上海市不同职业成人牙周健康状况抽样调查

目的抽样调查和分析400例上海市常住在职成年人牙周健康情况及相关因素。方法采用分层、整群、随机抽样方法,在郊区抽取农民200例,市区抽取职员和工人各100例,年龄25～59岁,男249例,女151例,进行问卷调查,并检查全口余留牙的牙龈指数(GI)、牙周探诊深度(PD)、临床附着丧失(CAL)、牙龈探诊出血(BOP)和松动度(mobility)情况。指数牙16、11、26、31、36和46,每个指数牙检查6个位点。采用SAS6.12软件包进行统计学分析。结果上海市成年人人群简化口腔卫生指数OHI-S=2.16±0.99,口腔卫生状况中等;人群牙龈指数GI=1.2227,牙龈炎为中度流行。上海市不同职业成年人牙周破坏程度有显著差异,其中职员的牙周破坏程度最轻;不同年龄组间也有极显著差异,高年龄组的牙周破坏重于低年龄组。轻、中度牙周炎146例,占36.5%,重度牙周炎140例,占35%。受检者中,接受过高中教育者317例,占79.25%;受过大学教育者79例,占19.75%;研究生文化程度者4例,占1%。患者受教育程度与牙周破坏的严重程度无显著相关性。400例被调查者中,330例从未接受过治疗,占82.5%;曾洁牙者70例,占12.5%;接受过正规的牙周治疗者仅13例,占3.25%。结论上海地区人群口腔卫生教育及牙周防病、治病意识还须加强。     

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目的评价利用Florida探针对不同程度牙周炎的基础治疗疗效。方法随机选择2005年6月至2007年6月期间,中国医科大学口腔医学院牙周科轻度、中度和重度牙周炎患者各50例为研究对象,全部行牙周基础治疗。患者在治疗前和治疗结束后3个月时采用Florida探针检测患者的探诊深度(PD)和临床附着丧失(CAL),检测位点为患者全口天然牙(不包括第三磨牙)的近中颊、颊侧正中、远中颊和舌侧正中4个位点。轻度牙周炎共检测1370颗牙5480个位点,中度牙周炎1180颗牙4720个位点,重度牙周炎940颗牙3760个位点,比较治疗前后PD、CAL的变化。结果中、重度牙周炎的PD和CAL均有明显改善(P<0.05)。轻度牙周炎PD治疗前后的改变差异无统计学意义(P>0.05),附着丧失略微加重。结论牙周基础治疗对中、重度牙周炎具有良好的治疗效果。轻度牙周炎在治疗时应注意避免器械的过度使用,以免引起医源性损伤。Florida探针能够较准确、客观地评价牙周状况。     

缓释氯己定凝胶在慢性牙周炎治疗中的应用

目的:观察龈上洁治术、龈下刮治术和根面平整术(scaling and root planing,SRP)结合缓释氯己定凝胶(chlorhexidine,CHX)对慢性牙周炎的治疗作用。方法:选择35～65岁的慢性牙周炎患者36例,将后牙区牙周袋数目较多的单颌设定为实验组,对颌为对照组。实验组采取SRP+CHX治疗,对照组采取SRP治疗。分别于牙周治疗前、中、后3个阶段,记录每个受试牙近颊、颊侧、远颊、近舌、舌侧和远舌位点的牙龈指数(GI)、探诊出血(BOP)、探诊深度(PD)、临床附着水平(CAL)、探诊出血指数(SBI)。结果:BOP、SBI、PD、GI四项指标在治疗后1个月,实验组与对照组之间有显著差异(P<0.05),4个月后则无显著性差异(P>0.05)。CAL在治疗后1个月,两组间无显著(P>0.05),而4个月后差异显著性差异(P<0.05)。无论是实验组还是对照组,治疗前后各项牙周指标后牙区位点对治疗的反应明显不如前牙区,但无显著性差异(P>0.05)。PD>7 mm的深牙周袋,SRP+CHX组与SRP组之间4个月后仍有显著性差异。结论:在慢性牙周炎治疗过程中,SRP+CHX治疗能够改善牙周临床指标,尤其对PD>7 mm的深牙周袋有更好的治疗作用。     

