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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract It was the purpose of the present investigation to monitor the composition of the subgingival microbiota at selected sites in individuals passing through puberty and to correlate observed changes with the development of pubertal maturation. Between the ages of 11 and 14 years, pubertal and skeletal maturation was monitored annually in 22 boys and 20 girls. During this time, subgingival microbial samples were taken every 4th to 5th month (10 times in 4 years) mesially of the upper first molars. High values in total bacterial counts were reached after the onset of puberty, followed by a decrease towards the end of the observation period. The frequency of detection of Actinomyces odontolyticus and of Capnocytophaga sp. increased with time. The frequencies of other selected species, specifically of black pigmenting Bacteroides sp. were not found to increase when tested by linear and quadratic models of time trend. However, a statistically significant rise in the frequency of detecting B. intermedius and B. melaninogenicus was noted in the initial pubertal phase identified by the onset of testicular growth in boys (p= 0.05). A significant relationship also existed between testes growth and increase of A. odontolyticus (p〈0.01). In girls, a similar increase was obtained for A. odontolyticus when studied in relation to the Tanner scores for breast development (p〈0.01). The changes observed in the subgingival microbiota during puberty may be related to the development of gingivitis, which was demonstrated by a higher tendency for gingival bleeding during the course of the pubertal maturation process.
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  • 2
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract 5 patients in maintenance, 1-3 years after periodontal therapy who showed sites with reinfected pockets and bleeding despite regular recall visits were selected. Darkfield microscopy from 3 sites in each patient showed an average of 41% spirochetes and 21% motile rods. Probing depths ranged from 7 to 9 mm and loss of clinical attachment from 6 to 13 mm in these sites. The patients were given 3 times 250 mg/day of metronidazole (Flagyl*) for 10 days. Darkfield microscopy and microbiological cultures of the subgingival plaque were performed twice prior to the study, at the end of the medication and after 3 weeks, 3 and 6 months. The plaque and gingival indices, probing depth and loss of clinical attachment were recorded. During the medication and at 3 and 6 months, the teeth were scaled and root planed. The samples were obtained with 3 paper points and cultured anaerobically in the glove box on non-selective and selective media and representative bacterial colonies identified by aerobic growth, gram stain and rapid biochemical tests. Presumptive pathogenic micro-organisms including Bacteroides were identified. The % of spirochetes, motile rods and non-motile bacteria were enumerated by darkfield microscopy. The clinical results show that administration of metronidazole and repeated root planing significantly decreased gingival inflammation, probing depth and loss of clinical attachment in reinfected sites. After treatment, these sites harbored significantly less spirochetes and more non-motile bacteria, while motile rods tended to return to baseline levels with time. The combined antibiotic and mechanical therapy resulted in a statistically significant decrease of gram-negative rods, Fusobacteria and Bacteroides gingivalis over 6 months. The strongest microbiological effects were evident at the end of the medication.
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  • 3
    ISSN: 1600-0765
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In this study, longitudinal changes in the composition of the subgingival microbiota of children between the ages of 11 and 14 and their association with changes of clinical parameters describing gingival health were investigated. During 4 years, subgingival microbial samples were taken in 22 boys and 20 girls 10 times. At the same time the gingival bleeding tendency was recorded by the Papillary Bleeding Index (FBI). A total of 840 samples was evaluated using darkfield microscopy and anaerobic culturing on non-selective and selective media. Children, who developed a marked and sustained increase in mean PBI scores (n = 21), had higher frequencies and mean proportions of spirochetes and Eikenella corrodens than children without pronounced puberty gingivitis (p 〈 = 0.05). The mean proportion of Actinomyces viscosus was also higher in these children (p 〈 = 0.05). Among the species discriminated, only Capnocytophaga sp. were found at a higher rate in samples taken immediately before a rise of PBI (p 〈 = 0.05). The detection frequencies of black-pigmented Bacteroides (particularly B. intermedius) increased later, and were significantly elevated after the establishment of a high bleeding tendency (p 〈 = 0.05). These findings implicate Capnocytophaga sp. in the initiation of puberty gingivitis, whereas the increased presence of Bacteroides may reflect a change in the subgingival environment secondary to increased bleeding.
