Gingival inflammatory reactions in children with rhinoconjunctivitis due to birch pollinosis

The present investigation was designed to study the degree of gingival inflammation in children with rhinoconjunctivitis due to birch pollinosis. Thirty-four children, 8-17 yr of age, participated. As controls, healthy classmates of the same age and sex were chosen. Dental examination was performed on three occasions: pollen season I (Spring 1987), off-season (Autumn 1987) and pollen season II (Spring 1988). The controls were examined on one occasion, mixed with the allergic children at the off-season examination. The degree of gingival inflammation was studied by determining the gingival bleeding tendency by standardized probing. Absence or presence of dental plaque was recorded after sulcular probing. In order to compensate for differences in oral hygiene level between the participants, the bleeding/plaque ratio according to Abbas et al. was calculated. The comparisons of the bleeding/plaque ratios revealed statistically significantly higher mean ratios in the allergic children during pollen seasons compared with off-season and with the controls. The results indicate that during the pollen season, children with allergic rhinoconjunctivitis exhibit an enhanced degree of gingival inflammatory reaction.     

Gingival inflammatory reaction in children at different ages

Earlier studies have demonstrated that, with similar levels of plaque accumulation, the tendency to develop gingivitis is lower in pre-school children than in young adults. No studies are available in which the gingival reaction in older children and adults to a given amount of plaque has been compared. The aim of the present study was to compare the gingival reaction to dental plaque in children of different ages and in adults. 3 groups of children (4-6, 7-9 and 14-16 years of age) and 1 group of adults (20-22 years of age) were studied. The degree of gingivitis was determined using the gingival index and the amount of dental plaque was assessed in terms of the plaque index. The results showed that with a given plaque score, the % of high gingivitis scores was less in the 4-6-year-old children than in the older children and adults. At all levels of plaque accumulation, the highest degree of gingival inflammation was noted in the 14-16-year-old children and in the adults. The results indicate that the gingival reactivity increases gradually from early childhood to adult age.     

A Comparison of the Gingival Health of Children with Down Syndrome to Healthy Children Residing in an Institution

The purpose of this study was to compare the onset and severity of gingivitis in children with Down syndrome, when compared to a healthy control group of children. The subjects included 41 children with Down syndrome ages two to 14 years (mean age: 7.6 years) and 112 age‐matched healthy controls. We assessed the gingival health of all subjects using the gingival inflammation (M‐PMA) index and periodontal probing depth (PD). Children were divided into three age categories: <5 years (AD, 5 to <10 years (AID, and 10 to <17 years (AIII). Supragingival plaque was measured using the Oral Hygiene Index (OHI) and the subjects were screened with the BANA test (Perioscan‐Oral‐B). Measurement of the M‐PMA index in the healthy children showed an age‐related increase (F = 10.369. p<0.001), and the M‐PMA index at the younger age group <5 year (AD was significantly lower than that for the other two age groups AII or AIII (p<0.005, p<0.001). In contrast, the M‐PMA index values at AI and AIII in the subjects with Down syndrome were significantly higher than those for healthy children (p<0.001, p<0.001). Both groups had an age‐related increase in PD (F=3.388, p<0.05 & F= 10.806, p<0.001). and PD at AIII was significantly higher than that at AI in both groups (p<0.01, p<0.001). The children with Down syndrome showed an age‐related increase in the BANA test score (F=3.452, p<0.05), and the BANA test score at AIII was significantly higher than that at AI (p<0.02). The BANA test score in the healthy children was not age‐related but was significantly higher than that in the children with Down syndrome (p<0.02, p<0.05).     

Experimental gingivitis in relation to susceptibility to periodontal disease

The aim of the present study was to investigate the rate of development of experimentally-induced gingival inflammation in relation to the susceptibility to periodontal disease. By selection according to age, a younger (25-39 years) and an older (45-54 years) age group, with a comparable reduced but healthy periodontium, was selected. This equal amount of periodontal breakdown may suggest that the younger age group represented individuals with a relatively higher degree of susceptibility to periodontal disease. At the start of the experiment, each patient was instructed to abstain from oral hygiene procedures in 1 quadrant of the mouth for a period of 18 days. Results showed that all subjects developed signs of gingival inflammation. Regarding the development of redness and swelling, no differences could be assessed between the 2 age groups. However, analysis of the bleeding scores revealed that bleeding on probing developed more rapidly in the younger age group. It was concluded that those patients who have suffered from a more rapid form of periodontal disease also develop inflammation, in terms of bleeding on probing, more rapidly.     

