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  • Munksgaard International Publishers  (13,314)
  • 1
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The primary stability of short orthodontic implants is important for anchorage.Methods: For this study 14 cadaveric human heads were used. The stability of orthodontic implants (Straumann) with lengths of 4 and 6 mm and different localization (palatal suture or paramedially) were evaluated. The implants with length of 6 mm were only placed in the suture and primary stability was non-invasively determined with the resonance frequency (Osstell®). The invasive method for the analysis of the morphometric parameters of the implant/bone contact was carried out by means of histological and radiological examinations.Results: The 6 mm implants have significant better primary stability in the palatal suture as 4 mm implants paramedially (P〈0.05). No differences were found between 6 and 4 mm implants in the palatal suture and between 4 mm implants in palatal suture to paramedially. The histological and radiological results demonstrate the ability to measure the implant stability by investigation of the bone offer and density around the implant. Bone structure, especially the pore size in the trabecular bone and the precision of placement may influence the stability.Conclusion: This study shows that the short implant gives sufficient bone fixation, independently of placement. The quality of implantation and bone structure are more important than the length of the orthodontic implant.
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  • 2
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: Bone tissue engineering is a promising approach for treatment of defective and lost bone in the maxillofacial region. Creating functional tissue for load bearing bone reconstruction using biocompatible and biodegradable scaffolds seeded with living cells is of crucial importance. The aim of our study was to compare the effects of poly-lactic-co-glycolic acid (PLGA) and hydroxyapatite (HA) ceramic granulae on growth, differentiation, mineralization and gene expression of mandibular mesenchymal cambial layer precursor cells (MCLPCs) cultured onto tissue engineered three-dimensional (3-D) composites in vitro. These 3-D composites were cultivated in a rotating cultivation system under osteogenic differentiation conditions for a maximum period of 21 days. After 6 and 21 days, histological examination was performed; scanning electron microscopy (SEM), alkaline phosphatase (ALP) activity and levels of DNA were investigated. Expression of bone-specific genes osteocalcin, osteonectin, osteopontin, ALP, core binding factor α 1 and collagen type I were investigated by using a reverse transcription-polymerase chain reaction (RT-PCR) method. After 6 and 21 days of incubation an initiation of mineralization and the presence of newly formed bone at the surface of the composites were shown after evaluation of ALP activity, DNA content, SEM and histological staining. Expression of bone-specific genes confirmed the bone-like character of these composites and different effects of PLGA or HA granulae on the osteogenic differentiation of human MCLPCs in vitro. The results of this study support the concept that substrate signals significantly influence MCLPCs growth, differentiation, mineralization and gene expression in vitro, and that the use of these cells in the manufacturing of 3-D cell/HA composites is a promising approach for load bearing bone reconstruction in the maxillofacial region in vivo.
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  • 3
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: The purpose of this study was to determine the clinical and biomechanical outcome of two different titanium mini-implant systems activated with different load regimens. A total of 200 mini-implants (102 Abso Anchor® and 98 Dual Top®) were placed in the mandible of eight Göttinger minipigs. Two implants each were immediately loaded in opposite direction by various forces (100, 300 or 500 cN) through tension coils. Additionally, three different distances between the neck of the implant and the bone rim (1, 2 and 3 mm) were used. The different load protocols were chosen to evaluate the load-related implant performance. The load was provided by superelastic tension coils, which are known to develop a virtually constant force. Non-loaded implants were used as a reference. Following an experimental loading period of 22 and 70 days half of the minipigs were sacrificed, and implant containing bone specimens evaluated for clinical performance and implant stability. Implant loosing was found to be statistically dependent on the tip moment (TM) at the bone rim. Clinical implant loosing were only present when load exceeded 900 cN mm. No movement of implants through the bone was found in the experimental groups, for any applied loads. Over the two experimental periods the non-loaded implants of one type of implant had a higher stability than those of the loaded implants. Dual Top® implants revealed a slightly higher removal torque compared with Abso Anchor® implants. Based on the results of this study, immediate loading of mini-implants can be performed without loss of stability when the load-related biomechanics do not exceed an upper limit of TM at the bone rim.
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  • 4
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: The important item of aesthetics is rarely included in evaluation studies. The aim of this study was to develop and validate an index for rating aesthetics of implant-supported single crowns and adjacent soft tissues.Material and methods: Nine items were selected, which have an influence on the aesthetic result. The items are based on the anatomic form, colour and surface characteristics of the crown and on the anatomic form, colour and surface characteristics of the peri-implant soft tissues. Two oral-maxillofacial surgeons and two prosthodontists rated 24 implant-supported single-tooth restorations and adjacent soft tissues on a form with the nine items of the rating index. The rating was carried out twice by each of the examiners. Weighted Cohen's κ was calculated to express the intra- and interobserver agreement.Results: Intraobserver results indicated that the agreement between the first and second rating of both the prosthodontists was good (both 0.7) and that the agreement of the oral-maxillofacial surgeons was moderate (0.49 and 0.56). The best interobserver agreement was found between the two prosthodontists (0.61, good agreement).Conclusions: The Implant Crown Aesthetic Index is an objective tool in rating aesthetics of implant-supported single crowns and adjacent soft tissues. The rating is best be carried out by one prosthodontist to have the highest reliability.
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  • 5
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: The aim of this controlled, parallel design clinical study was to compare the effectiveness of an Er:YAG laser (ERL) to that of mechanical debridement using plastic curettes and antiseptic therapy for nonsurgical treatment of peri-implantitis. Twenty patients with moderate to advanced peri-implantitis lesions were randomly treated with either (1) an ERL using a cone-shaped glass fiber tip at an energy setting of 100 mJ/pulse and 10 pps (ERL), or (2) mechanical debridement using plastic curettes and antiseptic therapy with chlorhexidine digluconate (0.2%) (C). The following clinical parameters were measured at baseline, 3 and 6 months after treatment by one blinded and calibrated examiner: Plaque index (PI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR) and clinical attachment level (CAL). At the baseline examination, there were no statistically significant differences in any of the investigated parameters. Mean value of BOP decreased in the ERL group from 83% at baseline to 31% after 6 months (P〈0.001) and in the C group from 80% at baseline to 58% after 6 months (P〈0.001). The difference between the two groups was statistically significant (P〈0.001, respectively). The sites treated with ERL demonstrated a mean CAL change from 5.8±1 mm at baseline to 5.1±1.1 mm (P〈0.01) after 6 months. The C sites demonstrated a mean CAL change from 6.2±1.5 mm at baseline to 5.6±1.6 mm (P〈0.001) after 6 months. After 6 months, the difference between the two groups was statistically not significant (P〉0.05). Within the limits of the present study, it was concluded that (i) at 6 months following treatment both therapies led to significant improvements of the investigated clinical parameters, and (ii) ERL resulted in a statistically significant higher reduction of BOP than C.
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  • 6
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: Due to lack of the periodontal ligament, osseointegrated implants, unlike natural teeth, react biomechanically in a different fashion to occlusal force. It is therefore believed that dental implants may be more prone to occlusal overloading, which is often regarded as one of the potential causes for peri-implant bone loss and failure of the implant/implant prosthesis. Overloading factors that may negatively influence on implant longevity include large cantilevers, parafunctions, improper occlusal designs, and premature contacts. Hence, it is important to control implant occlusion within physiologic limit and thus provide optimal implant load to ensure a long-term implant success. The purposes of this paper are to discuss the importance of implant occlusion for implant longevity and to provide clinical guidelines of optimal implant occlusion and possible solutions managing complications related to implant occlusion. It must be emphasized that currently there is no evidence-based, implant-specific concept of occlusion. Future studies in this area are needed to clarify the relationship between occlusion and implant success.
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  • 7
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: Distraction osteogenesis has recently evolved a challenging technique to overcome major drawbacks of conventional augmentation procedures. We, therefore, report the application of miniaturized intraosseous distraction devices for the rehabilitation of mandibular defects due to ablative tumor surgery.Methods: In 10 patients who had undergone box-shaped or segmental resections, augmentation of the residual mandibular bone or of full thickness iliac crest grafts was performed by intraosseous implant-shaped distractors. Distraction and reconsolidation was monitored by ultrasonography. Implants were inserted within 1 week after active distraction. Median follow-up after implant insertion was 38 months.Results: On average, a vertical gain of 7.3 mm was obtained by distraction. Except for one case (local infection), all distraction zones showed complete ossification by radiologic and ultrasonographic evaluation. Overall 28 implants were placed in the distracted bone. Two implants were lost at 2.4 and 22 months after placement. The estimated 4-year implant survival rate in this population was 90%. For the endpoint ‘bone loss’ (〉1.5 mm in the first and 〉1 mm in following years), the estimated 4-year success rate was 59% with four out of seven events occurring in a single patient (patient No. 1 of this series).Conclusion: Vertical distraction by means of implant distractors could be performed with reasonable success in tumor patients with box-shaped resection defects or undercontoured bone grafts. Overall morbidity was very low. Even though blood supply is continuously maintained in distraction osteogenesis, bone resorption remains a critical issue for this reconstruction technique too.
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  • 8
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Purpose: The histological differences between the defect and contact areas of the implant surface to bone were tested in 35 New Zealand White rabbits in a standardized model. Microwave plasma chemical vapor-coated implant probes were tested in control and uncoated materials.Material and methods:  In each femur of 35 rabbits, cylindrical implant rods with a planed side were inserted. Three groups, divided in coated and uncoated material at half, were observed 42, 84 and 168 days. The probes were examined histologically for bone–implant contact in the curved and plane (defect area) sides.Results: Generally the bone–implant contact seems to be nearly constant in time in the curved area of coated and uncoated probes. Here the implant was inserted in the press-fit mode. Diamond-coated probes showed similar bone–implant contact (51.9% (42 days), 62.5% (84 days), 56.1% (168 days)) compared to uncoated material (56.2%, 65.4%, 62.9%). The defect area (plane side) had no bone–implant contact at the time of insertion and showed increasing values on longer observation times with only significant differences in the 42-day group between coated (17.85%, 35.2%, 47.7%) and uncoated materials (35.5%, 40.55%, 51.81%).Conclusion: The evaluation of the curved side of the implant probe showed no great variation of bone–implant contact within the described observation times. This model simulates the usual implant insertion situation. The diamond-coated material becomes osseointegrated at a later time point. The bone–implant contact was only statistically relevant in one group in comparison to uncoated material.
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  • 9
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: The purpose of this randomized clinical trial was to compare the clinical outcome of two different surgical approaches for the treatment of peri-implantitis. Seventeen patients with ITI® implants were included consecutively over a period of 5 years. The patients were randomized with a lottery assignment. Ten patients were treated with resective surgery and modification of surface topography (test group). The remaining seven patients were treated with resective surgery only (control group). Clinical parameters (suppuration, modified plaque index – mPI, modified bleeding index – mBI, probing pocket depth – PPD, pseudopocket – DIM, mucosal recession – REC, probing attachment level – PAL) were recorded at baseline, as well as 6, 12, 24 and 36 months after treatment. The cumulative survival rate for the implants of the test group was 100% after 3 years. After 24 months, two hollow-screw implants of control group were removed because of mobility. Consequently, the cumulative survival rate was 87.5%. The recession index in the control group was significantly lower than in the test group at 24 months (Student's t-value of −2.14). On the contrary, control group showed higher PPD, PAL and mBI indexes than test group (Student's t-values of +5.5, +2.4 and +9.61, respectively). The PPD and mBI indexes for the implants of the control group were significantly higher at baseline than 24 months later (Student's t-values of +3.18 and +3.33, respectively). Recession and PAL indexes resulted in values significantly lower than baseline (Student's t-values of −4.62 and −2.77, respectively). For the implants of the test group PPD and mBI indexes were significantly higher at baseline than 36 months after (Student's t-values of +11.63 and +16.02, respectively). Recession index resulted in values significantly lower at baseline (Student's t-value of −5.05). No statistically significant differences were found between PAL index measurement at baseline and 36 months later (Student's t-value of +0.89). In conclusion, resective therapy associated with implantoplasty seems to influence positively the survival of oral implants affected by inflammatory processes.
