Journal of the International Academy of Periodontology最新文献

Objective: The present clinical trial was designed to investigate the effectiveness of systemic satranidazole (SZ) as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis.

Methods: Sixty-six subjects presenting with at least twelve teeth with probing depth (PD) > or = 4 mm were selected. Thirty-three subjects were randomly assigned to full-mouth SRP + placebo (Group 1) and 33 subjects were assigned to full-mouth SRP + SZ (Group 2). The clinical outcomes evaluated were plaque index (PI), gingival index (GI), clinical attachment level (CAL) and PD at baseline, 1 month, 3 months and 6 months. Also, microbial analysis of dental plaque using polymerase chain reaction was done at baseline, 3 and 6 months to estimate the number of sites harboring periodontopathogens.

Results: Sixty subjects were evaluated up to 6 months. At 6 months, Group 2 showed greater mean reduction (3.84 +/- 1.31 mm) in PD as compared to Group 1 (1.42 +/- 1.01 mm; p < 0.05) and there was a greater mean CAL gain (3.22 +/- 1.01 mm) in Group 2 as compared to Group 1 (1.15 +/- 1.49 mm; p < 0.05). These subjects also showed significant reductions in the number of certain periodontopathogens, such as Tannerella forsythia, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans.

Conclusion: The systemic use of SZ, when used as an adjunct to non-surgical periodontal therapy in subjects with periodontitis, achieves significantly better clinical and microbiological results than scaling and root planing alone.

Objectives: To study whether in vitrofertilization (IVF) treatment has any effect on women's preexisting periodontal status and, if pre-existing women's periodontal status has any impact on IVF outcomes, such as superovulation for multiple follicles maturation, oocyte retrieval and embryo transfer, as well as on pregnancy and its outcomes.

Methods: Sixty women aged 29 to 41 years were recruited in the study. Gingival inflammation (simplified gingival index, GI-S), plaque levels (plaque control record index, PCR), bleeding on probing (BOP) and probing depth (PD), were recorded for all participants before and after IVF. Blood tests were performed prior to IVF.

Results: A statistically significant increase in GI-S after IVF was observed in all women (31.9 +/- 18.7% to 61.7 +/- 23.5%), and was higher in women with gingivitis (37.1 +/- 5.7% to 77.6 +/- 6.7%). Women with periodontitis demonstrated a statistically significant increase in BOP (67.7 +/- 6.6% to 89.5 +/- 7.1%), and in the sum of probing pocket depths (from 243.8 +/- 56.2 mm to 250.5 +/- 58.3 mm). A trend for negative correlation between the number of follicles and transferred embryos and the gingival index, before and after IVF respectively, was recorded in all women. There was a similar trend with bleeding on probing after IVF in women with periodontitis.

Conclusions: Periodontal clinical parameters worsened in women undergoing IVF treatment. On the other hand, a poor pre-existing periodontal status seems to be associated with poorer outcomes of IVF treatment.

Objective: To investigate the correlation between the gingival crevicular fluid (GCF) levels of IL-6 and TNF-alpha with the levels in serum in obese patients.

Design: Twenty-six obese adults (BMI > or = 30, age 33-74) provided serum and GCF samples. Smokers and uncontrolled diabetics (HbA1c > 8%) were excluded. Serum and GCF samples were analysed for IL-6 and TNF-alpha using commercially available ELISA kits. Within each subject GCF was collected from two healthy sites (n = 26 subjects) and two gingivitis sites, defined by bleeding on probing (n = 22 subjects). The levels of IL-6 and TNF-alpha in the GCF were compared and correlated with the levels found in serum using Spearman's correlation analysis. A Bland-Altman analysis was used to determine the level of agreement between serum and GCF samples.

Results: IL-6 was more frequently detected than TNF-alpha. This was consistent in serum (100% vs 64%) and GCF samples from healthy (73% vs 52%) and gingivitis (95% vs 36%) sites. There were no significant correlations between the TNF-alpha in serum and GCF samples from healthy (r = 0.27, p = 0.22) and gingivitis (r = -0.19, p = 0.40) sites. In contrast, positive correlations were found for IL-6 between serum and GCF samples from healthy (r = 0.48, p = 0.03) and gingivitis (r = 0.79, p = 0.0001) sites. The correlation and agreement was strongest for IL-6 between serum and gingivitis GCF samples.

Conclusion: The results of this pilot study suggest a lack of correlation and poor agreement between serum and GCF samples in obese subjects. Studies examining the link between periodontitis and obesity should consider collecting both serum and GCF.

Objective: To assess the anatomical landmarks of the roots of bifurcated maxillary first premolars and study their effect on the diagnosis and management of periodontal disease.

