| 1. |
- Jansson, Henrik, et al.
(author)
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Type 2 diabetes and risk for periodontal disease: a role for dental health awareness
- 2006
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In: Journal of Clinical Periodontology. - 1600-051X .- 0303-6979. ; 33:6, s. 408-414
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Journal article (peer-reviewed)abstract
- Background: Several studies have found correlations between diabetes and an increased prevalence of periodontitis. Objective: To analyse, in a group of subjects with type 2 diabetes (T2D), (i) the association between medical characteristics and severe periodontal disease and (ii) dental care habits and knowledge of oral health. Methods: One hundred and ninety-one subjects with T2D were examined. Based on assessment of marginal bone height in panoramic radiographs, two periodontal subgroups were identified: one periodontally diseased (PD+) and one periodontally healthy (PD-) group. All subjects completed a questionnaire about their medical and oral health. Results: Twenty per cent of the subjects were classified as PD+. This was verified by clinical parameters. PD+ individuals had higher haemoglobin A1c (HbA1c) levels (p=0.033) and higher prevalences of cardiovascular complications (p=0.012). They were also less likely to be of Scandinavian origin (p=0.028) and more likely to smoke (p < 0.001) than the PD- group. The PD+ group rated their oral health as poor (p < 0.0001) and believed that T2D had an influence on their oral status (p < 0.0001). Conclusion: The best predictor for severe periodontal disease in subjects with T2D is smoking followed by HbA1c levels. T2D subjects should be informed about the increased risk for periodontal disease when suffering from T2D.
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| 2. |
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| 3. |
- Hugoson, A, et al.
(author)
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Periodontal disease in relation to smoking and the use of Swedish snus : epdemiological studies covering 20 years (1983-2003)
- 2011
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In: Journal of Clinical Periodontology. - : Wiley-Blackwell. - 0303-6979 .- 1600-051X. ; 38:9, s. 809-816
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Journal article (peer-reviewed)abstract
- AbstractAim: The aim of the present study was to examine how deleterious current smokingand the use of Swedish moist snuff (snus) is for periodontal health compared with nontobaccousers.Materials and Methods: The studies comprised three epidemiological crosssectionalstudies, in 1983, 1993 and 2003, of stratified random samples aged 20, 30, 40,50, 60 and 70 years. The numbers of dentate participants were 550, 552 and 523,respectively. The participants were examined clinically and radiographically.Diagnostic criteria were the number of teeth, plaque, gingival status, probing pocketdepth (PPD)X4 mm, height of the alveolar bone level and classification by periodontaldisease experience. In addition, participants were asked about their tobacco habits.Results: Multiple logistic regression shows, after adjusting for age, gender andsociodemographic variables, that relative to non-tobacco users, cigarette smokers hadstatistically significant less gingivitis, a higher frequency of PPDX4mm and a higherincidence of severe periodontitis. There was no significant association betweengingivitis, frequency of PPDX4mm and periodontal disease experience and snus use.Conclusions: Cigarette smokers were found to have a statistically significant higherrisk of severe periodontitis than non-tobacco users and users of snus. Using snus didnot seem to be a risk factor for periodontitis
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| 4. |
- Roos-Jansåker, Ann-Marie, et al.
(author)
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Submerged healing following surgical treatment of peri-implantitis : a case series
- 2007
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In: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 34:8, s. 723-727
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Journal article (peer-reviewed)abstract
- Objectives: The aim was to study a regenerative surgical treatment modality for peri-implantitis employing submerged healing. Material and Methods: Twelve patients, having a minimum of one osseointegrated implant with peri-implantitis, with a progressive loss of >= 3 threads (1.8 mm) following the first year of healing were involved in the study. After surgical exposure of the defect, granulomatous tissue was removed and the implant surface was treated using 3% hydrogen peroxide. The bone defects were filled with a bone substitute (Algipore((R))), a resorbable membrane (Osseoquest((R))) was placed over the grafted defect and a cover screw was connected to the fixture. The implant was then covered by flaps and submerged healing was allowed for 6 months. After 6 months the abutment was re-connected to the supra-structure. Results: A 1-year follow-up demonstrated clinical and radiographic improvements. Probing depth was reduced by 4.2 mm and a mean defect fill of 2.3 mm was obtained. Conclusion: Treatment of peri-implant defects using a bone graft substitute combined with a resorbable membrane and submerged healing results in defect fill and clinical healthier situations.
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| 5. |
- Aberg, Carola Höglund, et al.
(author)
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Presence of Aggregatibacter actinomycetemcomitans in young individuals : a 16-year clinical and microbiological follow-up study.
- 2009
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In: Journal of clinical periodontology. - 1600-051X. ; 36:10, s. 815-22
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Journal article (peer-reviewed)abstract
- AIM: To look for clinical signs of periodontal disease in young adults who exhibited radiographic bone loss and detectable numbers of Aggregatibacter actinomycetemcomitans in their primary dentition. MATERIAL AND METHODS: Periodontal status and radiographic bone loss were examined in each of the subjects 16 years after the baseline observations. Techniques for anaerobic and selective culture, and checkerboard, were used to detect periodontitis-associated bacterial species. The isolated A. actinomycetemcomitans strains were characterized by polymerase chain reaction. RESULTS: Signs of localized attachment loss were found in three out of the 13 examined subjects. A. actinomycetemcomitans was recovered from six of these subjects and two of these samples were from sites with deepened probing depths and attachment loss. Among the isolated A. actinomycetemcomitans strains, serotypes a-c and e, but not d or f, were found. None of the isolated strains belonged to the highly leucotoxic JP2 clone, and one strain lacked genes for the cytolethal distending toxin. CONCLUSIONS: This study indicates that the presence of A. actinomycetemcomitans and early bone loss in the primary dentition does not necessarily predispose the individual to periodontal attachment loss in the permanent dentition.
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| 6. |
- Aghazadeh, Ahmad, et al.