Effect of rinsing with povidone-iodine on bacteraemia due to scaling: a randomized-controlled trial

AIM: To investigate rinsing with povidone-iodine on bacteraemia caused by ultrasonic scaling. MATERIAL AND METHODS: Sixty patients with gingivitis undertook a randomized, placebo-controlled trial in which 30 rinsed with 0.9% saline and 30 with 7.5% povidone-iodine for 2 min. before ultrasonic scaling of FDI teeth 31-35. Blood samples before and after 30 s and 2 min. of scaling were cultured by lysocentrifugation. RESULTS: Oral bacteraemia occurred in 33.3% of the saline group and 10% of the povidone-iodine group. Regression analysis showed that rinsing with povidone-iodine was approximately 80% more effective than rinsing with saline in reducing the occurrence of bacteraemia, with a statistically significant odds ratio (OR) of 0.189 (95% confidence intervals, OR=0.043-0.827). There were 24 oral bacterial isolates in the saline group and 3 in the povidone-iodine group. Viridans streptococci comprised 11 of the isolates in the saline group and none in the povidone-iodine group. Bacteraemia magnitude was 0.1 colony-forming units/ml in the povidone-iodine subjects and 0.1-0.7 CFU/ml in the saline group. CONCLUSIONS: Rinsing with 7.5% povidone-iodine reduced the incidence and magnitude of bacteraemia and eliminated viridans streptococci from such bacteraemia. Povidone-iodine rinsing may be helpful for ultrasonic scaling of gingivitis patients at risk of infective endocarditis.     

牙周护理干预对儿童慢性龈炎的效果评价

目的：评价牙周护理干预对儿童慢性龈炎的预防效果。方法：采用随机分组法将100名学龄儿童慢性龈炎患者分为实验组和对照组。实验组给予牙周护理干预措施,包括口腔卫生指导和局部药物治疗;对照组不给予牙周护理干预措施。分别于干预后第1、6、12月通过探诊出血百分率来评价牙周护理干预效果。应用SPSS16．0软件对实验数据进行统计学分析。结果：在干预后第1、6、12月,实验组与对照组相比探诊出血百分率均有统计学差异（P〈0．05）。结论：牙周护理干预措施可以有效地控制探诊出血,从而达到防治儿童慢性龈炎的效果。     

The composition of gingival inflammatory cell infiltrates in children studied by enzyme histochemistry

Gingival biopsies were obtained from 23 children, aged 5-11 years (8.6 +/- 1.8 years). Specimens were taken from areas of the gingiva adjacent to the teeth which were to be extracted because of caries or its sequelae and which clinically had a gingival index score of at least 1. Staining for alpha-naphthyl acetate esterase with unspecific esterase at pH 5.8 (ANAE) permitted identification of T lymphocytes, monocytes/macrophages, plasma cells and non-reactive (ANAE-negative) cells. Cells which tentatively were identified as "natural killer" (NK) cells were also observed. Differential cell counting was performed for 10 specimens, selected on the basis of the presence of a well-defined inflammatory infiltrate, clear morphology throughout and good ANAE staining. Cell counts confirmed earlier studies showing that lymphocytes predominate in the inflammatory infiltrates in childrens' gingivitis. T lymphocytes dominated particularly in the periphery of the most densely infiltrated areas. Relatively few plasma cells were seen. It was concluded that T lymphocytes dominate in the inflammatory infiltrate in childrens' gingivitis.     

Gingival ulceration in HIV infection

Abstract. All cases of HIV-associated gingival ulceration seen at a dedicated dental clinic in a 5-ycar period were reviewed and compared against other patients attending the clinic. 94 (7.1%) of 1308 patients had 146 episodes of gingival ulceration. 89 patients had 140 episodes similar to acute necrotising ulcerative gingivitis (ANUG) and responded well to conventional treatment for ANUG. The cases were compared with 269 controls in logistic regression. Gingival ulceration was associated with oral candidiasis, lower age and lack of AIDS diagnosis possibly due to a protective effect of co-trimoxazole medication. 5 patients with neutropenia had extensive ulceration without the microflora of ANUG. Histopathology, viral and bacterial culture revealed non-specific changes. The ulcers did not respond to the treatment regimen for ANUG but responded to treatment of their neutropenia. Gingival ulceration is not common in HIV infection. Most cases resemble severe ANUG. It is more frequent in younger people, those with oral candidiasis and without AIDS. Co-trimoxazole may be protective. A minority of cases with ulceration and associated neutropenia resembled the non-specific oral ulceration associated with HIV.     