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目的评价牙周基础治疗对侵袭性牙周炎（AgP）患者的疗效。方法选择2011年2月至2012年7月南京大学医学院附属口腔医院牙周科就诊的AgP患者58例,进行全口牙周基础治疗。于治疗后1、3、6个月复查,检查患者口中所有天然牙的牙周探诊深度（PD）、附着丧失（CAL）、探诊出血（BOP）、牙龈退缩（GR）,记录松动度。结果治疗后1个月大体观察牙龈组织炎症明显好转,牙龈色泽、形态在多数牙位恢复正常。治疗后3个月PD、CAL与治疗前相比降低,差异有统计学意义（均P〈0．05）;GR增加、松动度好转,但差异无统计学意义（均P〉0．05）。治疗后6个月PD、CAL与治疗前相比降低,GR较治疗前增加,差异均有统计学意义（均P〈0．05）;松动度好转,但差异无统计学意义（P〉0．05）。治疗后6个月与治疗后3个月相比,各项临床指标差异均无统计学意义（均P〉0．05）。治疗后3、6个月,≥3．5mm牙周袋和BOP所占比例与治疗前相比明显下降,差异均有统计学意义（均P〈0．05）。结论基础治疗是治疗AgP的有效手段,中短期疗效可靠。     

重度牙周炎患者种植体与天然牙相互影响的回顾性研究

目的从改善天然牙牙周健康的角度, 评价规律复查的重度牙周炎患者后牙区种植修复治疗对天然牙的影响, 以及天然牙牙周状态对种植体的影响, 为临床提供参考。方法收集2014年6月至2023年6月于中国医科大学口腔医学院·附属口腔医院牙周病科就诊, 并完成后牙单冠种植修复治疗的重度牙周炎者53例, 其中男性16例, 女性37例, 年龄(52.2±8.0)岁, 种植体共136枚, 缺牙区相邻天然牙135颗。回顾性比较种植前后口内余留天然牙的探诊深度(PD)、探诊出血(BOP)和松动度变化, 并通过单因素和多因素分析探讨天然牙对种植体PD、BOP和末次复查时边缘骨丧失(MBL)的可能影响因素。结果 53例患者的随访时间为(44.5±14.1)个月, 最长复查间隔为(8.3±2.7)个月。缺牙区相邻天然牙PD由种植前的4.3(3.6, 4.6)mm显著改善至末次复查时的3.6(3.2, 4.0)mm(P<0.01), BOP(+)%由种植前的69.6%(94/135)显著改善至末次复查时的46.7%(63/135)(P<0.01), 松动度≥Ⅱ度的牙齿占比由15.6%(21/135)显著...     

二次牙周龈下刮治与牙周翻瓣术短期临床疗效比较

目的比较二次牙周龈下刮治和根面平整（scaling and root planning,SRP）与牙周翻瓣术治疗慢性牙周炎的短期临床疗效。方法选取牙周基础治疗3个月后牙周探诊深度为5～7mm的前牙或前磨牙共52颗作为研究对象,随机分为2组,二次SRP组行龈下刮治和根面平整术,翻瓣组进行改良Widman翻瓣术。分别在治疗前、治疗后3个月和6个月,检查记录探诊出血（bleeding on probing,BOP）、探诊深度（probing depth,PD）、牙龈退缩（gingival recession,GR）及临床附着水平（clinical attachment level,CAL）,并比较分析。结果二次SRP组和翻瓣组患牙的BOP阳性率、PD、GR、CAL治疗前分别为91.30%、（5.60±0.99）mm、（0.37±0.49）mm、（5.98±1.17）mm和92.13%、（5.87±1.02）mm、（0.30±0.47）mm、（6.03±1.30）mm,治疗后6个月分别为17.39%、（2.87±0.78）mm、（2.00±0.62）mm、（5.07±1.01）mm和11.23%、（2.53±0.51）mm、（2.36±0.68）mm、（4.89±0.84）mm,2组治疗后6个月各项指标与治疗前比较差异均有统计学意义（P〈0.01）。治疗后6个月2组间BOP阳性率、PD及CAL比较差异无统计学意义（P〉0.05）,但翻瓣组GR明显高于二次SRP组（P〈0.05）。结论对于前牙或前磨牙,二次SRP与牙周翻瓣术可达到相同的治疗效果,翻瓣术后牙龈退缩较二次牙周龈下刮治和根面平整后明显。     