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  • 10
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: The present study investigated the hypothesis that hydroxyapatite (HA), tricalcium phosphate (TCP), and a HA-gel coated on endosseous titanium (Ti) implants by spark discharging (SD) and dip coating would achieve predictable osseointegration without evident bioresorption of the coatings on the long term. A costal sheep model was used for the implantation of the HA/SD, HA/TCP/SD, and HA-gel/SD specimens, which were retrieved 6 and 12 months following implantation. HA and Ti coatings on implants obtained by conventional plasma spraying (HA/PS, Ti/PS) were used as controls. Microscopy showed that osseointegration was achieved from all types of implants. No evidence for bioresorption of the HA/SD, HA/TCP/SD, and HA-gel/SD coatings was present but cohesive failure with disruption of the coating/implant interface was seen. A statistical analysis of the histomorphometrical data showed no time-dependent effect, however. HA/PS coatings achieved significantly higher bone–implant contact (BIC) percentages of the total implant surface (toBIC) than the other types of coatings (P=0.01). If the BIC percentages were traced separately for implant portions placed into cortical and cancellous bone (coBIC and caBIC, respectively), detailed analysis showed that the caBIC values of HA-gel/SD and HA/PS coatings were significantly higher than that of the other types of coatings (P=0.01). CaBIC values were highly correlated with toBIC values (P〈0.001). The present study showed that the preparation techniques used produced thin, dense, and unresorbable coatings that achieved osseointegration. Compared with the control coatings, however, only HA-gel/SD coating can be recommended from the investigated preparation techniques for a future clinical use if a better coating cohesion is achieved.
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  • 11
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: To assess prospectively over 10 years the incidences of technical and/or biological complications and failures occurring in a cohort of consecutive partially edentulous patients with fixed reconstructions on implants of the ITI® Dental Implant System.Methods: Eighty-nine patients were available, 34 (38.2%) were male, 55 (61.8%) were female. At the 10-year examination (range 8–12 years), they were 58.9 years old (range 28–88 years).Results: Single crowns (SC): 48 patients had been restored with 69 SC on 69 implants. Five of the implants with the crowns were lost because of biological failures. Two crowns (2.9%) were remade because of technical failures. Total failure amounted to seven (10%). Implant borne fixed partial dentures (I-I FPD): In 29 patients who had been restored with 33 implant borne suprastructures, the total number of failed I-I FPD was 2 (6.1%). Tooth–implant borne fixed partial dentures (I-T FPD): In 21 patients, 22 mixed tooth–implant borne reconstructions were constructed. The number of failed FPD reached 7 (31.8%). Statistically significantly fewer biological failures occurred with I-I FPD compared with the I-T FPDs (ANOVA, Bonferroni, P=0.022). The I-T FPDs experienced statistically significantly more frequent technical failures compared with the other two groups of suprastructures (P=0.003, 0.031). Consequences of complications: The occurrence of loss of retention as a complication increased the odds ratio (OR) to 17.6 (P〈0.001) to end up in a technical failure. Similarly, the event of a porcelain fracture increased the OR for the suprastructure to be a failure at 10 years to 11.0 (P≤0.004). Treatment of periimplantitis increased the OR to 5.44 (P≤0.011) to result in a biological failure compared with implants in which this type of treatment was not applied.Conclusion: The three groups of suprastructures demonstrated marked differences in their patterns of failures and complications. Complications increased the risk for failure. Support by CRF, University of Berne, Switzerland.
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  • 12
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective: To determine the ability of a novel bovine cancellous bone xenoimplant to act as an osteoconductive graft in an ovine femoral defect model. An autograft harvested from the xenoimplant site was placed in a contralateral limb defect for comparison.Material and methods: The xenoimplant used had been rendered immunologically inert by a novel defatting and deproteinating process. Following surgical implantation of cores into condylar cancellous bone defects, fluorochrome labels were administered to 12 sheep at 2 1/2, 4 1/2 and 8 weeks. Incorporation of the xenoimplants and autografts into the host bone was compared radiographically and histomorphometrically at 10 weeks.Results: Radiographically, the degree of osteointegration was comparable. Histomorphometric data, consisting of labelled surface (LS) estimates, confirmed osteoconductive properties of both the xenoimplants and autografts. Remodelling activity was greatest in the xenoimplants at 2 1/2, weeks. At 4 1/2 weeks, there was more activity in the autograft, but by 8 weeks they were performing similarly. Xenoimplant-LS estimates were comparable or greater than those of the autograft at all times.Conclusions: Processed bovine cancellous bone xenoimplants were osteoconductive in this model and show promise for development as a biomaterial in human and veterinary orthopaedic surgery.
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  • 13
    Electronic Resource
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    Oxford, UK : Munksgaard International Publishers
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 14
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Long-term data on microbiological and clinical outcome as well as on patient satisfaction after implant therapy in the edentulous mandible are limited. Especially comparisons between fixed full prostheses (FFPs) and overdentures (ODs), or between anchoring systems for the latter are scarce.Aim: This study aimed to evaluate both of these parameters at the 10-year follow-up in a group of fully edentulous patients rehabilitated via an OD or a FFP (the latter to allow inter-group comparison).Material and methods: A total of 37 fully edentulous patients (25 ODs, 12 FFPs, age at implant installation ranged from 36 to 85 years) participated in this study. All subjects received their implants (Brånemark System®, Nobel Biocare AB, Gothenburg, Sweden) 10 years previously. For the ODs different attachment systems (bar, magnets, ball) had been applied that allowed a further intra-group comparison. At the follow-up visit, 10 years after the abutment insertion, a series of periodontal parameters were recorded, long-cone radiographs were taken and subgingival plaque samples were collected for analysis using checkerboard DNA–DNA hybridization. The clinical and radiographic data were recorded at abutment connection and after 1 and 10 years.Results: After 10 years of loading, mean plaque and bleeding indices and changes in attachment or marginal bone level were not significantly different, neither between the OD and FFP group, nor within the OD group. The marginal bone loss between abutment connection and year 10 was 0.86 and 0.73 mm for OD and FFP groups, respectively. The subgingival microbiota at implant sites from all (sub)-groups was comparable, with low numbers of DNA counts (±10 × 105) but high detection frequencies of Actinobacillus actinomycetemcomitans (〉90%), Porphyromonas gingivalis (〉85%) and Tannerella forsythensis (30%). The composition of the subgingival microbiota was influenced by probing depth and bleeding tendency. Patient satisfaction was very high for both types of prosthetic rehabilitation. The FFP group scored only slightly better for chewing comfort and general satisfaction.Conclusion: These data indicate that from the clinical and microbiological standpoint, as well as patient satisfaction, both an OD and a FFP offer a favourable long-term outcome.
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  • 15
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: The aim of this study was to evaluate whether the use of enamel matrix proteins with or without the use of deproteinized bovine bone influences bone formation when used as an adjunct to guided bone regeneration (GBR). Twenty rats, divided into four groups of five animals each, were used in this study. Group A1: A hemispherical PTFE capsule was placed empty on the lateral aspect of the mandibular ramus (GBR). At the contralateral side of the jaw, the capsule was filled with an enamel matrix derivative (EMD) before its placement. The healing period was 60 days. Group A2: The animals were treated in the same manner as in Group A1 but with a healing period of 120 days. Group B1: The animals were treated in the same manner as in Group A1 with the difference that deproteinized bovine bone mineral (DBBM) particles were packed in the capsule. At the contralateral side of the jaw, the capsule was filled with a mixture of EMD and DBBM. The healing period was 60 days. Group B2: The same treatment as in B1 but with a healing period of 120 days. The histological analysis revealed that in Groups A1 and A2 newly formed bone was covering a significant part of the empty capsules (GBR). The use of EMD in the capsule did not offer any added benefit to the use of the capsule alone in terms of new bone formation. At Groups B1 and B2, the presence of DBBM and/or EMD did not positively affect the amount of new bone formation. It can be suggested that neither the application of EMD nor the use of DBBM or the combination of EMD and DBBM results in enhanced amounts of bone formation in comparison with the GBR procedure alone.
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  • 16
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: The aim of the study was to investigate the effect of low-level laser therapy (LLLT) on attachment and proliferation of human gingival fibroblasts (HGF) cultured on titanium implant material. HGF were exposed to gallium–aluminum–arsenide diode laser at dosages of 1.5 or 3 J/cm2 and then cultured on commercially pure titanium discs. Cell profile areas were measured after 1, 3 and 24 h, using scanning electron microscopy and an automatic image analyzer. The results were expressed as percentage of attachment. In order to investigate the effect of LLLT on cellular growth after 8 and 10 days, HGF were cultured on titanium discs for 24 h and then exposed to laser irradiation on 3 consecutive days. Colony-forming efficiency (CFE) and clonal growth rates (CGR) were measured. Cell viability was determined by Hoechst and prodidium iodide staining. Non-lased cultures served as controls. Morphologically, the cells spread well on all titanium surfaces, indicating good attachment by both irradiated and non-irradiated cells. Fibroblasts exposed to laser irradiation had significantly higher percentages of cell attachment than the non-exposed cells (P〈0.05). CFE and CGR were also enhanced for the irradiated cells (P〈0.05). Cell viability was high (〉90%) in the irradiated and control groups, without significant differences. It is concluded that in vitro LLLT enhances the attachment and proliferation of HGF on titanium implant material.
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  • 17
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: To analyse the patients' perception of implant therapy, 10 years following installation of titanium oral implants.Material and methods: As a part of a prospective cohort study of patients with ITI® dental implants, 104 patients were recruited to answer a questionnaire with 13 statements on the subjective perception of implant treatment, 5–15 years after implant installation (mean: 10.2 years). In addition, the patients were asked to mark a visual analogue scale (VAS) in which 0 indicated ‘total discontent’ and 100 ‘total satisfaction’ with the statements mentioned in the questionnaire. Results from the qualified questions answered were then compared with those obtained from VAS analysis.Results: One hundred and four patients, with 214 installed oral implants participated. Forty-eight percent of the implants were reconstructed with single crowns and 52% with fixed partial dentures (FPD). The cumulative survival rate of the implants at 10 years was 93%. Two of the statements addressing function and chewing comfort yielded very high patient satisfaction (97% highly satisfied or satisfied, mean VAS: 94±13). Comparing chewing comfort for teeth or implants, respectively, 72.1% perceived no difference between the two, 17.3% felt more secure when masticating on teeth and 7.7% when masticating on implants (mean VAS: 54±24). The vast majority (96%, mean VAS: 96±10) was highly satisfied or satisfied with phonetic function and with aesthetics (97%, mean VAS: 93±13). A great majority of the patients (93%, mean VAS: 89±19) had no problems with cleansing the implant reconstruction. Indeed, one-third (37%, mean VAS: 55±27) indicated more ease to clean implants than to clean teeth. About half of the patients (47%) had noticed bleeding of the mucosa or the gingiva following brushing. In addition, half (47%) of those noticing bleeding felt that bleeding was less marked around implants than around teeth. Again, the vast majority of patients (92%, mean VAS: 92±14) indicated complete fulfilment of the treatment, i.e. the outcome satisfied their expectations. The same majority (94%, mean VAS: 93±17) would be willing to undergo the same treatment again, and (89%, mean VAS: 93±16) would even recommend such treatment to friends and relatives, if indicated. The cost for implant therapy was deemed to be reasonable to a large extent (87%, mean VAS: 85±20).Conclusion: Using oral implants, more than 90% of the patients were completely satisfied with implant therapy, both from a functional and aesthetic point of view. The costs associated with implant therapy were considered to be justified. This was determined by both qualified questions and the use of VAS after 10 years of function.
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  • 18
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective: Premature exposure of membranes used in guided bone regeneration (GBR) results in decreased bone formation. The effect of an expanded polytetrafluoroethylene (e-PTFE) and two collagen membrane on bone healing of buccal dehiscence defects around implants in cases with and without premature membrane exposure was clinically evaluated.Methods: Three groups were established: Group OS (Ossix™, n=73 implants, 41 patients), Group BG (Bio-Gide®, n=53 implants, 28 patients) and Group GT (e-PTFE, Gore-Tex®, n=34 implants, 17 patients). Defect height and width were measured at the time of implant placement and at second stage surgery. Surface area was calculated as half ellipses. When several implants were placed simultaneously, a mean of their defect width and height was calculated.Results: Mean percentage reduction of defect area (92.2±13.78% Group OS, 94.6±6.69% Group BG, and 97.3±4.91% Group GT) and height (81.6±23.19%, 85.4±12.26%, and 93.4±9.39% respectively) did not show statistically significant differences between groups. Differences between groups were not statistically significant for all parameters when cases without spontaneous membrane exposure were compared. However, differences were significant when spontaneous membrane exposure occurred. Mean percentage reduction of defect area among cases where membrane exposure occurred was 91.5±10.86% Group OS, 71.5±8.61% Group BG, and 73.7±13.97% Group GT. Mean percentage reduction of defect height among cases with membrane exposure was 76.4±18.28%, 53.4±9.86%, and 49.4±11.05%, respectively.Conclusions: Premature exposure of membranes and subsequent and consequent exposure of implants results in impaired bone healing. Certain barrier membranes, as used in group OS, are apparently capable of supporting gingival healing even when prematurely exposed that could be advantageous in GBR procedures.
