Influence of interleukin-1 gene polymorphism on periodontal regeneration in intrabony defects

The aim of this controlled retrospective study was to evaluate the influence of an IL-1 gene polymorphism on the clinical and radiographic healing outcomes of GTR therapy. The study included 47 adult periodontitis patients with 94 deep intrabony defects treated by GTR using different membrane materials. The following clinical parameters were recorded at baseline and 12 months after surgery: papillary bleeding index (PBI), gingival recession (REC), probing pocket depth (PPD), clinical attachment level (CAL), and the vertical relative attachment gain (V-rAG). Bone changes in the defect regions due to GTR therapy were quantitatively evaluated using digital subtraction radiography (DSR). Polymorphisms of the IL-1A gene at position - 889 and of the IL-1B gene at position + 3953 were analyzed by PCR. Statistical analysis was performed using the Mann-Whitney-U and the Wilcoxon-Signed-Rank tests (alpha = 0.05). The study comprised 19 IL-1 genotype positive (IL-1 +) patients and 28 IL-1 genotype negative (IL-1 -) patients. Twelve months after GTR therapy, both patient groups revealed statistically significant PPD reductions and CAL gain [median (25/75% percentiles)]: Delta PPD [IL-1 + : 4.0 (2.5/5.0) mm; IL-1-: 3.8 (3.0/4.9) mm], Delta CAL [IL-1 + : 3.5 (3.0/4.8) mm; IL-1 -: 3.0 (1, 2/4, 5) mm]. V-rAG amounted to 60.0 (47.7/78.6)% in IL-1 + patients and 53.1 (43.4/81.9)% in IL-1 - patients. Both patient groups showed significant bone density gain in 40% (IL-1 +) and 43.6% (IL-1 -) of the initial defect area due to GTR. Neither the clinical nor the radiographic healing parameters revealed any statistically significant differences in the GTR healing outcome between IL-1 + and IL-1 - patients. In conclusion, these 12-month findings indicate that the IL-1 gene polymorphism has no influence on the clinical and radiographic regeneration results following GTR therapy.     

Candidal carriage and plaque distribution before, during and after removable orthodontic appliance therapy

Candidal counts at 6 mucosal sites in 33 subjects were estimated by imprint culture before, during and after removable orthodontic appliance therapy. Additionally, dental plaque scores and salivary pH were measured at each stage. Whole mouth and site prevalence of candida rose significantly during therapy before falling to levels approximating initial values. A similar pattern was seen for candidal counts for the whole mouth and at individual mucosal sites, although post-treatment densities were usually lower than originally seen. The number of sites colonised by candida and salivary pH also increased significantly during treatment and fell significantly afterwards. Only the upper palatal plaque scores rose during therapy and most other dental sites showed a gradual decrease in value during the course of the study. This could be attributed to regular monitoring of the patient's oral hygiene procedures. This investigation demonstrated a direct relationship between the presence of an acrylic appliance, candida and low salivary pH levels. Furthermore, removable appliance therapy had a positive, though transient influence upon the prevalence and density of oral candidal carriage, suggesting that the appliance may initiate the carrier state.     

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目的评价吸烟与非吸烟药物性牙龈增生患者单纯牙周非手术治疗1个月后的临床疗效。方法2007年3月至2007年12月收集河北省人民医院口腔科钙拮抗剂类药物导致的牙龈增生男性患者20例,其中吸烟组9例,非吸烟组11例,两组患者基线时的临床参数具有可比性。观察的牙龈增生牙齿,探诊深度5~7mm,吸烟组78个位点,非吸烟组80个位点。在未停药的情况下进行牙周非手术治疗,观察这些位点在治疗前、后1个月菌斑指数(PLI)、探诊深度(PD)、附着丧失(AL)、牙龈增生指数(HI)和出血指数(BI)的变化。结果治疗前两组PLI、BI、PD、AL以及HI差异无统计学意义,牙周非手术治疗1个月后,两组临床指标均有明显改善,吸烟组改善程度明显低于非吸烟组,但只有PD、PLI和HI的变化有统计学意义(P<0.05),AL和BI变化无统计学意义(P>0.05)。结论药物性牙龈增生患者,牙周非手术治疗效果吸烟者差于非吸烟者。     

低强度激光治疗颞下颌关节紊乱病的疗效评价

目的 评估低强度激光(LLLT)疗颞下颌关节痛的效果.方法 将颞下颌关节痛的患者按随机、双盲原则分为激光组(n=21)和对照组(n=21),每位患者均接受连续6d、每天1次的激光或假激光治疗.在治疗前、治疗后、治疗后1月、治疗后2月14个时点对患者的疼痛程度、功能状态进行测量和评估.结果 2组中疼痛视觉模拟评分(VAS...     

