Mm Of Attachment Loss Research Articles

Natural history of periodontal disease in man. Rapid, moderate and no loss of attachment in Sri Lankan laborers 14 to 46 years of age.

This paper describes the initiation, rate of progress of periodontal disease and consequent tooth loss in a population never exposed to any programs or incidents relative to prevention and treatment of dental diseases. The group consisted of 480 male laborers at two tea plantations in Sri Lanka. The study design and baseline data have been published. At the initial examination in 1970, the age of the participants ranged between 14 and 31 years. Subsequent examinations occurred in 1971, 1973, 1977, 1982 and 1985. Thus, the study covers the age range 14-46 years. Throughout the study, the clinical indices were scored by the same two examiners, both well-trained and experienced periodontitis. Intra-examiner reproducibility for each index was tested at baseline and repeated periodically during the study. The data for each examination were computerized and updated on an ongoing basis. At the last examination in 1985, there were 161 individuals who had participated in the first survey. This population did not perform any conventional oral hygiene measures and consequently displayed quite uniformly large aggregates of plaque, calculus and stain on their teeth. Virtually all gingival units exhibited inflammation. Based on interproximal loss of attachment and tooth mortality rates, three subpopulations were identified: (1) individuals (approximately 8%) with rapid progression of periodontal disease (RP), those (approximately 81%) with moderate progression (MP), and a group (approximately 11%) who exhibited no progression (NP) of periodontal disease beyond gingivitis. At 35 years of age, the mean loss of attachment in the RP group was approximately 9 mm, the MP group had approximately 4 mm and the NP group had less than 1 mm loss of attachment. At the age of 45 years, the mean loss of attachment in the RP group was approximately 13 mm and the MP group approximately 7 mm. The annual rate of destruction in the RP group varied between 0.1 and 1.0 mm, in the MP group between 0.05 and 0.5 mm, and in the NP group between 0.05 and 0.09 mm. Since this population was virtually caries free, essentially all missing teeth were lost due to periodontal disease. In the RP group, tooth loss already occurred at 20 years of age and increased throughout the next 25 years. At 35 years of age, 12 teeth had been lost, at 40 years of age 20 teeth were missing and at 45 all teeth were lost. In the MP groups, tooth mortality started after 30 years of age and increased throughout the decade.(ABSTRACT TRUNCATED AT 400 WORDS)

Distribution of capnocytophaga in periodontal microfloras.

Concentrations and incidence of capnocytophagae were determined in 559 samples from persons with moderate (MP), severe (SP), and localized juvenile (JP) periodontitis; persons with healthy gingiva; and children and adults participating in experimental gingivitis studies. Capnocytophagae were most frequent in four children who participated in an experimental gingivitis study. The lowest incidence and concentrations were found in subgingival floras of affected sites of persons with MP, SP, or JP.Statistically significantly (P = 0.02 to 0.05) higher proportions of capnocytophagae were found in a) sites in children with gingival index (GI) of 0 than similar sites in adults, b) sites in children with GI of 2 than GI of 0, c) supragingival and subgingival samples from healthy persons than subgingival samples from SP, d) supragingival samples from SP than subgingival samples from SP and from JP, e) supragingival samples from MP than subgingival samples from SP.These data from cross‐sectional studies indicate that the significance of capnocytophagae in the etiology of periodontal diseases has been overestimated. Their higher incidence and proportional concentrations in healthy sites and supragingival floras than in the subgingival sulcus of sites with attachment loss would indicate that they are not as competitive in the sulcus as they are on the exposed tooth surface and would argue against their being active agents of these types of destructive periodontal diseases. However, preliminary data from three persons (MP) participating in longitudinal studies show that in one of the three persons the levels of C. ochracea increased to 10 to 20% of the flora in subgingival samples in which there had been at least a 2 mm loss of attachment within three months. No capnocytophagae were isolated from similar sites in one other person, and they constituted 6% of the flora in the breakdown site in the third person.

The effectiveness of hand versus ultrasonic instrumentation in open flap root planing.

The primary purpose of the study was to determine if, with an open flap approach, ultrasonic or hand instrumentation could remove all calculus from previously untreated teeth with moderate to severe loss of attachment. To be included in the study, teeth had to have at least 5 mm of attachment loss, be scheduled for extraction and be graded 2 or 3 on the Calculus Index of the Periodontal Disease Index system. Under local anesthesia, full-thickness, envelope-type flaps were elevated apical to the crest of bone to allow access to the root surfaces which were then treated with hand or ultrasonic instrumentation until the roots felt hard and smooth to a Hartzell explorer. The teeth were then removed, rinsed, and lightly scrubbed to remove debris and a No. 14 wheel bur was used to place a groove along the coronal extent of the connective tissue attachment. A stereomicroscope at magnification X 4.6 was used to quantitate the percentage of residual calculus on 25 teeth treated by each method. Overall, hand-scaled root surfaces demonstrated less residual calculus (5.78%) than ultrasonically treated surfaces (6.17%). Twenty teeth treated by each method were then prepared for histologic evaluation and evaluated under the light microscope at magnification X 100 for residual calculus and relative smoothness. Residual calculus was found on four ultrasonically and 12 hand-treated teeth and was almost evenly distributed between anterior and posterior teeth for both methods. The finding of considerably less calculus on histologic than on stereomicroscopic examination may have been due to the loosening of deposits by instrumentation, especially ultrasonic vibration, and their subsequent release during histologic preparation.(ABSTRACT TRUNCATED AT 250 WORDS)

Total cementum removal: a realistic objective?

The purpose of the study was to determine if total cementum removal from periodontally involved root surfaces was a clinically realistic objective. The experimental specimens were 36 periodontally involved teeth, extracted because of advanced periodontal disease. Eighteen teeth were from patients under age 36 while the other 18 were from patients over 36. All teeth had at least 6 mm of attachment loss on the proximal surface tested and showed no evidence of forceps damage. After removing all visible calculus, equal numbers of each tooth type in each age group were given 50 planing strokes with either a Jacquette scaler, a Gracey curet, or an Indiana University curet. Following the planing procedure the specimens were fixed, decalcified, and 7 microns thick sections prepared and stained with hematoxylin and eosin. Two teeth were excluded from the evaluation due to poor orientation. In none of the remaining 34 teeth was cementum totally removed over the entire proximal test surface. There was no apparent difference between the instruments in the amount of residual cementum found. Larger amounts of residual cementum were seen in more apical areas in both age groups.