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  • 19
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: Barrier membranes have become a standard treatment option in alveolar ridge augmentation prior to implant placement. However, non-resorbable membranes require secondary surgery and resorbable membranes show an unfavorable degradation profile. The purpose of this study was to evaluate the potential of a slowly biodegradable/bioresorbable prototype trilayer membrane (PTLM) for supporting bone regeneration in alveolar ridge augmentation. Clinically relevant cavities were made 3 months after the extraction of the first and second molars in each jaw of six baboons. Each animal was treated with four different regimens: (1) autogenous bone block (ABB) alone, (2) ABB+PTLM, (3) deproteinized bovine bone mineral (DBBM)+PTLM and (4) no treatment. After 9 months, the baboons were sacrificed and block sections of the augmented area were subjected to histologic and histomorphometric analyses. Newly formed bone areas were determined at a distance of 1, 3, 7 and 10 mm from crestal. The data showed a well-preserved ridge profile at the membrane-protected sites, whereas non-protected bone blocks and control sites underwent severe resorption resulting in knife-edge ridge profiles. Significant differences were found between ABB+PTLM and ABB (P=0.0137–0.0232). DBBM+PTLM also produced a larger bone area compared with ABB alone (P=0.0396–0.0439). No significant difference in bone area was detectable between ABB+PTLM and DBBM+PTLM (P〉0.05). The present study supports the use of the slowly biodegradable/bioresorbable PTLM with autografts and DBBM for lateral ridge augmentation in this type of bone defects.
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  • 20
    Electronic Resource
    Electronic Resource
    Oxford, UK : Munksgaard International Publishers
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract Objectives: The transfer of the osseofasciocutaneus fibula-free flap has become a routine procedure in the reconstruction of comprehensive orofacial defects. Besides its length, major advantages of the fibula-free flap include the trigonal diameter of the fibular bone, which usually allows the placement of dental implants.Patients and methods: In a prospective study, 16 consecutive patients who received free fibula grafts and in total 51 dental implants between 1999 and 2001 were examined. All implants were inserted secondary after bone grafting and loaded after 3 months of submerged healing. The observation period extended 2.5 years on average. The implant success was controlled clinically, radiographically and by resonance frequency analysis.Results: One implant that was located at the interface between the fibula graft and the mandible was lost due to dehiscence and local infection during the healing period. In two other patients, one implant had to remain unexposed as ‘sleeper’ due to an unfavourable soft tissue situation. The success rate calculated by Kaplan–Meier analysis was 96.1% after an observation period of 1400 days. Resonance frequency analysis (ISQ-values) revealed significant differences related to the orientation (vestibulo-oral/mesio-distal; vo/md) of the transducer unit (P〈0.01). In general, a high primary stability for implants placed in free fibula grafts could be achieved (vo/md 66/74.1), which on average increased slightly during the healing period (vo/md 67.4/75.4) and within 12 month of functional loading (vo/md 72.1/79.9). Additional augmentation with iliac bone grafts or reconstructions with a double barred fibula resulted in an improved reconstruction of the alveolar process, thus allowing superior individual implant positions or angulations, but no elevation of the ISQ-values.Conclusion: The fibula-free flap provides a consistent bone graft that allows a reliable and predictable restoration with dental implants.
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  • 21
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Introduction: Computer-guided navigation has proven a valuable tool in several surgical disciplines. During oral implant placement, its application is intended to accomplish optimal implant localization and to reduce the risk of damage to adjacent structures. The aim of this study was to compare the precision limits of conventional vs. navigated implant insertion in practice.Materials and methods: In cast models of the maxilla, implants were inserted to replace the left central incisor (n=40) and the right canine (n=40); each of those were inserted either conventionally (n=20) or navigated (n=20). Implant position, angulation and insertion depth were calculated from computer tomography scans of the implants that were connected to an index abutment of 40 cm length.Results: The variations of implant positions were reduced for implants that were inserted by navigation (P〈0.05). In both the axial and the transversal plane, the variations of implant angulations were reduced for implants that were inserted by a navigation protocol (P〈0.05). The variations of insertion depth were less (P〈0.05) when the implants were placed by navigation in comparison with conventional insertion procedures.Conclusions: Given the experimental conditions, although they tried to mimic a clinical situation, no final conclusions can be drawn. The in vitro application of a navigation system resulted in an improved precision of insertion surgery regarding the position, angulation and depth of an implant. Clinical studies will have to prove if routine image guidance will result in superior surgical outcome.
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  • 22
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: Direct bone-to-implant contact, defined as ‘osseointegration’, is considered most optimal for long-term stability and survival of dental implants. However, the possibility of the formation of a tooth-like attachment apparatus around implants has also been demonstrated. The purpose of this study was to explore the formation of periodontal tissues around titanium implants using a novel and unique experimental model. After resection of the crowns of the maxillary canine teeth in nine mongrel dogs, the roots were hollowed to a depth of 5 mm leaving a thin dentinal wall. Slits were prepared in the cavity wall to create passages from the chamber to the periodontal ligament area. A custom-made, titanium implant was placed into the center of each chamber. Machined, titanium plasma sprayed (TPS) and sand blasted with large grit and acid attacked (SLA) surfaces were used. A collagen barrier was placed over the submerged chamber. Following 4 months of healing, jaw sections were processed for histology. Newly formed periodontal ligament, alveolar bone, and root cementum filled the space between the implant and the wall of the chamber. Ingrown bone was neither in contact with dentin nor with the implant. Thus, an interposed soft connective tissue layer was present. Healing by fibrous encapsulation was observed around most implants. However, cellular cementum was deposited on one TPS and one SLA implant and on the dentinal walls of the chamber. This study shows a remarkable capacity for new periodontal tissue formation at a site where no such tissues ever existed. Maintenance of original periodontal tissue domains most likely prevented osseointegration of the implants. The cementum layer deposited on two implants was likely formed through cementoconductivity rather than by differentiation of periodontal ligament cells upon contact with the implant surface.
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  • 23
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: Microtomographic techniques are widely used for studying the trabecular architectures in the orthopedics and elucidation of tooth micromorphology in the field of dentistry. Its application to assess the osseointegration of dental implants has been studied as a non-invasive method, contrary to several conventional methods. The aim of this study is to evaluate the possibility of microtomography as a tool for assessing osseointegration. Twenty-four titanium dental implants (3.75 mm in diameter and 7 mm in total length) were installed in the tibia of New Zealand white rabbits, and retrieved with the surrounding bone after 3 months. The specimens were analyzed by three-dimensional microtomogram images (Skyscan 1074) and compared with the conventional histomorphography. The correlation coefficient was found to be 0.855, which means the two data sources are significantly correlated statistically. To predict the histomorphometric data using microtomographic data, a linear regression model was applied. These results showed some promise of using microtomograms for non-invasive osseointegration assessment if the methods can be calibrated more precisely by further study.
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  • 24
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective: The aim of the present study was to investigate the relationship between specific polymorphisms of the interleukin-1 gene cluster and the early failure of osseointegrated implants.Material and methods: The subject population was composed by a test group comprising 28 non-smoking patients (mean age 52.7) that had suffered one or more early implant failures and by a control group consisting of 34 individuals (mean age 43.3) with one or more healthy implants. Genomic DNA from buccal mucosa was amplified by the polymerase chain reaction (PCR), followed by restriction fragment length polymorphism (RFLP) and submitted to polyacrylamide gel electrophoresis to distinguish the alleles of the interleukin-1A (−889), interleukin-1B (+3953), interleukin-1B (−511) and interleukin-RN (intron 2) gene polymorphisms. Differences in the allele and genotype frequencies between control and test groups were assessed by χ2 test or by Monte Carlo simulations (P〈0.05). Haplotype frequencies, linkage disequilibrium and Hardy–Weinberg equilibrium were also estimated.Results: No statistically significant differences were found in the genotype distribution or allelic frequencies of the polymorphisms. No differences were observed between control and test groups when different interleukin-1 gene cluster haplotypes were compared. Nevertheless, the interleukin-1A (−889) and interleukin-1B (+3953) polymorphic sites were in strong linkage disequilibrium (P=0.00014 for control group and P=0.0238 for the test group).Conclusion: This study suggests that polymorphisms in the interleukin-1 gene cluster are not associated with early implant failure in a non-smoking Brazilian population.
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  • 25
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: This experimental study evaluated the effects of deproteinized bone grafts on guided bone regeneration (GBR). A groove was made in the bone marrow of the external cortical plate of the skull. A dome of non-resorbable membrane was placed on the groove and secured with titanium pins. The secluded graft space was filled with autogenous blood clots (control group) and deproteinized bone particles (experimental group). The rabbits were sacrified 2, 4, 8 and 12 weeks after the operation. Decalcified and paraffin-embedded, transverse 3-μm-thick sections were made and stained with hematoxylin and eosin. The proportions of newly formed bone and newly formed bone-graft particle contact surfaces were histomorphometrically measured in the basal, central, and peripheral areas from the cortical plate to the top of the dome. In the control group, the basal area showed a significant increase at 4 weeks (P〈0.01) and a significant decrease at 8 weeks (P〈0.01). The central and peripheral areas showed gradual increases in the proportion of newly formed bone. The experimental group showed significant increase at 4 weeks in the basal area and at 8 weeks in central and peripheral area (P〈0.01). There were significant differences between both groups in basal and central area (P〈0.01). The proportion of newly formed bone-graft particle contact length showed significant increases at 4 weeks (P〈0.01) and no significant decreases at 8 and 12 weeks in three areas. The present study showed that deproteinized bone grafts maintain newly formed bone in extensive areas for a prolonged period during GBR.
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  • 26
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: Cranial vault is widely used in experimental models on membranous bone healing in general, guided bone augmentation (GBA) studies being one example. To our knowledge, however, few studies on the characteristics of the untreated calvaria regarding bone density, vessel topography, and their intra/interindividual variations and associations are available. The aims of this investigation were to (1) map the large vessel topography of the skull vault, (2) describe the parietal bones of the adult rabbit histologically and morphometrically, and (3) histologically compare untreated parietal bone with parietal bone that had been treated with a GBA device.Material and methods: Ten adult untreated rabbits were microangiographed. General anesthesia was induced and the mediastinum was opened. Heparin and lidocaine were injected in the aorta followed by perfusion with India ink. After death, en bloc biopsies of the skull vault including the overlying soft tissues and dura mater were taken. The specimens were cleared with the Spalteholtz technique, microscopically examined, and digitally imaged. Thereafter, circular biopsies were harvested to obtain decalcified sections. In addition, sections from 14 GBA-treated rabbit skulls (of the same race, sex and age as the untreated animals) served as reference specimens for comparison. Histomorphometric examinations were carried out.Results: In the cleared specimens, all parietal bones were found to be supplied by one major branch of the meningeal artery. From each of these, separate branches supplied the dura wherein a fine vessel network covered the bone. No major vessels were found in the supracalvarial soft tissue. Numerous fine vessels were found within the periosteum and dura entering the cortical plates. The decalcified sections of the parietal bones revealed an outer and inner cortical plate enveloping a diploic space containing bone trabeculae, marrow tissue and larger sinusoids. Hollow connections were frequently found in both the outer and inner cortical plates in both the untreated and the GBA-treated specimens. These connections contained marrow tissue that extended to the periosteum and the dura. The morphometric measurements revealed similar proportions of cortical, trabecular, and marrow areas in the right and left untreated bones. The area of the outer cortical plate was significantly larger than the area of the inner cortical plate. Bone density was similar in the right and left untreated and GBA-treated specimens, as was the frequency and width of hollow connections through the cortical bone plates.Conclusions: The symmetry between the left and right parietal bones concerning the large vessel topography and the histomorphometric parameters assessed was high. Hollow connections in the cortical plates were frequently found. The bilateral use of the parietal bones is suggested to be reliable in experimental GBA models regarding the blood supply and bone quality.
