Red fluorescence of Interdental plaque for screening of gingival health.

BACKGROUND: Pathogenic dental plaque with deteriorated bacterial homeostasis around the gingival margin induces gingivitis. This study evaluated the applicability of red fluorescence (RF) properties of interdental plaque in screening for gingival health status. METHODS: This cross-sectional study examined 178 teeth of 40 healthy subjects who had not lost both their first and second molars in at least one quadrant. Three groups (healthy, gingivitis, and periodontitis) were identified based on the periodontal health status (bleeding on probing, probing depth, clinical attachment loss) and plaque accumulation level (plaque index) in the interdental site between the first and second molars was evaluated. This interdental plaque between the first (distal surface) and the second molar (mesial surface) was collected using dental floss. A quantitative light-induced fluorescence (QLF) technology was used to assess RF emitted from the interdental plaque. The RF properties of the interdental plaque were quantified by fluorescence intensity (R/G value) and area (%). The RF variables were compared between the groups. RESULTS: The RF variables of the interdental plaque (R/G value and area) were significantly higher in the gingivitis and periodontitis group compared to the healthy group (p<0.0001, p=0.001), but there was no significant difference between the gingivitis and periodontitis groups. Significant correlations were identified between R/G value and bleeding on probing (r = 0.49, P < 0.01) and between R/G value and visual plaque index (r = 0.59, P < 0.01) for each tooth. CONCLUSION: Interdental plaque obtained by flossing and its red fluorescence quantified by QLF technology could be used as a potential indicator of gingivitis.

A relação entre ciclo menstrual e gengivite / The relationship between the menstrual cycle and gingivitis

A gengivite é uma doença inflamatória que interfere nos tecidos de suporte dos dentes. Inicia-se pelo acúmulo da placa bacteriana sobre as faces dentárias e a margem gengival, promovendo a liberação de produtos tóxicos que são efeitos da combinação da bactéria e do hospedeiro. Há indícios de que os hormônios sexuais, principalmente os esteroidais, que estão presentes no ciclo menstrual, apresentem efeitos sobre a saúde periodontal, causando impactos diretos na inflamação gengival e em possíveis alterações de substâncias no fluido gengival. Para tanto, realizou-se uma pesquisa de campo com o intuito de validar a relação entre o ciclo menstrual e a gengivite e seus possíveis diagnósticos frente aos hormônios sexuais que se apresentam de forma tão relevante. OBJETIVO: O objetivo do presente trabalho é verificar através de uma pesquisa de campo, se durante o ciclo menstrual, as alterações hormonais causadas neste período têm capacidade de gerar alterações nos tecidos gengivais. METODOLOGIA: Trata-se de uma pesquisa de campo, realizada por meio de artigos indexados na base científica SciELO e avaliação clínica e sondagem da gengiva de 20 voluntárias durante o período pré-mentrual, menstrual e período pós-mentrual de cada uma.(AU)

Gingivitis is an inflammatory disease that affects the supporting tissues of the teeth. It begins by the accumulation of bacterial plaque on the dental faces and the gingival margin, promoting the release of toxic products that are effects of the combination of bacteria and the host. There are indications that the sex hormones, especially the steroidal ones, that are present in the menstrual cycle, have effects on the periodontal health, causing direct impacts on gingival inflammation and possible alterations of substances in the gingival fluid. Therefore, a field research was carried out with the purpose of validating the relationship between the menstrual cycle and gingivitis and its possible diagnoses against the sex hormones that present themselves in such a relevant way. OBJECTIVE: The objective of the present study is to verify through a field survey whether, during the menstrual cycle, the hormonal changes caused in this period have the capacity to generate alterations in the gingival tissues. METHODOLOGY: This is a field study, carried out by means of articles indexed in SciELO scientific basis and clinical evaluation and gingival probing of 20 volunteers during the pre-mentual period, menstrual period and post-mentual period of each.(AU)

Periodontal disease in relation to smoking and the use of Swedish snus: epidemiological studies covering 20 years (1983-2003).

