| 1. |
- Christersson, L. A., et al.
(författare)
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Topical application of tetracycline‐HCl in human periodontitis
- 1993
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Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 20:2, s. 88-95
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Tidskriftsartikel (refereegranskat)abstract
- Previous in vitro studies have suggested that tetracycline‐HCl (TTC‐HCl) is adsorbed and actively released from root dentin. The aim of the current study was to evaluate the binding to and release of TTC‐HCl from human root dentin surfaces in vivo, and to evaluate the clinical utility of TTC‐HCl irrigation as an adjunct to scaling and root planing. Experiment I utilized two contralateral mandibular single‐rooted teeth which were examined in four adults with severe generalized periodontitis. One tooth in each patient was carefully scaled and root planed, under local anesthesia, and the other used as an unsealed control. Each subgingival root surface was irrigated for 5 min with an aqueous TTC‐HCl solution at a concentration of 100 mg/ml. Gingival crevicular fluid samples were collected on paper strips for the next three weeks. The TTC‐HCl concentrations in each sample were determined by the inhibition zone of B. cereus cultured on agar plates. The TTC‐HCl concentrations in gingival crevicular fluid collected 15 min after irrigation were 3100±670 μg/ml from the scaled lesions and 4700±1300 μg/ml from the unsealed root surfaces. The antibiotic concentrations decreased logarithmically over the next 7 days; 1500±270 μ/g/ml and 1100±330μ/g/ml at 2 h. 880±350μ/g/ml and 1300±360 μ/g/ml at 6 h and 19±5μ/g/ml and 31±26 μ/g/ml at 1 week for scaled and unsealed root surfaces, respectively. Results for week two and three indicated an average of over 8 μg/ml. The TTC‐HCl concentrations in gingival crevicular fluid from scaled and unsealed root surfaces were not statistically different at any time point. The tetracycline irrigation resulted in release of tetracycline at concentrations well above therapeutic concentrations for at least 1 week. Experiment II comprised 11 patients with severe adult periodontitis. All subjects were scaled and root planed prior to baseline measurements. The patients were monitored by the following parameters: probing pocket depth (PPD), probing attachment level (PAL), gingival index (GI) and plaque index (PI). 54 contralateral teeth exhibiting residual pocket depths of 5 mm were selected. Within each pair identified for the study, teeth were randomly assigned as test or control sites. After baseline measurement, each subgingival root surface was irrigated for 5 min; either with an aqueous TTC‐HCl solution of 100 mg/ml (test), or a 0.9% NaCl solution (control). At 3 and 6 months post‐treatment, the PI was unchanged for both groups. The GI index was reduced (0.062 > p > 0.001) in a similar manner for both groups. PPD showed statistically significant (p < 0.001) mean/patient decrease of similar magnitudes, 2.3±1.0 mm (test), and ‐1.6±0.8 mm (control) at 3 months, and ‐2.1±1.1 mm (test), and ‐1.4±0.9 mm at 6 months (control), respectively. Also, PAL measurements indicated a statistically significant average gain/patient of 2.1±1.1 mm in the test group (p<0.00l) and again of 1.2±1.0 mm in the controls (p = 0.002) at 3 months, and 1.8±1.1 mm (test; p<0.001) and 1.0±0.9 mm (controls; p= 0.005) at 6 months. Comparisons of the changes, between the groups, indicated statistically greater gain of PAL in the test group at both the 3 (p= 0.042) and 6 months (p= 0.034) intervals. These results suggest that TTC‐HCl irrigation of root surfaces for long periods of time (5 min) results in a subsequent release of active antibiotic into the gingival fluid at therapeutic levels for at least 1 week. TTC‐HCl irrigation resulted in significantly greater attachment gain as compared to scaling and root planing alone over at least a month period of healing.
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| 2. |
- Gerdner, Arne, et al.
(författare)
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Alkoholism som sjukdom
- 1993
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Ingår i: Nordisk Alkoholtidskrift. - 0789-6069. ; 10:3, s. 133-144
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Tidskriftsartikel (refereegranskat)
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| 3. |
- Karlsson, Jan-Erik, et al.
(författare)
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Ambulatory ST-recording has no additional value to exercise test for identification of severe coronary lesions after an episode of unstable coronary artery disease in men
- 1993
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Ingår i: International Journal of Cardiac Imaging. - : Wolters Kluwer. - 0167-9899. ; 9:4, s. 281-289
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Tidskriftsartikel (refereegranskat)abstract
- One month after an episode of unstable coronary artery disease, 95 male patients performed coronary angiography, 48 hours ambulatory ST-recording and also an exercise test. ST-depression occurred in 29.5% during the ST-recording and in 44.2% during the exercise test (p<0.05). In patients with ST-depression at ambulatory monitoring, 79% demonstrated the same finding at the exercise test. A high risk response at the exercise test - defined as either ST-depression in ≥ 3 leads, ST-depression in 1-2 leads with a maximal work load below the 60th percentile or a maximal work load below the 30th percentile regardless of the ECG reaction - occurred in 56.8%. Severe coronary lesions - defined as three vessel disease, left main stenosis or proximal left anterior descending artery stenosis as part of two vessel disease - was observed in 46.3%. Patents with a high risk exercise test response and patients with ST-depression during ST-recording had severe coronary lesions in 67% and 64% respectively. However, a high risk exercise test response occurred in 82%, while ST-depression at ambulatory monitoring was observed only in 41% of the patients with severe coronary lesions (p < 0.001). Thus, ambulatory ST-recording one month after an episode of unstable coronary artery disease in men adds no further information to a symptom limited exercise test in order to identify patients with severe coronary lesions.