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  • 27
    Electronic Resource
    Electronic Resource
    Oxford, UK : Munksgaard International Publishers
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 28
    Electronic Resource
    Electronic Resource
    Oxford, UK : Munksgaard International Publishers
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: Implant rehabilitation of the edentulous maxilla may be somewhat problematic because of anatomic situations involving insufficient bone thickness. One approach in this situation is localized ridge augmentation with the split crest technique. This surgical approach allows the external cortical plate of the maxilla to be moved in a labial direction to gain an increase in width to introduce implants of appropriate diameter. This ongoing prospective study evaluated: (i) the surgical advantages that the new ITI TE® implants have showed compared with the ITI standard solid-screw implants when placed in conjunction with the split crest technique and (ii) the implant success rate associated with 42 ITI TE® implants and 40 ITI standard solid-screw implants placed in 40 patients in conjunction with the split crest technique. ITI TE® implants have shown direct and indirect advantages in reducing the risk of fracture of the labial cortical plate during all the three fundamental surgical steps of this technique: (a) the ridge expansion with osteotomes; (b) implant site preparation with drills and (c) implant insertion. The overall success rates of ITI TE® implants and standard screw implants were 100% and 95%, respectively. Based on the preliminary results of the present study, it can be concluded that ITI TE® implants inserted in conjunction with split crest technique seem to be a promising surgical procedure to treat selected anatomic situations involving insufficient maxillary bone thickness.
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  • 29
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: Titanium platelets with a sand-blasted and acid-etched surface were coated with bovine serum albumin and incubated with a suspension of Porphyromonas gingivalis (ATCC 33277). Four groups with a total of 48 specimens were formed. Laser irradiation of the specimens (n=12) was performed on a computer-controlled XY translation stage at pulse energy 60 mJ and frequency 10 pps. Twelve specimens were treated with an air powder system. After the respective treatment, human gingival fibroblasts were incubated on the specimens. The proliferation rate was determined by means of fluorescence activity of a redox indicator (Alamar Blue® Assay) which is reduced by metabolic activity related to cellular growth. Proliferation was determined up to 72 h. Contaminated and non-treated as well as sterile specimens served as positive and negative controls. Proliferation activity was significantly (Mann–Whitney U-test, P〈0.05) reduced on contaminated and non-treated platelets when compared to sterile specimens. Both on laser as well as air powder-treated specimens, cell growth was not significantly different from that on sterile specimens. Air powder treatment led to microscopically visible alterations of the implant surface whereas laser-treated surfaces remained unchanged. Both air powder and Er : YAG laser irradiation have a good potential to remove cytotoxic bacterial components from implant surfaces. At the irradiation parameters investigated, the Er : YAG laser ensures a reliable decontamination of implants in vitro without altering surface morphology.
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  • 30
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: A novel methodology which allows for fast and fully automatic structural analysis during preoperative planning for dental implant surgery is presented. This method integrates a fully automatic fast finite element solver within the framework of new concepts in computer-assisted preoperative planning for implant surgery. The planning system including optimized structural planning was validated by experimental results. Nine implants were placed in pig mandibles and mechanically loaded using a testing rig. The resulting displacements were measured and compared with those predicted by numerical analysis during planning. The results show that there were no statistically significant differences (P=0.65) between the results of the models and the experiments. The results show that fast structural analysis can be integrated with surgical planning software allowing the initial axial implant stability to be predicted in real time during planning. It is believed that such a system could be used to select patients for immediate implant loading and, when further developed, be useful in other areas of preoperative surgical planning.
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  • 31
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The development of endosseous implants and free vascularized bone grafting has permitted increased possibilities of oromandibular reconstruction in patients with oral cancer. In this study, a concept combining surgical and prosthodontic treatments for mandibular fibula free flap reconstruction after tumor surgery was made based on a classification of bone defects. A follow-up study was performed to evaluate the treatment concept for oral rehabilitation in order to identify possible factors which may influence the functional result.Material and methods: A follow-up examination included 28 patients who underwent the ablative tumor surgery and mandibular reconstruction during a 4-year period. The follow-up protocol included clinical examination, radiological evaluation, and an interview using a standardized questionnaire. The timing of the study was set to allow for a minimum 2-year follow-up (mean 45 months).Results and conclusion: At the time of examination, prosthesis-based oral rehabilitation was completed in six patients (21%), and the prosthodontic work was still unfinished in four other patients. The other 18 had no dental prosthetic rehabilitation. Thirteen patients received a total of 37 oral implants, and 23 implants were functionally loaded. No implant loss was recorded. Oral functions such as speech, diet tolerance and oral competence were not directly affected by the presence of dentures. A decisive factor affecting the oral function was the extent of soft-tissue loss. According to the classification described here, the extent of the mandibular defect did not correlate with oral functions. The application of oral implants seemed to be advantageous for the oral rehabilitation of patients who had undergone intraoral resections.
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  • 32
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective: The aim of this 5-year prospective comparative study was to evaluate treatment outcome (survival rate, condition of hard and soft peri-implant tissues, patient satisfaction, prosthetic and surgical aftercare) of mandibular overdentures supported by two or four implants.Material and methods: Sixty edentulous patients with a mandibular height between 12 and 18 mm participated. Thirty patients were treated with an overdenture supported by two IMZ implants (group A) and 30 patients were treated with an overdenture supported by four IMZ implants (group B). Standardised clinical and radiographic parameters were evaluated 6 weeks after completion of the prosthetic treatment and after 1, 2, 3, 4 and 5 years of functional loading. Prosthetic and surgical aftercare was scored during the evaluation period.Results: One implant was lost (group A) during the healing period. There were no significant differences with regard to any of the studied clinical or radiographic parameters of the peri-implant tissues between the groups. None of the patients reported sensory disturbances in the lip or chin region. No differences in satisfaction were observed between the groups. With regard to aftercare, there was a tendency of a greater need of prosthetic interventions in group A, while correction of soft-tissue problems was restricted to patients of group B.Conclusion: There is no difference in clinical and radiographical state of patients treated with an overdenture on two or four implants during a 5-year evaluation period. Patients of both groups were as satisfied with their overdentures.
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  • 33
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: Serum C-reactive protein (CRP) has been shown to be a risk predictor for cardiovascular disease. Periodontal treatment reduces elevated CRP levels. The aim of this pilot investigation was to evaluate if dental implants placed after extractions in patients with end-stage periodontitis affect the serum CRP levels.Material and methods: Serum CRP levels in 10 subjects with end-stage periodontitis were measured prior to tooth extraction and placement of dental implants, and at 3-month intervals for a year post-operatively. Univariate repeated measures analysis of variance was used to estimate and test the changes in CRP levels over time.Results: Mean CRP levels decreased significantly following tooth extraction and replacement with dental implants from 3.45 to 1.55 mg/dl after 12 months (P〈0.01). Six-, 9-, and 12-month post-implant placement mean CRP values were statistically significantly different from the mean pre-operative CRP value (P〈0.01).Conclusions: The pilot data suggest that extraction of advanced periodontally involved teeth and their replacement with dental implants lead to a decrease in CRP levels, and dental implant placement does not change the lowered CRP levels over a 12-month period.
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  • 34
    Electronic Resource
    Electronic Resource
    Oxford, UK : Munksgaard International Publishers
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 35
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Introduction: Transient bacteraemias are frequently detected following dental manipulation. Infective endocarditis (IE) can arise in susceptible individuals and antibiotic prophylaxis is routinely performed for certain procedures considered to be “at risk” of IE. Evidence is emerging that periodontal disease may be a significant risk factor for the development of certain systemic diseases such as cardiovascular disease. These systemic conditions could be initiated or detrimentally influenced by the repeated entry of bacteria into the bloodstream.Materials and Methods: The present study comprised a single blind parallel study of 2 weeks duration. A baseline blood sample was obtained from 30 volunteers with untreated periodontal disease following which a periodontal probing depth chart was collected. A further blood sample was taken following this procedure, and each subject was recalled 2 weeks later. A blood sample was collected, the subject carried out toothbrushing and a further blood sample taken. Full-mouth ultrasonic scaling was then performed and a final blood sample taken. Blood samples were analysed for bacteraemia using conventional microbiological culture and polymerase chain reaction (PCR) using universal bacterial primers that target the 16S ribosomal RNA gene of the vast majority of bacteria.Results: Using culture methods, the incidence of bacteraemias was as follows: following ultrasonic scaling (13%), periodontal probing (20%) and toothbrushing (3%). PCR analysis revealed bacteraemia incidences following ultrasonic scaling, periodontal probing and toothbrushing of 23%, 16% and 13%, respectively.Conclusion: These findings suggest that detectable dental bacteraemias induced by periodontal procedures are at a lower level than previously reported.
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  • 36
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective: To assess differences between selected periodontal measures by demographic and behavioural factors in a nationally representative sample of the United States.Methods: Data for 11,347 person's ages 20–79 years from the third National Health and Nutrition Examination Survey (NHANES III) were used. Indices and measures constructed from NHANES III data used for this study were: derived community periodontal index (dCPI), attachment loss extent index (ALEI), attachment loss (AL) scores, and a Periodontal Status Measure (PSM) developed for this study.Results: The influence of demographic and behavioural factors varied across the four indices examined in multivariate cumulative logistic models. Moreover, there was significant effect modification by cigarette smoking with age in the ALEI and AL models. The odds ratio (OR) of increasing periodontal disease status among 20–39 year olds as measured by AL or ALEI for current smokers compared with non-smokers were OR=6.2 (95% confidence interval (CI)=4.1, 8.7) and OR=5.6 (95% CI=3.7, 8.7), respectively. In a similar comparison, the OR for dCPI was 2.6 (95% CI=1.7, 3.8). Furthermore, Mexican American ethnicity was generally not significant in any models using dCPI, PSM, AL, or ALEI and prior dental visit was more likely to be significant only in the dCPI and PSM models.Discussion: Among the well-known demographic and behavioural influences on periodontal health status, some, such as race/ethnicity and prior dental visit status have different relationships with differing periodontal measures employed to assess periodontal status. Moreover, potential interactions among cofactors also are dependent upon the measure selected. Periodontal research findings may be influenced significantly by periodontal measure selection and its affect on measurement validity. This may have particular relevance to issues concerning disease surveillance and assessing reduction of disparities in oral health. Consequently, a renewed approach to developing appropriate measures for periodontal epidemiology is needed.
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  • 37
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective: The aim of this study was to analyse changes in bone height after 17 years in smokers and non-smokers with periodontal disease, and to compare these with clinical assessment outcome.Material and Methods: Participants comprised 50 adults with periodontitis and 18 healthy controls from a randomly selected epidemiological sample. Their mean age at the end of the study was 54.2 (SD±3.09) years. The study included radiographic analysis compared with clinical data.Results: The periodontitis group had significantly (p〈0.001) higher values than their healthy counterparts for plaque index (PLI), gingival index (GI), calculus index (CI), and bleeding on probing (BOP) at baseline and after 17 years. At the end of the follow-up, never-smokers with periodontitis had higher values for PLI (p〈0.05) and ex-smokers and smokers had higher GI and BOP (p〈0.001) than the controls. In all individuals with periodontitis, maxillary molars were most affected. Smokers had more severe marginal bone loss over time. Vertical bone defects were more often seen on the mesial side of teeth (p〈0.05).Conclusion: Marginal bone level in this prospective study did reveal tooth groups at higher risk for progression of periodontal disease.
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  • 38
    Electronic Resource
    Electronic Resource
    Oxford, UK : Munksgaard International Publishers
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: The aims of this paper are to review and compare existing techniques for creation of interdental/interimplant papillae, to address factors that may influence its appearance and to present an approach that authors developed that could help clinicians to manage and recreate the interproximal papillae.Methods: Papers related to interdental and interimplant papillae published over the last 30 years were selected and analyzed.Results: Thorough treatment planning is essential for maintenance of the height of the interproximal papillae following tooth removal. The key for achieving an esthetically pleasing outcome is the clinicians' ability of properly managing/creating interdental/interimplant papillae. Bone support is the foundation for any soft tissue existence, techniques such as socket augmentation, orthodontic extrusion, guided bone regeneration, onlay graft and distraction osteogenesis are often used for this purpose. Soft tissue grafts as well as esthetic mimic restorations can also be used to enhance the esthetic outcomes.Conclusions: An esthetic triangle is developed to address the foundations that are essential for maintaining/creating papilla. These include adequate bone volume, proper soft tissue thickness as well as esthetic appearing restorations.
