Journal of Clinical Periodontology

Deinzer, R.; Förster, P.; Fuck, L.; Herforth, A.; Stiller‐Winkler, R.; Idel, H.

doi: 10.1034/j.1600-051X.1999.260101.xpmid: 9923503

Abstract. This study analyses the effects of academic stress on crevicular interleukin‐1b (Il‐1β) both at experimental gingivitis sites and at sites of perfect oral hygiene. Il‐1β is thought to play a predominant role in periodontal tissue destruction. 13 medical students participating in a major medical exam (exam group) and 13 medical students not participating in any exam throughout the study period (control group) volunteered for the study. In a split‐mouth‐design, they refrained from any oral hygiene procedures in two opposite quadrants for 21 days (experimental gingivitis) while they maintained perfect hygiene levels at the remaining sites. Crevicular fluid was sampled for further Il‐1b analysis at teeth 5 and 6 of the upper jaw at days 1, 5, 8, 11, 14, 18 and 21 of the experimental gingivitis period. Exam students showed significantly higher Il‐1b levels than controls both at experimental gingivitis sites (area under the curve, exam group: 1240.64±140.07; control group: 697.61±111.30; p=0.004) and at sites of perfect oral hygiene (exam group: 290.42±63.19; control group: 143.98±42.71; p=0.04). These results indicate that stress might affect periodontal health by increasing local Il‐1β levels especially when oral hygiene is neglected.

Persson, L.; Bergström, J.; Gustafsson, A.; Âsman, B.

doi: 10.1034/j.1600-051X.1999.260102.xpmid: 9923504

Abstract. The influence of smoking on the activity of the gingival neutrophils in young periodontally healthy adults was studied. The neutrophil activity was measured in terms of the gingival crevicular fluid (GCF) levels of elastase, lactoferrin (LF), a‐1‐antitrypsin (a‐1‐AT), α‐2‐macroglobulin (α‐2 MG) and protein. 30 healthy dental students with no clinical signs of periodontitis, 15 smokers (8 women and 7 men) aged 20–32 years and 15 non‐smokers (7 women and 8 men) aged 22–31 years, volunteered to take part in the investigation. The gingival inflammation was registered at 6 sites and the GCF volume was collected from the same sites. The GCF volume was measured with a Periotron 6000®. The elastase activity was measured with a chromogenic low molecular substrate and the LF, α‐1‐AT, α‐2‐MG levels were determined with ELISA. The protein concentration was measured by the Bradford method.The results showed a statistically significantly lower GCF volume among smokers as compared to non‐smokers. No significant difference was found in the elastase activity/μl of the GCF supernatant between smokers and non‐smokers but there was a large inter‐individual variation. Nor did the concentrations of LF, α‐1‐AT, 7alpha;‐2‐MG and protein per μl GCF differ significantly between the 2 groups. The results suggest that the influence of smoking on the examined factors associated with neutrophil activity is limited under healthy or slightly inflamed gingival conditions giving only small amounts of GCF.

Furuichi, Yasushi; Birkhed, Dowen

doi: 10.1034/j.1600-051X.1999.260103.xpmid: 9923505

Abstract. The aim of the present investigation was to compare: (i) de novo plaque formation, and (ii) fluoride and triclosan concentration in approximal plaque, when a NaF/triclosan/Gantrez®‐containing dentifrice slurry or a mouthrinse were administrated during a 2‐week period of no mechanical plaque control. 10 subjects rinsed for 60 s, 2× daily, for a 14‐day period with one of the following 3 test products: (A) a dentifrice slurry including 1 ml of a NaF/triclosan/Gantrez® dentifrice mixed with 10 ml of tap water, (B) 10 ml of a NaF/triclosan/Gantrez® mouthrinse, or (C) 10 ml of a NaF mouthrinse. De novo plaque formation was assessed on days 4, 7 and 14 using the Turesky's modification of the Quigley and Hein index system. Samples of approximal plaque were obtained immediately after clinical examination on day 14. The samples were analyzed with respect to concentration of fluoride and triclosan using an ion‐specific electrode and a HPLC system, respectively. The 14‐day period was repeated using another test product until all 10 subjects had used all 3 test products in a randomized order. The results showed that: (i) significantly more fluoride was retained in the approximal plaque following periods A and B than period C, and (ii) less plaque was formed during period B than periods A and C.

