Showing papers in "Journal of Periodontology in 1979"
TL;DR: The first part of the analysis is a general appraisal of the longitudinal value of periodontal therapy related to variations in initial pocket depth, and the second part attempts to determine if treatment modality will influence the maintenance ofperiodontal attachment dependent on variations inInitial severity of the disease.
Abstract: In previous papers we have reported longitudinal results of periodontal treatment based on mean values for all treated teeth,1,2 and analysis based on mean values from the half mouths of patients.3 These methods of analysis, however, did not reveal specifically what happened over time to pockets of various depth and attachment levels. Prognosis is a very elusive, but fundamentally important consideration in treatment planning, and since pocket depth and loss of attachment traditionally are basic elements in assessment of periodontal prognosis, it was decided to analyze our longitudinal treatment results with the initial pocket depth and attachment level serving as reference. The first part of the analysis is a general appraisal of the longitudinal value of periodontal therapy related to variations in initial pocket depth, and the second part attempts to determine if treatment modality will influence the maintenance ofperiodontal attachment dependent on variations in initial severity of the disease.
366 citations
TL;DR: The present results showed that maarked and long-lasting changes in the subgingival microflora associated withperiodontal disease could be achieved by a single course of periodontal treatment.
Abstract: 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.
338 citations
TL;DR: It has been demonstrated that teeth with severely reduced periodontal support and with progressive mobility can serve as reliable abutment teeth for extensive fixed splints/bridges providedperiodontal health has been established and can be maintained in the remaining dentition and provided the bridgework is designed as to preclude undue stress concentrations in the supporting apparatus.
Abstract: Clinical and laboratory research endeavors have revealed unanimously that most, if not all, forms of periodontal disease are plaque associated disorders. Consequently, treatment of gingivitis and Periodontitis must always involve debridement, elimination of deepened periodontal pockets and other retention factors for plaque and the institution of a careful plaque control program including regularly repeated oral prophylaxis and tooth cleaning instruction. Studies by Lovdal et al.,1 Suomi et al.,2 Ramfjord et al.,3,4 Lindhe and Nyman,0 Rosling et al.,6 Axelsson and Lindhe' have documented that such treatment will eliminate clinical signs of gingivitis and prevent further deterioration of the supporting tissues. Frequently in cases of advanced Periodontitis, the destruction of the attachment apparatus has reached a level which calls for extraction of several teeth. This implies that towards the end of the initial treatment phase0 of such patients only a few teeth may remain, teeth which in addition to having reduced periodontal tissue support often also exhibit pronounced hypermobility or even signs ofprogressive, i.e. gradually increasing, mobility. In such cases there is an obvious need for splinting and additional prosthetic treatment,8 even if prevalent concepts prescribe that in this particular situation prosthetic treatment involving fixed bridgework is hazardous.9"11 It has been demonstrated,12'13 however, that teeth with severely reduced periodontal support and with progressive mobility can serve as reliable abutment teeth for extensive fixed splints/bridges provided periodontal health has been established and can be maintained in the remaining dentition, and provided the bridgework is designed as to preclude undue stress concentrations in the supporting apparatus. The present investigation describes the result of treatment of a group of patients who initially suffered from advanced Periodontitis, in many instances complicated
276 citations
TL;DR: In attempting to reach his objective, the restorative dentist must remember the fundamental precept of the health professions, which is: Do no harm.
Abstract: When treating patients, the objectives of restorative therapy must be clear. The first and most basic objective is preservation of the teeth. The attainment of this objective would be far less complex if it could be considered independent of restoration of function, comfort and esthetics, but such is not the case. The latter objectives usually require sophisticated restorative dentistry and often include restorations with intracrevicular margins. Although it is widely accepted that the best restorative margin is one that is placed coronal to marginal tissue, most restorations have margins in the gingival crevice, and permanent tissue damage is common. In attempting to reach his objective, the restorative dentist must remember the fundamental precept of the health professions, which is: Do no harm. Daily observation of the three physiologic dimensions permits the therapist to restore teeth with minimal injury to the periodontium.
