Journal of Clinical Periodontology

Brecx, Michel; Theilade, Jorgan

doi: 10.1111/j.1600-051X.1984.tb00908.xpmid: 6593327

Abstract The effect of chlorhexidine on early plaque formation was studied in vivo in order to assess potential structural and quantitative changes. 3 subjects with healthy gingiva were used. Plastic films were applied to the buccal surfaces of the maxillary right first premolars and plaque was allowed to form for either 4 or 24 h. A single 1‐min rinse with 0.2% chlorhexidine digluconate was used for the 4‐h experiments, 1 min after film placement, whereas, for the 24‐h experiments, an additional 1 min rinse was used at 12 h. In total, 62 films were obtained, half treated and half controls. These were processed for light and transmission electron microscopy, using standardized techniques for area sampling and cell counting. All plastic films were covered by a surface coating of a cellular material in or on which bacteria, epithelial cells and leukocytes were observed. In the controls, an important increase in bacterial count was seen between 4 and 24 h, whereas the increase with chlorhexidine was slight. There were fewer bacteria in the chlorhexidine as compared to the water specimens, for both time periods. Many microorganisms in the chlorhexidine. Samples appeared to be undergoing degeneration with coagulated cytoplasm and disrupted cell walls.

Eide, Bjørn; Lie, Tryggve; Selvig, Knut A.

doi: 10.1111/j.1600-051X.1984.tb00909.xpmid: 6593328

Abstract Root surfaces, exposed by periodontal disease, were studied after treatment with sodium hypochlorite. Observations of the anorganic specimens demonstrated that substantial changes occur in root surfaces incident to periodontal disease. A mineralized surface coating was seen in all areas of the involved root surface, although local regions occurred where the coating was apparently unmineralized. These findings generally confirmed the results of a previous study where the same specimens were studied without hypochlorite treatment. It is concluded that the coating is probably identical to the dental cuticle, and stems from adsorption of components of the gingival inflammatory exudate to the root surface. The coating may also be the carrier matrix for exogenous cytotoxic substances, previously thought to be located in the cementum. The findings may have implications for the way of treating periodontitis‐involved root surfaces.

Newman, H. N.; Yeung, F. I. S.; Yusof, W. Z. A. B.; Addy, M.

doi: 10.1111/j.1600-051X.1984.tb00910.xpmid: 6593329

Abstract The present study is one of a series aimed at devising practical methods of control of chronic periodontitis that do not depend upon stringent interdental cleaning by the patient. The regime consists of professional and home care components thought to be realistic for general practice. Patients with chronic periodontitis, but without any complicating factor, such as systemic disease, recent antimicrobial therapy or occlusal traumatism were selected. They received an initial thorough scaling, root planing and an instruction in Bass brushing, using a multituft brush and a sodium fluoride toothpaste, but without emphasis on inter‐dental cleaning. They were then assigned to one of two groups, one of which received, in addition to the above mechanical oral hygiene regime, low (0.5 %) and the other high (40 %) dose metronidazole locally in periodontal pockets once a week for 4 weeks. The low dose was supplied in the form of solution inside fine dialysis tubing. The high dose was in the form of metronidazole powder incorporated in acrylic resin. Plaque index, sulcus bleeding index, probeable pocket depth and gingival shrinkage were monitored during this period and for a further 8 weeks. Both groups showed highly significant reductions in (supragingival) plaque and periodontal inflammation, maintained at least 8 weeks after the end of the 4‐week chemotherapy period. Reductions in SBI were greatest for the 40% metronidazole group. It was concluded that local metronidazole, even in the form of 0.5% metronidazole in a small portion of dialysis tubing, has a positive role in the control of chronic periodontitis.

Löst, Claus

doi: 10.1111/j.1600-051X.1984.tb00911.xpmid: 6593330

Abstract Dehiscence depths were measured in vivo during surgical treatment of 113 teeth with gingival recession in 27 subjects. The average dehiscence depth determined was 5.43 mm with an average recession depth of 2.67 mm. Statistical evidence of a correlation between recession depth and dehiscence depth (average distance between lowest point of recession and dehiscence = 2.8 mm) leaves 16 affected teeth (n= 113) with a distance of 4 mm or more (up to a maximum of 7.5 mm) between the gingival margin and the alveolar crest (facial) unaccounted for. The significance of these deviations from mean values in the etiology and prognosis of recessions is discussed.