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| 4. |
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| 5. |
- Machtei, E. E., et al.
(författare)
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Guided tissue regeneration and anti-infective therapy in the treatment of class II furcation defects
- 1993
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Ingår i: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 64:10, s. 968-973
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Tidskriftsartikel (refereegranskat)abstract
- THE PURPOSE OF THE PRESENT STUDY WAS TO EVALUATE the effect of anti-infective therapy on the success of periodontal regeneration in mandibular Class II furcation defects. Eighteen patients with mandibular bilateral Class II furcation defects were enrolled. Following an initial hygienic phase, guided tissue regeneration (GTR) was performed using an expanded polytetrafluoroethylene (e-PTFE) membrane barrier. The area was surgically exposed, thoroughly root planed, and irrigated with either tetracycline (100 mg/ml) or 0.9% saline. Post-operative care included systemic tetracycline (250 mg q.i.d.) and chlorhexidine 0.12% mouthwash twice daily. Patients were maintained on a prophylaxis schedule of every 2 weeks for the first 3 months, and monthly thereafter. Clinical parameters of probing depth (PD), probing attachment level - vertical (PAL-v), probing attachment level - horizontal (PAL-h), and target periodontal pathogens were monitored at baseline and quarterly for one year. An overall improvement in all clinical parameters was observed in both groups: probing reduction (3.1 mm), PAL-h gain (2.3 mm), and PAL-v gain (1.2 mm) were all statistically significant compared to baseline measurements. Vertical measurements were performed parallel to the long axis of the tooth with no attempt to angulate the probe into the furcation. There was no significant difference in sites receiving tetracycline. A strong positive correlation was noted between initial PD and pocket reduction (r = 0.77, P <0.0001) and between initial PD and PAL-h gain (r = 0.54) and PAL-v gain (r = 0.45) suggesting that initial probing depth might be used to assess the regenerative potential of a given site. PD and PAL have shown marked improvement as early as 6 months post-operatively, but further improvement occurred over the 12 months of the study. Mean plaque indices were reduced to 0.5 with slight increases at 9 months, while gingival indices were steady at 0.5 through the year. Immunofluorescence demonstrated minimal infection with the target periodontal pathogens following surgery. Actinobacillus actinomycetemcomitans was detected in 5 sites during the monitoring phase and was associated with less favorable clinical results. This finding suggests that anti-infective therapy and monitoring for A. actinomycetemcomitans and/or other periodontal pathogens might be useful in GTR therapy.
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| 6. |
- Machtei, E E, et al.
(författare)
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The rate of periodontal attachment loss in subjects with established periodontitis.
- 1993
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Ingår i: Journal of Periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 64:8
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Tidskriftsartikel (refereegranskat)abstract
- A stepwise approach to determine attachment level changes was utilized to assess the nature of progression of periodontal disease. Following initial screening, 51 subjects with established periodontitis were monitored quarterly for 9 more months. Probing depth (PD) and relative attachment level (RAL) were recorded using an automated, pressure sensitive probe system. To establish intra-examiner error, repeated measurements were performed for all sites at the final visit. An overall standard deviation (SD) for RAL repeated measurements was initially calculated (0.76 mm) using all 6,935 double measurements. Sites were sorted by factors which contribute to the error of attachment level measurements; i.e., pocket depth (shallow, moderate, deep), tooth type (molar, non-molar) and location (buccal, lingual). Data were sorted by the above 12 groups, and SD for repeated measurements was calculated separately for them. The ratio between these SD and the overall SD served as the corrective factor. Each patient's initial threshold (2 SD) was multiplied by these corrective factors thus resulting in 12 thresholds for each subject. Next, linear, exponential and logarithmic regression models were tested for each site, and the regression model showing the highest R value was chosen for that site. AL changes were tested against the patient's threshold for that site. Sites with attachment loss exceeding the threshold were deemed active. Five hundred eighty-one sites (8.3%) exhibited attachment loss exceeding the various thresholds. Of these, linear progression occurred in 195, logarithmic in 224, and exponential in 162 sites. Individual patient's attachment loss ranged from 0.6 to 19.4% of all sites.
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| 7. |
- Norderyd, Ola, et al.
(författare)
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Periodontal status of women taking postmenopausal estrogen supplementation
- 1993
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Ingår i: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 64:10, s. 957-962
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Tidskriftsartikel (refereegranskat)abstract
- THE ASSOCIATION BETWEEN SUPPLEMENTARY ESTROGEN intake and periodontal and gingival status in a total of 228 women 50 to 64 years of age was examined. Clinical parameters including visible supragingival plaque, subgingival calculus, probing pocket depth, clinical attachment level, alveolar bone height measurements, and number of remaining teeth were measured. Gingival status was recorded as gingival bleeding after gentle manipulation. Selected periopathogens, socio-economic, demographic, smoking habits, and health care variables were assessed. Gingival bleeding was significantly lower in the estrogen supplement group (n = 57) compared to the control group (n = 171) (P = 0.009); the estrogen group also exhibited significantly lower visible plaque levels (P = 0.030) and fewer Capnocytophaga-ssp. (P = 0.032). Dental care was more frequent (P < 0.001), and education levels were higher (P = 0.022) in the estrogen group. To investigate whether differences among the above parameters contributed to the difference in gingival bleeding, an age-adjusted analysis of covariance (ANCOVA) was used. The final ANCOVA indicated non-significant relationships for all parameters examined except estrogen intake (P = 0.044). Women taking estrogen exhibited lower gingival bleeding than the control group after correcting for these factors. The results indicate that estrogen supplementation is associated with less gingival bleeding in women aged 50 to 64, as compared to an age-matched control group.
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