Gingival crevicular fluid inflammatory mediators and bacteriology of gingivitis in nonhuman primates related to susceptibility to periodontitis

The hypothesis to be tested was that the microbiota and resulting local host inflammatory response characteristics in oral conditions of high levels of chronic gingival inflammation increases susceptibility to progressing periodontitis. This study used cynomolgus monkeys, Macaca fascicularis (nonhuman primates), with high and low levels of long-standing gingival inflammation to define the profiles of gingival crevicular fluid mediators, cytokines and immunoglobulins; describe the subgingival microbiota; and evaluate their susceptibility to ligature-induced periodontitis. Sixteen nonhuman primates were stratified into two groups (HI, LO) based upon Bleeding Index as a measure of the natural level of inflammation (HI = 1.26 +/- 0.45; LO = 0.22 +/- 0.16). The host mediator levels, subgingival microbiota, and clinical characteristics of the LO and HI groups were compared after 30 days of oral hygiene, during a 30 day experimental gingivitis (7, 14, and 30 days), and during periodontitis (30, 60, and 90 days). The results demonstrated that nonhuman primates with high levels of long-standing gingival inflammation when compared to those nonhuman primates with low inflammation show: 1) different inflammatory mediator profiles in gingival crevicular fluid (particularly for immunoglobulin A (IgA) and IgG levels), 2) a different quantitative and qualitative subgingival microbiota; and 3) a similar progression of periodontitis. Thus, while variations in host inflammatory responses to local factors exist in the nonhuman primates, an extensive subgingival challenge (such as ligation) may negate these individual differences.     

Periodontal changes during chronic benign granulocytopenia in childhood A case report

Abstract This report describes two children with chronic benign granulocytopenia, suffering from gingivitis and marginal periodontitis in the deciduous dentition. The radicular areas of the attached gingiva were well delineated against the alveolar and papillary mucosa.     

Hibitane in periodontal disease

Abstract It is generally accepted that gingivitis and periodontal disease can be prevented by means of an effective daily plaque control- Also in the treatment of periodontitis plaque control seems to be essential. The plaque-inhibiting capacity of Hibitane is well documented, and the ability of the agent to prevent gingivitis for a relatively short time has been shown. Thus Hibitane is a valuable drug in dentistry in cases when conventional plaque control is difficult or impossible for a limited period of time. The longterm effect of the drug is less known in humans. However, a few studies in selected populations indicate that the effect is preserved after continuous use for several years. Established destructive periodontitis with pocket formation and subgingival plaque seems unaffected by chlorhexidine, but healthy gingival conditions may probably be maintained by two daily applications of the agent. The indications for long-term use of Hibitane in the mouth are still not satisfactorily clarified. Such use must be regarded and controlled as experiments. Although systemic side effects seem to be rare, some embarrassing local adverse effects have been frequently reported. The staining of teeth and fillings constitutes a serious obstacle to a more generalized use of the agent in dental practice. Several modes of application of Hibitane in the mouth have been suggested. However, the pharmacodynamic properties of chlorhexidine as a plaque-inhibitor are dependent on a series of complicated chemical reactions and may in several ways be jeopardized by components of a vehicle. Therefore, reliable clinical investigations proving the effect of commercial products containing Hibitane are indispensable before advocating their use.     

Gingival inflammation and subgingival calculus as determinants of disease progression in early-onset periodontitis

Abstract. This study was undertaken to test the hypothesis that gingival inflammation and dental calculus are important determinants of the development and progression of early-onset periodontitis. The study sample included 156 individuals who were 13–20 years old at baseline and who were examined 2× during 6 years to assess the attachment loss, gingival state and the presence of dental calculus. 33 (21%), 62 (40%), and 61 (39%) individuals were classified as having localized, generalized, or incidental EOP, respectively. The results showed an increase in the % of teeth with overt gingivitis and subgingival calculus, and also an increase in the % of teeth showing attachment loss during the 6-year period in ail classification groups. Of teeth with 0–2 mm attachment loss at the beginning of the study and which developed ≥3 mm attachment loss during the following 6 years, there were 2× as many teeth with overt gingival inflammation, and 4× more teeth with subgingival calculus at baseline than teeth without. Gingivitis and subgingival calculus when present at both examinations resulted in a stronger association with the development of new lesions than presence of these variables at baseline. Teeth with gingivitis at baseline had a significantly higher mean attachment loss during 6 years than teeth without gingivitis (p<0.0001), and teeth with subgingival calculus at baseline had a significantly higher mean attachment loss than teeth without subgingival calculus (p<0.0001), The presence of gingivitis and subgingival calculus at baseline and 6 years later was associated with the occurrence of even higher disease progression during this period. The association between gingival inflammation and subgingival calculus and the development and progression of attachment loss during the study period in the generalized and the localized EOP groups was significantly higher than the association in the incidental EOP group. In an appreciable % of the sites in all 3 groups, however, the presence of the 2 factors was not associated with attachment loss during 6 years. The results suggest a significant association between gingival inflammation and subgingival calculus and the development and progression of early-onset periodontitis.     