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  • 39
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: The aim of this split-mouth, double-blind controlled clinical trial was to study the effects of irradiation with low-level lasers as an adjunctive treatment of inflamed gingival tissue.Materials and Methods: Seventeen patients with moderate periodontitis were included. After clinical examination, all teeth were scaled and root planed (SRP). One week after SRP, we took samples of gingival crevicular fluid (GCF) and subgingival plaque. The laser therapy was started 1 week later and continued once a week for 6 weeks. One side of the upper jaw was treated with active laser and the other with a placebo. The test side was treated with two low-level lasers having wavelengths of 635 and 830 nm. The patients then underwent another clinical examination with sampling of GCF and plaque. The GCF samples were analysed for elastase activity, interleukin-1β (IL-1β) and metalloproteinase-8 (MMP-8). We examined the subgingival plaque for 12 bacteria using DNA probes.Results: The clinical variables i.e. probing pocket depth, plaque and gingival indices were reduced more on the laser side than on the placebo one (p〈0.01). The decrease in GCF volume was also greater on the laser side, 0, 12 μl, than on the placebo side, 0.05 μl (p=0.01). The total amount of MMP-8 increased on the placebo side but was slightly lower on the laser side (p=0.052). Elastase activity, IL-1β concentration and the microbiological analyses showed no significant differences between the laser and placebo sides.Conclusion: Additional treatment with low-level lasers reduced periodontal gingival inflammation.
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  • 40
    Electronic Resource
    Electronic Resource
    Oxford, UK : Munksgaard International Publishers
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 41
    Electronic Resource
    Electronic Resource
    Oxford, UK : Munksgaard International Publishers
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: To study the association between tobacco smoking, in particular water pipe smoking, and periodontal bone height.Methods: A study sample of 355 individuals in the age range 17–60 years was recruited from Jeddah, Saudi Arabia. The smoking behavior was registered through a questionnaire during interview. Participants were stratified into water pipe smokers (33%), cigarette smokers (20%), mixed smokers (19%) and non-smokers (28%). The periodontal bone height was measured from digital panoramic radiographs mesially and distally to each tooth and expressed as a percentage of the root length.Results: The mean periodontal bone height was 76.2% for water pipe smokers, 75.8% for cigarette smokers, 80.2% for mixed smokers and 80.9% for non-smokers. The association between smoking and mean bone height was statistically significant controlling for age (p〈0.001). The association between life-time smoking exposure and mean bone height controlling for age was statistically significant in water pipe smokers and cigarette smokers (p〈0.01).The prevalence of bone loss in excess of 30% of the bone height was 27% in water pipe smokers, 24% in cigarette smokers, 9% in mixed smokers and 6% in non-smokers. The prevalence was significantly greater in water pipe smokers and cigarette smokers compared with non-smokers (p〈0.001). The relative risk of periodontal bone loss associated with water pipe and cigarette smoking after adjustment for age was 3.5-fold and 4.3-fold elevated, respectively, compared with non-smoking (p〈0.01).Conclusion: An association between tobacco smoking and periodontal bone height reduction is observed. The impact of water pipe smoking is of the same magnitude as that of cigarette smoking.
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  • 42
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: The aim of this study was to investigate the influence of cementum removal on periodontal repair.Material and Methods: Forty subjects with chronic periodontitis and presenting, at least, two proximal sites in anterior teeth (upper or lower) with probing depth 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE815:ges" location="ges.gif"/〉5 mm were selected. After oral hygiene instructions and ultrasonic supragingival instrumentation, the subjects were randomly assigned for one of the following groups: CIC, scaled with Gracey curettes; CIUS, scaled with ultrasonic device; CDC, calculus deattachment with Gracey curettes and brushing with saline solution; and CDUS, calculus deattachment with ultrasonic device and brushing with saline solution. Full-thickness flaps were reflected and the instrumentation was performed with a clinical microscope. Probing depth (PD), relative gingival margin level (RGML) and relative attachment level (RAL) were registered at five experimental periods: baseline and 30, 60, 90 and 120 days postoperative.Results: All the approaches were able to markedly reduce the PD values from the baseline to the other evaluation periods (p〈0.0001). The increase in RGML values was statistically significant only for the CDUS group. There were no statistically significant differences between the baseline and postoperative values in all groups for the RAL changes. The changes in RAL were statistically significant only among the groups CDC and CDUS (p〈0.0001).Conclusion: The conventional scaling and root planing and the calculus deattachment were effective in reducing the probing depth values, regardless of the instrumentation method.
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  • 43
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: The aim of this study was to evaluate the effects of phase I periodontal treatment on gingival crevicular fluid (GCF) levels of matrix metalloproteinase (MMP)-3 and tissue inhibitors of metalloproteinase (TIMP)-1.Methods: Plaque index, gingival index, pocket depth and clinical attachment loss were recorded and GCF samples were collected from 20 chronic periodontitis (CP) patients and 20 periodontally healthy controls (C) before treatment. CP patients received phase I periodontal treatment and all clinical parameters were recorded and GCF samples were collected once more after treatment. Assays were performed by an enzyme-linked immunosorbent assay.Results: All of the clinical parameters improved significantly after the therapy (p〈0.05). Baseline GCF levels of MMP-3 were significantly higher than C and that level was reduced significantly by treatment compared with baseline levels (p〈0.05). Baseline GCF levels of TIMP-1 were lower than post-treatment levels and C (p〈0.05). GCF levels of TIMP-1 increased significantly by treatment compared with baseline levels (p〈0.05).Conclusion: This study shows that the clinical improvements after phase I periodontal therapy are accompanied by reduction in MMP-3 and increasing in TIMP-1 GCF levels.
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  • 44
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: The purpose of the present study was to evaluate the clinical effects of aetiological periodontal treatment in a group of transplant patients medicated with cyclosporin A (CsA) who exhibited severe gingival overgrowth.Materials and Methods: Twenty-one patients received oral hygiene instructions, supra- and subgingival scaling and periodontal maintenance therapy and were monitored for 12 months. Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), periodontal probing depth and degree of gingival overgrowth (Seymour index GO) were recorded at baseline, 6 and 12 months after treatment.Results: Statistical evaluation revealed that all clinical variables significantly decreased compared with baseline. At baseline 18 out of 21 treated patients (85.71%) exhibited clinically significant overgrowth. Initial GO score of 2.38±1.92 in the anterior sextants and of 1.29±1.59 in the posterior segments were reduced to 0.56±0.83 and to 0.45±0.84 at 12 months (p〈0.001). A difference of 1.82 and 0.84 in the severity of treated GO was accompained by a 42% and 34% decrease in FMPS and FMBS, respectively.Conclusions: Aetiological periodontal treatment and regular maintenance therapy were effective in resolving the inflammation and in eliminating the need for surgical treatment in patients receiving CsA.
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  • 45
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: The present investigation was performed to study how type 1 diabetics responded to non-surgical periodontal treatment with and without adjunctive doxycycline.Method: Sixty diabetic type 1 patients (mean age 35.3±9 years) with moderate-to-severe periodontal disease were selected and divided into two groups of 30 patients each. Both groups were sex and age matched and had similar amounts of periodontal destruction. Plaque index (PI), bleeding on probing (BOP), probing depth (PD) and clinical attachment levels (CAL) were recorded. Group 1 (30 patients) was treated with oral hygiene instruction, scaling and root planing, chlorhexidine rinses twice a day and doxycycline (100 mg/day for 15 days). Group 2 (30 patients) had the same treatment but without doxycycline. After 12 weeks their periodontal condition was reevaluated.Results: After treatment, both groups had a significant improvement in all periodontal parameters, since PI, BOP, probing pocket depth (PPD) and CAL were significantly reduced. However, the reduction in PD in pockets 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE736:ges" location="ges.gif"/〉6 mm and in BOP were more evident when doxycycline was used (group 1). Differences between groups for these parameters were statistically significant (p=0.03).Conclusion: Although both periodontal treatment regimens are effective in type 1 diabetics, the use of doxycycline as an adjunct, provided more significant results when good plaque control was achieved.
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  • 46
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background/Aims: The use of specific antimicrobial agents in toothpastes may help reduce plaque and gingivitis. There would also appear to be some value in formulating products that contain combinations of such agents that may potentiate any activity present. The aims of this exploratory and pragmatic study were twofold:- (1) exploratory: to compare the effects on plaque re-growth of two zinc citrate/triclosan formulations, one of which contained bromochlorophene and hence demonstrate any additional beneficial effects produced by the addition of the phenol. (2) pragmatic: to assess whether both pastes were significantly better than a benchmark control, proprietary fluoride toothpaste at inhibiting plaque formation.Methods: Following an initial prophylaxis to remove all plaque and calculus, toothpaste slurry rinses were used over a 96 h period by 24 volunteers, while omitting all other oral hygiene procedures. After 24, 48 and 96 h, plaque was measured by plaque area and by plaque index. For comparative purposes, a conventional commercial fluoride toothpaste rinse was also used as a benchmark control in this triple cross-over double-blind study.Results: With one exception, comparisons between the three pastes failed to show any significant differences in plaque accumulation at 96 h whether assessed by plaque index or area. At this time period, significantly more plaque was seen with the zinc citrate paste without bromochlorophene, compared with that of the control paste.Conclusions: The findings from this study failed to demonstrate a plaque-inhibitory action from the two novel formulations beyond that of a conventional benchmark toothpaste, although overall levels of plaque formed by the volunteers, especially on the control paste were generally lower than in previous studies. Nevertheless, it remains to be determined whether the test formulations could exert a direct anti-inflammatory action against gingivitis by way of the triclosan delivery system. Neither test formulation was subsequently marketed.
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  • 47
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: To evaluate the clinical efficacy of (i) a single session of “full-mouth ultrasonic debridement” (Fm-UD) as an initial periodontal treatment approach and (ii) re-instrumentation of periodontal pockets not properly responding to initial subgingival instrumentation.Methods: Forty-one patients, having on the average 35 periodontal sites with probing pocket depth (PPD) 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE776:ges" location="ges.gif"/〉5 mm, were randomly assigned to two different treatment protocols following stratification for smoking : a single session of full-mouth subgingival instrumentation using a piezoceramic ultrasonic device (EMS PiezonMaster 400, A+PerioSlim tips) with water coolant (Fm-UD) or quadrant scaling/root planing (Q-SRP) with hand instruments . At 3 months, all sites with remaining PPD〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE776:ges" location="ges.gif"/〉5 mm were subjected to repeated debridement with either the ultrasonic device or hand instruments. Plaque, PPD, relative attachment level (RAL) and bleeding following pocket probing (BoP) were assessed at baseline, 3 and 6 months. Primary efficacy variables were percentage of “closed pockets” (PPD〈inlineGraphic alt="leqslant R: less-than-or-eq, slant" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE776:les" location="les.gif"/〉4 mm), and changes in BoP, PPD and RAL.Results: The percentage of “closed pockets” was 58% at 3 months for the Fm-UD approach and 66% for the Q-SRP approach (p〉0.05). Both treatment groups showed a mean reduction in PPD of 1.8 mm, while the mean RAL gain amounted to 1.3 mm for Fm-UD and 1.2 mm for Q-SRP (p〉0.05). The re-treatment at 3 months resulted in a further mean PPD reduction of 0.4 mm and RAL gain of 0.3 mm at 6 months, independent of the use of ultrasonic or hand instruments. The efficiency of the initial treatment phase (time used for instrumentation/number of pockets closed) was significantly higher for the Fm-UD than the Q-SRP approach: 3.3 versus 8.8 min. per closed pocket (p〈0.01). The efficiency of the re-treatment session at 3 months was 11.5 min. for ultrasonic and 12.6 min. for hand instrumentation (p〉0.05).Conclusion: The results demonstrated that a single session of Fm-UD is a justified initial treatment approach that offers tangible benefits for the chronic periodontitis patient.