Teiwik, Anders; Johansson, Lars‐Åke; Hamp, Sven‐Erik

doi: 10.1111/j.1600-051X.1984.tb00912.xpmid: 6593331

Abstract A radiographic evaluation was made of the marginal bone height in youth, subject to different preventive dental care regimens. A test group consisted of 14–15‐year‐olds who for 4 years had received preventive dental care based on oral hygiene education, professional tooth cleaning and topical fluorides and/or mouth rinsings every 3rd week. A comparison group had been given solely fluoride mouth rinsings every 2nd week with no particular emphasis on oral hygiene measures. The radiographic evaluation showed average differences between the investigated groups of less than 0.3 mm in the distance from the cementoenamel junction to the alveolar bone crest. In the mandibular premolar‐molar region of the comparison group, the marginal bone height differed significantly from the corresponding region in the test group. No such differences in the maxillary regions were noted. The clinical relevance of the results is discussed.

Haffajee, A. D.; Socransky, S. S.; Ebersole, J. L.; Smith, D. J.

doi: 10.1111/j.1600-051X.1984.tb00913.xpmid: 6386896

Abstract Clinical, microbiological and immunological factors were examined using data from a subject with periodontosis. The subject was monitored at bimonthly intervals for 26 months at 6 sites per tooth for redness, plaque, suppuration, bleeding on probing, pocket depth, and attachment level. Using attachment level measurements and the tolerance method of analysis, sites with active disease and control (inactive) sites of equal pocket depth were selected. Subgingival plaque samples were taken from these sites for predominant cultivable and dark field evaluation before, and 5 and 13 months after treatment by Widman flap surgery and systemic tetracycline. 50 isolates from each of 5 sites monitored before and after treatment were characterized and, if possible, identified. Active sites showed between 2 and 6 mm of attachment loss prior to therapy and “gained” between 2 and 9 mm of attachment after therapy. The control sites “gained” 0 to 1 mm of attachment after therapy. Bleeding on probing was significantly reduced after treatment, whereas plaque accumulation increased significantly in the sampled sites. Similar changes were seen in the remaining sites. The proportions of Actinobacillus actinomycetemcomitans and Selenomonas sputigena were elevated in active sites, while proportions of Bacleroides intermedius were elevated in control sites. 5 months after treatment, proportions of A. actinomycetemcomitans, S. sputigena and Eikenella corrodens were significantly decreased in the previously active sites and proportions of B. intermedius and E. corrodens were significantly decreased in the control sites. 13 months after therapy, the proportions of Fusobacterium nucleatum and Capnocytophaga species had increased. Multiple linear regression analysis was used to examine models which could “predict” the outcome, attachment level change in the previous monitoring period. The proportions of A. actinomycetemcomitans and S. sputigena, which were associated with destruction, coupled with the proportions of Streptococcus sanguis II and Campylobacter concisus which were associated with “gain” could predict prior attachment level change with an r2 of 0.93. Humoral antibody response to A. actinomycetemcomitans and C. sputigena significantly increased in a period in which multiple actively breaking down sites were detected. Antibody responses to 20 other species tested did not significantly change during the course of monitoring. Crevicular fluid and tissue levels of antibody to A. actinomycetemcomitans were elevated in 5 of 6 active destructive lesions prior to therapy. Surgical and tetracycline therapy diminished the local antibody response to A. actinomycetemcomitans to levels found in serum.

Pack, Angela R. C.

doi: 10.1111/j.1600-051X.1984.tb00914.xpmid: 6386897

Abstract A double blind study was designed to determine the effects of folate mouthwash (MW) on established gingivitis in non‐pregnant adults. 60 subjects who had >20 teeth, visible gingival inflammation around >6 teeth, no complicated medical history, currently not receiving periodontal treatment or medication, and not wearing dentures, were randomly assigned to control or experimental groups. Full mouth assessment included plaque scores, gingival colour changes, bleeding tendency around every tooth and experience of disease and local factors. Subjects used 5 ml of MW twice daily for 4 weeks, rinsing for 1 min before expectorating. Experimental MW contained 5 mg folate per 5 ml. The control group used a placebo MW. A detailed 3‐day diet record was kept by each subject. The oral examination was repeated after 4 weeks. Initially, groups were similar except that the experimental group exhibited more bleeding sites at the outset, but after 4 weeks, the experimental group showed a significant decrease in mean number of colour change sites (from 70.17 ±12.89 to 56.62 ±17.42) and in bleeding sites (from 48.59 ±24.28 to 29.28 ±19.64) compared with control group (colour: from 66.93±15.27 to 66.20± 18.83; bleeding: from 36.93±16.96 to 39.47± 16.67)p<0.001. Dietary analysis showed that few subjects ate >200,μg folate daily. However, the level of dietary folate did not correlate with changes in inflammation in experimental subjects, r=0.097. Folate MW appears to have an influence on gingival health through local rather than systemic influence.