慢性牙周炎栖牙密螺旋体和牙周袋内硫化物水平的相关性研究

目的 研究慢性牙周炎病人牙周袋内栖牙密螺旋体和牙周袋内硫化物水平的关系。方法 临床上选取17例诊断为慢性牙周炎的病人,采用金刚探针/牙周诊断仪检测牙周袋内硫化物水平,记录牙周袋探诊深度、临床附着丧失以及探诊出血相关牙周指标。同时,采用16S rRNA PCR检测相同位点的栖牙密螺旋体。结果 慢性牙周炎病人栖牙密螺旋体检出率为88.2%,硫化物阳性位点和硫化物阴性位点中栖牙密螺旋体的检出率分别为68.5%和43.2%。硫化物阳性位点与阴性位点中牙周附着丧失（clinical attachment loss, CAL）平均值分别为（2.84±2.33）mm和（1.83±1.60）mm,两者差异有统计学意义（P<0.01）。硫化物阳性位点与阴性位点牙周探诊深度（probing depth, PD）平均值分别为（4.20±1.57）mm和（3.83±1.30）mm,两者差异无统计学意义(P＞0.05)。硫化物阳性位点中牙周探诊出血（bleeding on probing, BOP）阳性检出为率92.5%,大于硫化物阴性位点（75.8%）,两者差异有统计学意义（P<0.01）。结论 慢性牙周炎病人牙周袋内的硫化物水平能反映牙周栖牙密螺旋体分布情况,与牙周附着丧失存在相关性。     

超声系统治疗与牙周翻瓣术的短期疗效比较

目的 比较Vector超声系统治疗和牙周翻瓣术治疗慢性牙周炎的1年临床疗效.方法 选取牙周基础治疗3个月后,30例慢性牙周炎患者,其口内的单根牙及多根牙都存在牙周探诊深度5～7 mm的位点,随机分为3组各10例患者,Vector超声系统治疗组进行Vector超声治疗、牙周翻瓣术组进行改良Widman翻瓣术、常规龈下刮治和根面平整组进行龈下刮治和根面平整术,记录治疗结束1d后的疼痛程度,并在治疗前,治疗后3、6、12个月,采用Florida探针系统检查记录探诊出血(BOP)、探诊深度(PD)、牙龈退缩(GR)、临床附着丧失(CAL),并比较分析.结果 3组治疗后1d的疼痛程度评价,Vector超声系统治疗组最低2.2,牙周翻瓣术组最高为6.4,组间差异具有统计学意义(P＜0.05).对于单根牙,3组在治疗后的3、6、12个月PD、GR、BOP与治疗前比较都有显著改善(P＜0.01);治疗后的第12个月,Vector超声系统治疗组和牙周翻瓣术组PD改善相同,且该组的GR和CAL低于牙周翻瓣术组和常规龈下刮治和根面平整组.对于多根牙,治疗后3、6个月,3组PD较治疗前有改善,GR较治疗前明显增加(P＜0.01),翻瓣术组和Vector超声系统治疗组的CAL值较治疗前减少(P＜0.05);治疗后12个月只有翻瓣术组的PD、CAL值较治疗前减少(P＜0.05),3组的GR较治疗前明显增加(P＜0.01);3组的BOP阳性率在治疗后的3、6、12个月,翻瓣术组与治疗前比较显著下降(P＜0.01),另两组则在治疗后的12个月与治疗前差异无统计学意义(P＞0.05).结论 对于基础治疗后3个月,仍存在5～7 mm牙周袋位点的单根牙,采用Vector超声系统进行治疗的患者,1年后的疗效优于牙周翻瓣术;而对于多根牙,Vector超声系统治疗的效果不及牙周翻瓣手术的效果.     