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  • 48
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: Previous studies suggest differences between geographically and racially distinct populations in the prevalence of periodontopathic bacteria as well as greater periodontal destruction associated with infection by highly leucotoxic Actinobacillus actinomycetemcomitans. The present study examined these hypotheses in Brazilians with aggressive or chronic periodontitis.Materials and Methods: Clinical, radiographical, and microbiological assessments were performed on 25 aggressive periodontitis and 178 chronic periodontitis patients including 71 males and 132 females, 15–69 years of age.Results: The prevalence of Porphyromonas gingivalis was similar to that of other South American populations. The prevalence of A. actinomycetemcomitans and its highly leucotoxic subgroup was higher in Brazilians. Highly leucotoxic A. actinomycetemcomitans was more prevalent in aggressive periodontitis (χ2=27.83) and positively associated with deep pockets (〉6 mm, χ2=18.26) and young age (〈29 years, χ2=18.68). Greater mean attachment loss was found in subjects with highly leucotoxic A. actinomycetemcomitans than in subjects with minimally leucotoxic (p=0.0029) or subjects not infected (p=0.0001).Conclusion: These data support the hypothesis of differences between populations in the prevalence of periodontopathic bacteria and of greater attachment loss in sites infected with highly leucotoxic A. actinomycetemcomitans. Detection of highly leucotoxic A. actinomycetemcomitans in children and adolescents may be a useful marker for aggressive periodontitis.
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  • 49
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: To evaluate longitudinally the effect of smoking cessation on clinical and radiographic outcomes following non-surgical treatment in smokers with chronic periodontitis.Material and Methods: Forty-nine smokers with chronic periodontitis who wished to quit smoking were recruited. Full-mouth probing depths, bleeding and plaque data were recorded at baseline, 3, 6 and 12 months. Clinical attachment levels were recorded at target sites and subtraction radiography was used to assess bone density changes. Patients received non-surgical periodontal therapy during the first 3 months and supportive periodontal care over the remainder of the study. Smoking cessation counselling was provided according to individual need.Results: After 12 months, of patients with complete data, 10 had continuously quit smoking (20% of the original population), 10 continued smoking and six were oscillators (those patients who quit and then relapsed). There were no differences between the groups following treatment with respect to mean clinical or radiographic parameters. Analysis of probing depth reductions between baseline and month 12, however, and comparing quitters with the other two groups combined, demonstrated a significant difference in favour of quitters (p〈0.05). Furthermore, quitters were significantly more likely to demonstrate probing depth reductions 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE779:ges" location="ges.gif"/〉2 and 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE779:ges" location="ges.gif"/〉3 mm than non-quitters and oscillators (p〈0.05).Conclusion: Quitting smoking has an additional beneficial effect in reducing probing depths following non-surgical treatment over a 12-month period.
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  • 50
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Periodontal diseases may differ, which could be attributed to the factors that might modify the host response to microbial pathogens. The aim of this study was to examine gingival crevicular fluid (GCF) levels of EMAP-II, MIP-1α and MIP-1β in patients with different periodontal diseases (EMAP-II, endothelial-monocyte activating polypeptide; MIP-1α, macrophage inflammatory protein-1α; MIP-1β, macrophage inflammatory protein-1β).Methods: Eighty-two subjects were included in this study. GCF samples were collected from 26 patients with generalized aggressive periodontitis (G-AgP), 26 patients with chronic periodontitis (CP), 15 with gingivitis and 15 periodontally healthy subjects. Clinical periodontal parameters were recorded. GCF EMAP-II, MIP-1α and MIP-1β levels were quantified by enzyme immunoassay.Results: GCF EMAP-II levels of G-AgP group were higher than those of gingivitis and healthy groups (p〈0.008). G-AgP group showed a trend for higher GCF EMAP-II levels compared with CP group (p〉0.008). G-AgP, CP, gingivitis and healthy groups had comparable GCF MIP-1α and MIP-1β levels.Conclusions: Our results suggest that elevated GCF EMAP-II could contribute to the pathogenesis of G-AgP. Alternatively, EMAP-II reflects the extent of the inflammatory activity in the periodontal tissues. At this point, MIP-1α and MIP-1β levels in GCF do not seem to play a discriminatory role in periodontitis. Our data document for the first time the essential role of EMAP-II in the pathogenesis of different periodontal diseases.
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  • 51
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective: We have investigated whether a purified immunomodulatory water soluble β-1,3/1,6-glucan isolated from the cell wall of Bakers yeast, Saccharomyces cerevisiae, would influence the progression of ligature-induced periodontal disease, and to modulate accompanying cytokine and hypothalamic–pituitary–adrenal (HPA) axis responses to a lipopolysaccharide (LPS) challenge.Material and Methods: β-1,3/1,6-glucan (10 mg/kg/day) was given in the drinking water to Wistar rats during the entire experiment, starting 14 days before disease induction, while control rats were given tap water only. Periodontal disease was assessed when the ligatures had been in place for 35 days.Results: Orally administered soluble β-1,3/1,6-glucan significantly reduced periodontal bone loss as measured on digital X-rays (p=0,026). Glucan-treated rats also showed a significantly enhanced plasma level of the HPA axis-driven hormone corticosterone (p=0.047), and of the cytokine transforming growth factor-1β (p=0.032), as well as a tendency to enhanced IL-10 (p=0.106), induced by intra-peritoneally administered LPS.Conclusion: Soluble β-1,3/1,6-glucan administered by the oral route diminishes ligature-induced periodontal bone loss in this model. This effect may be attributable to the well documented ability of β-1,3/1,6-glucan to stimulate macrophage phagocytosis and to skew the T helper (Th)1/Th2 balance towards Th1 and T regulatory responses. The HPA axis may play a significant role in β-1,3/1,6-glucan induced immune modulation.
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  • 52
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: The anti-viral efficacy of oral antimicrobial rinses has not been adequately studied in terms of potential clinical significance. As a follow-up to an in vitro study on the effect of oral antiseptics on Herpes simplex virus, Type 1, this study was undertaken to evaluate the in vivo effect of an essential oil containing oral antiseptic on the reduction of viral titer in saliva during active viral infection.Method: Patients were recruited and evaluated in a single visit protocol at the onset of a perioral outbreak, consistent historically and clinically with recurrent Herpes labialis. Direct immunofluorescence of cytological smears of the lesions/oral fluids was used to confirm Herpes simplex virus types I or II. Patients were randomly assigned to one of two treatment groups: (1) active ingredient and (2) sterile water control. The viral lesion was evaluated as to clinical stage according to standard protocol. Salivary fluid samples were taken: (1) at baseline; (2) immediately following a 30 s rinse; (3) 30 min. after the 30 s rinse; and (4) on the repeat trial, also at 60 min. after the 30 s rinse. All samples were evaluated for viral titer and results compared.Results: In Trial 1, the sample population consisted of 19 males and 21 females with an average age of 29.2 and in Trial 2, 21 males, 19 females with an average age of 28. In both Trials 1 and 2, recoverable infectious virions were reduced to zero after a 30 s experimental rinse; whereas, the control rinse resulted in a non-significant (p〉0.05) reduction. The experimental group also demonstrated a continued significant (p〈0.05) reduction 30 min. post rinse when compared with baseline while the control group returned to baseline levels. In Trial 2, the 60 min. post rinse follow-up demonstrated a 1–2 log residual reduction from baseline in the experimental group; however, this was not significant.Conclusions: There is clinical efficacy in utilizing an oral rinse with the antimicrobial agent Listerine® Antiseptic in reducing the presence of viral contamination in oral fluids for at least 30 min. after oral rinse. The risk of viral cross contamination generated from these oral fluids in person to person contact or during dental treatment may be reduced.
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  • 53
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Interleukin-17 (IL-17) is exclusively produced by activated T cells, and this cytokine can induce inflammatory responses, support immune responses (Th1), and stimulate osteoclastic bone resorption in combination with receptor activator of NF-κB (RANK) and RANK ligand (RANKL). These biological functions are relevant to the aetiopathogenesis of periodontitis, and thus we sought to investigate whether IL-17 is produced in periodontal lesions and to assess the relationship of gene expression between IL-17 and other cytokines, and to determine the effect of IL-17 on IL-6 production in human gingival fibroblasts (HGF).Materials and Methods: IL-17 was detected and measured in periodontal tissues obtained as biopsy samples during periodontal surgery and in the cell-free culture supernatants cultured ex vivo, by using Western immunoblotting and enzyme-linked immunosorbent assay, respectively. IL-17 and other cytokine gene expression were investigated by the reverse transcription-polymerase chain reaction (RT-PCR) method. The contribution of IL-17 to IL-6 production by HGF was studied.Results: IL-17 protein was moderately detected in periodontal tissues. In contrast, IL-17 mRNA was expressed only in nine of 23 periodontitis tissue samples by RT-PCR. The IL-17 mRNA-positive samples simultaneously expressed mRNAs encoding interferon (IFN)-γ, IL-2, RANK, and RANKL, but not IL-4. IL-10 (Th2 cytokine) was detected more frequently in the samples than IFN-γ and IL-2 (Th1 cytokine). Recombinant human IL-17 induced IL-6 production from HGF in a dose- and time-dependent fashion.Conclusions: These results indicate that IL-17 is produced in periodontal lesions, which may be involved in Th1 modulation and enhance inflammatory reactions via gingival fibroblast-derived mediators in periodontal disease. Thus, IL-17, together with other cytokines, has a potential role in the aetiopathogenesis of periodontal disease.
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  • 54
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: Two studies were conducted to determine the antimicrobial effect of rinsing with an essential oil-containing mouth rinse 12 h after a single rinse and 12 h after 2 weeks of twice daily rinsing, during the daytime and overnight.Materials and Methods: These studies utilized a randomized, double-blind, controlled crossover design. Following baseline sampling of bacteria from supragingival plaque and the dorsum of the tongue, subjects began twice-daily rinsing with either an essential oil mouth rinse containing 0.09% zinc chloride (Tartar Control Listerine® Antiseptic) or a negative control rinse. Bacterial sampling was repeated 12 h after the first rinse, and again 12 h after the final rinse 14 days later. The sampling schedule was adjusted according to whether the study was investigating daytime or overnight activity. Samples were plated on Schaedlers medium (total anaerobes), Schaedlers Nalidixic/Vancomycin medium (Gram-negative anaerobes), and OOPS medium (volatile sulphur compound (VSC)-producing organisms). Inter-group log10 transformed colony-forming units /ml counts from samples of supragingival plaque and tongue swabs on each of the three media were compared by analysis of covariance.Results: The mean bacterial counts in subjects using the essential oil mouth rinse were significantly lower (p〈inlineGraphic alt="leqslant R: less-than-or-eq, slant" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE674:les" location="les.gif"/〉0.005) than mean counts in subjects using the control rinse in all the comparisons, i.e., tongue and supragingival plaque samples on each of three media at two sampling periods in the daytime and overnight study, respectively. Mean bacterial count percent reductions for plaque samples ranged from 56.3 to 95.3; percent reductions for tongue samples ranged from 61.1 to 96.1. There was a trend to higher reductions after 14 days' rinsing than after the initial rinse.Conclusion: Rinsing with the essential oil mouth rinse can have long-lasting effects in reducing anaerobic bacteria overall as well as Gram-negative anaerobes and VSC-producing bacteria. The significant reductions in numbers of these bacteria produced by the essential oil mouth rinse, both in plaque and on the dorsum of the tongue, can play a key role in explaining the essential oil mouth rinse's effectiveness in reducing supragingival plaque and gingivitis as well as its effectiveness in controlling intrinsic oral malodor over prolonged periods.