(author)
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A single-center randomized controlled clinical trial on the adjunct treatment of intra-bony defects with autogenous bone or a xenograft : results after 12 months
- 2012
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In: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 39:7, s. 666-673
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Journal article (peer-reviewed)abstract
- Background Limited evidence exists on the efficacy of regenerative treatment of peri-implantitis Materials and methods Subjects receiving antibiotics and surgical debridement were randomly assigned to placement of autogenous bone (AB) or bovine derived xenograft (BDX) with placement of a collagen membrane. The primary outcome was: evidence of radiographic bone fill and the secondary outcomes included reductions of probing depth (PD) bleeding on probing (BOP) and suppuration. Results 22 subjects were included in the AB and 23 subjects in the BDX group. Statistical analysis failed to demonstrate differences for 38/39 variables assessed at baseline. At 12 months, significant better results were obtained in the BDX group for bone levels (p < 0.001), BOP (p = 0.004), PI (p = 0.003), and suppuration (p < 0.01). When adjusting for number of implants treated per subject, a successful treatment outcome PD≤ 5.0 mm, no pus, no bone loss and BOP at 1/4 sites the likelihood of defect fill was higher in the BDX group (LR: 3.2, 95 % CI: 1.0 to 10.6, p < 0.05). Conclusions Bovine xenograft provided more radiographic bone fill than autogenous bone. The success for both surgical regenerative procedures was limited. Decreases in PD, BOP, and suppuration were observed.
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| 7. |
- Aghazadeh, Ahmad, et al.
(author)
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A single-centre randomized controlled clinical trial on the adjunct treatment of intra-bony defects with autogenous bone or a xenograft : results after 12 months
- 2012
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In: Journal of Clinical Periodontology. - : Wiley Blackwell. - 0303-6979 .- 1600-051X. ; 39:7, s. 666-673
-
Journal article (peer-reviewed)abstract
- Background Limited evidence exists on the efficacy of regenerative treatment of peri-implantitis. Material and Methods Subjects receiving antibiotics and surgical debridement were randomly assigned to placement of autogenous bone (AB) or bovine-derived xenograft (BDX) and with placement of a collagen membrane. The primary outcome was evidence of radiographic bone fill and the secondary outcomes included reductions of probing depth (PD) bleeding on probing (BOP) and suppuration. Results Twenty-two subjects were included in the AB and 23 subjects in the BDX group. Statistical analysis failed to demonstrate differences for 38/39 variables assessed at baseline. At 12 months, significant better results were obtained in the BDX group for bone levels (p < 0.001), BOP (p = 0.004), PI (p = 0.003) and suppuration (p < 0.01). When adjusting for number of implants treated per subject, a successful treatment outcome PD = 5.0 mm, no pus, no bone loss and BOP at 1/4 or less sites the likelihood of defect fill was higher in the BDX group (LR: 3.2, 95% CI: 1.010.6, p < 0.05). Conclusions Bovine xenograft provided more radiographic bone fill than AB. The success for both surgical regenerative procedures was limited. Decreases in PD, BOP, and suppuration were observed.
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| 8. |
- Al-Otaibi, M, et al.
(author)
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Subgingival plaque microbiota in Saudi Arabians after use of miswak chewing stick and toothbrush
- 2004
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In: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 31:12, s. 1048-53
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Journal article (peer-reviewed)abstract
- BACKGROUND: The chewing stick, the miswak, is used in many developing countries as the traditional means for oral hygiene. It is prepared from the roots, twigs and stem of Salvadora persica or other alternative local plants. OBJECTIVES: To compare the effects of the chewing stick miswak (from S. persica) and toothbrush on subgingival plaque microflora among Saudi Arabian individuals. Further, to investigate whether components extracted from S. persica may interfere with the subgingival plaque micro-organisms. MATERIAL AND METHODS: Fifteen healthy Saudi Arabian male volunteers aged 21-36 years were included in a single-blind, randomized cross-over study. The participants were taught how to use each device properly. Plaque sampling for DNA test was performed at the baseline, 1 week after professional tooth cleaning, and after 3 weeks of either miswak or toothbrush use. Identification and quantification of microbial species were performed by the checkerboard method, using whole genomic, digoxigenin-labelled DNA probes. Inhibition zones around miswak were examined on agar plates with Actinobacillus actinomycetemcomitans and the leukotoxicity of this bacterium was analyzed in a bioassay with macrophages+/-extracts of miswak. RESULTS: Miswak and toothbrushing had a similar influence on the levels of the subgingival microbiota. However, A. actinomycetemcomitans was significantly more reduced by miswak (p<0.05) than by toothbrushing. These results were supported by our in vitro results which, indicated that extracts from S. persica might interfere with the growth and leukotoxicity of A. actinomycetemcomitans. CONCLUSIONS: In contrast to toothbrush use, miswak use significantly reduced the amount of A. actinomycetemcomitans in the subgingival plaque.
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| 9. |
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| 10. |
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| 11. |
- Albrektsson, Tomas, 1945, et al.
(author)
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State of the art in oral implants.
- 1991
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In: Journal of clinical periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 18:6, s. 474-81
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Research review (peer-reviewed)abstract
- Uncontrolled oral implant devices are still being widely used. The documentation of most oral implant systems is poorly backed up or not followed up for an adequate time period. Success rates are being quoted without reference to any defined success criteria. Frequently used oral implant designs such as the Core-Vent, IMZ and Calcitek hydroxyapatite coated implants are in neither case supported by any adequate clinical reports from minimally 5-years of follow-up. Other implant systems such as the ITI, some subperiosteal designs and the Tübingen implant demonstrate well-controlled and acceptable 5-year data but are not followed up in a sufficient number or have demonstrated less good results in the 10-year evaluation. The Small transosteal staple has been adequately reported for more than 10 years of follow-up, whereas the Brånemark implant is the only endosseous design that has demonstrated acceptable 15-year success rates.
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| 12. |
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| 13. |
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| 14. |
- Berglundh, Tord, 1954, et al.
