Abstract. A newly developed metronidazole 25% dental gel was compared with subgingival scaling in the treatment of adult periodontitis. 206 patients in 9 centres participated in the study. Probing pocket depth (PPD) and bleeding on probing (BOP) were recorded before treatment and 2, 6, 12, 18, and 24 weeks after the treatment. All patients had at least I tooth in each quadrant with a PPD of 5 mm or more. The treatments consisted of 2 applications of dental gel (days 0 and 7) in 2 randomly selected quadrants (split mouth design) and 2 sessions of subgingival scaling (1 quadrant on day 0, and 1 quadrant on day 7). Instruction in oral hygiene was given 2 weeks after completed treatment. The average PPD and the average frequency of BOP were calculated over all sites with initial PPD of 5 mm or more. PPD and BOP were thus, at each examination, calculated from the same sites. The mean PPD was 5.9 mm before gel application and 5.8 mm before scaling (p= 0.31). BOP was 88% in both treatment groups. 24 weeks after the treatment. PPD and BOP were significantly reduced in both groups and for both parameters (p < 0.01). PPD was reduced by 1.3 mm after gel application and 1.5 mm after scaling; BOP was reduced by 32% and 39%, respectively. The difference between the treatments was statistically significant, but considered as clinically unimportant.
The changes in the balance of microbial flora in the periodontium after antibiotic treatment were investigated in a blind study. The prevalence of gram-negative enteric rods, staphylococci and yeasts was followed before and during penicillin or erythromycin treatment of 72 periodontitis patients without periodontal cleaning. The prevalence of subgingival coagulase-positive staphylococci increased significantly following systemic penicillin therapy. After systemic erythromycin therapy, the prevalence of subgingival gram-negative enteric rods increased. Ten of 24 (42%) patients receiving systemic penicillin therapy developed clinical evidence of periodontal abscesses. In the absence of conventional mechanical cleaning, systemic administration of penicillin and erythromycin antibiotic to patients with pre-existing periodontitis may lead to periodontal superinfection with opportunistic organisms.
The clinical effects of systemic penicillin and erythromycin on the periodontium were investigated. There are only a few studies of the effects of these antibiotics on clinical periodontal parameters. Of the 72 subjects in the study, 24 belonged to the penicillin group, 21 to the erythromycin group and 27 to the control group. Plaque and gingival indices, tooth mobility, and probing depths of gingival pockets were recorded before the drug treatment. Radiographs were taken. Both antibiotics decreased plaque, and erythromycin also decreased gingivitis. In the penicillin group 10 of the 24 patients developed abscesses during the study, and the studied clinical parameters worsened. These patients had more severe periodontitis initially than the persons with no acute reaction. The clinical changes had returned to the baseline level by 12 weeks after the antibiotic treatments. There were no significant or lasting effects of antibiotic treatment alone in patients with overt periodontitis.
The effect of extrinsic asthma on periodontal conditions was studied in a group of 30 asthmatic children. Clinical examination revealed that asthmatic children had more gingivitis than their healthy controls. The asthmatic children who received an inhaled corticosteroid as treatment had more severe gingivitis compared with asthmatic children on disodium cromoglycate treatment. The amount of plaque was not altered. The peroxidase activity was assessed from whole saliva. The results revealed that this defense mechanism was not altered in asthma. An enzyme group which is involved in inflammation, the arginine aminopeptidases, was found to be slightly elevated in the gingival fluid of asthmatic children. The results indicate that gingival inflammation is increased in asthma.
A representative sample (n = 8000) was drawn from the population aged 30 years and over, registered as living in Finland. Periodontal disease status was recorded according to the modified Periodontal Treatment Need System (PTNS). Plaque retentions were examined separately. Of the subjects with four or more teeth 3.4% had a healthy periodontal status, while 10.2% of the jaw quadrants were healthy. Plaque retentions were found in 96.6% of the subjects and 90.9% of the jaw segments. Periodontal treatment need was calculated in three ways and was 195 +/- 111 (S.D.) min when the calculation was based on WHO recommendations (1978). Number of teeth, age, sex, caries and filling scores, and education explained about 30% of the treatment need when tested by multiple linear regression analysis.
Abstract— The molecular forms of fibronectin (FN) in gingival crevicular fluid of five subjects with at least two sites exhibiting clinical signs of inflammation and pockets of at least 4 mm (test group) and five subjects with clinically healthy periodontium (control group) were investigated. Samples were collected with standard filter paper strips. In the test group samples from both diseased and healthy sites were collected. After collection the test group received one episode of periodontal treatment (scaling and root planing). The sampling and clinical recordings were repeated for the diseased sites after about 2 wk. The crevicular fluid FN was analyzed using sodium dodecyl sulphate gel electrophoresis followed by western blotting with polyclonal antibodies against FN. Both intact FN and FN fragments were found in all samples. A larger proportion of FN was in degraded form in the diseased sites than in the healthy or the treated sites. FN was also degraded into smaller peptide fragments in the diseased than in the treated sites. These results suggest that crevicular fluid FN is partially degraded both in periodontal health and disease and that the degree of degradation of FN increases with periodontal inflammation and decreases with periodontal treatment.
A total of 49 crevicular fluid (CF) samples were collected with paper strips from 12 healthy adults. Each sample was eluted into sterile saline and two aliquots were drawn for SDS–PAGE, one for fibronectin and one for fibrin analysis. Peptides were transferred to nitrocellulose membranes, and fibronectin and fibrin were detected using specific antibodies. The relative amounts of different molecular forms of fibronectin and fibrin were analyzed using a laser densitometer. After the sample collection, Plaque Index, Papilla Bleeding Index and pocket depth were measured. Bone loss was estimated from the orthopantho‐mograms. Fibronectin fragments were seen in all CF samples. Intact fibronectin was seen in 21 samples, of which 76% were collected from periodontitis‐affected sites. There was a positive correlation between the proportion of intact fibronectin and the clinical parameters. Intact fibrin and fibrin fragments were seen in all samples. Fibrin‐positive material with larger molecular weight than intact fibrin was also seen in all samples. A negative correlation was found between the proportion of intact fibrin and the clinical parameters. There was no correlation between total amounts and concentrations of fibronectin and fibrin. Molecular forms of fibronectin and fibrin may affect the pathogenesis and healing of periodontal diseases, since the biologic effects of the fragments of these molecules differ from those of the intact molecules.
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