Bio-Oss Collagen治疗牙周炎骨下袋的临床疗效观察

目的评价Bio—OssCollagen治疗牙周骨下袋的临床效果。方法选择全身健康的牙用基础治疗后6周左右的慢性牙周炎患者10例,男性6例,女性4例,平均年龄40．8岁,共有18处骨下袋,试验组9处骨下袋17个位点。对照组9处骨下袋15个位点。牙周翻瓣术分别植入Bio-Om Collagen(试验组)和Bio-Oss(对照组)。分别在手术前和手术后6个月检查牙周袋探诊深度(PD)、牙龈出血指数(BI)、牙龈退缩(GR)和临床附着水平(C地),拍摄术区平行定位X线片评价植骨前后骨缺损处牙槽骨的修复情况。结果植骨前两组的各项指标阃无显著性差异。Bio-Om CoUagen组植骨前的PD(6．6±1．2mm)、BI(2．7±0．8)、GR(2．2±0．8mm)和CAl．,(8．8±1．3mm),植骨后6个月分则为PD(3．8±0．9ram)、BI(1．9±0．7)、GR(2．4±1．Imm)和CAL(6．2士1．2mm);Bio -Oss组植骨前的PD(6．1±1．0mm)、BI(2．2±0．7)、GR(1．9±1．5mm)和CAL(8．0±2．0mm),植骨后6个月分别为PD(4．0±0．7mm)、BI(1．9±0．7)、GR(1．9±1．2mm)和CAL(5．9±1．6mm),两组PD和CAL以及试验组BI的改变均有明显的统计学意义(P相似文献   

伴口呼吸及错牙合畸形慢性牙周炎牙周序列治疗观察

目的:探讨前牙区牙龈增生伴张口呼吸、错牙合畸形的慢性牙周炎患者接受牙周序列治疗的临床疗效。方法:选择2007年9月~2008年9月在大连市口腔医院牙周黏膜科就诊的前牙区牙龈增生伴张口呼吸、错牙合畸形的慢性牙周炎患者10例,进行牙周序列治疗(基础治疗、牙周手术治疗、正畸治疗和牙周支持治疗),历时5年以上。在治疗前、正畸治疗后1~3年采用Florida探针检查记录前牙区探诊深度(PD)、附着丧失(CAL)、牙齿松动度(TM)、探诊出血(BOP)等临床指标,并进行统计分析。在治疗前和正畸治疗后1～3年拍摄曲面断层片。结果:正畸治疗后1～3年前牙区PD、CAL均较治疗前有明显降低,BOP阳性位点较治疗前明显减少,差异均有统计学意义(P<0.01);TM较治疗前无明显变化,差异无统计学意义。治疗后3年较治疗后1年和2年,PD、CAL下降,BOP阳性位点减少,但差异均无统计学意义。结论:前牙区牙龈增生伴张口呼吸、错牙合畸形的慢性牙周炎患者进行历时5年以上牙周序列治疗,临床疗效良好且稳定     

Clinical responses to mechanical periodontal treatment in Chinese chronic periodontitis patients with and without Actinobacillus actinomycetemcomitans