AIM: The aim of the present study was to examine how deleterious current smoking and the use of Swedish moist snuff (snus) is for periodontal health compared with non-tobacco users. MATERIALS AND METHODS: The studies comprised three epidemiological cross-sectional studies, in 1983, 1993 and 2003, of stratified random samples aged 20, 30, 40, 50, 60 and 70 years. The numbers of dentate participants were 550, 552 and 523, respectively. The participants were examined clinically and radiographically. Diagnostic criteria were the number of teeth, plaque, gingival status, probing pocket depth (PPD) ≥ 4 mm, height of the alveolar bone level and classification by periodontal disease experience. In addition, participants were asked about their tobacco habits. RESULTS: Multiple logistic regression shows, after adjusting for age, gender and sociodemographic variables, that relative to non-tobacco users, cigarette smokers had statistically significant less gingivitis, a higher frequency of PPD ≥ 4 mm and a higher incidence of severe periodontitis. There was no significant association between gingivitis, frequency of PPD ≥ 4 mm and periodontal disease experience and snus use. CONCLUSIONS: Cigarette smokers were found to have a statistically significant higher risk of severe periodontitis than non-tobacco users and users of snus. Using snus did not seem to be a risk factor for periodontitis.

Variance components of gingival thickness.

OBJECTIVES: Distinct periodontal phenotypes have been identified by cluster analysis, which is an explorative method with very low external validity. The aim of the present study was to investigate variance components of facial gingival thickness in young adults with mild gingivitis. MATERIAL AND METHODS: Thirty-three non-smoking females, 18-23 years of age, with mild or moderate plaque-induced gingivitis participated. Gingival thickness was measured at every tooth present by use of ultrasound technology to the next 0.1 mm with a lowest measurement of 0.5 mm. Periodontal probing depth and clinical attachment level were measured with a pressure-controlled probe. Gingival bleeding index was assessed after probing on a 0-2 scale, where 1 was slight, and 2 was profuse bleeding on probing. The Silness-Loe plaque index was recorded. Multilevel variance components and random intercept models were built. RESULTS: A 2-level (subject, tooth) variance component model of gingival thickness without any explanatory variable revealed an intercept (mean) of 0.93 +/- 0.02 mm. Subject variation of gingival thickness amounted to 4.2% of the total variance. Addition of tooth- and subject-related covariates to the model revealed, after adjusting for tooth type, an association with periodontal probing depth (estimated coefficient 0.067 +/- 0.025), and considerable association with average bleeding index (-0.395 +/- 0.149) and plaque index (0.125 +/- 0.048). Variation at the tooth level was drastically reduced; subject variation amounted to 5.2%. CONCLUSION: Gingival thickness is mainly associated with tooth-related variables. Bleeding tendency is higher if gingiva is thin. Subject variability related to periodontal phenotype may add to the total variance, however, to a very low extent.

Probing around implants and teeth with healthy or inflamed peri-implant mucosa/gingiva. A histologic comparison in cynomolgus monkeys (Macaca fascicularis).

The purpose of this study was to obtain a better understanding of probing measurements around osseointegrated oral implants. A comparison was made of probe tip position around Astra Tech implants and teeth of eight cynomolgus monkeys (Macaca fascicularis) in conditions of i) healthy peri-implant mucosa/gingiva, ii) mild mucositis/gingivitis, iii) severe mucositis/gingivitis or iv) peri-implantitis/periodontitis. Histological sections of 128 probes that were attached to implants or teeth with surrounding tissues were prepared by the cutting-grinding technique. No systematic differences were identified in the clinical and histological estimates of the distance between the mucosal/gingival margin and the probe tip. The differences were mainly smaller than 0.5 mm, and in no case were they larger than 0.7 mm. For implants and teeth with healthy peri-implant mucosa/gingiva, the distance between the probe tip and the alveolar bone was similar and ranged from 0.5 to 1.5 mm (P = 0.97). However, the probe tip was closer to bone around implants than around teeth in conditions of mild mucositis/gingivitis (P = 0.034), severe mucositis/gingivitis (P < or = 0.0001) and peri-implantitis/periodontitis (P < or = 0.0001). Around implants with severe mucositis and peri-implantitis, the distance was generally smaller than 0.5 mm, whereas teeth with severe gingivitis and periodontitis showed distances that mainly ranged from 0.5 to 1.5 mm. In conclusion, the probing measurements around osseointegrated oral implants and teeth were different. Even mild marginal inflammation was associated with deeper probe penetration around implants in comparison to teeth.

