longitudinal study of randomly selected Norwegian students and academicians has shown that 50% of the 17-year olds have lost no periodontal support, and the other 50% exhibited slight localized loss of attachment primarily on buccal surfaces of first molars and first bicuspids of both jaws. At 21 all students show one or more of these lesions as well as loss of attachment on interproximal surfaces. At 30 years of age the mean cumulative loss is still less than 1 mm. As they approach 40 years of age the mean individual loss of attachment is slightly above 1.5 mm or 10% of the total periodontal support, and the mean annual rate of attachment loss is 0.08 for interproximal surfaces and 0.1 mm for buccal surfaces. No case of juvenile periodontitis (periodontosis) or adult aggressive periodontitis were seen in this population. Seventy percent of the 15-year-old Sri Lankans have no or very little loss of periodontal support. However, approximately 30% exhibit localized lesions measuring between 2 and 9 mm and more than 1% have one or more root surfaces with 10 mm loss of attachment or more. In this age group the lesions occur at the interproximal and buccal aspects of lower central incisors and in first molars of both jaws. At 30 years of age the mean loss of attachment is 3.11 mm and approximately 25% of the tea laborers have lesions extending 10 mm or more below the cemento-enamel junction. As the Sri Lankan approaches 40 years of age the mean loss of attachment is 4.50 mm and the mean rate of progress of the lesion is 0.20 mm per year for buccal surfaces and 0.30 mm for interproximal surfaces. This study suggests that without interference the periodontal lesion progresses at a relatively even pace and that the progress is continuous.

Adolescent↗

PubMed1979

The absence of proprioceptive nerve endings in the human periodontal ligament: the role of periodontal mechanoreceptors in the reflex control of mastication.

A review of the literature was conducted to determine the presence or absence of proprioceptive nerve endings in the human periodontal ligament. A histologic review of the periodontal ligament innervation concluded that nerve endings found were those mediating pain, pressure, or touch and that there is no histologic evidence of any "classic" proprioceptive nerve ending in the periodontal ligament. A summary is given concerning the precise role of nerve endings in the periodontal membrane, their afferent pathways, and the role of masticatory muscle proprioception, jaw reflexes, and the temporomandibular joint in the coordinated control of mastication and mandibular proprioception.

Afferent Pathways↗

PubMed1978

Oral hygiene, periodontal health and need for periodontal treatment among institutionalized mentally subnormal persons in Norway.

Oral hygiene, periodontal health and periodontal treatment needs were studied in the dentulous patients (n = 328) of a sample selected to be representative of all institutionalized mentally subnormal persons in Norway aged 5--45. The average oral hygiene and periodontal health was poor except for patients in a few institutions where the nurses were trained to clean teeth regularly. Increased age, epilepsy, Down's syndrome and a high degree of mental deficiency were all elements that apparently contributed to impairment of periodontal health and to increased treatment requirements. The preventive programs used in some institutions seemed to be effective. Still better results, however, could probably be obtained by the use of dental hygienists.

Adolescent↗

PubMed1979

Periodontal self-examination. A motivational tool in periodontics.

The institution of proper oral hygiene procedures and habits is a learning process. This paper describes a self-instructing periodontal self-examination program to be used in the initial phase of periodontal treatment. The program was designed in an effort to facilitate learning by taking the teaching conditions into consideration. The program tries to utilize the patient's curiosity and need for activity and to involve the patient himself in an effort to make the patient apprehend the relevance of subject matter. The program also allows for an individualized learning speed of the patient. The self-examination program was tested on 108 periodontal patients (19-75 years of age) and the patients' findings were compared to those made by a dentist. Questionnaires before and after the self-examination were used in the evaluation of opinions of the patient. The present study showed that the patients were able to perform the self-examination without individual professional guidance. A rather close correlation was noted between findings made by the patient and the dentist. Furthermore, the program was well accepted and appreciated by the patients according to their answers on the questionnaires.

Activities of Daily Living↗

PubMed1978

A comparison of WHO periodontal status index with the periodontal and oral hygiene indices.

Examination of 2,138 subjects, aged 15-65+ years, was carried out by calibrated examiners using mirrors and fibre optic illumination. Each subject was scored by the Periodontal Status Index, PSI (WHO Oral Health Surveys), Periodontal Index, PI (Russell) and the Oral Hygiene Index, OHI (Greene & Vermillion). For the PSI, PI and OHI all scores were age-dependent with the exception of soft deposits in PSI and OHI, which were age-independent. The advantages of the PSI system were considered to be the ease of scoring and the opportunity to assess treatment requirements, in terms of time, at the public health service level. Disadvantages were lack of quantitation, difficulties of diagnosis of intense gingivitis, and localized and general conditions. The PI and OHI systems provided a more objective, quantitative and sensitive basis of scoring than the PSI. Statistical tests showed the respective indices are associated and measuring the same kind of criteria. Examiner calibration and consistency were similar for both scoring systems.

Adolescent↗

PubMed1979

Importance of combined periodontal and acid-etch composite treatment in restoration of anterior teeth and periodontal health.

Severely fractured, hypoplastic, and carious mandibular anterior teeth in a 17-year-old patient precluded the ability to use adequate methods of control of plaque. With simple, inexpensive techniques, periodontal health was restored and a functional and esthetic occlusion was provided. This treatment plan was accomplished with minimal risk of injuring the pulps of the teeth.

Acid Etching, Dental↗

PubMed1978

[The periodontal-prophylactic effect of the toothpaste "Silka". 2. Effects of circulation-stimulations additives on the periodontium in relation to age and sex and in smokers based on Kötzschke's periodontal index].

On subdiving the patients into age-groups, it was found that the relative improvement in the 46--55 year-old patients amounted only to 18% as compared to nearly 27% in patients of age-groups in which hormonal influences are likely to occur. The sex-linked differences in the periodontal condition became evident by higher initial values for the inflammatory component and a low relative improvement (25.53%) in women than in men (28.25%). The relative improvement in smokers (43.49%) as compared to that in non-smokers (23.01%) demonstrated the beneficial effect of benzylnicotinate on the nicotine-induced vasoconstriction.

Age Factors↗

PubMed1977