BACKGROUND: The purpose of this study was to compare 12-month clinical responses to mechanical periodontal treatment in Chinese chronic periodontitis patients at sites with and without Actinobacillus actinomycetemcomitans at baseline, and to investigate the ability of mechanical periodontal treatment to eliminate A. actinomycetemcomitans. METHODS: Nineteen patients and a total of 76 selected sites with a mean probing depth (PD) of > or = 7 mm were studied. Whole mouth presence or absence of supragingival plaque (PI%), bleeding on probing (BOP%), probing depth (PD), and probing attachment level (PAL) were recorded at six sites per tooth at baseline and after 3, 9, and 12 months. Baseline subgingival plaque samples were taken from the deepest PD site in each quadrant using sterile paper points and were cultured on TSBV plates for 5 days in a 5% CO2-air incubator. All sites received mechanical periodontal treatment, which included oral hygiene instructions and supragingival and subgingival instrumentation with or without surgical access, with maintenance care being provided once every 3 months thereafter. RESULTS: At baseline, A. actinomycetemcomitans was isolated in 13 of the 19 subjects (68%) and in 29 out of the 76 sampled sites (38%). At the end of 12 months, in three of the initially A. actinomycetemcomitans-positive subjects, A. actinomycetemcomitans was not detected in the sampled sites, while one subject, in whom A. actinomycetemcomitans was not initially found at the sampled sites was A. actinomycetemcomitans-positive at 12 months. Multi-level variance component models showed there was no statistically significant difference in all clinical parameters between A. actinomycetemcomitans-positive and -negative subjects (P > 0.05). In the sampled sites of the initially A. actinomycetemcomitans-positive subjects, the mean PD was reduced from 7.6 +/- 1.6 mm to 3.2 +/- 1.8 mm, the mean PAL gain was 1.4 +/- 2.0 mm, and the mean recession was 3.0 +/- 2.3 mm. The corresponding figures in the sampled sites of the initially A. actinomycetemcomitans-negative subjects were 7.5 +/- 1.6 mm to 2.7 +/- 1.0 mm, 2.3 +/- 2.6 mm and 2.4 +/- 2.2 mm for mean PD changes, PAL gain, and mean recession, respectively. CONCLUSIONS: Favorable clinical responses to mechanical periodontal therapy may occur in Chinese chronic periodontitis patients at sites infected with A. actinomycetemcomitans. The mere detection of subgignival A. actinomycetemcomitans does not necessarily imply poorer treatment outcomes in the control of chronic periodontitis.     

A cross‐sectional study of dentine hypersensitivity in China

Objective : To carry out a cross‐sectional study of the prevalence of dentine hypersensitivity and related risk factors in Chengdu City, China. Methods : A total of 1,320 subjects were distributed equally in six communities in Chengdu City and of all age groups (10 years for an age group) including the same number of male and female subjects in each community. Each subject completed a structured interview and the subjects who reported hypersensitivity were examined further using a triple syringe to administer a blast of cold air to confirm the diagnosis of dentine hypersensitivity. Periodontal attachment loss and gingival recession of all sensitive teeth were measured. Results : The prevalence of dentine hypersensitivity was 25.5% in the oral test. Only 16.6% of subjects who reported hypersensitivity symptoms had received desensitising treatment. 50–59 year age group was the cohort with the greatest number of subjects with DH and the premolar was the most commonly affected tooth. Low education level, gingival recession, and attachment loss were related to dentine hypersensitivity. Conclusions : The prevalence of dentine hypersensitivity in an urban adult population in Chengdu City was 25.5%.     

Subepithelial connective tissue graft for root coverage in smokers and non-smokers: a clinical and histologic controlled study in humans

BACKGROUND: The aim of this study was to evaluate root coverage of gingival recessions and to compare graft vascularization in smokers and non-smokers. METHODS: Thirty subjects, 15 smokers and 15 non-smokers, were selected. Each subject had one Miller Class I or II recession in a non-molar tooth. Clinical measurements of probing depth (PD), relative clinical attachment level (CAL), gingival recession (GR), and width of keratinized tissue (KT) were determined at baseline and 3 and 6 months after surgery. The recessions were treated surgically with a coronally positioned flap associated with a subepithelial connective tissue graft. A small portion of this graft was prepared for immunohistochemistry. Blood vessels were identified and counted by expression of factor VIII-related antigen-stained endothelial cells. RESULTS: Intragroup analysis showed that after 6 months there a was gain in CAL, a decrease in GR, and an increase in KT for both groups (P <0.05), whereas changes in PD were not statistically significant. Smokers had less root coverage than non-smokers (58.02% +/- 19.75% versus 83.35% +/- 18.53%; P <0.05). Furthermore, the smokers had more GR (1.48 +/- 0.79 mm versus 0.52 +/- 0.60 mm) than the non-smokers (P <0.05). Histomorphometry of the donor tissue revealed a blood vessel density of 49.01 +/- 11.91 vessels/200x field for non-smokers and 36.53 +/- 10.23 vessels/200x field for smokers (P <0.05). CONCLUSION: Root coverage with subepithelial connective tissue graft was negatively affected by smoking, which limited and jeopardized treatment results.     