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  • 4
    ISSN: 1600-0765
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The experimental gingivitis model was used to compare the antigingivitis, antiplaque, and antimicrobial efficacies of two commercially available (a phenolic and a plant alkaloid) compounds used as mouthrinses with those of a mouthrinse containing chlorhexidine digluconate. Thirty-one male and female volunteers with healthy gingivae and clean teeth ceased all oral hygiene procedures for 21 days during which they rinsed twice daily with: a) a phenolic compound (Listerine®), b) sanguinarine (Viadent®), c) 0.12% chlorhexidine digluconate, or d) a placebo mouthrinse. After 21 days of rinsing, virtually no signs of clinical gingivitis were observed in the chlorhexidine group. Subjects rinsing with Listerine, Viadent, or placebo developed clinical signs of gingivitis as measured by gingivitis occurrence, severity, and the proportion of gingival bleeding sites. At the same time, plaque accumulation was only slightly higher than at baseline in the chlorhexidine group, while the Listerine, Viadent, and placebo groups had significantly greater plaque accumulations, particularly during the initial period of treatment between day 0 and day 7. Microbiological enumeration of supragingival plaque collected at the end of the treatment period showed that chlorhexidine digluconate reduced plaque bacteria by 62–62% compared to the placebo group. No significant reductions in plaque bacteria were found among subjects using Listerine or Viadent.This study demonstrated that 0.12% chlorhexidine digluconate was superior to Listerine and Viadent in its ability to maintain optimal gingival health during the entire three weeks of mouthrinse use. It was of particular interest to note these effects during the final 14 to 21-day period of extreme challenge in this experimental model when gingivitis severity and bleeding site occurrence are most pronounced in the placebo group.
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  • 5
    ISSN: 1600-0765
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 6
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Different studies have shown that various substances may have an influence on early human dental plaque formation. The purpose of the present study was to compare on tooth substances and supporting prosthetic materials the amount of plaque deposition by SEM and the quantity of selected bacteria using anaerobic culturing techniques. 5 bridges, replacing a missing molar or premolar, were incorporated in 3 patients. In the midbuccal area of each pontic, a semi-precision attachment was placed allowing the insertion of the following test facings: enamel, dentine, non γ2-amalgam, alloys of 85% and 55% gold, silver-palladium, chrome-cobalt, chrome-cobalttitanium, and ceramic. For each material, 2 facings were fabricated. After 4 and 24 hours in situ, bacteriological samples were taken and processed for further identification. After a 2nd period of 4 and 24 hours in situ, the same facings were carefully removed and prepared for SEM-examination. All 4-hour specimens exhibited various areas covered by plaque, the amount of which varied with the different supporting substances. The very smooth surfaces (e.g., gold) harbored sparse deposits, while the rougher (e.g., amalgam) were covered by more plaque. After 24 hours of plaque development, an increase in the number of micro-organisms was noted for all the specimens. After 4 and 24 hours of plaque accumulation, no specific trends suggesting a preferential colonization on the different substances were observed. This study has shown that the amount of early deposits on different substances seems to be related to the degree of their surface roughness, while plaque formation was qualitatively similar.
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  • 7
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract The purpose of this investigation was to follow the development of the gingival conditions during puberty and to correlate oral clinical parameters with chronological age as well as with parameters used for the determination of the pubertal development. In 22 boys and 20 girls pubertal and skeletal development, as well as plaque index (PII) and gingival index (GI) were monitored at 1-year intervals between the ages of 11 and 15 years. During this time, the papillary bleeding index (FBI) was assessed 10 times in all interdental spaces of the dentition. The bleeding tendency, represented by whole mouth mean FBI values, as well as the % of bleeding interdental sites, was found to increase significantly with the start of the pubertal phase. It reached a peak value after 1–5 years in 35% of the children. A significant trend of decrease was noted after the age of 14 years in boys and girls. In boys, mean FBI and the % of interdental sites with bleeding were correlated with testes growth, in girls with the Tanner index for secondary sex characteristics (breast development). PII and GI. which were only recorded annually, did not show a significant trend of increase or decrease.