Kuru, Bahar; Yilmaz, Selçuk; Noyan, Ülkü; Acar, Okan; Kadýÿr, Tanju

doi: 10.1034/j.1600-051X.1999.260104.xpmid: 9923506

Abstract. Gingival crevicular fluid (GCF) reflects the immune and inflammatory reactions and the specific host‐microbe interactions that lead to periodontal diseases. Aspartate aminotransferase enzyme (AST) is one of the components of GCF that is released as a result of cell death. In this study, periodontal sites (4 sites/patient) with a probing depth of ≥5 mm in early onset periodontitis (EOP) patients were first examined for the AST levels in GCF by the PeriogardTM periodontal tissue monitor.To be eligible for the study, each of the patients had at least 1 AST positive site with clinical inflammatory changes (AST+, CIC+) and 1 AST negative site with no or minimum clinical inflammatory changes (AST−, CIC−). In 15 EOP patients who met the entry criteria, 30 AST+, CIC+ sites (1st group) and 19 AST−, CIC− sites (2nd group) were evaluated for microbiological variables. Certain microbial species, including Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Prevotella intermedia were detected more frequently (p<0.001, p<0.001 and p<0.05, respectively) in the 1st group, while gram‐positive facultative organisms such as Actinomyces species were found more often (p<0.001) in the 2nd group. Parallel to the AST levels, the 2nd group had a lower number of total bacteria and proportion of obligate anaerobic and capnophilic micro‐organisms than the first group (p<0.05 and p<0.05, respectively). Within the scope of this study, AST activity and microbiological data were found in agreement in the examined groups. These findings are encouraging and indicate the need for further studies to evaluate the ability of the AST test to differentiate the microbial flora of progressing sites and those that are inflamed, but not progressing.

Reiker, Jurgen; Van Der Velden, Ubele; Barendregt, Dick S.; Loos, Bruno G.

doi: 10.1034/j.1600-051X.1999.260105.xpmid: 9923507

Abstract. The aim of this cross‐sectional study was to investigate cross‐sectionally the prevalence and several risk indicators of root caries in 45 periodontal maintenance patients, who had been actively treated for adult periodontitis 11–22 years ago. These patients were part of a routine 3–6 monthly maintenance schedule. Active and inactive root caries and root fillings were recorded, as well as coronal caries experience. Plaque and bleeding scores, number of exposed root surfaces, rate of saliva secretion, saliva buffering capacity, mutans streptococci counts and Lactobacilli were also scored. From the total of 45 study subjects, 37 patients (82%) showed root lesions (root caries and/or root fillings), while only 8 patients were free of any root lesions. On average, there were 4.3 root lesions per patient (range 0–19) in the present study. 10 patients had active root caries lesions. Of all damaged root surfaces, 9% were active lesions, mostly located on mandibular teeth at lingual and vestibulair sites; 40% were inactive lesions often detected at vestibular sites. The remaining damaged root surfaces (51%) were restored; they were equally divided over both jaws. A higher number of root lesions was observed in those patients with >106mutans streptococci/ ml saliva. Although the actual number of lesions per patient was low in relation to the large number of sites with gingival recession, the results from this cross‐sectional study in periodontal maintenance patients indicate that: (1) root caries can be regarded as a complication in periodontal maintenance patients; (2) the individual number of root lesions correlate with individual dental plaque scores; (3) a high number of root lesions is associated with high counts of salivary mutans streptococci; (4) no relation between root caries and coronal caries experience, salivary secretion rate or salivary buffering capacity seems present. Therefore, repeated oral hygiene instructions and adjunctive preventive measures including diet counseling and fluoride rinses, as well as fluoride and chlorhexidine varnishes, should be advocated in high‐risk patients.

Peacock, J. M.; Orchardson, R.

doi: 10.1034/j.1600-051X.1999.260106.xpmid: 9923508

Abstract. Objectives: potassium salts in desensitising formulations are believed to act by blocking nerve conduction. The aim of this study was to assess the ability of some organic potassium salts to block action potential conduction and to compare their effects with potassium chloride and potassium nitrate. Materials and methods: potassium citrate, oxalate or tartrate were added to Krebs’ solutions to raise the potassium concentration to 8–64 mM. The test solutions were applied to rat spinal nerves in a bath while monitoring the compound action potentials evoked by electrical stimulation. Results: all potassium salts attenuated the compound action potential in a dose‐dependent manner. There were no significant differences between the effects of potassium tartrate and potassium citrate solutions (p>0.1) which caused significantly greater compound action potential attenuation than the same concentrations of potassium oxalate (p<0.05). On the basis of the potassium ion concentration required to cause 50% attenuation of the compound nerve action potential, the relative potencies of the potassium salts citrate=tartrate>oxalate>chloride=nitrate. Conclusion: potassium citrate were: and potassium tartrate were more effective than other potassium salts in blocking nerve conduction and may be more effective dentinal desensitising agents.

Trikilis, Nicholas; Rawlinson, Andrew; Walsh, Trevor F.

doi: 10.1034/j.1600-051X.1999.260107.xpmid: 9923509

Abstract. The aim of this study was to investigate the difference in subgingival temperature between smokers and non‐smokers at different probing depths, and the effect of probing depth on subgingival temperature for smokers and non‐smokers. 20 smokers and 20 non‐smokers, with adult periodontitis, and retained upper anterior teeth were included. Initially sublingual temperatures were recorded, followed by subgingival temperature, pocket probing depth, and bleeding upon probing measurements at 3 buccal points at probing depths of 2, 3, 4, 5, and 6 mm for each of the anterior teeth. Sublingual temperatures were consistently higher than subgingival temperatures. The subgingival temperature measurements of pockets which bled upon probing, were subtracted from the sublingual temperature to produce temperature differentials (DT), independent of individual body temperature, that were compared between smokers and non‐smokers. The relationship between probing depth and DT was examined in, and between, smokers and nonsmokers for bleeding sites. DT was found to decrease linearly with the increase of probing depth, suggesting a subsequent increase of subgingival temperature. Smokers were found to have significantly increased DT (suggesting lower subgingival temperatures) compared to non‐smokers, at probing depths of 2, 3, 4, and 5 mm. The differences in DT for sites 6 mm in depth were not statistically significant between the 2 groups. It is concluded that for maxillary buccal anterior sites, there is a decrease of temperature differentials with an increase of probing depth at bleeding sites for both smokers and non‐smokers. Smokers had higher temperature differentials compared to non‐smokers, at probing depths of 2, 3, 4 and 5 mm.