Methods: One hundred sixty-five maxillary first premolars were selected. The frequency of single-, two-rooted, and three-rooted premolars was assessed, but only the dual-rooted were used for the purpose of this study. For each tooth, the following measurements were obtained using a micrometer caliper: buccal and palatal root length, mesial and distal root trunk length, crown length, and width of the furcation entrance. The types of root trunk were classified according to the ratio of root trunk height to root length into types A, B and C. Root trunk types A, B and C are defined as root trunks involving the cervical third or less, up to half of the length of the root, or greater than the apical half of the root, respectively. The presence of any root grooves and concavities, as well as bifurational ridges, was assessed. The crown to root ratio was calculated.

Results: Of the 165 maxillary first premolar teeth retrieved, 100 (60.6%) were two-rooted, 62 (37.57%) were single-rooted, and three (1.81%) were triple-rooted. Type A root trunks comprised only 7% of the examined teeth, while types B and C had more or less comparable results (46% and 47% respectively). Type B was more common in distal root trunks while type C was dominant in mesial root trunks. Bifurcation ridges were observed in 37% of the teeth; the mean root trunk length was greater in teeth with bifurcation ridges than in teeth without (7.41 mm vs. 5.96 mm). Root grooves and concavities were found in 96% of the mesial aspects of the root, and in 57% of the palatal aspect of the buccal root. The mean width of the furcation entrance was 0.89 +/- 0.19 mm (range 0.39-1.28). The average crown to root ratio was 0.69:1.

Conclusion: Awareness of root surface anatomical variations may help the practitioner when assessing the diagnosis, treatment plan and prognosis of periodontally involved two-rooted maxillary premolars.

Objective: The aim of the study was to evaluate the prevalence of periodontal pathogens Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Treponema denticola in subgingival plaque collected at different probing depths of type 1 diabetes patients with periodontal disease in correlation to metabolic control.

Methods: Twenty-one patients 40 to 50 years old were included in the study. In each patient blood samples were taken for the evaluation of HbA1c level and subgingival plaque samples were taken with paper points from the two deepest pockets. The presence of five periodontal pathogens was detected by multiplex polymerase chain reaction.

Results: The results of 38 plaque samples showed that T. forsythia was found in 48% followed by T. denticola in 31%, P. gingivalis in 26%, P. intermedia in 9% and A. actinomycetemcomitans in 7%. T. forsythia and T. denticola were the most frequent combination of periodontal pathogens found in the same sample. The serum level of HbA1c in nine patients where T. forsythia was detected (7.5 +/- 1.4%) was significantly higher (F-test, p = 0.001) than in 12 patients where T. forsythia was not detected (6.8 +/- 0.5%). Similarly, the serum level of HbA1c was significantly higher (F-test, p = 0.001) in eight patients where T. denticola was detected (7.5 +/- 1.8%) compared to the 13 patients where T. denticola was not detected (7.0 +/- 0.5%). No such correlation was found for P. gingivalis, P. intermedia or A. actinomycetemcomitans.

Conclusions: We conclude that T. forsythia and T. denticola are most frequently found in subgingival plaque samples of type 1 diabetic patients and these findings correlate with poorer metabolic control of diabetes.

Introduction: The aim of this study was to examine a potential link between apoptotic biomarkers in gingival crevicular fluid (GCF) and periodontal destruction in four cases of localized aggressive periodontitis (LAP), diagnostically enhanced by cone beam computed tomography.

Case series: This study examined the GCF in four patients diagnosed with LAP (formerly localized juvenile periodontitis) at a routine periodontal examination. The LAP diseased sites had attachment loss ranging from 5-12 mm. Atotal of 62 samples of GCF were collected from diseased sites and from contralateral, matched healthy sites with minimal or no attachment loss. All samples were assayed for apoptotic markers, including Fas/FasL, DNAfragmentation, and nitric oxide. The GCF samples were analyzed utilizing enzyme-linked immunosorbent assays for DNA fragments and nitric oxide levels, whereas Western blotting was used for Fas/FasL analyses. Our results showed a significant increase in the apoptotic markers Fas/FasL and DNA fragmentation when comparing GCF from diseased versus non-diseased sites in patients with LAP.

Conclusion: To our knowledge, this is the first report of apoptotic biomarkers associated with patients diagnosed with LAP. Finding significantly increased levels of these markers in localized areas may help us understand the pathophysiology associated with this specific form of periodontitis, and, furthermore, may provide a basis for a quantifiably prognostic test when attempting to treat this disease.

Aim: To evaluate the effect of bone grafting in corticotomy-facilitated orthodontics in adults, using a further modified conventional corticotomy technique.