An uncommon presentation of an inflammatory gingival enlargement--responding to non-surgical periodontal therapy

To cite this article:
Int J Dent Hygiene 9 , 2011; 303–307 DOI: 10.1111/j.1601‐5037.2010.00497.x
Agrawal N, Agrawal K, Mhaske S. An uncommon presentation of an inflammatory gingival enlargement – responding to non‐surgical periodontal therapy. Abstract: Background: The various clinical manifestations of inflammatory gingival enlargement reported are more or less similar regardless of the underlying aetiological factors. Unusual presentation and unknown aetiology pose a diagnostic challenge for a periodontist. Methods: A 34‐year‐old Indian woman presented with the complaint of gum swelling that was sessile, lobulated, soft in consistency and bluish red in colour with ulcerated surface in some region, which was covered by the necrotic slough. This type of enlargement was unusual and some underlying systemic pathology was suspected. But a written consultation from her physician confirmed her systemic health, which was based on clinical, radiological and haematological investigations. Histopathological examination confirmed the diagnosis of inflammatory gingival enlargement. Patient was treated with oral hygiene instructions, scaling and root planning. Result: Within a month of conventional periodontal therapy, gum enlargement reduced markedly and patient was put on oral hygiene maintenance programme. Conclusion: Periodontal therapy is diagnosis‐driven and, to the extent possible, should address all the possible factors that impact development and progression of diseases that may affect periodontal tissue. In plaque‐induced periodontal diseases, non‐surgical periodontal therapy is still a gold standard among all the therapies available.     

Distribution of periodontal disease in a Swedish adult population 1973, 1983 and 1993

Abstract. The aim of this study was to compare changes in periodontal status in a Swedish poplation over a period of 20 years. Cross-sectional studies were carried out in Jönköping County in 1973, 1983, and 1993. Individuals were randomly selected from the following age groups: 20, 30, 40, 50, 60, and 70 years. A total of 600 individuals were examined in 1973, 597 in 1983, and 584 in 1993. The number of dentate individuals was 537 in 1973, 550 in 1983, and 552 in 1993. Based on clinical data and full mouth intra-oral radiographs, all individuals were classified into 5 groups according to the severity of the periodontal disease experience. Individuals were classified as having a healthy periodontium (group 1). gingivitis without signs of alveolar bone loss (group 2), moderate alveolar bone loss not exceeding 1/3 of the normal alveolar bone height (group 3), severe alveolar bone loss ranging between 1/3 and 2/3 of the normal alveolar bone height (group 4), or alveolar bone loss exceeding 2/3 of the normal bone height and angular bony defects and/or furcation defects (group 5). During these 20 years, the number of individuals in groups 1 and 2 increased from 49%. in 1973 to 60% in 1993. In addition, there was a decrease in the number of individuals in group 3, the group with moderate periodontal bone loss. Groups 4 and 5 comprised 13% of the population and showed no change in general between 1983 and 1993. The individuals comprising these groups in 1993, however, had more teeth than those who comprised these groups in 1983; on the average, the individuals in disease group 4 had 4 more teeth and those in disease group 5, 2 more teeth per subject. ID 1973, these 2 groups were considerably smaller, probably because of wider indications for tooth extractions and fewer possibilities for periodontal care which meant that many of these individuals had become edentulous and were not placed in a group. Individuals in groups 3, 4, and 5 were subdivided according to the number of surfaces (%) with gingivitis and periodontal pockets (≥4 mm). In 1993, 20%, 42%, and 67% of the individuals m groups 3, 4, and 5 respectively were classified as diseased and in need of periodontal therapy with >20% bleeding sites and >10% sites with periodontal pockets ≥4 mm. In conclusion, an increase in the number of individuals with no marginal bone loss and a decrease in the number of individuals with moderate alveolar bone loss can be seen. The prevalence of individuals in the severe periodontal disease groups (4, 5) was unchanged during the last 10 years; however, the number of teeth per subject increased.     