(author)
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Are peri-implantitis lesions different from periodontitis lesions?
- 2011
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In: Journal of clinical periodontology. - 1600-051X. ; 38 Suppl 11, s. 188-202
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Research review (peer-reviewed)abstract
- Aim:To compare histopathological characteristics of peri-implantitis and periodontitis lesions. METHODS: A search was conducted on publications up to July 2010. Studies carried out on human biopsy material and animal experiments were considered. RESULTS: While comprehensive information exists regarding histopathological characteristics of human periodontitis lesions, few studies evaluated peri-implantitis lesions in human biopsy material. Experimental peri-implantitis lesions were evaluated in 10 studies and three of the studies included comparisons to experimental periodontitis. Human biopsy material: the apical extension of the inflammatory cell infiltrate (ICT) was more pronounced in peri-implantitis than in periodontitis and was in most cases located apical of the pocket epithelium. Plasma cells and lymphocytes dominated among cells in both types of lesions, whereas neutrophil granulocytes and macrophages occurred in larger proportions in peri-implantitis. Experimental studies: placement of ligatures together with plaque formation resulted in loss of supporting tissues and large ICTs around implants and teeth. Following ligature removal, a "self-limiting" process occurred in the tissues around teeth with a connective tissue capsule that separated the ICT from bone, while in peri-implant tissues the ICT extended to the bone crest. CONCLUSION: Despite similarities regarding clinical features and aetiology of peri-implantitis and periodontitis, critical histopathological differences exist between the two lesions
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| 15. |
- Berglundh, Tord, 1954, et al.
(author)
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Preclinical in vivo research in implant dentistry. Consensus of the eighth European workshop on periodontology.
- 2012
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In: Journal of clinical periodontology. - 1600-051X. ; 39 Suppl 12, s. 1-5
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Research review (peer-reviewed)abstract
- Guidelines for improving the reporting in preclinical in vivo research (ARRIVE) have been recently proposed. AIM: The aim was to assess to what extent the ARRIVE guidelines were considered in preclinical in vivo studies in implant dentistry. MATERIAL AND METHODS: Four comprehensive systematic reviews evaluated to what extent the ARRIVE guidelines were considered in preclinical in vivo studies in implant dentistry. Studies on the influence of implant material, surface and design on tissue integration to implants placed in pristine bone, in locally compromised sites and/or systemically compromised animals, as well as on peri-implant mucositis and peri-implantitis were evaluated. The four reviews introduced different modifications to the ARRIVE guidelines dedicated to the specific assignment of the review. RESULTS: A large variation in the frequency of reporting with regard to the items of the modified ARRIVE guidelines was observed. The reviews revealed that relevant information, e.g. sample size calculation, blinding of the assessor etc., was often not reported. It was also identified that several items in the ARRIVE guidelines may be less--if at all--applicable to research in implant dentistry. CONCLUSION: It is suggested that researchers implement, whenever relevant, the ARRIVE guidelines during planning and reporting of preclinical in vivo studies related to dental implants.
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| 16. |
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| 17. |
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| 18. |
- Bogren, Anna, 1963, et al.
(author)
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Long-term effect of the combined use of powered toothbrush and triclosan dentifrice in periodontal maintenance patients.
- 2008
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In: Journal of clinical periodontology. - 1600-051X. ; 35:2, s. 157-64
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Journal article (peer-reviewed)abstract
- AIM: To test the hypothesis of a superior clinical and microbiological effect of the combined use of powered toothbrush+triclosan-containing dentifrice compared with manual toothbrush+regular fluoride-containing dentifrice in periodontal maintenance patients. MATERIAL AND METHODS: A total of 128 periodontitis subjects involved in recall programmes were randomized to use either powered toothbrush with triclosan-dentifrice (test) or manual toothbrush and standard dentifrice (control). Supportive periodontal treatment was provided at baseline and every 6 months. Plaque, bleeding on probing (BoP), probing pocket depth (PPD) and relative attachment level (RAL) were scored at baseline, 1, 2 and 3 years. Subgingival plaque samples were taken and analysed for their content of 40 bacterial species at each examination interval. All analyses were performed by "intention-to-treat" protocol. RESULTS: Both groups showed significant reduction in BoP, PPD and in mean total counts of the 40 bacterial species between baseline and 3 years, while plaque score and RAL remained almost unchanged. No significant differences between the two prevention programmes were found for any of the clinical outcome variables or in mean counts of the various bacterial species. CONCLUSIONS: The study failed to demonstrate superior clinical and microbiological effects of powered toothbrush+triclosan dentifrice compared with manual toothbrush+standard fluoride-dentifrice in periodontitis-susceptible patients on regular maintenance therapy.
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| 19. |
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| 20. |
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| 21. |
- Bratthall, G., et al.
(author)
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Comparison of ready-to-use EMDOGAIN®-gel and EMDOGAIN® in patients with chronic adult periodontitis. A multicenter clinical study
- 2001
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 28:10, s. 923-929
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Journal article (peer-reviewed)abstract
- Objectives: The aim of this multicenter trial was to compare the clinical and radiographical outcome of a ready-to-use Emdogain®-gel (test) with the marketed Emdogain® (control). Methods: Subjects with bilateral infrabony defects ≥4 mm deep and ≥2 mm wide according to radiographs were selected. 88 subjects with probing pocket depth (PPD) ≥6 mm ≥1 month after supervised oral hygiene and scaling participated. At baseline plaque index, bleeding on probing, PPD and probing attachment level were recorded and reproducible radiographs for computer-based bone level measurements were taken. In each subject, 1 tooth was randomly treated with the test and 1 tooth with the control gel. Examinations were repeated 8 and 16 months post-operatively. Results: After 16 months, the mean test PPD was 4.1 mm and the mean control PPD 4.2 mm. The mean gain of attachment was 2.7 mm for test and 2.9 mm for the control sites, and the radiographic measurements demonstrated a mean gain of 1 mm for both test and control sites. Conclusion: This series of cases demonstrated a statistically significant reduction of pocket depths and gain of attachment and bone after 8 and 16 months with no difference between the 2 preparations.