Vrotsos, John A.; Parashis, Andreas O.; Theofanatos, Gerasimos D.; Smulow, Jerome B.

doi: 10.1034/j.1600-051X.1999.260108.xpmid: 9923510

Abstract. The purpose of the present investigation was to evaluate the prevalence and distribution of different forms of bone defects using direct observation during periodontal surgery. 286 patients with moderate or advanced adult periodontitis diagnosed during clinical and radiographic examination provided a sample of 5476 teeth. After full thickness mucoperiosteal flaps were raised, osseous defects were explored and classified according to their morphology as interdental craters, hemisepta and infrabony defects with 1, 2, 3 or 4 osseous walls. 981 defects were detected; 533 were in the maxilla and 448 in the mandible (15.4% and 22.4%, respectively, of the teeth examined). The posterior mandibular segment had the highest % of teeth with defects (33.8%) followed by the posterior maxillary segment (19.9%). The proportions of teeth with defects in the anterior segments of both arches were similar. The comparison between maxilla and mandible showed a highly significant difference for the posterior segments (p=0.00001) but no difference for the anterior segments (p=0.88). The distribution of defects differed between the maxilla and the mandible, both for the posterior and anterior segments. Craters accounted for almost half the defects, being more prevalent in posterior segments, while hemisepta formed the lowest proportion. Anatomical variations in shape and the original morphology of the alveolar bone between the maxilla and the mandible and the anterior and posterior regions might have been the reason for the differences observed.

Giannopoulou, Catherine; Geinoz, Anne; Cimasoni, Giorgio

doi: 10.1034/j.1600-051X.1999.260109.xpmid: 9923511

Abstract. Cigarette smoking is associated with increased incidence of periodontal disease and poor response to therapy. In the present study, we examined the effects of nicotine on several functions of periodontal ligament fibroblasts (PDLF): proliferation, attachment, alkaline phosphatase production and chemotaxis. Nicotine concentrations varying from 5 ng/ml to 250 μg7sol;ml were tested. Proliferation of cells was studied by the incorporation of 3H‐thymidine, and a dose‐dependent inhibition was observed with concentrations ≥100 ng/ml. Similar results were observed when studying the attachment of the cells on plastic surfaces, using a colorimetric method. The inhibition of attachment was even more evident after 6 h incubation of the cells with nicotine. The activity of alkaline phosphatase, as determined with the substrate p‐nitrophenyl phosphate, in both conditioned medium (CM) and cellular extract (CE), was also significantly decreased in a concentration‐related fashion. Finally, the chemotaxis of PDLF, as examined by a modification of the Boyden's blind‐well chamber technique, was inhibited in a dose‐dependent manner. The degree of inhibition varied from 15% with the lowest concentration of nicotine (50 ng/ml), to almost 90% with the highest (5 μg/ml). The results show that nicotine can have direct adverse effects on various functions of the periodontal cells.

Lundgren, D.; Slotte, C.

doi: 10.1034/j.1600-051X.1999.260110.xpmid: 9923512

Abstract. 6 anatomically complicated periodontal intrabony defects in 6 patients were surgically reconstructed using a bioresorbable GTR barrier supported by cancellous bovine bone mineral. Following cause‐related periodontal treatment, open‐flap surgery was performed to expose the defects. After debridement, the defects were filled with the bone mineral and covered with the barrier. All patients were advised to rinse 2× daily with an 0.2% chlorhexidine digluconate solution and to avoid brushing in the operated area for 6 weeks. The treatment results were evaluated clinically and radiographically 6 months after surgery. All defects healed uneventfully and all patients maintained a high standard of plaque control throughout the study. Probing assessments during surgery showed a bone defect depth and width of on average 7.2 and 2.8 mm. The corresponding measures on presurgical intra‐oral radiographs were 7.9 and 2.6 mm, respectively. Clinical attachment level (CAL) gain averaged 5.3 mm, corresponding to 73% of the original bone defect depth. Radiographically, the defect fill averaged 6.2 mm or 80% of the original radiographic bone defect. It was concluded that the placement of bovine bone mineral beneath bioresorbable GTR barriers facilitates the clinical handling of the barrier and enhances the space for potential periodontal reconstruction of anatomically complicated defects. It remains, however, to be ascertained to what degree the achieved clinical and radiographic results reflect a gain in new connective tissue attachment and alveolar bone.