Frequency distribution of individuals aged 20–70 years according to severity of periodontal disease experience in 1973 and 1983

The aim of this study was to compare changes in periodontal status of a Swedish population over a 10-year period expressed as frequency distributions of individuals according to severity of periodontal disease experience. The study involved 600 randomly selected individuals evenly distributed into age groups 20, 30, 40, 50, 60 and 70 years, examined in 1973 and another randomly selected group of 597 individuals similarly age distributed and examined in 1983. Based on clinical data and full mouth intraoral radiographs all individuals were classified into 5 groups according to severity of periodontal disease experience. In 1983, 23% of the individuals were classified as having healthy periodontal tissues, group 1, compared to 8% in 1973. The changes were most pronounced in the age groups 20 and 30 years, among whom 58% and 35%, respectively, were registered as having healthy periodontium in 1983. The prevalence of individuals with gingivitis without signs of lowered periodontal bone level, group 2, was 22% in 1983 compared to 41% in 1973. In all, 49% of the dentate population in 1973 and 45% in 1983 showed no marginal alveolar bone loss. Moderate periodontal bone loss, group 3, was found in 41% of the population in 1983 compared to 47% in 1973. Among 30-, 40-, and 50-year-olds, there were more, and among 60- and 70-year-olds, fewer individuals in this group in 1983 compared to 1973. 96% of the dentate population were classified as belonging to groups 1, 2 or 3 in 1973 compared to 86% in 1983.(ABSTRACT TRUNCATED AT 250 WORDS)     

Oral health comparison between children with neutropenia and healthy controls

The purpose of this cross‐sectional study was to assess and compare the oral health of children with neutropenia, who are under the active care of a hematologist in a designated marrow failure and myelodysplasia program, to a healthy control group. Children aged 6–18 with neutropenia attending the Marrow Failure and Myelodysplasia Program at SickKids Hospital and controls attending the Children's Clinic, Faculty of Dentistry, University of Toronto were asked to participate in the study consisting of a patient questionnaire followed by a dental and radiographic examination. Fifteen patients with neutropenia (mean age 12.14 ± 4.04 years) and 26 healthy controls (mean age 11.61 ± 3.82 years) participated in this study. Patients with neutropenia reported significantly increased mouth sores (p < .008) and bleeding gums while brushing (p < .001). The dmft/t score was significantly lower for the neutropenia group (p < .009). The clinical examination also showed that there were no statistically significant differences with respect to ulcerations, gingival recession, tooth mobility, gingival inflammation, periodontal bone loss, DMFT/T scores, plaque, and calculus levels. Preliminary data demonstrates that pediatric patients who are under the active care of a hematologist do not present with an increased risk of oral diseases.     

Attachment loss in rural Chinese children over a 3-year period

OBJECTIVES: The periodontal condition of 84 children (9-14 years old, 38 males and 46 females) in a rural area of China was monitored over a 3-year period in order to determine the clinical parameters that act as risk factors for attachment loss. METHODS: Plaque and calculus accumulation (PSS and CI), modified gingival index (MGI), pocket depth (PD) and attachment level (AL) of two quadrants of each child were examined in 1993 and 1996. Following calculation of the mean of each of these parameters and statistical analysis of the change in each of the clinical parameters over the 3-year period, the relationship between attachment loss and clinical parameters was analyzed using multiple regression analysis. RESULTS: At the beginning of this study, the mean values for males and females were 3.66 and 3.58 for PSS, 1.22 and 1.17 for MGI, 1.07 and 0.90 for CI, 2.21 and 2.22 for PD, and both 0.02 for AL respectively. No significant difference between males and females was observed. After 3 years, all except mean PSS had increased significantly. Multiple regression analysis indicated that AL correlated only to age (P<0.01). In 1993, although the AL was > or =1 mm for at least one site in 21 children, none had an AL> or =3 mm. In 1996, the number of children with an AL> or =1 mm had increased to 63, and nine of these children exhibited 3 mm AL (one to six sites per child). No other significant differences were observed between the clinical data of these nine children and those of the other children. CONCLUSION: Although attachment loss tended to increase with age, no clinical parameters correlated with attachment loss in children.