249 citations
TL;DR: The posterior segments of the mouth had the largest amounts of bone loss between the first and last examinations and all 29 patients showed radiographic evidence of progressive bone resorption between examinations.
Abstract: Thirty diagnosed but untreated patients with moderate to advanced periodontal disease were examined a minimum of two times. The examination time intervals ranged between 18 and 115 months. 2. A total of 83 teeth were lost between examinations. 3. Excluding a patient who lost 25 teeth, a total of 58 teeth were lost. The adjusted tooth loss was 0.61 tooth per patient per year (or 0.36 with the elimination of 22 "hopeless" teeth). 4. The mandibular and maxillary molars had the greatest percentage of tooth loss between examinations. 5. All 29 patients completing the study had progessive increases in pocket depth during their time in the study. Increases in the mean annual pocket depths per tooth per patient varied from 0.24 millimeter per year to 2.46 millimeters per year. 6. The disto-lingual and mesio-lingual interproximal surfaces had the greatest increases in surface pocket depths. The lingual and buccal surfaces had the smallest increases in pocket depth. 7. The rate of increase in pocket depths was less in patients over 44 years of age. 8. The teeth which were lost had greater initial pocket depths and mobility scores than those which were present at both examinations. 9. There was no correlation between increases in pocket depth and changes in mobility. 10. All 29 patients showed radiographic evidence of progressive bone resorption between examinations. The posterior segments of the mouth had the largest amounts of bone loss between the first and last examinations.
210 citations
203 citations
173 citations
TL;DR: The furcation entrance diameter of first permanent molar teeth has been investigated, and found to be smaller than the blade face width of commonly used periodontal curettes in 58% of the furcations examined.
Abstract: The furcation entrance diameter of first permanent molar teeth has been investigated in a sample of 114 maxillary and 103 mandibular teeth, and found to be smaller than the blade face width of commonly used periodontal curettes in 58% of the furcations examined. It is suggested that because of this size disparity curettes when used alone may not be suitable for root preparation in this area as part of periodontal therapy. Alternative methods of instrumentation require clinical appraisal before recommendation. The buccal furcation entrance diameters of the maxillary first molar teeth examined tended to be smaller than either the mesiopalatal or distopalatal. Similarly the buccal entrance diameter in the mandibular first molar teeth examined tended to be smaller than the linqual. The mesiodistal widths at the cementoenamel junction of both maxillary and mandibular first molar teeth were found to have very low correlation with their furcation entrance diameters. Large teeth therefore do not necessarily have large furcation entrance diameters.
162 citations
TL;DR: RRR is probably multifactorial process subject to a wide number of covariables, and the dentist who wishes to help his edentulous patient should seek to be sensitive to all these variables.
Abstract: RRR is probably multifactorial process subject to a wide number of covariables. In any given patient, these convariables will be in a unique combination which will determine the rate of RRR for that patient at that time. If the variable change in any given patient, the rate of RRR may change. The dentist who wishes to help his edentulous patient should seek to be sensitive to all these variables, and to understand and treat that unique combination of factors which exists in that patient.
153 citations
TL;DR: Indomethacin was shown to delay the onset and to suppress the magnitude of the acute inflammatory reaction, and decrease the degree of alveolar bone resorption.
Abstract: 1. The placement of cotton floss ligatures in a position apical to the gingival margin of premolars and molars in young dogs induced an acute inflammatory reaction in the periodontal tissues resulting in loss of connective tissue attachment and alveolar bone. 2. Bone resorption could be observed histologically within 7 days, and radiographically within 2 to 3 weeks after ligature placement. 3. Daily administration of indomethacin interfered with the periodontal tissue response to ligature placement. Indomethacin was shown to (i) delay the onset and to suppress the magnitude of the acute inflammatory reaction, and (ii) decrease the degree of alveolar bone resorption.
150 citations
TL;DR: The coronal attachment of gingival tissues to the root surface (increased resistance to probing) commonly reported following root planing and soft tissue curettage appears to result from the formation of a long junctional epithelium rather than new connective tissue attachment.