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  • 55
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: The objectives of the present study include investigation of the relationship between attitudes and desires with respect to oral health at initial office visit and compliance with supportive periodontal treatment (SPT) and identification of prognostic factors with respect to low-compliance with SPT.Materials and Methods: Four hundred thirty-one patients were evaluated. Subjects completed a questionnaire concerning attitude and desire with respect to oral health and subjective symptoms prior to periodontal treatment. Survival probabilities of SPT were estimated by the Kaplan–Meier method and compared between answers for each item of the questionnaire via the Cox–Mantel test. Finally, a multivariate Cox proportional hazards regression model was constructed, which included age and gender.Results: Greater than 95% of participants desired toothbrushing proficiency and lifelong retention of teeth at the initial office visit; however, the overall survival probabilities of SPT were only 52.7% after about 5 years. Patients exhibiting unfavourable attitudes toward oral health at the initial office visit, in comparison with those displaying favourable attitudes, exhibited greater tendency to abandon SPT. A Cox regression model revealed that lack of brushing on the gingival margin, non-use of an inter-dental brush or dental floss, non-use of fluoride toothpaste and frequent consumption of sugar-containing drinks were significant independent prognostic factors for low-compliance with SPT (p〈0.05; Hazard ratios=2.27, 2.00, 2.56 and 2.06, respectively).Conclusions: Desire for satisfactory oral health is not related consistently to continuation of SPT. Unfavourable attitudes toward oral health were correlated to low-compliance with SPT. Clinicians may wish to establish methods for improvement of patient compliance employing behavioural approaches applicable to the attitudes of potential low-compliance individuals.
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  • 56
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: To evaluate the efficacy of two power toothbrushes (Cybersonic and Braun 3D Excel) and one manual brush (Elmex super 29).Material and Methods: After professional toothcleaning 120 subjects were randomly assigned to three groups. Four weeks later, at baseline, the Quigley–Hein plaque index (QHI), the modified approximal plaque index (API), and the papillary bleeding index (PBI) were recorded. Thereafter the subjects used the assigned toothbrushes for 8 weeks. Improvements of the indices after 4 and 8 weeks were calculated as medians. Kruskal–Wallis- and Mann–Whitney U-test served for statistical analysis.Results: All indices showed statistically significant reductions for both power toothbrushes which were superior to the manual brush (4 weeks: Cybersonic: API, 0.21; PBI, 0.25; QHI, 0.23; Braun: API, 0.20; PBI, 0.39; QHI, 0.22; Elmex: API, 0.04; PBI, 0.02; QHI, 0.07; 8 weeks: Cybersonic: API, 0.28; PBI, 0.36; QHI, 0.41; Braun: API, 0.36; PBI, 0.61; QHI, 0.35; Elmex: API, 0.03; PBI, 0.10; QHI, 0.08; p〈0.001). The Braun was superior to the Cybersonic with respect to API after 8 weeks (p〈0.05) and PBI after 4 and 8 weeks (p〈0.01).Conclusion: Cybersonic and Braun 3D Excel may be more efficacious than a manual toothbrush in removing plaque and reducing gingivitis.
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  • 57
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract Objective: To evaluate the effect of a mouth-rinse formulation combining benzydamine hydrochloride and cetylpyridinium chloride (BNZ+CPC) in preventing de novo plaque formation, in comparison with CPC and placebo mouth rinses.Patients and Methods: This was a controlled, observer-blind, cross-over study. In this model of plaque re-growth, subjects received a session of oral prophylaxis and were directed to withdraw oral hygiene measures for the next 4 days, using only the mouth rinse assigned. The outcome parameters were the plaque index (PlI) and gingival index (GI). In addition, microbiological evaluation of the subgingival microflora, by means of culture, was performed, as well as patient-based variables. Data analysis was carried out using anova for Latin-square design.Results: The analysis of variance showed a significant statistical difference between the BNZ+CPC association and placebo (p〈0.0001). No differences between CPC and placebo were detected considering multiple comparisons between treatments. The 90% confidence interval of the differences between BNZ+CPC and CPC showed no equivalence between treatments, being the PlI lower in the BNZ+CPC group. No significant difference between groups in GI was observed. Mean anaerobic colony-forming units (CFU) demonstrated a significant increase between visits in all groups (p〈0.001) and differences among groups were not significant. Subjects treated with BNZ+CPC frequently reported “tingling mouth” and “numbness mouth”.Conclusion: Within the limitations of the study model, the BNZ+CPC combination showed a statistically significant plaque-inhibitory capacity, as compared with the placebo mouth rinse, and an additive effect as compared with CPC. No relevant clinical or microbiological adverse effects were detected.
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  • 58
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background and Aims: Interleukin-17 (IL-17) is a T-cell-derived cytokine that may play an important role in the initiation or maintenance of the pro-inflammatory response and has recently been found to stimulate osteoclastic resorption. The purpose of the present study was to determine the presence of IL-17 in gingival crevicular fluid (GCF) samples and in the culture supernatants of gingival cells from patients with chronic periodontitis.Method: GCF samples were collected during 30 s from two sites in 16 patients from periodontally affected sites (probing depth 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE684:ges" location="ges.gif"/〉5 mm, attachment loss 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE684:ges" location="ges.gif"/〉3 mm). The comparison with healthy controls was carried out by collecting GCF samples from eight healthy volunteers. GCF was collected using a paper strip and ELISA was performed to determine the total amount of IL-17. Supernatant cellular cultures of gingival cells were obtained from periodontal biopsies taken from 12 periodontitis patients and from eight healthy control subjects during the surgical removal of wisdom teeth. Spontaneous and phytohaemagglutinin (PHA)-stimulated levels of IL-17 were determined by ELISA.Results: The total amount of cytokine IL-17 was significantly higher in the periodontitis group than the control group (45.9 versus 35.6 pg, p=0.005). Significantly higher GCF volume and amount of total proteins were obtained from periodontitis patients as compared with control subjects (0.98 versus 0.36 μl, p=0.0005; 0.12 versus 0.05 μg, p=0.0005, respectively). A higher concentration of IL-17 was detected in culture supernatants from periodontitis patients compared with healthy subjects, either without stimulation (36.28±8.39 versus 28.81±1.50 μg/ml, p=0.011) or with PHA stimulation (52.12±14.56 versus 39.00±4.90 μg/ml, p=0.012). Treatment with PHA induced a significant increase in the production of IL-17 in healthy subjects and periodontitis patients (p=0.001 and 0.003).Conclusions: The total amount of cytokine IL-17 in GCF samples and in the culture supernatants of gingival cells are significantly increased in periodontal disease.
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  • 59
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Chlorhexidine (CHX) mouth rinse/spray can still be considered the gold standard in the chemical prevention of plaque formation and development of gingivitis. The product unfortunately has some side effects, such as extrinsic tooth staining, poor taste, taste disturbance, sensitivity changes in tongue, pain and irritation because of the alcohol content. These side effects led to the search of new formulations.Methods: In this double-blind, randomized, long-term, parallel study, 48 moderate periodontitis patients rinsed for 6 months (starting immediately after a “one-stage, full-mouth” disinfection) with one of the following products: CHX 0.2%+alcohol (Corsodyl®), CHX 0.05%+ cetyl pyridinium chloride (CPC) 0.05% and no alcohol (Perio-Aid Maintenance®, a new formulation), or the placebo of the latter. After 1, 3 and 6 months a series of clinical and microbiological parameters were recorded for the supra- and subgingival area as well as for saliva.Results: Although there was a significant treatment impact (mechanical debridement) in all groups, both CHX solutions further decreased both plaque and gingivitis indices (p〈0.001 and p〈0.05, respectively), when compared with placebo. This was also reflected by additional reductions in the number of CFU/ml of aerobic and especially anaerobic species and by a suppression of Streptococcus mutans (versus an overgrowth for the placebo), in all niches. Differences between both CHX solutions were never encountered. The subjective ratings were slightly in favour of the new CHX–CPC formulation when compared with the other CHX–alcohol formulation, especially for taste of the product (p〈0.05), but less impressive for the staining of teeth and tongue.Conclusions: The results of this study demonstrated the potential of a new CHX 0.05%+CPC 0.05% non-alcoholic formulation as an effective antiplaque agent for long-term use with reduced subjective side effects.
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  • 60
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: It is not clear if periodontal dressing influences the long-term results in a non-surgical treatment procedure.Material and Methods: The periodontal parameters (pre-baseline) of 36 patients with aggressive periodontitis were obtained before the patients were treated initially (1st step) by a dental hygienist, who completely removed the supra- and subgingival concrements. Baseline parameters were raised 3 weeks after the 1st step, before the 2nd therapy step was conducted. It consisted of a non-surgical procedure, which comprised a closed full-mouth manual root curettage (root planing), immediate systemic application of metronidazole, and the placement of a periodontal dressing (Vocopac®, Voco). The patients were randomized to two test groups having their periodontal packs removed after 3–4 days (group 1, n=12) and 7–8 days (group 2, n=12), respectively and a control group (n=12) without periodontal dressing. Clinical parameters were raised again after 6 and 24 months.Results: Six and 24 months later, changes in probing pocket depth (PPD) and probing attachment level (PAL) were observed in all three groups compared with baseline, but the difference was significant in group 2 only. In addition, group 2 showed a greater reduction in mean PPD and also a significantly greater gain of attachment in comparison with the controls.Conclusion: Wound dressing has a positive effect on clinical long-term results using a two-step non-surgical procedure. Moreover, removing the dressing after 7–8 days leads to clearly better results than removing it earlier.
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  • 61
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: Areca chewers have a higher prevalence of periodontal diseases than non-chewers. This study was to determine the possible effects of ripe areca nut extracts (rANE) on viability and gene expression of alkaline phosphatase (ALP), receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG) in human osteoblasts.Methods: The effects of rANE on cell viability of osteoblast-like MG63 cells were determined using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyltetrazolium bromide (MTT) that measures metabolic activity. Gene expression of ALP, RANKL and OPG was examined using reverse transcription-polymerase chain reaction. ALP activity and RANKL protein were further examined using substrate assay and confocal laser scanning microscopy, respectively.Results: Relative viability was reduced to approximately 50% when 25 μg/ml of rANE was used. The expression of OPG mRNA in MG63 cells was not altered by rANE. However, decreased levels of mRNA and enzyme activity of ALP were observed. Moreover, the expressions of mRNA and protein of RANKL were stimulated by rANE in a dose-dependent manner.Conclusions: The rANE affected morphology and viability of osteoblasts. We also present novel evidence demonstrating that areca nut may compromise the periodontal health of areca chewers by suppression of ALP gene expression and elevation of RANKL gene expression in osteoblasts.
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  • 62
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    Electronic Resource
    Oxford, UK : Munksgaard International Publishers
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: A number of reports exist on the side effects of materials used to restore teeth. Most of the cases involve local allergy reactions, but also skin lesions are described. Few cases are described where both local effects on the mucosa and skin lesions distant to the oral cavity are caused by amalgam.Result: The case presented indicates that the release of mercury from amalgam fillings is able to induce hypersensitivity reactions resulting in soft-tissue changes in the gingiva, buccal mucosa, tongue and on the skin of the back of the hands.
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  • 63
    Electronic Resource
    Electronic Resource
    Oxford, UK : Munksgaard International Publishers
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective: Clinical effects of periodontal treatment on biochemical and clinical markers of disease severity in rheumatoid arthritis (RA) patients with periodontal disease were evaluated.Methods: Forty-two patients were assigned to two groups, G1 (n=16) and G2 (n=26). G1 patients were submitted to oral hygiene instruction and professional tooth cleaning and G2 patients additionally had full-mouth scaling and root planing (SRP). Clinical periodontal measurements were obtained at baseline and 3 months after periodontal treatment. A Health Assessment Questionnaire (HAQ) was used to evaluate their performance on daily living. Rheumatoid factor (RF), erythrocyte sedimentation rate (ESR) and drug therapy were assessed.Results: Both groups presented a full-mouth improvement in all periodontal clinical parameters (p〈0.05), with the exception of clinical attachment level (CAL) and probing pocket depth (PPD) 〉6 mm for G1. G2 showed greater mean reductions on PPD 〉4 mm than G1 (p〈0.001). HAQ analyses showed a reduction on the degree of disability of G2, but not statistically significant. ESR was significantly reduced for G2 after SRP although RF did not show statistical reductions.Conclusion: The data suggest that periodontal treatment with SRP might have an effect on the ESR reduction.
