Retrospective evaluation of the influence of the interleukin-1 genotype on radiographic bone levels in treated periodontal patients over 10 years.

BACKGROUND: A difference in genetic susceptibility to plaque accumulation has been advocated to explain different responses to periodontal therapy. The purpose of this study is to assess the role of the interleukin-1 (IL-1) polymorphism on the rate of bone and tooth loss in non-smoking periodontally treated patients during maintenance. METHODS: Sixty consecutive non-smoking patients (mean age 46.8 +/- 5.0) with moderate to severe periodontitis, treated and maintained for over 10 years were selected. At baseline (T0), radiographic evaluation (cemento-enamel junction [CEJ]-root apex, CEJ-bottom of defect mesial and distal, CEJ-bone crest mesial and distal, crown-root ratio) was performed. All patients received scaling and root planing; 36 patients then underwent surgical therapy. Subsequently, all patients were enrolled in a periodontal maintenance program with recall visits every 3.4 +/- 1.0 months for at least 10 years. At the latest recall visit (T2) the same radiographic measurements evaluated at baseline were taken and a DNA sample for IL-1 genetic susceptibility testing was collected and sent for analysis. RESULTS: Twenty-three of the 60 patients (38.3%) were IL-1 genotype positive. A total of 52 teeth (3.3%) out of 1,566 were lost due to periodontitis between T0 and T2; 28 of 957 (2.9%) in the IL-1 genotype negative group and 24 of 609 (3.9%) in IL-1 genotype positive group. The mean variation in bone defect level (DeltaBD) averaged -0.04 mm in IL-1 genotype negative patients and 0.01 mm in IL-1 genotype positive patients. The mean variation in bone crest level (DeltaBC) averaged -0.24 mm in IL-1 genotype negative patients and -0.28 mm in IL-1 genotype positive patients. However, a few patients showed significant differences in response to therapy based on initial bone levels and genotype. IL-1 negative patients who showed minimal initial bone loss responded to the therapy better than the IL-1 positive patients. IL-1 positive patients with severe initial bone loss showed a better response to the therapy than IL-1 negative patients. CONCLUSIONS: On average, there were no significant differences related to IL-1 genotype in tooth loss after 10 years in a non-smoking, well-maintained periodontal population. On an individual patient basis, the IL-1 genotype, in combination with the initial bone level, seems useful at the beginning of therapy for predicting bone level variation.

Tetracycline fiber used alone or with scaling and root planing in periodontal maintenance patients: clinical results.

This study evaluated the 6-month clinical response to sustained-release tetracycline fibers used alone or with scaling and root planing in 25 adult periodontal maintenance patients. All subjects had at least one pocket > or = 4.0 mm that bled on probing and required therapy. Thirty-six teeth were treated with tetracycline fibers for 7 to 12 days; twelve of the 36 teeth also received scaling and root planing. The selection of teeth for scaling and root planing was based on the condition of the teeth. Therapeutic results were evaluated by changes in probing depth and frequency of bleeding on probing. Use of tetracycline fibers and fibers with scaling produced 1.8- and 1.7-mm reductions in probing depth, respectively, 1 month after treatment; reductions declined to 1.3 and 0.8 mm at 3 months, but rebounded to 1.5 and 1.3 mm at 6 months. The percentage of teeth exhibiting bleeding on probing decreased from 100% at baseline to 68% and 50% in the fiber and fiber plus scaling groups, respectively, at 6 months. None of the differences was statistically significant. Tetracycline fibers clearly decreased clinical signs of periodontal inflammation. Addition of scaling and root planing at the time of fiber placement further decreased, although not significantly, the degree of inflammation.

[A longitudinal clinical study of the efficacy of tetracyclines combined with root planing in patients with periodontal disease]. / Studio clinico longitudinale sull'efficacia delle tetracicline associate alla levigatura radicolare in pazienti affetti da malattia parodontale.

A retrospective longitudinal study was performed to assess the effectiveness of tetracycline therapy associated with root planing compared with root planing alone in patients affected by medium to severe periodontal disease. From an analysis of results it appeared that the combined therapy was generally more successful, even though statistical significance was only achieved in cases of healing angular bone lesions. In conclusion, larger studies should be carried out to contribute to broaden the spectrum of indications for the use of antibiotic therapy in periodontal disease in adults.

[The IUD: experience on 1,000 cases]. / Il dispositivo intrauterino oggi: esperienza su 1000 casi.

PIP: The authors have followed 1000 patients (830 multiparae, 160 primiparae, 10 nulliparae) who were fitted with Copper T IUDs. They have selected the Copper T because it is well-tolerated, and causes fewer expulsions and bleeding than other types of IUDs. Prior to the insertion of the device, the patients were subjected to several tests, with a view to excluding any pregnancy in progress, any previous ectopic pregnancy, any anomaly or inflammation, or malignant lesion of the genital tract, etc. The IUDs were kept in place for 30 months and within the 1st months after insertion, there has been no associated oral contraceptive therapy. In the 1st month only spermicide substances were used. In general, the results have been satisfactory. There have been 8 spontaneous expulsions and 5 IUD removals. Pain and stiffness have also resulted. The number of pregnancies have been restricted to a Pearl index of 0.8 pregnancies/100 woman-years. No particular complications were observed. (author's)^ieng