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  • 8
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract In association studies, micro-organisms can only be recognized as suspects for playing a major rôle in the development of a pathological environment, if their destructive action goes along with a marked proportional increase of their numbers or if their first detection can be related to the clinical onset of the disease. Limitations in the reproducibility of repeated samples have lo be taken into account, when changes of the microbial composition of subgingival environments are to be studied, and when local clinical changes are to be related to shifts in the composition of the pertaining microbiological compartment. To study reproducibility, a total of 109 sites was sampled repeatedly with sterile paperpoints at an interval of 7 to 10 days in 24 patients suffering from periodontal disease and 12 edentulous patients wearing successful and failing osseointegrated titanium implants. Using continuous anaerobic techniques, the samples were cultured on nonselective and selective media and were studied by darkfield microscopy. Both the intertest-agreements of frequencies of detection (x-statistics) as well as the discrepancies of proportions of bacterial groups and selected bacterial species were determined. The standard deviation of proportional differences between first and second samples ranged between 6.4% (fusiform organisms) and 17.2% (coccoid cells) for darkfield parameters, between 4.3% (B. melaninogenicus on ETSA/Kana.) and 14.0% (B. gingivalis on ETSA/Kana.) for selected bacterial species and between 6.9% (gram-negative anaerobic cocci) and 24.0% (gram-positive facultative cocci) for bacterial groups classified according to gram stain characteristics and atmospheric growth conditions. As the magnitude of deviation depended upon the mean value, coefficients of variation (cv) were also determined. The lowest cv values (0.25) were found for the proportions of spirochetes in the darkfield microscope, for the proportions of the gram-positive facultative rods (0.29) for gross bacterial groups and for Fusobacterium spp. (0.60) for selected bacterial species. The intertest-agreement of the frequencies of detection were best for spirochetes in the microscope and for B. intermedius with selected cultivated species. The results did not indicate a general bias of the results of second samples due to the previous sampling (McNemar's x2). Methodological proposals for estimation and comparison of proportions of bacteria are made and discussed in an appendix.
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  • 9
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract The purpose of this study was to evaluate the use of Ornidazole as an adjunct to root planing in the therapy of patients suffering from recurrent periodontal disease. In 10 individuals who had previously been treated with scaling, root planing and periodontal surgery and who had followed a regular maintenance program including recall visits every 3-5 months for 1–7 years, 2 sites with recurrent periodontitis and 1 shallow site were selected. Reinfected sites had a record of losing clinical attachment of more than 3 mm since the completion of initial therapy, were bleeding upon probing and had a mean pocket probing depth of 7.85 ± 1.31 mm. They had been reinstrumented several times by a registered dental hygienist, when clinical signs of recurrence of disease had appeared and the root surfaces were judged to be smooth and free of deposits. Clinical parameters were recorded and microbial samples were collected twice prior to retreatment. Then, 500 mg Ornidazole, to be taken twice a day for 10 days, was administered, and the whole dentition was thoroughly scaled and root planed. At day 10 as well as 2, 5, 8 and 11 months thereafter, samples were again obtained. At baseline, reinfected sites showed over 20% spirochetes, over 20% motile rods and over 9% fusiform organisms in darkfield preparations of subgingival plaque samples. Culturally, over 1/10 of organisms were identified as black pigmenting Bacteroides and in 18% of all baseline samples collected, B. gingivalis was found. Immediately following therapy, total counts of bacteria were reduced to approximately 5% of the baseline counts and more than half of the bacteria were characterized as coccoid cells; Gram-negative anaerobic rods were reduced to less than 3%. Among them, black -pigmenting Bacteroides, were reduced below 1%. B. gingivalis could no longer be detected. In the first weeks following therapy, most microbiological parameters showed a tendency to increase, but after some time, the microbiological situation appeared to reach a steady state and a statistically significant long-term reduction of Gram-negative rods, including Bacteroides ssp. persisted. These findings were paralleled by a significant decrease of pocket probing depth, no further loss of attachment and a decrease in bleeding tendency. These findings indicate that Ornidazole has an additional, beneficial clinical and microbiological effect when used as adjunct to mechanical re-treatment of recurrent periodontitis.
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  • 10
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract The aim of the present investigation was to evaluate the oral hygiene habits and the periodontal conditions of a group of cleft lip, alveolus and palate patients at the end of a longitudinal multidisciplinary treatment. From a total of 120 patients who had been supervised at the University of Berne, Clinic for Pediatric Surgery for at least 18 years in a co-ordinated team approach, 80 were selected on the basis of availability. Plaque control record (PCR), calculus index (CI), gingival bleeding index (GBI), pocket probing depth (PD), loss of attachment (LA) and furcation involvement were recorded. Using the technique and the ruler described by Schei et al., the radiographic height of the alveolar crest from the cemento-enamel junction was determined.Between the different groups of deformities, no statistically significant differences were found for all the clinical parameters with the exception of the mean PD orally and the mean PD bucally which were shallower in the isolated cleft lip group. These differences were attributed to the long-term orthodontic therapy with fixed appliances.When the PD and the LA at the sites adjacent to the cleft region were compared to two “unaffected” control sites, no statistically significant differences were found, whereas the comparison with the radiographic bone loss showed a statistically significant lower bone height. These results may indicate the presence of a long connective tissue attachment without bony support in the cleft region.As a result of inadequate oral hygiene, the patients with cleft lip, alveolus and palate showed beginning periodontitis with loss of attachment and beginning furcation involvement in most of the cases. Since these patients need long-term orthodontic therapy with fixed appliances, they should be incorporated in intensive prophylaxis programs as early in age as possible.
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