Abstract: Utilizing a nonhuman primate model, a study was carried out to determine the nature of the attachment between the tooth and the gingival tissues following periodic root planing and soft tissue curettage. Under the conditions of this investigation, periodic root planing and soft tissue curettage combined with thrice weekly plaque control resulted in the formation of a long junctional epithelium with no new connective tissue attachment. In eight of the 22 experimental pockets, however, this procedure produced discontinuities or "windows" in the junctional epithelium. The coronal attachment of gingival tissues to the root surface (increased resistance to probing) commonly reported following root planing and soft tissue curettage appears to result from the formation of a long junctional epithelium rather than new connective tissue attachment.
TL;DR: The role of trauma from occlusion and subgingival plaque in the pathogenesis of the infrabony pocket as observed in the radiograph was studied in 48 teeth which had to be extracted because of advanced periodontal disease.
Abstract: The role of trauma from occlusion and subgingival plaque in the pathogenesis of the infrabony pocket as observed in the radiograph was studied in 48 teeth which had to be extracted because of advanced periodontal disease. Prior to extraction the teeth were examined with regard to the degree of mobility and the direction of the horizontal components of the masticatory forces. Following extraction, the teeth were stained and examined under the stereomicroscope. When the tooth is adequately stained, the subgingival plaque and the remaining attachment fibers can be distinguished easily from the area of the junctional epithelium. The observations which were made on the extracted teeth were then correlated with what could be seen in the radiograph. The following major observations were made: In the depth of the infrabony pocket there was a close congruence between the front of the subgingival plaque and the borderline of the remaining attachment fibers, the distance varying between 0.2 and 2.0 mm. There was also a close relationship between the front of the subgingival plaque and the alveolar crest adjacent to the tooth as well as between the surface of the subgingival plaque and the opposite vertical wall of the infrabony pocket, the distances ranging between 1 and 3 mm. The horizontal forces were mainly or exclusively oriented bucco-lingually, whereas the infrabony pockets were located mesially or distally, i.e. parallel to the direction of the force and not at a right angle to it as observed in experimental studies. The mobility of the teeth adjacent to which infrabony pockets developed was normal in 42% of the cases, slightly increased in 31%, and only in 11% of the cases was it excessively increased. In 19 cases the infrabony pocket was located on one of the roots of lower molars which were removed by hemisection. In eight of the 12 cases, which were observed for periods from 1 to 10 years, the remaining root functioned well without further development of angular bone defects or infrabony pockets. All of them became markedly firmer as a consequence of successful periodontal treatment. Three of the four remaining roots were extracted because of periapical problems. There was no evidence to indicate that trauma from occlusion had been involved in the pathogenesis of the infrabony pockets.
TL;DR: To investigate the cellular and extracellular composition of the diphenylhydantoin (DPH) induced overgrowth, 12 epileptic patients medicated with DPH and who manifested gingival enlargement of the fibrous type, were studied.