Methods: Twenty adult orthodontic patients with moderate crowding of the lower anterior teeth were equally divided into two groups and treated with either a modified corticotomy-faciIitated orthodontic tooth movement alone (Group I) or modified corticotomy-facilitated orthodontic tooth movement combined with bone grafting (Group II). Total treatment time was calculated in weeks from the time of activation of the orthodontic appliance immediately following the corticotomy procedure to the time of debracketing. Clinical periodontal parameters and standardized periapical radiographs were recorded at baseline, post-orthodontic treatment (debracketing time) and six months post-operatively. The primary radiographic variables were root length and bone density.

Results: Treatment duration for patients in both groups ranged from 14-20 weeks. There was no statistically significant difference between the two groups in clinical parameters at each time interval. The net percentage of change that occurred to bone density from baseline to six months post-orthodontic treatment was statistically significantly different between the two groups. Group I demonstrated a net decrease in bone density of -17.59%, while Group II demonstrated a net increase in bone density of 25.85%. Group I demonstrated an average net decrease in root length of -0.056 mm +/- 0.025, while Group II demonstrated an average net decrease in root length of -0.050 mm +/- 0.026, which was not statistically significantly different.

Conclusion: The results of the current study suggest that corticotomy-facilitated orthodontic tooth movement significantly reduces the total time of treatment. In addition, the incidence of apical root resorption and periodontal problems associated with orthodontic tooth movement were reduced. The incorporation of bone graft material significantly increased the alveolar bone density in adult patients.

Objective: Effective plaque control is essential for prevention of gingivitis and periodontitis. The aim of this 24-week follow-up parallel study was to evaluate the efficacy of three topical gels in the treatment of gingivitis as compared to placebo gel.

Methods: One hundred twenty subjects diagnosed with chronic generalized gingivitis were selected and randomly divided into four groups: Group 1--placebo gel, Group 2--chlorhexidine (CHX) gel, Group 3--metronidazole (MTZ) gel and Group 4--chlorhexidine-metronidazole (CHX-MTZ) gel. Clinical evaluation was undertaken using the gingival index (GI) of Löe and Silness and the plaque index (PI) at baseline, 6 weeks, 12 weeks and 24 weeks. Microbiological analysis was also done at the same time intervals. A subjective evaluation was also undertaken by questionnaire.

Results: Groups treated with all three gels (CHX, MTZ and CHX-MTZ) showed significant clinical and microbiological improvement as compared to the group treated with a placebo gel. The reduction in PI, GI and microbiological count in the group treated with the CHX-MTZ combination gel was significant when compared to those treated with CHX and MTZ gels.

Conclusion: Topical application of CHX or MTZ alone or in combination may have a role in the management of gingivitis.

History teaches us that a great deal of effort is put forward in giving birth to a classification system, only to have it be quickly contradicted or condemned. Though we have made great strides towards the understanding of periodontitis in general, the bitter truth is that we have not hit the bull's eye on the true nature of etiopathogenesis. Until then any classification based on infectious etiology would be a misfit. Aclassification that is easy to understand and based on treatment needs would be more apt at this juncture. This article is aimed at discussing the present American Academy of Periodontology 1999 classification and to suggest a new and simplified classification.

Aim: To evaluate the effect of corticotomy-facilitated orthodontics (CFO) in adults using a further modified technique versus traditional therapy in orthodontic tooth movement.

Methods: Twenty adult orthodontic patients with moderate crowding of the lower anterior teeth were randomly divided and treated with either a modified technique of corticotomy-facilitated orthodontic tooth movement (Group I) or conventional orthodontic therapy (Group II). Total treatment time was calculated in weeks from the time of activation of the orthodontic appliance immediately following the corticotomy procedure to the time of debracketing. Clinical periodontal parameters and standardized periapical radiographs were recorded at baseline, post-orthodontic treatment (time of debracketing) and six months post-operatively. The primary radiographic variables were root length and bone density.

Results: Treatment duration for patients in both groups ranged from 14-20 weeks. There was a statistically significant difference between the two groups regarding the treatment duration: 17.5 +/- 2.8 weeks in the CFO group and 49 +/- 12.3 weeks in the conventional orthodontic therapy group. No significant changes occurred in clinical probing depth in either group at any time interval. The net percentage of change that occurred in bone density from baseline to six months post-treatment was not statistically significantly different between the two groups. Group I demonstrated a net decrease in bone density of 21.8%, while Group II demonstrated a net decrease of 37.2%. Group I demonstrated an average net decrease in root length of 0.02 +/- 0.10 mm, while Group II demonstrated an average net decrease of 1.4 +/- 0.8 mm, which was not statistically significantly different.

Conclusion: The results of the current study suggest that corticotomy-facilitated orthodontic tooth movement using a further modified technique significantly reduces the total time of treatment. In addition, the incidence of root resorption and adverse effect on teeth investing tissues associated with orthodontic tooth movement were reduced. Moreover, the acceleration of tooth movement through the proposed technique motivated patient cooperation.