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  • 64
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The present study assessed levels of plasminogen activator (PA) system proteins in gingival crevicular fluid (GCF) and serum of chronic gingivitis, chronic periodontitis patients and periodontally healthy subjects and evaluated how smoking influenced these levels.Methods: Twenty chronic gingivitis; 20 chronic periodontitis patients and 20 periodontally healthy volunteers were consecutively recruited according to the inclusion criteria so that exactly half of the subjects in each category were smokers. GCF samples from four sites together with serum samples were obtained from each subject. GCF levels of tissue type PA (t-PA), urokinase type PA (u-PA), PA inhibitor-1 (PAI-1) and PA inhibitor-2 (PAI-2) and serum concentrations of cotinine, u-PA and PAI-1 were analysed by enzyme-linked immunosorbent assay.Results: The only statistically significant difference between smokers and non-smokers was a lower GCF PAI-2 concentrations in healthy smokers compared with healthy non-smokers (p〈0.01). Gingivitis and periodontitis patients had higher GCF concentrations of PAI-2 than healthy subjects (p〈0.002 and p〈0.02 respectively). The ratio of u-PA:PAI-1 and t-PA:PAI-1 were significantly higher in GCF of smokers with periodontitis compared with “healthy” smokers, whereas the ratio of t-PA:PAI-2 was significantly lower in smokers with periodontal disease (p〈0.05).Conclusions: GCF levels of the PA system proteins are increased in chronic gingivitis and periodontitis compared with healthy gingiva. Smoking had only subtle effects on the GCF PA system proteins with the exception of PAI-2, and the balance of activators and inhibitors. These findings suggest one mechanism whereby smoking may exert detrimental effects on the periodontal tissues.
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  • 65
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: A recently introduced piezo-driven ultrasonic device (Vector®) generates longitudinal oscillations. As a result, the instrument tip moves parallel to the tooth surface. By avoiding vertical oscillations, maintenance treatment with the Vector® device should be less painful than treatment with conventional systems. We investigated whether patients perceive treatment with the Vector® device as less painful than with a conventional ultrasonic device, and whether the clinical efficacy of the Vector® device is comparable with that of the conventional ultrasonic device in maintenance patients.Material and methods: Thirty-eight maintenance patients with moderate to advanced periodontal disease took part in this prospective, randomized controlled clinical study. Each patients had to have at least two teeth with probing depths of 〉4 mm. They were treated either with Dentsply® (n=22) at a reduced power setting or with the Vector® device (n=16). The observation period was 6 months. Probing pocket depth, attachment level, and bleeding upon probing were assessed at six sites on each treated tooth by a blinded investigator Patient were asked to report perceived pain during instrumentation with a visual analog scale immediately after treatment, in the evening of the treatment day, and in the evenings 1 and 2 days after treatment.Results: Bleeding on probing, probing depth, and attachment level improved in both instrumentation groups from baseline to month 6; however, there was no difference between the two instrumentation modalities. The patients perceived treatment with neither instrument as unpleasant, and their perception of pain intensity both during instrumentation and on the following days did not differ.Conclusion: In maintenance therapy, clinical efficacy of the vector® device is comparable with that of conventional ultrasonic device. It makes no difference whether the ultrasonic device at a reduced power setting or the Vector® device is used, since patients perceive both instruments as causing very little pain.
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  • 66
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: The aim of this observer-blind, controlled, three-cell cross-over study was to evaluate the influence of an amine fluoride/stannous fluoride (Meridol®, 250 ppm; ASF) and a chlorhexidine mouthrinse (CHX; Chlorhexamed forte®, 0.2%) compared with water on in situ biofilm growth.Material and Methods: After a professional toothcleaning seven volunteers had to wear a special acrylic appliance, in which six specimens each were inserted to allow the build-up of intra-oral biofilms. The volunteers had to rinse twice daily for 1 min. with 10 ml of the allocated mouthrinse. After 48 h of wearing, the specimens with the adhering biofilms were removed from the splints and stained with two fluorescent dyes, which selectively stain vital bacteria green and dead bacteria red. Under the confocal laser scanning microscope biofilm thickness (BT) was evaluated. To examine bacterial vitality (BV%) the biofilms were scanned (1 μm sections) and digital images were made. An image analysis program was used to calculate the mean BV as well as the BV of the single sections. After a wash-out period of 14 days a new test cycle was started.Results: The use of CHX and ASF resulted in a BT of 8.4±4.4 μm and 15.7±9.9 compared with 76.7±29.4 μm using water. The mean vitality (in %) was reduced from 66.1±20.4 to 23.3±11.6 and 23.9±12.4 using CHX and ASF, respectively. Both active solutions reduced BT and BV significantly compared with water (p〈0.001). Differences between the two active solutions were not significant (p〉0.05).Conclusion: Both mouthrinses showed antibacterial and plaque-reducing properties against the in situ biofilm. The study design enables the examination of an undisturbed oral biofilm and for the first time shows the influence of antibacterial components applied under clinical conditions regarding biofilm formation.
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  • 67
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: This study was designed to evaluate two factors possibly influencing incidence of gingival abrasion during toothbrushing: (1) the abrasiveness of a dentifrice and (2) the possible influence of feedback of oral sensory perception.Material and Methods: For this purpose, two separate, single blind, randomized clinical experiments were performed. The two groups of subjects were requested not to brush their teeth 48 h, prior to the experiments. After staining with disclosing solution gingival abrasion sites were recorded as small (〈inlineGraphic alt="leqslant R: less-than-or-eq, slant" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE652:les" location="les.gif"/〉5 mm) and large (〉5 mm), both before and after brushing. The dentifrice experiment was a split-mouth design, including 36 subjects, brushing their teeth in two randomly selected contra-lateral quadrants, either with or without dentifrice, whereas the remaining two quadrants were brushed, using the alternative choice. The sensory perception feedback experiment was a full-mouth design, including 43 subjects and two separate brushing exercises with use of dentifrice. The first brushing-exercise was performed by a dental hygienist, excluding the feedback of oral sensory perception of the brusher. After a 4 weeks period of familiarization to the manual toothbrush, subjects brushed themselves in the same random order as the hygienist, using a fresh brush, thus including oral sensory perception.Results: In the dentifrice experiment, the increment of small abrasion sites was 5.86 for brushing with and 5.75 without dentifrice. There was no statistically significant difference between brushing with and without dentifrice. Both with and without dentifrice, more small abrasions were found vestibular, (3.78 and 4.22, respectively) as compared with lingual (2.22 and 1.42, respectively) (p=0.027, p〈0.001). In the sensory perception feedback experiment, the increment in small gingival abrasion sites was larger for the subjects brushing themselves (8.86) as compared with the professional brushing (2.94, p 〈0.0001). Subjects caused more abrasion on the vestibular surfaces (6.28) as compared with the lingual (0.60, p=0.0001), where the professional did not show this difference (vestibular: 1.88, lingual: 1.30, p=0. 1388).Conclusions: No statistically significant difference in the incidence of gingival abrasion was found between brushing with dentifrice or without dentifrice. Neither did oral sensory perception seem to affect the incidence of gingival abrasion.
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  • 68
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: Bone replacement substitutes are almost unavoidable in augmentation procedures such as sinus grafting. The objective of the present study was to evaluate the osteoconductive capability of two different scaffold fillers in inducing newly formed bone in this procedure.Material and Methods: Sinus floor augmentation and implant placement were carried out bilaterally in 12 patients. Bovine bone mineral (BBM) was grafted on one side and β-tricalcium phosphate (β-TCP) on the contralateral side. Both were mixed (1:1 ratio) with autogenous cortical bone chips harvested from the mandible by a scraper. Hard tissue specimen cores were retrieved from the augmented sites (at the previous window area) at 12 months. Decalcified sections were stained with haematoxylin–eosin and the fraction area of new bone and filler particles was measured. In addition to the effect of the filler on new bone formation, the latter was tested to determine whether it correlated with the tissue depth and residual amount of the grafted material.Results: Bone area fraction increased significantly from peripheral to deeper areas at both grafted sites in all cores: from 26.0% to 37.7% at the β-TCP sites and from 33.5% to 53.7% at the BBM-grafted sites. At each depth the amount of new bone in BBM sites was significantly greater than that in TCP sites. However, the average area fraction of grafted material particles was similar in both fillers and all depth levels (β-TCP=27.9–23.2% and BBM=29.2–22.6%, NS). A significant negative correlation was found between bone area fraction and particle area fraction at the middle (p=0.009) and deep (p=0.014) depths in the β-TCP sites, but not at the BBM sites.Conclusion: At 12 months post-augmentation, the two examined bone fillers, β-TCP and BBM, promoted new bone formation in sinus grafting but the amount of newly formed bone was significantly greater in BBM-grafted sites. However, both exhibited similar residual grafted material area fraction at this healing period. This could imply that BBM possesses better osteoconductive properties.
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  • 69
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective: Pre-term delivery of low-birth-weight infants [pre-term low birth weight (PLBW)] remains a significant public health issue and a major cause of neonatal death and long-term health problems. There is a growing consensus that infections remote from fetal–placental unit may influence PLBW infants. Recent studies have suggested that maternal periodontal disease may be an independent risk factor for PLBW. The purpose of the present study was to evaluate the possible link between periodontal infections and PLBW by means of clinical and microbiological data in post-partum women with low socioeconomic level.Methods: Clinical periodontal recordings comprising dental plaque, bleeding on probing, probing pocket depth and gingival recession were performed (six sites/tooth) in a total number of 181 women (53 cases and 128 controls) within 3 days post-partum. Subgingival plaque samples from mesio–or disto–buccal aspect of randomly selected one first molar and one incisor tooth have been obtained by paperpoints and were analysed by checkerboard DNA–DNA hybridization with respect to 12 bacterial species. In all analyses, the individual subject was the computational unit. Thus, mean values for all clinical parameters were calculated and bacterial scores from each individual sample were averaged. Statistical methods included Student's t-test, Fisher's exact test/χ2 test, and multiple logistic regression analysis.Results: The cases have gained significantly less weight during the pregnancy than did the controls (p〈0.05). There were no statistically significant differences between the cases and controls with regard to the dental and periodontal parameters and the values of clinical periodontal recordings were found to be very similar (p〉0.05). Mean and median scores (bacterial loads) of Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Actinobacillus actinomycetemcomitans, and Streptococcus intermedius in the subgingival plaque sampling sites were significantly higher in the controls than in the cases (p〈0.05). The occurrence rates of P. intermedia, Fusobacterium nucleatum, Peptostreptococcus micros, Campylobacter rectus, Eikenella corrodens, Selenomonas noxia and S. intermedius were higher in the cases compared with the controls, but the differences were not statistically significant (p〉0.05). According to the model created by the multiple logistic regression analysis, P. micros and C. rectus were found to significantly increase the risk of PLBW (p〈0.01 and p〈0.05 respectively), while P. nigrescens and A. actinomycetemcomitans decreased this risk (p〈0.01).Conclusion: The present findings indicated that when subgingival bacteria were evaluated together, P. micros and C. rectus may have a role in increasing the risk for PLBW, although no single bacteria exhibited any relation with the risk of PLBW. Further studies are required to better clarify the possible relationship between periodontal diseases and PLBW.
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  • 70
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: To investigate the effect of Bio-Oss® with and without the local application of recombinant human platelet-derived growth factor (rhPDGF-BB) on bone formation under Teflon capsules.Materials and Methods: Eight male, 6-month-old, Wistar strain rats were used in the study. In each animal, the lateral aspect of the mandibular ramus was exposed and small perforations were produced in the bone. A rigid, non-porous hemispherical teflon capsule (diameter 7 mm) was placed on the ramus in both sides of the animals. The capsule placed on the one side of the jaw was filled with Bio-Oss® granules soaked in a solution of PDGF-BB (20 μg/capsule) and autogenous blood prior to placement. The capsules placed on the other side of the jaw were filled with Bio-Oss® granules soaked in autogenous blood only (controls). Four rats were sacrificed after 3 months and the remaining four after 5 months. Undecalcified sections containing the capsule and surrounding tissues were prepared and analysed in the microscope.Results: Histologic analysis revealed limited amounts of bone formation. Most of the space underneath the capsules was occupied by Bio-Oss® particles surrounded by fibrovascular connective tissue. Given the small sample size statistical analysis was not possible, however, the mean amount of mineralized new bone in the control group (20.8%) appeared to be larger than that in the test group (6.7%). After 5 months the amount of newly formed bone appeared similar in the two groups (23.0% test, 26.0% controls). The Bio-Oss® particles occupied between 31.4% and 41.1% of the capsule area at 3 months and between 34.0% and 34.7% at 5 months. Only particles adjacent to the mandibular ramus were incorporated in newly formed bone.Conclusion: Limited bone formation was present in the capsules grafted with Bio-Oss® with or without the growth factor.
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  • 71
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