Abstract: Histologic Evidence for Impaired Growth Control in Diphenylhydantoin Gingival Overgrowth in Man Hassel, T M, Page, R C and Lindhe, J Arch Oral Biol 23: 381, May, 1978 To investigate the cellular and extracellular composition of the diphenylhydantoin (DPH) induced overgrowth, 12 epileptic patients medicated with DPH and who manifested gingival enlargement of the fibrous type, were studied A control group of age-matched nonepilep- tics with healthy gingiva and no exposure to DPH were studied Sections of excised interdental papillae were stained and fibroblast nuclei present within a given mass, were counted When analyzed by direct count, neither nuclear length nor number of nuclei per unit area of DPH enlarged gingival tissue differed from normal gingiva The conclusions drawn were that there is no evidence of hypertrophy, hyperplasia, nor fibrosis but rather a gingival overgrowth of normal compositon Departments of Pathology and Periodontics, and the Center for Research in Oral Biology, University of Washington, Schools of Medicine and Dentistry, Seattle, Wash 98195 Dr Gary Galovic Retention and Plaque-Inhibiting Effect in Man of Chlorhexidine After Multiple Mouth Rinses and Retention and Release of Chlorhexidine After Toothbrushing With A Chlorhexidine Gel Bonesvoll, P Arch Oral Biol 23: 295, No 4, 1978 To study the retention of Chlorhexidine after multiple mouth rinses of varying concentrations and to relate the findings to the plaque- inhibiting effect of Chlorhexidine measured on short-term sucrose- stimulated plaque, Chlorhexidine retention was measured during 10 consecutive 15-second mouth rinses with 10 ml of 005, 010, 020%; and 20 ml of 005% chlorhexidine-digluconate Retention of the drug in the mouth was increased by multiple mouth rinses and by increasing the rinsing volume or concentration In the plaque-inhibition experiment, rinsing with 10 ml of a 15% sucrose solution every 2 hours increased the plaque Retention after toothbrushing with a 10% chlor- hexidine-digluconate gel was the same as the retention after a 01% rinse The release of Chlorhexidine into saliva during the following 24 hours followed the same pattern as observed earlier after Chlorhexidine mouth rinses Retention varied greatly between subjects Department of Physiology and Biochemistry, Dental Faculty, University of Oslo, Oslo, Norway Dr Yau-Fwu Huang A Complication of Orthodontic Therapy: Localized Facial Recession and Loss of Attached Gingiva Treated by Grafting Israel, H Angle Orthod 48: 149, April, 1978 Frequently problems which in reality were mucogingival defects of missing attached gingiva, were formerly treated as frenai aberrations by frenectomy Three cases were described to illustrate orthodontic patients with areas of loss of attached gingiva, gingival recession (gingival cleft), and muscle pull of the free gingival margin The three patients were treated with free gingival grafts to create new attached gingiva The purpose of the article was to help orthodontists become aware of the nature of the problems and current means of treatment The goal of treatment suggested was to approximate tissue attachment as close as possible to the cementoenamel junction for aesthetics Children's Medical Center, 1735 Chapel Street, Dayton, Ohio 45404 Dr Larry Johnson
TL;DR: Dental plaque growth was observed among 180 teenage boys during a 28-day period following prophylaxis and the regrowth rate for the group brushing with dentifrice was 27% lower than for thegroup brushing without a dentif rice.
Abstract: Dental plaque growth was observed among 180 teenage boys during a 28-day period following prophylaxis. During this period, subjects brushed their teeth under supervision for 2 minutes daily. Plaque levels were measured immediately after brushing and 24 hours after brushing. Both levels increased rapidly during the first 14 days and appeared to be leveled off at 28 days. Less than half of the plaque was removed with one brushing per day leaving about 60% after brushing to promote rapid regrowth. Regrowth rate after brushing on the 28th day was 0.032 plaque units per hour over a 24-hour period. The regrowth rate for the group brushing with dentifrice was 27% lower than for the group brushing without a dentifrice.
TL;DR: Meticulous root planing as performed in this study produced values similar to those for unerupted periodontally healthy teeth, but ultrasonic scaling resulted in endotoxin values approximately eight times greater.
Abstract: In this study, the average net total endotoxin in the solubilized extracts from each sample were healthy teeth, 1.46 ng/ml; periodontally diseased teeth, 169.5 ng/ml; ultrasonically scaled teeth, 16.8 ng/ml; root planed teeth, 2.09 ng/ml. The material that was extracted and assayed was not conclusively proven to be endotoxin, but recent studies suggest it was. Meticulous root planing as performed in this study produced values similar to those for unerupted periodontally healthy teeth. Ultrasonic scaling resulted in endotoxin values approximately eight times greater.
TL;DR: The purpose of this study was to describe the predominant cultivable microbiota of the periodontal abscess utilizing newly developed anaerobic techniques to improve the understanding of the prognosis, early diagnosis, treatment and eventually, prevention of the Periodontal Abscess.
