Periodontal clinical investigations : official publication of the Northeastern Society of Periodontists最新文献

This case report delineates an instance whereby a peripheral giant cell granuloma mimicked certain features of an endodontic-periodontic lesion. When the area did not resolve following endodontic therapy, and in fact actually increased in size in a relatively short time, the decision to biopsy the area was made. After histologic examination, a definitive diagnosis of peripheral giant cell granuloma was possible. The patient is being monitored postoperatively to ensure no recurrence of the lesion. The relevance of this case report is that it exemplifies the fact that the lesion may be encountered by periodontists, and that the lesion may clinically resemble a mucocele or peripheral ossifying fibroma.

Standardization of intraoral radiographs is necessary for longitudinal studies of alveolar bone changes. Several methods of standardizing have been developed. These all involve fixing the geometric relations between the object, the x-ray tube, and the film. This usually involves a film holder, mounted on an occlusal stent and connected to the x-ray tube via an adapter ring. There is, however, a problem of compatibility between various commercial adapter rings and film holder assemblies. In an attempt to overcome this problem, we developed a method of producing cast acrylic adapters by making a plaster cast from a silicon rubber impression of the x-ray tube. The adapter was devised so that radiographs could be taken of all four segments using the same standard commercially available film holder. A total of 128 radiographs were taken from 42 patients who underwent various types of periodontal surgery; 64 were taken preoperatively and 64 at 6 months postoperatively. These pairs were superposed and approximately 58% were found by qualitative inspection to show total matching of geometric outlines as well as maintenance of position on the film, and approximately 73% to show geometric matching. Changes in alveolar bone height were evaluated for 11 of these totally matching pairs by counting millimetric grids and by a computer-based indirect digital imaging system. These were found to correlate satisfactorily (r = .63).

As a diagnostic test, "Periocheck" can detect the N-carbobenzoxyglycyl-glycy-arginyl peptidase that is produced by Treponema denticola, Porphyromonas gingivalis, and Bacteroides forsythus. The aim of this study was to clarify the relationship between peptidase activity and attachment loss. After Phase 1 and surgical therapy, a total of 111 sites from 47 adult periodontitis patients were divided into four groups according to peptidase activity (trypsin unit, TU): A, < 0.1 TU; B, 0.1-0.2 TU; C and D > or = 0.2 TU. All sites in groups A, B, and C were untreated, whereas both subgingival 3% hydrogen peroxide irrigation and 2% minocycline application were undertaken every 45 days throughout the experiment in group D. All subjects were recalled at 3-month intervals. Peptidase activity and clinical assessments were measured for the 18-month period. Significant attachment loss associated with high values of the peptidase activity was found through the experimental period in groups B and C. In contrast, no obvious change of attachment loss was found in groups A and D following low peptidase activity at 6, 12, and 18 months. The mean attachment loss throughout the 18-month period was 0.22 mm in group A, 1.04 mm in group B, 1.53 mm in group C, and -0.35 mm in group D. Probing depth and percentages of bleeding on probing significantly increased in group C, whereas they decreased in group D. This peptidase test displayed a 77.8% sensitivity and 68.6% specificity regarding the detection of > or = 1 mm attachment loss with a cut-off value of 0.1 TU. Multiple linear regression analysis showed a close relationship between peptidase activity and predictable attachment loss within a 12-month period. These findings suggest that this peptidase test is useful in identifying the risk sites for predictable attachment loss.

The purpose of this study was to determine to what extent a given long-term prognosis of a periodontally involved tooth is in agreement with the actual outcome after periodontal therapy. Five hundred and eighty teeth in 24 subjects diagnosed with adult periodontitis and treated 5-13 years ago were evaluated. Subject's age, gender, race, plaque index, gingival index, missing teeth, tooth mobility, probing depth, presence of furcation, alveolar bone level, and frequency of supportive periodontal therapy were recorded. A prognosis was then determined for each tooth and compared to the initial prognosis using the same measures retrieved from the subject's record. Results of the study suggest that (1) it is less common to project accurately the progress of individual teeth when a prognosis is other than good; and (2) it is more difficult to predict correctly the outcome of multirooted teeth than single-rooted ones.

We have previously reported that the Periocheck test offers a rapid, simple periodontal diagnostic tool by detecting peptidase activity specifically attributed to Treponema denticola, Porphyromonas gingivalis, and Bacteroides forsythus. Relationships between the peptidase activity detected by the Periocheck test and clinical measures were investigated. Fifty-seven Periocheck-positive sites selected from 27 patients with adult periodontitis were subjected to scaling and root planing. Two weeks later, a Periocheck test was undertaken in the test sites. Two groups were then determined, one composed of 40 Periocheck-positive sits, and the other consisting of 17 Periocheck-negative sites. All sites were re-examined at 6, 10, 14 and 18 weeks using both the Periocheck test and clinical measures. On week 18, the negative group displayed a significant decrease in probing pocket depth (PD) and a significant attachment level (AL) gain (2.1 and 1.2 mm, respectively), while the positive group showed a slight decrease in PD and AL gain (0.9 and 0.3 mm, respectively). The differences between negative and positive groups in PD and AL became statistically significant by the tenth week. Improvement of gingival index (GI) and bleeding on probing (BOP) was more apparent in the negative group. The detection of intrapocket microbiological status by the Periocheck test preceded the changes in PD, AL, GI, and BOP after periodontal therapy. In conclusion, the Periocheck test may provide a promising chairside monitoring tool for effectively evaluating therapies associated with scaling and root planing.

1. Necrotizing ulcerative gingivitis (NUG) was commonly seen in children who attended the Dugbe Dental Centre in Nigeria. 2. The most severe form of NUG occurred in children between 3 and 5 years of age. 3. No cases occurred in infants under 12 months of age. 4. Malnutrition as well as infectious and parasitic disease appeared to play a significant role in the etiology of NUG among the children affected.