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| 22. |
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| 23. |
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| 24. |
- Buhlin, K., et al.
(author)
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Risk factors for atherosclerosis in cases with severe periodontitis
- 2009
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 36:7, s. 541-549
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Journal article (peer-reviewed)abstract
- Aim: Studies have reported on an association between cardiovascular disease (CVD) and periodontitis. The purpose of this case-control study was to provide an insight into this association by determining the plasma levels of some risk markers for CVD in cases with periodontitis.Materials and Methods: Sixty-eight cases with periodontitis, mean age 53.9 (SD 7.9) years, and 48 randomly selected healthy controls, mean age 53.1 (SD 7.9) years, were investigated. Fasting blood plasma was analysed for glucose, lipids, markers systemic inflammation, cytokines and antibodies against heat shock proteins (Hsp). The associations between periodontitis and the various substances analysed in plasma were calculated using a multivariate logistic regression model, which compensated for age, gender, smoking and body mass index.Results: The regression analyses revealed a significant association between periodontitis and high levels of C-reactive protein (CRP) [odds ratio (OR) 4.0, confidence interval (CI) 1.4-11.4] and fibrinogen (OR 8.7, CI 2.6-28.4), IL-18 (OR 6.5, CI 2.2-19.5), and decreased levels of IL-4 (OR 0.12, CI 0.0-0.5). The study showed increased levels of antibodies against Hsp65 (OR 2.8, CI 1-7.6) and 70 (OR 2.9, CI 1.1-7.8) and decreased levels of antibodies against Hsp60 (OR 0.3, CI 0.1-0.8).Conclusions: Periodontitis was associated with increased levels of CRP, glucose, fibrinogen and IL-18, and with decreased levels of IL-4.
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| 25. |
- Charalampakis, Georgios, et al.
(author)
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A follow-up study of peri-implantitis cases after treatment.
- 2011
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In: Journal of clinical periodontology. - 1600-051X. ; 38:9, s. 864-71
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Journal article (peer-reviewed)abstract
- The aim of this retrospective study was to follow patient cases in a longitudinal manner after peri-implantitis treatment.
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| 26. |
- Christersson, L. A., et al.
(author)
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Topical application of tetracycline‐HCl in human periodontitis
- 1993
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 20:2, s. 88-95
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Journal article (peer-reviewed)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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| 27. |
- Chung, Whasun O, et al.
(author)
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Distribution of erm(F) and tet(Q) genes in 4 oral bacterial species and genotypic variation between resistant and susceptible isolates.
- 2002
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In: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 29:2, s. 152-158
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Journal article (peer-reviewed)abstract
- BACKGROUND: Bacteroides forsythus, Porphyromonas gingivalis and Prevotella intermedia are Gram-negative anaerobic bacteria that are currently considered potential periopathogens. Prevotella nigrescens has recently been separated from P. intermedia and its rôle in periodontitis is unknown. The erm(F) gene codes for an rRNA methylase, conferring resistance to macrolides, lincosamides and streptogramin B (MLSB), and the tet(Q) gene for a ribosomal protection protein, conferring resistance to tetracycline. The presence of these resistance genes could impair the use of antibiotics for therapy.PURPOSE: The aim of this study was to determine the carriage of erm(F) and tet(Q), and genetic variability of 12 Porphyromonas gingivalis, 10 Prevotella intermedia, 25 Prevotella nigrescens and 17 Bacteroides forsythus isolates from 9 different patient samples.METHODS: We used polymerase chain reaction (PCR) for detecting antibiotic resistance genes, and pulsed-field gel electrophoresis (PFGE) for detecting genetic variability among the isolates.RESULTS: Thirty-one (48%) isolates were resistant to both erythromycin and tetracycline and carried the erm(F) and tet(Q) genes, eight (13%) were tetracycline resistant and carried the tet(Q) gene, 9 (14%) were erythromycin resistant and carried the erm(F) gene, and 12 (19%) isolates did not carry antibiotic resistance genes. PFGE was used to compare isolates from the same patient and isolates from different patient samples digested with XbaI. No association was found between antibiotic resistance gene carriage and PFGE patterns in any species examined. All isolates of the same species from the same patient had highly related or identical PFGE patterns. Isolates of same species from different patients had unique PFGE pattern for each species tested.CONCLUSION: All isolates of the same species from any one patient were genetically related to each other but distinct from isolates from other patients, and 66% of the patients carried antibiotic resistant isolates, which could impair antibiotic therapy.
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| 28. |
- Claesson, Rolf, et al.
(author)
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Detection of the highly leucotoxic JP2 clone of Aggregatibacter actinomycetemcomitans in members of a Caucasian family living in Sweden
- 2011
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 38:2, s. 115-121
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Journal article (peer-reviewed)abstract
- Background: Carriers of the JP2 clone of Aggregatibacter actinomycetemcomitans exhibit an enhanced risk for developing aggressive periodontitis compared with individuals carrying non-JP2 clones. While the JP2 clone is almost exclusively detected among adolescents of African descent, reports on Caucasians colonized with the JP2 clone are remarkably few.Objective: The aim of this paper is to report on the history of periodontal disease and microbiological findings in a Caucasian family.Material and Methods: A. actinomycetemcomitans and other periodontitis-associated bacterial species in subgingival plaque samples were quantified by conventional culture technique. Leucotoxin promoter typing, serotyping and further characterizations of A. actinomycetemcomitans isolates were performed by PCR. DNA sequencing of the pseudogene, hbpA was performed to determine the origin of the detected JP2 clones. Further, genetically ancestry testing of family members was carried out.Results: The JP2 clone was detected in samples from two of the family members, a 33-year-old daughter and her 62-year-old mother. Relationship of their JP2 clones with JP2 clone strains from the Mediterranean area of Africa was indicated. Genotyping confirmed the Caucasian origin of all family members.Conclusions: Caucasian JP2 carriers exist and older subjects can carry the JP2 clone of A. actinomycetemcomitans.