Abstract: The formation and pathogenesis of the periodontal abscess is not completely understood. Most investigators agree that it is formed by occlusion or trauma to the orifice of a periodontal pocket resulting in extension of infection from the pocket into supporting tissues and localization of suppurative inflammation.1 Several factors may be responsible for the exacerbation of the acute abscess. The increased activity of the bacteria acting in combination with lowered tissue resistance and the virulence and number of organisms determine the rapidity and amount of destruction which is produced.2 The nature of the bacteria which are associated with abscess formation and acute infection have not been adequately described. A search of the literature revealed that only a few microbiological studies of acute dentoalveolar abscesses have been reported and none specifically directed at describing the aerobic and anaerobic flora associated with the periodontal abscess.'1"11 Past reports revealed problems in sampling, cultivation and enumeration of isolated bacteria. Often bacteria from periodontally involved sites were mixed (pooled) with bacteria from healthy sites obscuring differences which may have been present. The inability to adequately cultivate oxygen-sensitive organisms suggested that the previous bacterial description of this periodontal condition may have been incomplete. The purpose of this study was to describe the predominant cultivable microbiota of the periodontal abscess utilizing newly developed anaerobic techniques. Knowledge gained will improve our understanding of the prognosis, early diagnosis, treatment and eventually, prevention of the periodontal abscess.
TL;DR: It is suggested that the presence of newly formed bone on surgical reentry following bone grafting in periodontal lesions does not necessarily imply that regeneration of the periodontium has occurred.
Abstract: A histological study of the site of a clinically successful bone graft revealed the presence of a downgrowing junctional epithelium between the root surface and the altered graft bone. No new cementum could be seen associated with the osseous autograft, nor was a functional periodontal ligament in evidence adjacent to the grafted bone. It is suggested that the presence of newly formed bone on surgical reentry following bone grafting in periodontal lesions does not necessarily imply that regeneration of the periodontium has occurred.
TL;DR: The ability of two different toothbrush bristle ends to produce traumatic gingival abrasion was assessed in a double blind study of 15 male and 15 female young adults.
Abstract: The ability of two different toothbrush bristle ends to produce traumatic gingival abrasion was assessed in a double blind study of 15 male and 15 female young adults. Brushing was performed in a circular fashion using a modified Bass Technique. An apparatus allowing continuous visual feedback of the average brushing force permitted a degree of standardization of the system. The upper left canine and bicuspid area had to be brushed for 30 seconds with cut toothbrush bristles (CP) and with round ended toothbrush bristles (RP) respectively. A two week interval separated the two brushing sessions. Traumatic lesions of the attached gingiva were stained with a disclosing solution, photographed and evaluated planimetrically. The "cut bristles" caused gingival abrasions 30% greater in extent than the round end bristles. The difference was not due to single brushing strokes accidentally greater for the "cut bristles". The size of the lesions was not sex dependent. To prevent gingival damage it is desirable to either round the bristles in production or to rid the bristle ends at least of sharp edges.
TL;DR: A significant feature of the metabolism of testosterone and androstenedione by inflamed gingiva was an increase of 5 alpha-A-ring reductase activity and 17 beta-oxidoreductase activity, which showed a significant correlation with the plasma progesterone concentration.
Abstract: The present study evaluates the relationship between periodontal status, concentration of circulating hormones and metabolism of androgens by human male and female gingiva in vitro. In both male and female patients with healthy gingiva the plasma concentration of gonadotropins (LH and FSH) and steroid hormones (testosterone, androstenedione, estradiol-17 beta, progesterone and cortisol) were in a normal range. However, an alteration in the plasma concentration of progesterone was found in both male and female patients with periodontal pathosis. Both androgens (testosterone and androstenedione) were readily metabolized by human gingiva tissue in vitro. The major pathway of the metabolism of testosterone was via the formation of 17 beta-hydroxy-5 alpha-A-ring reduced androgens (5 alpha-dihydrotestosterone and 3 alpha-, 3 beta-androstanediol). In contrast, androstenedione was metabolized mainly to 17-keto-5 alpha-A-ring reduced (5 alpha-androstanedione, androsterone and epiandrosterone) and 17 beta-oxidoreduced (testosterone) compounds. In addition both substrates were metabolized to 5 beta-A-ring reduced androgens (5 beta-dihydrotestosterone, 5 beta-androstanediol and 5 beta-androstanedione). A significant feature of the metabolism of testosterone and androstenedione by inflamed gingiva was an increase of 5 alpha-A-ring reductase activity (mainly the formation of 5 alpha-dihydrotestosterone and 5 alpha-androstanedione) and 17 beta-oxidoreductase activity (mainly the formation of testosterone from androstenedione). The increase in 5 alpha-reductase activity also showed a significant correlation with the plasma progesterone concentration.