Changes in periodontal disease experience from 26 to 32 years of age in a birth cohort

BACKGROUND: Information is lacking on the natural history of periodontitis through the third and fourth decades of life. METHODS: Periodontal examinations were conducted at 26 and 32 years of age in a longstanding prospective study of a birth cohort born in Dunedin, New Zealand, in 1972 and 1973. At each age, gingival recession (GR) and probing depth (PD) were recorded at three sites per tooth using a diagonal half-mouth design (measurements were made in all four quadrants at 32 years of age, but longitudinal comparisons were made using only the half-mouth data). RESULTS: A total of 882 individuals were examined at both ages. The mean number of measured sites fell between 26 and 32 years of age. The overall prevalence of one or more sites with >or=4 mm combined attachment loss (CAL) rose from 18.6% to 21.8%, whereas there were greater increases in the proportion with two or more sites with >or=4 mm CAL (from 8.0% to 12.6%) and one or more sites with >or=5 mm CAL (from 3.6% to 8.0%). The extent and severity of CAL also increased. A total of 403 individuals (45.7%) had an increase in CAL >or=2 mm at one or more sites, whereas 110 (12.5%) had a CAL increase >or=3 mm at one or more sites. Seen in approximately 4% of sites, negative GR (i.e., gingival enlargement) had a substantial effect on PD-based estimates. An increase in PD >or=2 mm at one or more sites was experienced by 345 individuals (39.1%), whereas 88 people (10.0%) had an increase in PD >or=3 mm at one or more sites. The greatest mean attachment loss was experienced at disto-lingual sites on molars, and most manifested as PD increases. Notable increases in GR were seen with lower incisors and canines. CONCLUSIONS: Periodontal loss of attachment continues among a sizable proportion of people from the third to the fourth decade of life; however, contrary to patterns in older adults, changes in the PD component are greater than the changes in the recession component. Incident attachment loss is most frequently observed at proximal sites on posterior teeth.     

Root coverage: comparison of coronally positioned flap with and without titanium-reinforced barrier membrane

BACKGROUND: Various surgical procedures have been proposed as effective treatment methods for recession defects. The purpose of this study was to evaluate the clinical outcome of root coverage comparing the coronally positioned flap (CPF) with and without guided tissue regeneration (GTR) using a titanium-reinforced expanded polytetrafluoroethylene barrier in paired gingival recession defects. METHODS: Procedures were performed in 10 patients having bilateral buccal recession defects > or = 2.0 mm on maxillary canines and first premolars. Mucoperiosteal flaps were raised and root surfaces were scaled, planed, and conditioned. Randomly assigned sites received either GTR + CPF or CPF treatment. Clinical parameters measured at baseline and at 6 months after the procedure included gingival recession depth (GRD), clinical attachment level (CAL), probing depth (PD), keratinized gingival width (KGW), and alveolar crest level (ACL). RESULTS: GRD decreased from 3.4 +/- 0.6 mm to 1.9 +/- 1.2 mm with GTR (45% root coverage) and from 3.3 +/- 0.4 mm to 1.3 +/- 0.7 mm with CPF (60% root coverage). The difference in GRD decrease between procedures was significant. CAL, KGW, and PD differences between procedures were not significant. ACL mean gain was significant (1.0 +/- 0.6 mm in the GTR group and 0.2 +/- 0.3 mm in the CPF group; P < 0.05). CONCLUSIONS: Both GTR and CPF procedures result in root coverage. The amount of root coverage obtained with CPF was greater than that observed with GTR, although GTR resulted in significantly greater ACL gain.     