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| 29. |
- Claffey, Noel, et al.
(author)
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Surgical treatment of peri-implantitis
- 2008
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In: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 35:8 Suppl, s. 316-32
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Research review (other academic/artistic)abstract
- OBJECTIVES: To review the literature on surgical treatment of peri-implantitis. MATERIAL AND METHODS: A search of PubMed and as well as a hand search of articles were conducted. Publications and articles accepted for publication up to November 2007 were included. RESULTS: A total of 43 studies were selected for the review. Only 13 of these were studies in humans and only one study directly addressed disease resolution. Thus the available evidence for surgical treatment of peri-implantitis is extremely limited. ANIMAL STUDIES: Re-osseointegration can occur on previously contaminated surfaces. The surface characteristics are decisive for regeneration and re-osseointegration. No single surface decontamination method appears to be distinctly superior. Open debridement with surface decontamination can achieve resolution. HUMAN STUDIES: Access surgery has been investigated in one study demonstrating that resolution occurred in 58% of the lesions. No single method of surface decontamination (chemical agents, air abrasives and lasers) was found to be superior. The use of regenerative procedures such as bone graft techniques with or without the use of barrier membranes has been reported with various degrees of success. However, it must be stressed that such techniques do not address disease resolution but rather merely attempt to fill the osseous defect.
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| 30. |
- Claffey, Noel, et al.
(author)
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Surgical treatment of peri-implantitis
- 2008
-
In: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 35:8 Suppl, s. 316-32
-
Research review (other academic/artistic)abstract
- OBJECTIVES: To review the literature on surgical treatment of peri-implantitis. MATERIAL AND METHODS: A search of PubMed and as well as a hand search of articles were conducted. Publications and articles accepted for publication up to November 2007 were included. RESULTS: A total of 43 studies were selected for the review. Only 13 of these were studies in humans and only one study directly addressed disease resolution. Thus the available evidence for surgical treatment of peri-implantitis is extremely limited. ANIMAL STUDIES: Re-osseointegration can occur on previously contaminated surfaces. The surface characteristics are decisive for regeneration and re-osseointegration. No single surface decontamination method appears to be distinctly superior. Open debridement with surface decontamination can achieve resolution. HUMAN STUDIES: Access surgery has been investigated in one study demonstrating that resolution occurred in 58% of the lesions. No single method of surface decontamination (chemical agents, air abrasives and lasers) was found to be superior. The use of regenerative procedures such as bone graft techniques with or without the use of barrier membranes has been reported with various degrees of success. However, it must be stressed that such techniques do not address disease resolution but rather merely attempt to fill the osseous defect.
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| 32. |
- Cosyn, Jan, et al.
(author)
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An analysis of the decision-making process for single implant treatment in general practice
- 2012
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 39:2, s. 166-172
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Journal article (peer-reviewed)abstract
- Purpose To study the frequency of and factors associated with the decision to perform single implant treatment after tooth extraction by general practitioners in a private, fee-for-service setting. Material and methods One hundred practitioners with a general dental practice in Ghent were randomly selected. Clinicians were asked to fill in a study form for every single extraction they performed during an 8-week period. The form related to the treatment decision and a number of patient- and clinician-related factors. Results Ninety-four general dentists (52 men, 42 women; mean age 49; range 24–68) agreed to participate and extracted 1180 single teeth. After exclusion of third molars and cases where the reason for tooth loss would generally prohibit replacement, 900 cases were identified. In 24% of these patients, there was no treatment decision and in 18% replacement was deemed unnecessary. When replacement was necessary (n = 526), removable partial denture (RPD), fixed partial denture (FPD), single implant treatment and resin-bonded bridge were chosen in 54%, 24%, 21% and 1% of the patients, respectively. Multinomial logistic regression was used to evaluate the decision-making process for single implant treatment against RPD and FPD. In relation to RPD, single implant treatment was more likely in highly educated patients with few missing teeth and no bone loss at adjacent teeth. In relation to FPD, single implant treatment was more likely in patients with intact adjacent teeth and when the tooth was extracted by a female dentist. Experience in implant prosthetics was positively associated with single implant treatment in all analyses. Conclusions Single implant treatment is not the most common procedure in daily practice to restore a single tooth gap. Patient's education, oral factors and clinician-related factors may affect the decision-making process, whereas medical factors may not.
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| 33. |
- Cosyn, Jan, et al.
(author)
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Predictors of inter-proximal and midfacial recession following single implant treatment in the anterior maxilla : a multivariate analysis
- 2012
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 39:9, s. 895-903
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Journal article (peer-reviewed)abstract
- Purpose A number of factors have been associated with soft tissue recession following single implant treatment. However, given the cross-sectional design of most of these studies and crude associations based on univariate analyses, such factors may only be considered risk indicators. The objective of the present retrospective cohort study using multivariate analyses was to identify predictors of recession. Material and Methods Patients who had been treated by two periodontists and two prosthodontists in 2006 and 2007 for a single implant in the anterior maxilla were re-examined in 2009 and their records were scrutinized. Subjects treated via flap surgery with and without ridge re-contouring were considered. Outcome variables were inter-proximal and midfacial recession. Explanatory variables included demographic data, the surgical approach and a number of local factors that were evaluated on radiographs taken pre-operatively or at permanent crown installation (baseline). Results Data pertaining to 97/115 (60 females, 37 males; mean age 51, SD 13, range 23–80) patients were available for evaluation. Significant bone loss was observed between baseline and re-examination at the implant surface (0.2–0.3 mm, p < 0.001) and tooth surface (0.3–0.5 mm, p < 0.001). Surgery with ridge re-contouring demonstrated 0.2 mm additional bone loss at the distal tooth surface when compared to surgery without ridge re-contouring (p = 0.034). This could be explained by a disparity in possible papilla-opening procedures (three versus one or two). As a result, regression analyses identified surgery with ridge re-contouring as a predictor of inter-proximal recession (OR ≥ 3.4). Pre-operative bone level at the tooth surface was another predictor of inter-proximal recession (OR ≥ 2.1). Recession of the distal papilla was also affected by a missing contact point (OR = 221.9), the implant-to-tooth distance (OR = 0.3) and the distance of the bone peak to the contact point (OR = 2.9). Midfacial recession was only associated with a buccal shoulder position (OR = 17.2). Conclusions To optimize soft tissue levels around single implants, clinicians should limit papilla-opening procedures and pay utmost attention to a correct implant and contact point positioning.