TL;DR: Though storage and handling of tricalcium phosphate was simpler, use of allogenic bone led to greater bone apposition and reduction in pocket depth and there were no complications during the period of the study.
Abstract: As part of their treatment, eight patients with 47 infrabony pockets and horizontal bone defects had 29 tricalcium phosphate and 18 frozen allogenic bone implants placed. One year after surgery the sites were reentered. At the tricalcium phosphate implant sites the average amount of bone apposition was 1.2 mm and pocket depth induction 1.8 mm; 38% of the pockets remained deeper than 3.0 mm. At the allogenic bone sites the average amount of bone apposition was 1.5 mm and pocket depth reduction was 2.0 mm; 22% of the pockets remained deeper than 3.0 mm. The implant materials were well tolerated and there were no complications during the period of the study. Though storage and handling of tricalcium phosphate was simpler, use of allogenic bone led to greater bone apposition and reduction in pocket depth.
TL;DR: Evaluation revealed that an autologous control such as incorporated in the "mirrow-image" design of this study is probably the most valid experimental model available for evaluating the clinical effectiveness of any human periodontal grafting procedures.
Abstract: Nine patients with 10 pairs of intraosseous periodontal defects were treated. Most of the patients had identical bilateral lesions (referred to as "mirror-image" defects). In each pair, one of the defects was randomly selected and treated as a flap and currettage control whereas the other defect was grafted with freeze-dried cortical powdered allografts of bone. Evaluation was based on radiographs, photographs, and measurements taken during both the initial surgery and at reentry approximately 1 year after transplantation. Control procedures (flap and curettage) demonstrated the same amount of osseous regeneration as that seen with the graft procedure. The amount of osseous regeneration demonstrated with the grafting procedures agreed with previously published studies. Evaluation revealed that (1) an autologous control such as incorporated in the "mirrow-image" design of this study is probably the most valid experimental model available for evaluating the clinical effectiveness of any human periodontal grafting procedures; (2) the effectiveness of freeze-dried cortical powdered bone allografts in human periodontal osseous defects is questionable and needs additional study; and (3) nongrafting procedures may be more effective in generating new attachments or reattachments in human periodontal osseous defects than previously believed.
TL;DR: The results of this investigation demonstrated no statistically significant difference between exudate flow and the clinical degree of inflammation while demonstrating a statisticallysignificant difference betweenExudate Flow and the Clinical assessment of inflammation.
Abstract: Sulcular exudate flow measurements were obtained from 45 subjects and compared to the clinical as well as histologic degrees of inflammation. The results of this investigation demonstrated no statistically significant difference between exudate flow and the clinical degree of inflammation while demonstrating a statistically significant difference between exudate flow and the clinical assessment of inflammation. It was proposed that current clinical indices do not accurately reflect the microscopic degree of gingival inflammation.
TL;DR: Using in vitro methods, it was shown that during pregnancy there is a depression of maternal T-cell responsiveness and it is suggested that this depression of the cell-mediated immune response could be a factor in the altered responsiveness of the gingival tissues to plaque.
