Non-surgical periodontal therapy with adjunctive topical doxycycline: a double-masked, randomized, controlled multicenter study. II. Microbiological results.

Background: Topical application of active substances offers an additional option in periodontal therapy. The aim of this study was to examine the influence of the administration of a novel, biodegradable 14% doxycycline gel on microbiological findings, in connection with scaling and root planing.

Methods: One hundred ten patients in three centers (Frankfurt and Heidelberg, Germany; Nijmegen, The Netherlands) with moderate to advanced periodontitis were evaluated in this randomized, double-masked, split-mouth clinical trial.

Root proximity as a risk marker for periodontal disease: a case-control study.

Aim: The aim of this study is first, to examine the prevalence, symmetry and spread of root proximity using the measurement tools and classification as described in part I of the study, and second to examine whether root proximity is a risk marker for periodontal disease.

Material And Methods: The radiographs of 227 patients were examined. The study consisted of a study group of 197 patients with advanced periodontal disease with at least one site with bone loss more than one third of the root length and 30 controls without periodontal disease.

Classification, reproducibility and prevalence of root proximity in periodontal patients.

Aim: The primary aim of this study is to define and classify root proximity. The secondary aim is to examine the reproducibility of the measurement tools, to study the prevalence per inter-dental area and to examine whether the distance from the cemento-enamel junction (CEJ) to the bone crest (BC) differs between sites with root proximity and their contra-lateral sites without root proximity.

Material And Methods: In order to indicate the location of root proximity, a modification of the Shei ruler was developed, dividing the roots into three equal parts.

Pharmacokinetic profile of a locally administered doxycycline gel in crevicular fluid, blood, and saliva.

Background: With the help of so-called controlled release delivery systems, the half-life period of locally administered antibiotics in gingival crevicular fluid (GCF) can be extended significantly. The aim of this study was to characterize the delivery profile of a new one-component 14% doxycycline free amine gel for local application. Pharmacokinetics of doxycycline (DOXY) were analyzed in GCF, saliva, and serum.

Non-surgical periodontal therapy with adjunctive topical doxycycline: a double-blind randomized controlled multicenter study.

Aim: Evaluation of the clinical effect of topical application of doxycycline adjunctive to non-surgical periodontal therapy.

Methods: A total of 111 patients suffering from untreated or recurrent moderate to severe periodontitis at 3 different centers (Heidelberg, Frankfurt, Nijmegen) were treated in this double-blind split-mouth study. In each patient, 3 different treatment modalities were assigned randomly to 3 test teeth: scaling and root planing alone (SRP), SRP with subgingival vehicle control (VEH), and SRP with subgingival application of a newly developed biodegradable 15% doxycycline gel (DOXI).

Pocket elimination surgery with simultaneous connective tissue graft. A case report with 3-year follow-up.

Background, Aims: The purpose of the present case report was to present 2 ways of treating recession in a periodontal patient combined with regular pocket elimination surgery. The techniques used enabled the operator to reduce the number of surgical sessions and clinically evaluate the 3-year coverage of gingival recessions using a subpedicle connective tissue graft.

Methods: Surgery consisted of pocket elimination procedures to treat adult periodontitis as a way to harvest connective tissue to be placed in the areas of recession.

Response of rat bone marrow cells to differently roughened titanium discs.

The purpose of the present in vitro study was to examine the effect of surface roughness on the behaviour of osteoblast-like cells. Rat bone marrow (RBM) cells were cultured on commercially pure titanium discs. The discs were used as machined (Ti M) or ground with 4000 (Ti 4000) or 320 (Ti 320) grit paper.

A possible association of alpha1-antitrypsin deficiency with the periodontal condition in adults.

Alpha1-antitrypsin (alpha1AT) is a serum inhibitor of several neutrophil-derived proteolytic enzymes, the serine proteinases. In certain individuals, a deficiency of this enzyme inhibitor is present, whereby only 10 to 20% of the normal concentration is present in the circulation. The purpose of this study was to evaluate the influence of this alpha1AT deficiency on the periodontal condition in a case control study.

[Antibiotic use in periodontics. Results from a research study].

The sensitivity of the subgingival plaque for amoxicillin, doxycycline, ofloxacin and clindamycin was estimated by agar diffusion disks and Etest in 22 periodontal patients. The sensitivity of the subgingival plaque varied per patient. Resistance of the subgingival plaque for amoxicillin was observed in 50% of the patients and was significantly related to the use of antibiotics in the previous 6 months.