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| 34. |
- Cosyn, Jan, et al.
(author)
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Regenerative periodontal therapy of infrabony defects using minimally invasive surgery and a collagen-enriched bovine-derived xenograft : a 1-year prospective study on clinical and aesthetic outcome
- 2012
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In: Journal of Clinical Periodontology. - : Wiley-Blackwell. - 0303-6979 .- 1600-051X. ; 39:10, s. 979-986
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Journal article (peer-reviewed)abstract
- AIM: To evaluate the clinical and aesthetic outcome of regenerative periodontal therapy (RPT) using minimally invasive surgery and a collagen-enriched bovine-derived xenograft (1); to identify risk factors for failure (clinical attachment level (CAL) gain ≤ 1 mm) and advanced gingival recession (REC) increase (>1 mm) (2). MATERIAL AND METHODS: Ninety-five non-smoking patients, with ≤ 25% full-mouth plaque and bleeding presenting ≥ 6 months after initial periodontal therapy with ≥ 1 isolated inter-dental infrabony defect were recruited. Patients were consecutively treated by the same clinician using minimally invasive surgery and a collagen-enriched bovine-derived xenograft. Clinical, radiographic and aesthetic data were collected before surgery and up to 1 year. Multivariate analyses were used to identify risk factors for failure and advanced REC increase. RESULTS: Eighty-four patients (39 men, 45 women; mean age 53) complied and demonstrated mean probing depth (PD) of 7.8 mm, CAL of 10.0 mm and defect depth of 5.2 mm before surgery. At 1 year, postsurgery mean PD reduction was 3.5 mm (range 0.0-8.0), CAL gain was 3.1 mm (range 0.0-7.0) and radiographic defect fill was 53% (range 0-100). Forty-nine percentage showed ≥ 4 mm CAL gain, whereas 15% were considered failures. Mean inter-dental and midfacial REC increase was 0.3 mm (range-2.0-2.0) and 0.5 mm (range-1.5-2.0) respectively. Midfacial REC increase and contour deterioration contributed most to a small, yet significant reduction in the Pink Esthetic Score from 10.06 to 9.42 (p = 0.002). Risk factors for failure included defects with a non-supportive anatomy (OR: ≥ 10.4), plaque (OR: 14.7) and complication(s) (OR: 12.0). Risk factors for advanced midfacial REC increase included defects with a non-supportive anatomy (OR: 58.8) and a thin-scalloped gingival biotype (OR: 76.9). CONCLUSIONS: RPT using minimally invasive surgery and a collagen-enriched bovine-derived xenograft demonstrated favourable clinical outcome after 1 year, even though soft tissue aesthetics could not be fully preserved. Defects with a non-supporting anatomy may be at risk for failure and advanced midfacial recession.
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| 36. |
- Duncan, W J, et al.
(author)
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Ovine periodontitis as a potential model for periodontal studies. Cross-sectional analysis of clinical, microbiological, and serum immunological parameters.
- 2003
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In: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 30:1, s. 63-72
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Journal article (peer-reviewed)abstract
- OBJECTIVES: : To investigate infection and host immunity patterns in sheep with naturally occurring "broken-mouth" periodontitis.MATERIALS AND METHODS: : Eight periodontally healthy (HS) and eight periodontally diseased ewes (PDS) were selected. Subgingival plaque and sera were collected and examined for evidence of human periodontitis-associated pathogens. Serum IgG titers were measured by ELISA to multiple strains of Porphyromonas gingivalis, Bacteroides forsythus, Dichelobacter nodosus, Actinobacillus actinomycetemcomitans, Prevotella intermedia, and Fusobacterium nucleatum as well as several purified antigens (cysteine proteases, LPS, K, and fimbriae).RESULTS: : Neither the organism Aa nor antigens to Aa were found in any animal. Most animals were positive for Pg, Bf, and Pi, but DNA probes detected no difference between HS and PDS relative to amounts of pathogens in subgingival plaque. PDS had significantly higher serum IgG titers to all Pg strains, to 50% of Bf strains, to the Pi and Fn strains, and to fimbriae and the two cysteine proteases (p-values ranging from 0.05 to 0.001). Regression analysis demonstrated a significant association between number of teeth lost and serum IgG antibody titers to whole-cell sonicate antigens of P. gingivalis strains (p<0.01) and body weight (p<0.01).CONCLUSIONS: : The presence of pathogens associated with periodontitis was reflected in differences in serum IgG titers between healthy and diseased sheep. This may have influenced animal body weight and might have systemic health and economic consequences. The data suggest that susceptible and non-susceptible sheep can be identified for periodontal research.
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| 37. |
- Duss, Christof, et al.
(author)
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A randomized, controlled clinical trial on the clinical, microbiological, and staining effects of a novel 0.05% chlorhexidine/herbal extract and a 0.1% chlorhexidine mouthrinse adjunct to periodontal surgery
- 2010
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In: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 37:11, s. 988-997
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Journal article (peer-reviewed)abstract
- Background Chlorhexidine (CHX) rinsing after periodontal surgery is common. We assessed the clinical and microbiological effects of two CHX concentrations following periodontal surgery. Materials and methods In a randomized, controlled clinical trial, 45 subjects were assigned to 4 weeks rinsing with a 0.05 CHX/herbal extract combination (test) or a 0.1% CHX solution. Clinical and staining effects were studied. Subgingival bacteria were assessed using the DNA-DNA checkerboard. Statistics included parametric and non-parametric tests (p < 0001 to declare significance at 80% power). Results At weeks 4 and 12, more staining was found in the control group (p < 0.05 and p < 0.001, respectively). A higher risk for staining was found in the control group (crude OR: 2.3:1, 95% CI: 1.3 to 4.4, p < 0.01). The absolute staining reduction in the test group was 21.1% (9 5% CI: 9.4-32.8%). Probing pocket depth (PPD) decreases were significant (p < 0.001) in both groups and similar (p=0.92). No rinse group differences in changes of bacterial counts for any species were found between baseline and week 12. Conclusions The test CHX rinse resulted in less tooth staining. At the study endpoint, similar and high counts of periodontal pathogens were found.