Abstract: The exacerbation of a chronic gingivitis during pregnancy was confirmed in a group of 24 pregnant patients who were observed at the 14th and 30th weeks of pregnancy and postpartum. This exacerbation occurred despite a fall in the amount of plaque accumulation and confirmed that during pregnancy some factor in addition to plaque is involved in the increased inflammation. Using in vitro methods, it was shown that during pregnancy there is a depression of maternal T-cell responsiveness and it is suggested that this depression of the cell-mediated immune response could be a factor in the altered responsiveness of the gingival tissues to plaque. However lymphocytes responses to Veillonella alkalescens ultrasonicate (a plaque antigen) were generally poor and it was not possible to demonstrate any significant difference between the altered responsiveness of maternal lymphocytes to Veillonella and those of nonpregnant controls.
TL;DR: The placement of silk ligatures around the necks of teeth and into the gingival sulcus causes a rapid, acute inflammatory response leading to vigorous osteoclastic resorption of alveolar crestal bone.
Abstract: The placement of silk ligatures around the necks of teeth and into the gingival sulcus causes a rapid, acute inflammatory response leading to vigorous osteoclastic resorption of alveolar crestal bone Associated with the large numbers of osteoclasts are mononuclear cells, predominantly fibroblast-like cells and macrophages Some fibroblast-like cells contain intracellular collagen fibrils It is suggested that in periodontal disease these mononuclear cells may compliment the action of osteoclasts by ingesting and degrading matrix molecules mobilized from bone but not ingested or degraded by osteoclasts
TL;DR: It is suggested that nonimmune mechanisms such as the direct effect of bacterial products on supporting tissues can account for at least some of the clinical manifestations of periodontal disease.
Abstract: The periodontal status of patients with reduced immunocapacity was assessed. Gingival inflammation, periodontal destruction, and plaque accumulation were compared in three groups--renal transplant patients, dialysis patients, and normal individuals. The levels of all parameters were similar in the three groups indicating that immunosuppression does not affect the clinical appearance of periodontal disease when measurements are made in a single examination. In the transplant group, however, there is a lack of correlation between P.I. and G.I. and between P.I. and P.D.I., indicating a dissociation between plaque accumulation and the tissue response. Long-term longitudinal studies of periodontal disease in such patients are needed in order to obtain more meaningful information on the role of the immune system in affecting the rate of periodontal destruction. This study suggests that nonimmune mechanisms such as the direct effect of bacterial products on supporting tissues can account for at least some of the clinical manifestations of periodontal disease.
TL;DR: Preliminary investigations seem to indicate that the periotron may be useful in assessment of the presence of gingival inflammation in the clinical periodontal pockets by showing a high correlation with increased known volumes of fluid and with assessment of gedival inflammation using the GI.
Abstract: These preliminary investigations seem to indicate that the periotron may be useful in assessment of the presence of gingival inflammation in the clinical periodontal pockets. Successive recordings of the same volume varied from 5 to 11%. Data from the periotron showed a high correlation with increased known volumes of fluid and with assessment of gingival inflammation using the GI. Assessment with the periotron varied with the dissipation constant of fluids. Since the dissipation constant of gingival fluid varied among individuals, this constant must be evaluated when the instrument is used in clinical and research efforts.
TL;DR: A graft of epithelial and connective tissue was taken from the maxillary tuberosity and placed into the defect, which resulted in the filling of the defect and the correction of the esthetic problem.
Abstract: A patient was left with a severe defect following the extraction of the right maxillary lateral and central incisors. A graft of epithelial and connective tissue was taken from the maxillary tuberosity and placed into the defect. This resulted in the filling of the defect and the correction of the esthetic problem.
TL;DR: There is an increase in gingival inflammation between the 14th and 30th weeks of pregnancy and this will occur despite a fall in the amount of plaque at the dento-gingival junction, which implicates a further factor in addition to plaque accumulation to explain the increased inflammmation.
Abstract: This investigation has confirmed that there is an increase in gingival inflammation between the 14th and 30th weeks of pregnancy and that this will occur despite a fall in the amount of plaque at the dento-gingival junction. This implicates a further factor in addition to plaque accumulation to explain the increased inflammmation. It was confirmed that there are marked increases in the plasma levels of estradiol and progesterone between the 14th and 30th weeks of pregnancy but it was not possible to demonstrate a direct association between these increases and the increase in gingival inflammation.