Morphologic operations used to distinguish between two patient populations differing in periodontal health.

OBJECTIVES: This study was conducted to determine whether morphologic operation procedures applied to digitized, non-standardized, clinical radiographs of mandibular alveolar bone could be used to distinguish between a population of patients diagnosed with periodontitis and a population of patients either diagnosed with gingivitis or having healthy gingivae. STUDY DESIGN: Two groups, one consisting of 29 patients who either had healthy gingivae or had been diagnosed with gingivitis and the other consisting of 32 patients who had been diagnosed with periodontitis, were compared. Pre-existing clinical radiographs were digitized, and for each patient three to six regions of interest were placed on an image of the mandibular posterior region of the interdental bone. The regions of interest were processed under two morphologic-operations protocols, and a mean density (referred to as an MO number) was calculated for each patient. With paired t-tests, the resulting MO numbers for the two groups were compared. RESULTS: The two populations were statistically different (p < 0.05). CONCLUSION: The results of this study indicate that morphologic operations have the potential to differentiate between patient groups differing in periodontal health.

Dental treatment of Papillon-Lefèvre syndrome: 15-year follow-up.

A 9-year-old girl was initially treated for the periodontal component of Papillon-Lefèvre syndrome by extraction of all patient's erupted teeth, after unsuccessful clinical treatment with two different antibiotics. Follow-up dental records at age 24 showed the patient to have generalized gingivitis and poor oral hygiene; however, no additional teeth were lost or mobile. Radiographically, the alveolar crests, lamina dura, and periodontal ligament spaces appeared normal for a subject with missing teeth. Initially, the patient had depressed polymorphonuclear leukocyte (PMN) chemotaxis and adherence, as well as evidence of periodontal infection with Actinobacillus actinomycetemcomitans, (A.a.). The 6 and 15-year follow-ups showed normal PMN function and no detectable A.a. The improvement of the patient's PMN function was coincident with lack of detection of certain periodontopathic bacteria. If the PMN dysfunction of PLS is secondary to the infection, the reasons for the initiation of the disease still need to be clarified.

[Clearance rate of gingiva and content of collagen of inflammated and clinically non-inflammated papilla interdentalis]. / Clearancerate der Gingiva und Kollagengehalt der entzündeten und klinisch entzündungsfreien Papilla interdentalis.

UNLABELLED: The gingiva vessel function has been defined by gingivitis (A), clinical sound gingiva without (B) and with loss in attachment (C) as well as the collagen fraction by biopsy material. The division of the probands at the age between 20 and 24 years into groups has been carried out after checking the SBI, PII (Silness/Loe) and the loss of attachment of the teeth 43-33. The vessel function has been found out through the impulse rate of the gingiva Xenon-133-clearance by calculating the clearance rates (CR) (groups: A1 n = 15; B1 n = 18; C1 n = 16). The vestibular interdental papillae have been elaborated in a second study for finding out the collagen fractions with the Stegemann method modified by Woessner (groups: A2 n = 18; B2 n = 10; C2 n = 12). The statistical reliability has been checked by the t-test (F-test) and the u-test by Mann and Whitney. RESULTS: In the clearance study the CR in group A1 are higher and in group C1 lower than in group B1. In the second study the increased collagen solubility in group A2 by inflammation is confirmed, in group C2 a significant higher share in unsoluble collagen and total collagen has been defined than in group B2.

Use of technetium-99m as a radioactive label to study migratory patterns of leukocytes.

Technetium-99m had been used as a radioactive label to study the migratory patterns of neutrophils. In a previous in vitro study, neutrophils were labeled with Tc-99m and infused into patients with and without various hematological disorders. Increased pulmonary localization was detected by scintillation camera within 10 min; this decreased gradually within 3 hr. Accumulation was seen in the liver and spleen at 3 hr. The same results were noted by using neutrophils labeled with Tc-99m sulfur colloid. In a patient with severe ulceration in the oral cavity, due to acute leukemia, Tc-99m-labeled transfused neutrophils that were collected by filtration leukopheresis were concentrated in the infected lesions.