[How sensible are bacteriological tests in periodontology?].

Periodontitis is a mixed infection with subgingival bacteria that belong to the microflora of the host. The bacteriological tests (Microscopy, Culture, Omnigene, Affirm DP and Evalusite) are mainly aimed at spirochetes or A. actinomycetemcomitans, P.

Histological evaluation of surgically treated oral tissues after application of a photocuring periodontal dressing material. An animal study.

At present no information is available about biological effects on oral tissues of the photocuring periodontal dressing Barricaid. This animal study examines histologically the tissue responses of surgical areas covered during 7 days with either Barricaid, the eugenol-containing dressing Ward's Wondrpak or the bionert control gel Carboxyl Methyl Cellulose. One group was studied immediately after the removal of the dressings; in the other group, further healing was permitted for another week.

[Effective treatment of periodontitis].

Based upon clinical periodontal parameters and roentgenographic diagnosis a temporary treatment plan is made, which results in a definite one after the initial treatment. Only a rigorous removal of dental plaque guarantees an effective and efficient working manner, which starts with indirect scaling and rootplaning sustained by the personal oral hygiene. If the indirect therapy appears to fail, the roots must be cleaned under direct view.

The importance of a coordinated restorative and maintenance program following periodontal therapy: a case report.

The problems arising during the maintenance phase of therapy following a combination of periodontal, orthodontic, and restorative treatment are illustrated by this case report. Emphasis is placed on the combined responsibility of the patient, general dental practitioner, and periodontist to recognize signs of recurrent disease at an early stage, thereby allowing corrective measures to be initiated promptly. By applying these principles, even when disease recurs during the maintenance phase, re-treatment is possible and a satisfactory result can be achieved.

Comparison of the antimicrobial effect of the application of chlorhexidine gel, amine fluoride gel and stannous fluoride gel in debrided periodontal pockets.

The clinical and microbiological effect of locally-applied chlorhexidine gel 2%, amine fluoride gel 1.25%, stannous fluoride gel 4% or placebo gel in 40 periodontal pockets of 10 patients were studied. The gels were applied 3 x within 10 min.

Short-term bactericidal activity of chlorhexidine gel, stannous fluoride gel and amine fluoride gel tested in periodontal pockets.

The short-term bactericidal effect of 2% chlorhexidine gel, 4% stannous fluoride gel or amine fluoride gel containing 1.25% fluoride on the subgingival microflora was determined in 40 periodontal pockets of 10 patients. The antimicrobial gels or placebo gel were applied in 5-9 mm deep periodontal pockets 3 times within 10 min.

Clearance of a topically applied fluorescein gel from periodontal pockets.

The clearance of a fluorescein gel applied with an irrigation technique in periodontal pockets was studied. In order to evaluate the time a drug remains in a periodontal pocket, the alteration in concentration of this drug in a given time period was investigated. After application of the gel in 4 pockets of 10 patients, samples were taken from 1 of the 4 pockets at 5, 10, 20 and 40 min.

[Sharpening of periodontal instruments].

Sharp hand instruments are the first pre-requisite for scaling and root planing. Different sharpening techniques are reported, and the time at which an instrument is evaluated for its sharpness or dullness is indicated. The shape and form of several instruments are described together with the appropriate sharpening technique.

Bactericidal concentrations of chlorhexidine-digluconate, amine fluoride gel and stannous fluoride gel for subgingival bacteria tested in serum at short contact times.

In vitro inhibitory and bactericidal concentrations in serum of chlorhexidine-digluconate, amine fluoride gel, stannous fluoride gel, stannous fluoride, metronidazole and amoxicillin were determined against Bacteroides gingivalis, Bacteroides intermedius, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans and Capnocytophaga sputigena. The minimal inhibitory concentration was assessed by the agar dilution technique. The killing curves and minimal bactericidal concentration of the antimicrobial agents in inactivated bovine serum were determined after 5, 10, 20 and 60 minutes contact time.

The effect of subgingival debridement with hand and ultrasonic instruments on the subgingival microflora.

The effect of hand or ultrasonic instrumentation on the subgingival microflora of periodontal pockets was investigated. Pockets with probing depths of 6-9 mm were selected in 12 patients and were randomly assigned per patient to the experimental and control groups. After oral hygiene instruction, instrumentation of the experimental pockets was carried out either by ultrasonic or by hand instruments in a split-mouth design.