Association of T CD4 lymphocyte levels and chronic periodontitis in HIV-infected brazilian patients undergoing highly active anti-retroviral therapy: clinical results

BACKGROUND: Controversial data regarding the association between immunosuppression and prevalence/ severity of periodontal diseases in HIV infection have been reported. Thus, the aim of this study was to test the hypothesis that lower T CD4 lymphocyte levels are not related to a higher prevalence of chronic periodontitis in HIV-infected Brazilians undergoing highly active anti-retroviral therapy (HAART). METHODS: Sixty-four HIV-infected patients under HAART were classified as having chronic periodontitis; i.e., > or = three sites with probing depth (PD) and/or clinical attachment level (CAL) > or = 5 mm or periodontal healthy (no sites with PD > 3 mm and/or CAL > 4 mm). All subjects received conventional periodontal therapy. Bleeding on probing, plaque accumulation, PD, and CAL were registered at six sites/tooth at baseline and 4 months after therapy. Epidemiological features and levels of T CD4 lymphocytes were obtained from medical records. Significance of differences in periodontal clinical parameters within and between groups were determined using Wilcoxon signed-rank and Mann-Whitney or independent sample t tests. Associations between T CD4 levels and clinical parameters were determined using the chi square test. RESULTS: Sixty-one percent of the HIV-infected patients represented AIDS cases, although 69% of them were periodontally healthy. The overall T CD4 lymphocyte mean levels was 333 +/- 254 cells/mm3 and viral load was 12,815 +/- 24,607 copies/mm3. Yet the prevalence of chronic periodontitis was relatively low (36%). In addition, patients with periodontitis presented a moderate disease (mean PD = 2.2 +/- 0.10; mean CAL = 2.6 +/- 0.13) and responded successfully to periodontal therapy. These subjects showed higher levels of T CD4 cells, but lower counts of neutrophils than periodontally healthy patients. Among periodontally healthy and chronic periodontitis patients, 41.7% and 22.9%, respectively, had low levels of T CD4 lymphocytes. No significant differences between periodontal status and epidemiological and immunological parameters were observed. CONCLUSION: Based on these results, the hypothesis that lower T CD4 lymphocyte levels are not associated with higher prevalence of chronic periodontitis in HIV-infected Brazilians under HAART cannot be rejected.     

Locally delivered doxycycline as an adjunctive therapy to scaling and root planing in the treatment of smokers: a clinical study

BACKGROUND: The aim of this clinical study was to evaluate the association of locally delivered doxycycline (10%) with scaling and root planing in the periodontal treatment of smokers. METHODS: Forty-three patients with chronic periodontitis and a minimum of four pockets (> or = 5 mm) on anterior teeth that bled on probing were selected. Patients were randomly assigned to scaling and root planing (SRP) or scaling and root planing followed by local application of doxycycline (SRP-D). Plaque, bleeding on probing, gingival recession, relative attachment level (RAL), and probing depth (PD) were recorded at baseline, 45 days, and 3 and 6 months. Differences between baseline and each period were considered for analysis. RESULTS: At 6 months, no difference was found between groups regarding plaque, bleeding reduction, gingival recession or PD (P > 0.05). However, RAL gain was greater for SRP-D (1.63 +/- 0.93 mm) than for SRP (1.04 +/- 0.71 mm) (P = 0.025). In addition, deep pockets (> or = 7 mm) showed a significant reduction (3.78 +/- 1.41 versus 2.60 +/- 1.28 mm, P = 0.039) and RAL gain (2.54 +/- 1.27 mm versus 1.29 +/- 0.95 mm, P = 0.01) when doxycycline was applied. The proportion of sites showing RAL gain of 1 to 2 mm was 36.8% versus 21.7% for SRP-D and SRP, respectively (P = 0.01). CONCLUSION: The use of locally delivered doxycycline may constitute an important adjunct for the treatment of severe periodontal disease in smokers.     

Analysis of the Community Periodontal Index of Treatment Needs--study on adults in France. IV. The significance of gingival recession

A total of 1005 persons were examined using the CPITN criteria which were recorded for every tooth. All the teeth were also measured on both their buccal and lingual aspects to assess the amount of gingival recession. The combination of pocket depth and gingival recession was computed using a specially written program: 93.8 per cent of the teeth had 1 mm or less gingival recession; 82.5 per cent of the teeth with gingival recession did not present pockets; 26.6 per cent of all subjects had at least one tooth with gingival recession of 2 mm or more but only 9.9 per cent had at least one tooth with 2 mm or more gingival recession and a periodontal pocket.