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| 38. |
- Duss, Christof, et al.
(author)
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A randomized, controlled clinical trial on the clinical, microbiological, and staining effects of a novel 0.05% chlorhexidine/herbal extract and a 0.1% chlorhexidine mouthrinse adjunct to periodontal surgery
- 2010
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In: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 37:11, s. 988-997
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Journal article (peer-reviewed)abstract
- Background Chlorhexidine (CHX) rinsing after periodontal surgery is common. We assessed the clinical and microbiological effects of two CHX concentrations following periodontal surgery. Materials and methods In a randomized, controlled clinical trial, 45 subjects were assigned to 4 weeks rinsing with a 0.05 CHX/herbal extract combination (test) or a 0.1% CHX solution. Clinical and staining effects were studied. Subgingival bacteria were assessed using the DNA-DNA checkerboard. Statistics included parametric and non-parametric tests (p < 0001 to declare significance at 80% power). Results At weeks 4 and 12, more staining was found in the control group (p < 0.05 and p < 0.001, respectively). A higher risk for staining was found in the control group (crude OR: 2.3:1, 95% CI: 1.3 to 4.4, p < 0.01). The absolute staining reduction in the test group was 21.1% (9 5% CI: 9.4-32.8%). Probing pocket depth (PPD) decreases were significant (p < 0.001) in both groups and similar (p=0.92). No rinse group differences in changes of bacterial counts for any species were found between baseline and week 12. Conclusions The test CHX rinse resulted in less tooth staining. At the study endpoint, similar and high counts of periodontal pathogens were found.
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| 39. |
- Dörtbudak, Orhun, et al.
(author)
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Periodontitis, a marker of risk in pregnancy for preterm birth.
- 2005
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In: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 32:1, s. 45-52
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Journal article (peer-reviewed)abstract
- BACKGROUND: Why chronic periodontitis may induce an inflammatory response with premature pregnancy termination is unclear.AIMS: (1) To assess if periodontitis predicts premature gestation; (2) to study amniotic fluid cytokines and periodontitis variables in early-stage pregnancy.MATERIAL AND METHODS: A periodontal examination and collection of amniotic fluid was performed (weeks 15-20) of pregnancy in 36 women at risk for pregnancy complications. Amniotic fluid (bacteria), vaginal smears and intra-oral plaque samples were studied. Cytokine levels in amniotic fluid were studied in relation to other study variables.RESULTS: Periodontitis was diagnosed in 20% of normal and in 83% of preterm birth cases (p<0.01). Bacteria were never found in the amniotic fluids studied. Sub-gingival plaque samples including bacteria in the orange and red complexes were found in 18% of full-term 100% of preterm cases (p<0.001) and total colony-forming units (CFUs) were higher in preterm birth (p<0.01). Amniotic levels of interleukin (IL)-6 and prostaglandin-E2 (PGE2) were higher in preterm cases (p<0.001). Amniotic IL-6 (r=0.56, p<0.01) and PGE2 (r=0.50, p<0.01) cytokine levels were correlated with CFU from sub-gingival plaque samples (r2=0.44). The odds ratio of preterm delivery and having periodontitis was 20.0 (95% confidence interval (CI): 2.0-201.7, p<0.01). The odds of >60 CFU in sub-gingival plaque and preterm birth was 32.5:1 (95% CI: 3.0-335.1, p<01).CONCLUSIONS: Pregnant women with findings of elevated amniotic fluid levels of PGE2, IL-6 and IL-8 in the 15-20 weeks of pregnancy and with periodontitis are at high risk for premature birth. The implication of this is that periodontitis can induce a primary host response in the chorioamnion leading to preterm birth.
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| 47. |
- Franke Stenport, Victoria, et al.
(author)
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Enamel matrix derivative and titanium implants : An experimental pilot study in the rabbit
- 2003
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In: Journal of Clinical Periodontology. - : Blackwell. - 0303-6979 .- 1600-051X. ; 30:4, s. 359-363
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Journal article (peer-reviewed)abstract
- Aim: The aim of present study was to evaluate if an enamel matrix derivative (Emdogain®) may enhance bone formation and osseointegration of titanium implants, using a well-documented rabbit model. Material and methods: Thirty-six threaded commercially pure titanium (cp.ti.) implants were inserted in six New Zealand white rabbits. One implant was placed in each femur and two in each tibia. Prior to implant insertion approximately 0.5 mL of Emdogain (EMD) (test) or the vehicle gel (PGA: propylene glycol alginate) (control) was injected into the surgically prepared implant site. The follow-up time was 6 weeks. Biomechanical evaluations by resonance frequency analysis (RFA) and removal torque measurements (RTQ) were performed. Histomorphometrical quantifications were made on ground sections by measurements of the percentage of bone-to-metal contact, bone area inside the threads as well as outside the threads (mirror image). Bone lengths along the implant surface were also measured and used for shear strength calculations. Results: The results demonstrated no beneficial effects from the EMD treatment on bone formation around titanium implants in any of the tested parameters. Significant differences were demonstrated with removal torque test and shear force calculations for the control implants. No other parameter demonstrated a statistically significant difference. Conclusion: The results of the present study may indicate that EMD does not contribute to bone formation around titanium implants. This observation may indicate that the bone formation that occurs after EMD treatment in periodontal defects is the result of functional adaptation. However, further research is required to evaluate the effect of EMD treatment on bone formation.
