Site-specific gingival bleeding on probing in a steady-state plaque environment: influence of polymorphisms in the interleukin-1 gene cluster.

BACKGROUND: We previously reported a high prevalence of a combination of alleles 2 at positions interleukin (IL)-1A(-889) and IL-1B(+3954) in an Arabic population with gingivitis. In a steady state, the proportion of sites with bleeding on probing (BOP) was consistently reduced. The aim of the present study is to expand this observation by considering the site level. METHODS: Fifty healthy non-smoking volunteers, 19 to 28 years of age, participated in this study. Clinical examinations included probing depth, BOP, plaque index (PI), and calculus. Examinations were repeated after 2 and 4 weeks, and subjects were advised not to change oral hygiene habits. Polymorphisms in the IL-1 gene cluster were assessed using a reverse hybridization assay. RESULTS: Twenty-six subjects (52%) carried alleles 2 at positions IL-1A(-889) and IL-1B(+3954) and were designated genotype positive. In multivariate multilevel models of BOP, bleeding tendency in subjects with positive IL-1 genotype was only reduced at sites with PI 0 (odds ratio of 0.98, 0.65, and 0.56 at baseline and 2 and 4 weeks, respectively; chi(2)((3)) = 11.946; P = 0.008) or 1 (chi(2)((3)) = 6.027; P = 0.110). A decreased bleeding tendency at certain tooth types in subjects who were IL-1 positive was largely related to the relative cleanliness of these areas. Random parts of the models revealed very low biserial correlations of 0.13 to 0.15 at the site level, whereas correlations were considerably higher (0.76 to 0.83) at the subject level. CONCLUSION: Multilevel modeling of site-specific data yielded new information about the influence of the IL-1 genotype in plaque-induced gingivitis.

Repeatability of ultrasonic determination of gingival thickness.

The aim of the present study was to assess the degree of disagreement of ultrasonic measurements of gingival thickness at different teeth. Gingival thickness was determined in 33 volunteers with plaque-induced gingivitis. Facial/buccal gingiva was measured at the level of the gingival sulcus depth. Measurements were repeated after 2 and 4 weeks. A repeated measures, two-level (occasion, subject), variance components model revealed a within-subject variance of 0.187 mm(2) resulting in a repeatability coefficient of 1.20 mm. When modeling level 1 (occasion) variance as a function of tooth type, respective error terms were used for calculating 95% repeatability coefficients for different teeth. Unreliable measurements were largely confined to upper and lower second and third molars. Error terms were lowest (0.03-0.05) at upper canines and first premolars as well as lower anterior teeth and premolars, where repeatability coefficients of 0.5 to 0.6 mm could be estimated. It was concluded that performance of the device was best at certain tooth types with rather thin gingiva. The present resolution and rather high degree of disagreement may preclude, however, detection of minute increases in thickness in the micrometer range, which seem to occur during gingivitis.

The radiographic outcomes of direct pulp-capping procedures performed by dental students: a retrospective study.

BACKGROUND: The decision between pulp capping and root canal therapy after pulp exposure is a clinical issue. The aim of the authors' study was to evaluate the outcome of direct pulp-capping procedures performed by dental students. METHODS: The authors followed the treatment outcomes of 193 patients with 204 pulp exposures with direct pulp capping. They determined the outcome of pulp capping radiographically using periapical radiographs taken at least three years after pulp exposure. The outcome was considered as successful if the tooth was present and not associated with periapical radiolucency or root canal treatment; otherwise, the outcome was considered as being a failure. RESULTS: Overall, the success rate of pulp capping was 59.3 percent. The success was associated more with mechanical exposure than with carious exposure (92.2 versus 33.3 percent) (P < .001), more with permanent restoration than with temporary restoration (80.8 versus 47.3 percent) (P < .001) and more with class I occlusal restoration (83.8 percent) than with proximal multiple surface restorations (Class II, 56.1 percent; Class III, 58.8 percent; mesial-occlusal-distal, 28.6 percent) (P = .009). Patients' age, sex, and tooth location and position had no significant effect on the outcome (P > .05). CONCLUSION: The success rate of direct pulp capping was 92.2 percent with mechanical exposure and 33.3 percent with carious exposure. CLINICAL IMPLICATIONS: Direct pulp capping is recommended after mechanical exposure with immediate placement of permanent restoration, while root canal therapy would be the choice of treatment if the exposure was due to caries.

Gutta-percha retreatment: effectiveness of nickel-titanium rotary instruments versus stainless steel hand files.

This study compared the cleanliness of the root canal walls after retreatment using nickel titanium (NiTi) rotary and stainless steel (SS) files. Also compared were time of retreatment and canal deviation. Forty extracted canines were step-back prepared and obturated with gutta-percha and sealer. Retreatment was performed either by using chloroform and SS hand files or chloroform and NiTi rotary files. Time for retreatment was recorded. Radiographs of the root canal system before and after retreatment were made. Teeth were split longitudinally, photographed, and projected onto a screen. The amount of gutta-percha/sealer remaining on the canal walls was then traced and measured. The amount remaining was analyzed and compared statistically between NiTi and SS groups by t test. Results showed that the mean percentage of wall coverage by remaining obturating material in the SS group was 13.6% and was 15.2% for the NiTi group. There was no statistically significant difference (p = 0.361). No severe canal deviation occurred with either retreatment method. Mean retreatment time for the SS group was 6.3 min and 7.9 min for the NiTi group; the difference was statistically significant (t test p < 0.001). In conclusion, NiTi rotary and SS hand were similar in material remaining after retreatment, but SS hand was a bit faster.