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| 2. |
- Norderyd, Ola, et al.
(author)
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Periodontal status of women taking postmenopausal estrogen supplementation
- 1993
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In: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 64:10, s. 957-962
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Journal article (peer-reviewed)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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| 3. |
- Grossi, S. G., et al.
(author)
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Assessment of risk for periodontal disease. I. Risk indicators for attachment loss
- 1994
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In: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 65:3, s. 260-267
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Journal article (peer-reviewed)abstract
- Specific risk indicators associated with either susceptibility or resistance to severe forms of periodontal disease were evaluated in a cross-section of 1,426 subjects, 25 to 74 years of age, mostly metropolitan dwellers, residing in Erie County, New York, and surrounding areas. The study sample exhibited a wide range of periodontal disease experience defined by different levels of attachment loss. Therefore, it was possible to accurately assess associations between the extent of periodontal disease and patient characteristics including age, smoking, systemic diseases, exposure to occupational hazards, and subgingival microbial flora. Age was the factor most strongly associated with attachment loss, with odds ratios for subjects 35 to 44 years old ranging from 1.72 (95% CI: 1.18 to 2.49) to 9.01 (5.86 to 13.89) for subjects 65 to 74 years old. Diabetes mellitus was the only systemic disease positively associated with attachment loss with an odds ratio of 2.32 (95% CI: 1.17-4.60). Smoking had relative risks ranging from 2.05 (95% CI: 1.47-2.87) for light smokers increasing to 4.75 (95% CI: 3.28-6.91) for heavy smokers. The presence of two bacteria, Porphyromonas gingivalis and Bacteroides forsythus, in the subgingival flora represented risks of 1.59 (95% CI: 1.11-2.25) and 2.45 (95% CI: 1.87-3.24), respectively. Our results show that age, smoking, diabetes mellitus, and the presence of subgingival P. gingivalis and B. forsythus are risk indicators for attachment loss. These associations remain valid after controlling for gender, socioeconomic status, income, education, and oral hygiene status expressed in terms of supragingival plaque accumulation and subgingival calculus. Longitudinal, intervention, and etiology-focused studies will establish whether these indicators are true risk factors.
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| 4. |
- Hausmann, E, et al.
(author)
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Studies on the relationship between changes in radiographic bone height and probing attachment
- 1994
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In: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 21:2
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Journal article (peer-reviewed)abstract
- The aim of this investigation was to determine the relationship between loss of radiographic crestal bone height and probing attachment loss. As part of this aim, we are introducing a new method for determination of a threshold for significant probing attachment loss which takes into account the error contributed by alteration in tissue tone. 57 adults with established periodontitis were selected. Radiographs were taken using the Rinn alignment system. Crestal change was determined from bone height measurements on digitized images of pairs of radiographs using the "side-by-side" technique of analysis developed recently by us. Probing attachment loss was measured using the Florida electronic probe system. Radiographic and probing measurements were made at baseline and after 1 year. No treatment was given during this period. A direct and significant relationship was observed between radiographic bone loss and probing attachment loss on a site basis (p = 0.0001, r2 = 0.018) and between subject means (p = 0.0014, r2 = 0.16). Radiographic and probing attachment change at all categories of sites, dichotomously classified as to not changing or loosing indicated 13% of sites were loosing by measurement of radiographic change and 9.6% were loosing by measurement of attachment change. Concordance in radiographic and attachment level change was found in 82% of sites examined. The relative diagnostic import of change in probing attachment or change in radiographic bone height requires treatment outcome studies based on use of diagnostic information of the 2 measuring techniques used singly and in combination.
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| 5. |
- Machtei, E E, et al.
(author)
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Clinical, microbiological, and histological factors which influence the success of regenerative periodontal therapy.
- 1994
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In: Journal of Periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 65:2
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Journal article (peer-reviewed)abstract
- The primary objectives of this double-blind, controlled clinical trial were to assess factor(s) which affect the success of guided tissue regeneration (GTR) procedures in mandibular Class II buccal furcation defects. Thirty subjects, with mandibular Class II furcation defects, were randomly assigned to one of two treatment groups; patients in Group A received oral hygiene instructions with scaling and root planing, while subjects in Group B received similar treatment but without subgingival scaling and root planing at the affected site. After initial oral hygiene instructions and scaling and root planing, GTR surgery was performed using ePTFE barrier membranes. Membranes were retrieved at 6 weeks and subjected to histological examination. Twelve months after regenerative therapy, clinical measurements and re-entry surgical measurements were repeated. Probing reduction (2.61 mm), horizontal probing attachment gain (2.59 mm), and vertical probing attachment gain (0.95 mm) were all significantly better compared to baseline. Likewise, significant improvements in furcation volume (8.0 microliters) and in bone measurements were observed at re-entry. There was no discernible difference between subjects for whom complete anti-infective therapy was deferred to the time of the surgery (Group B) compared to subjects in whom complete anti-infective therapy was performed as part of the hygienic phase of therapy (Group A). Pre-operative pocket depth was directly correlated with the magnitude of attachment gain as well as the amount of new bone formation in the furcation area. Subjects who maintained good oral hygiene and who had minimal gingival inflammation throughout the study demonstrated consistently better regenerative response.(ABSTRACT TRUNCATED AT 250 WORDS)
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| 6. |
- Machtei, E. E., et al.
(author)
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Guided tissue regeneration and anti-infective therapy in the treatment of class II furcation defects
- 1993
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In: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 64:10, s. 968-973
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Journal article (peer-reviewed)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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| 7. |
- Machtei, E E, et al.
(author)
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The rate of periodontal attachment loss in subjects with established periodontitis.
- 1993
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In: Journal of Periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 64:8
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Journal article (peer-reviewed)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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