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| 48. |
- Fransson, Christer, 1956, et al.
(author)
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Extent of peri-implantitis-associated bone loss.
- 2009
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In: Journal of clinical periodontology. - 1600-051X. ; 36:4, s. 357-63
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The purpose of the present study was to describe the extent of peri-implantitis-associated bone loss with regard to implant position. MATERIAL AND METHODS: Patient files and intra-oral radiographs from 182 subjects were analysed. Among the 1070 examined implants, 419 exhibited peri-implantitis-associated bone loss. The position of each implant within the jaw and fixed reconstructions was determined. In the radiographs the distance between the abutment-fixture junction and the most coronal position of bone to implant contact was assessed at the 419 "affected" implants using a magnifying lens (x 7) with a 0.1 mm graded scale. RESULTS: About 40% of the implants in each subject was affected by peri-implantitis-associated bone loss. The proportion of such implants varied between 30% and 52% in different jaw positions and the most common position was the lower front region. In addition, affected implants were found in larger proportions among "mid" than "end" abutments irrespective of supporting fixed complete or fixed partial dentures. CONCLUSION: It is suggested that peri-implantitis occurs in all jaw positions and that an "end"-abutment position in a fixed reconstruction is not associated with an enhanced risk for peri-implantitis.
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| 49. |
- Fransson, Christer, 1956, et al.
(author)
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Severity and pattern of peri-implantitis-associated bone loss.
- 2010
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In: Journal of clinical periodontology. - 1600-051X. ; 37:5, s. 442-8
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Journal article (peer-reviewed)abstract
- Objective: The purpose of the present study was to describe the severity and pattern of peri-implantitis-associated bone loss. Material and Methods: Intra-oral radiographs from 182 subjects were analysed. Bone-level measurements were performed in 419 implants with a history of bone loss. All radiographs obtained in the interval from the 1-year follow-up to the end-point examination (5–23 years) were analysed. The amount of bone loss that occurred from 1 year after prosthesis insertion was assessed and the pattern of bone loss was evaluated. Results: The average bone loss after the first year of function was 1.68 mm and 32% of the implants demonstrated bone loss geqslant R: gt-or-equal, slanted2 mm. The multilevel model revealed that the bone loss showed a non-linear pattern and that the rate of bone loss increased over time. The model also revealed that the pattern of peri-implantitis associated bone loss was similar within the same subject. Conclusion: It is suggested that peri-implantitis-associated bone loss varies between subjects and is, in most cases, characterized by a non-linear progression, with the rate of loss increasing over time. One of the main goals in implant therapy is to preserve tissue integration and thereby maintain bone support. Marginal bone loss is thus considered a critical outcome variable in the evaluation of implant therapy. It has been suggested that data on bone loss during the first year of function should be distinguished from that occurring during the subsequent period of service. According to the suggested success criteria for implants (Albrektsson et al. 1986, Albrektsson & Zarb 1993), marginal bone loss should not exceed 1.5 mm during the first year in function and should be <0.2 mm/year thereafter. A modification to these criteria that indicated a maximum bone loss of 2 mm between prosthesis installation and 5 years of follow-up was presented in a consensus report from the European Workshop on Periodontology in 1999 (Wennström & Palmer 1999). Whether certain amounts of bone loss around implants should be acceptable or not requires an understanding of the mechanisms involved in the process of bone resorption. Although the question on the aetiology of marginal bone loss around implants still has to be completely unravelled, previous studies have demonstrated the association between progressive bone loss during function and clinical signs of inflammation in peri-implant tissues (Roos-Jansåker et al. 2006, Fransson et al. 2008). We have previously reported on the prevalence and extent of peri-implantitis-associated bone loss (Fransson et al. 2005, 2009). From the analysis of radiographs obtained from 662 subjects treated with implant-supported prosthesis, it was documented that 184 (27.8%) of the subjects had geqslant R: gt-or-equal, slanted1 implant with peri-implantitis-associated bone loss (Fransson et al. 2005, 2008). Within this group of subjects, about 40% of the implants were affected (Fransson et al. 2009). Using this subject sample, the purpose of the present study was to describe the severity and pattern of peri-implantitis-associated bone loss.
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| 50. |
- Friskopp, Johan, et al.
(author)
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The anesthetic onset and duration of a new lidocaine/prilocaine gel intra-pocket anesthetic (Oraqix) for periodontal scaling/root planing
- 2001
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 28:5, s. 453-458
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Journal article (peer-reviewed)abstract
- BACKGROUND: A new non-injection anesthetic, lidocaine/prilocaine gel (Oraqix, AstraZeneca) in a reversible thermosetting system, has been developed to provide local anesthesia for scaling/root planing (SRP). The aim of this study was to determine the anesthetic onset and duration of the gel for SRP in patients with periodontitis.METHODS: 30 patients were randomized to either 30 s, 2 min, or 5 min of treatment with the gel prior to SRP of a tooth. The gel was applied to periodontal pockets with a blunt applicator. On completion of the SRP of each tooth (2-3 teeth treated/patient), the patients rated their pain on a 100-mm visual analogue scale (VAS).RESULTS: The median VAS pain score was 7.5 mm in the 30-s group, 28.5 mm in the 2-min group, and 15.5 mm in the 5-min group, with a significant difference between the 30-s and 2-min groups (p=0.03). In 2 patients in the 5-min group, but none in the other groups, the SRP was interrupted due to pain. The mean duration of anesthesia measured as pain on probing were 18.1, 17.3, and 19.9 min in the 30-s, 2-min, and 5-min groups, respectively. There were no reports of numbness of the tongue, lip, or cheek, neither were there any adverse local reactions in the oral mucosa. The gel was easy to apply and did not interfere with the SRP procedure.CONCLUSION: Oraqix provides anesthesia after an application time of 30 s, with a mean duration of action of about 17 to 20 min.
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