Subgingival plaque removal in buccal and lingual sites using a novel low abrasive air-polishing powder

AIM OF THE STUDY: This study was aimed at assessing the efficacy of subgingival plaque removal in buccal and lingual sites during supportive periodontal therapy (SPT) using a novel low abrasive air-polishing powder. MATERIAL AND METHODS: In 27 SPT patients, subgingival debridement was performed using the novel air-polishing powder (test) and hand instruments (positive control) in a randomized split mouth design. Before and immediately after treatment, subgingival plaque samples were taken from two teeth with pockets of 3-5 mm depth in both groups. To assess the influence of plaque sampling on the microflora, samples were also taken twice from two untreated teeth (negative control). The mean reduction in total colony forming units (CFU) was assessed by anaerobic culture. The patients' perception of treatment was assessed by a visual analog score (VAS). Therapy and plaque sampling were repeated after a 3-month interval. RESULTS: Test treatment resulted in a significantly greater reduction in mean CFU than positive control treatment (log 1.7+/-0.98 and log 0.61+/-0.79 respectively; p<0.05). Following both treatments, the CFU reduction was significantly greater compared to negative control treatment (log 0.06+/-0.49; p<0.05). In addition, test treatment was perceived as significantly more pleasant than hand instrumentation (p<0.05). CONCLUSION: The novel low abrasive air-polishing powder is superior to curettes in removing subgingival plaque from pockets of 3-5 mm depth in supportive periodontal therapy and offers greater patient comfort.     

Influence of residual bacteria on periapical tissue healing after chemomechanical treatment and root filling of experimentally infected monkey teeth

The purpose of this study was twofold: first, to determine the influence on the healing of the periapical tissues when selected bacterial strains and combinations thereof remain after root canal treatment; and, second, the relationship to healing of the quality of the root filling. In eight monkeys, 175 root canals, previously infected with combinations of four or five bacterial strains and with radiographically verified apical periodontitis, were endodontically treated, bacteriologically controlled, and permanently obturated. After 2-2.5 yr, the periapical regions were radiographically and histologically examined. Of these teeth, 48 root canals were also examined for bacteria remaining after removal of the root fillings. When bacteria remained after the endodontic treatment, 79% of the root canals showed non-healed periapical lesions, compared with 28% where no bacteria were found. Combinations of residual bacterial species were more frequently related to non-healed lesions than were single strains. When no bacteria remained, healing occurred independently of the quality of the root filling. In contrast, when bacteria remained, there was a greater correlation with non-healing in poor-quality root fillings than in technically well-performed fillings. In root canals where bacteria were found after removal of the root filling, 97% had not healed, compared with 18% for those root canals with no bacteria detected. The present study demonstrates the importance of obtaining a bacteria-free root canal system before permanent root filling in order to achieve optimal healing conditions for the periapical tissues.     

Endodontic therapy on a dentition exhibiting multiple periapical radiolucencies associated with dentinal dysplasia Type 1

Dentinal dysplasia (DD) Type I, is a hereditary disturbance in dentine formation. In this anomaly, teeth in both primary and secondary dentitions are affected, and radiographically show short and blunted roots with obliterated root canals and periapical pathosis. Management of patients with DD has presented dentists with problems. Extraction has been suggested as a treatment alternative for teeth with pulp necrosis and periapical abscess. Follow-up and routine conservative treatment is another choice of treatment plan in DD. Another approach for the treatment of teeth with DD has included periapical surgery and retrograde filling, which is recommended in the teeth with long roots. The purpose of this report is to present an unusual case of dentinal dysplasia Type I in a 22-year-old woman showing upper and lower teeth with obliterated root canals and periapical radiolucencies. In this case, conventional endodontic treatment was performed. Postoperative radiographs and clinical evaluation demonstrated periapical healing and successful results. Based on the results of this case report, conventional endodontic treatment for cases with pulp necrosis and periapical radiolucencies in dentinal dysplasia is highly recommended.     

Temporomandibular joint involvement caused by Borrelia Burgdorferi

BACKGROUND: Lyme borreliosis is an endemic disease in Slovenia with an incidence of around 150 patients per 100,000 inhabitants. Although the large joints are most typically affected in Lyme borreliosis, there are also periods of disease activity with arthritis or arthralgias involving smaller joints, including the temporo-mandibular joint. PATIENTS: During the years between 2000 and 2003, two patients with Lyme borreliosis affecting the temporo-mandibular joints were treated. The patients presented with fatigue and pain in diverse muscle groups accompanied by arthralgia, which was most pronounced in the temporomandibular joint area. None of the patients were febrile or had joint effusions. METHODS: Both patients were examined by means of biochemical and serological examinations for Borrelia burgdorferi using ELISA assay and Western blot test (both for IgM and IgG), plain radiographs, MR and CT scans, and scinti-scan of the temporo-mandibular joints They both had positive serum markers for an acute B. burgdorferi infection and were treated with intravenous ceftriaxone. RESULTS: None of the patients had clinical or laboratory signs of chronic Lyme disease activity two and four years following therapy, respectively. Roentgenographic and nuclear magnetic resonance imaging of the temporo-mandibular joints had not shown any persistent sign of acute inflammation. CONCLUSION: There are only few reports of patients with manifest temporo-mandibular joint involvement of Lyme borreliosis in the literature. This report emphasizes the importance of differential diagnosis of acute temporo-mandibular joint arthralgia, of early diagnosis of Lyme borreliosis, and of the necessity for prompt antibiotic treatment.