Periodontics and Periodontology Commons^™

Pain Experienced By Patients During Periodontal Recall Treatment, Thu-Diem Chung

Loma Linda University Electronic Theses, Dissertations & Projects

The aims of this study were to determine; 1) the degree of pain experienced by patients during probing and debridement; 2) if the treating hygienists could estimate the degree of pain experienced by the patients; and 3) if the patients' pain responses could be predicted by factors such as the patients' age, gender, number of residual periodontal lesions, and the patients' answers to a questionnaire on dental anxiety.

Prior to the maintenance procedures, 2 groups of 20 adult patients to be treated by 2 hygienists completed an anxiety questionnaire. Subsequently, measurements of probing depths were performed, followed by pain ratings …

Probing Bone Level Measurements For Determination Of The Depths Of Class Ii Furcation Defects, Youngil Suh

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Probing bone measurements as an alternative to open bone measurements to evaluate regenerative procedures in furcation defects do not seem to have been used as of yet. The purpose of the present study was to investigate the reliability of probing bone measurements in such defects.

Methods:15 patients scheduled for surgical treatment of a total of 30 mandibular 1st or 2nd molars with buccal or lingual class II furcation defects were studied. During treatment, duplicate vertical and horizontal recordings of probing attachment levels, probing bone levels and open bone levels were taken by independent examiners. Results: Deviations of both …

Dna-Dna Checkerboard Hybridization To Identify Bacteria In Human Plaque Samples, Jasan Lee Zimmerman

Loma Linda University Electronic Theses, Dissertations & Projects

Previous research has shown that using DNA probes to identify the presence of specific bacteria in human plaque samples is superior to the commonly used anaerobic cultural procedures. Some periodontal pathogens are either uncultivable or very difficult to grow, such as Prevotella intermedia, P. nigrescens, and Eubacterium brachy. Digoxygenin probes were prepared for 15 oral bacteria. These probes were used with a checkerboard DNA-DNA hybridization scheme to analyze whether human plaque samples contained any of the 15 bacterial species. Our results have shown that this method is successful in identifying bacterial DNA present in the subgingival patient plaque …

Regeneration In Periodontal Defects With Rhbmp-2 : A Dosage Study, Paola Guglielmoni

Loma Linda University Electronic Theses, Dissertations & Projects

Bone morphogenetic proteins (BMPs) have been shown to induce bone formation in ectopic and orthotopic sites. This inductive capability has led to their evaluation as possible adjuncts in periodontal reconstructive therapy. Indeed, studies have reported periodontal regeneration following surgical implantation of recombinant human BMP-2. This study evaluated regeneration of alveolar bone and cementum following periodontal reconstructive surgery including implantation of a construct consisting of sterile lyophilized rhBMP-2 in buffer adsorbed onto an absorbable collagen sponge. Critical size mandibular supra-alveolar periodontal defects were surgically created, and an incomplete block design was used to evaluate the regenerative potential of rhBMP-2 at 0.05, …

Periodontal Repair In Dogs : Effect Of Recombinant Human Transforming Growth Factor Beta-1 On Guided Tissue Regeneration, Saghi Shayan Razi

Loma Linda University Electronic Theses, Dissertations & Projects

The objective of this study was to evaluate bone and cementum regeneration in the critical size, supraalveolar, periodontal defect model following surgical implantation of recombinant human transforming growth factor beta-1 (rhTGFß-1) in conjunction with guided tissue regeneration (GTR). Five male beagle dogs were used in a split-mouth design. Alternate jaw quadrants in consecutive animals received GTR with rhTGFß-1 in a resorbable calcium carbonate carrier. Contralateral jaw quadrants received GTR with carrier only (control). The healing interval was 4 weeks. Clinical healing was generally uneventful, however, minor membrane exposures were observed for both treatments with limited gingival inflammation. All defects with …

Bone Morphogenetic Proteins And Periodontal Repair, Michael B. Lee

Loma Linda University Electronic Theses, Dissertations & Projects

For over thirty years now, research has been carried out to isolate and purify bone morphogenetic protein (BMP), a substance which has been shown to induce heterotopic bone formation in various animal species. Recent advances in the fields of developmental biology, molecular biology and genetics, have shown that the BMPs not only are responsible for postfetal bone induction (including normal bone remodeling, healing and repair), but are also critical during embryogenesis - not only in regards to the skeletal system, but quite possibly in the morphogenesis and pattern formation of other tissues and organs as well.

Due to their bone …

Alveolar Bone And Cementum Regeneration Following Periodontal Reconstructive Therapy : A Review Of Histologic Observations In Man And Experimental Animals, Karen E. Rodden

Loma Linda University Electronic Theses, Dissertations & Projects

Periodontal regeneration includes the formation of both alveolar bone and cementum. Studies reporting histologic evidence of healing following periodontal reconstructive therapy were reviewed to determine whether regeneration of these structures improves with increasing healing interval, and whether they regenerate independently or whether regeneration of one structure is dependent upon regeneration of the other. Additionally, the review addresses whether specific reconstructive modalities predictably yield increased amounts of regeneration. Differences in regenerative potential between humans, nonhuman primates, and canines were also examined. Results of over a decade of studies of periodontal reconstructive therapy were tabulated by family (human, nonhuman primate, and canine) …

Periodontal Repair In Dogs : Evaluation Of Rhbmp-2 Carriers, Lauralee Nygaard

Loma Linda University Electronic Theses, Dissertations & Projects

This study evaluated candidate carriers for recombinant human bone morphogenic protein-2 (rhBMP-2) in periodontal reconstructive surgery.

Canine demineralized bone matrix (DBM), bovine inorganic crystallene bone matrix (Bio-Oss), bovine derived microfibrillar collagen matrix (Helistat), poly (D,L-lactide-coglycolide) micropaiticles (PLGA), and polylactic acid granules (Drilac) were used with rhBMP-2 (20 (µg/100 µl implant volume) in routine critical size canine supraalveolar periodontal defects. Contralateral defects in six beagle dogs were randomly assigned to receive: DBM/rhBMP-2, DBM-control, Bio-Oss/rhBMP-2, Helistat/rhBMP-2, PLGA/rhBMP-2, or Drilac/rhBMP-2, all with autologous blood except for Helistat and PLGA. Animals were sacrificed eight weeks post-surgery and block sections of the defects were processed …

Experimental Peri-Implant Tissue Breakdown In Rhesus Monkeys, Oliver Hanisch

Loma Linda University Electronic Theses, Dissertations & Projects

The aim of this investigation was to characterize peri-implant tissue breakdown following ligature-induced plaque accumulation around osseointegrated implants in the rhesus monkey. Two hydroxyapatite-coated cylindrical implants were inserted bilaterally in the second premolar and first molar region of both mandible and maxilla in four non-human primates (Macaca mulatto). The implants were left submerged to osseointegrate for one year. Eight weeks after healing abutment connection, a two-month plaque control program was initiated. At the end of this period, clinical and radiographic recordings were carried out, and peri-implant subgingival microbial samples were obtained (baseline). Subsequently, cotton ligatures were placed around …

Healing Following Periodontal Reconstructive Surgery : Surgical Implantation Of A Collagen Matrix Or Demineralized Freeze-Dried Bone Allograft, Seong Yong Choi

Loma Linda University Electronic Theses, Dissertations & Projects

Healing following periodontal reconstructive surgery including surgical implantation of a collagen matrix or demineralized freeze-dried bone allograft (DFDBA) was evaluated in a preclinical (collagen) and a clinical (DFDB A) study.

Contralateral periodontal fenestration defects in 7 beagle dogs were used to evaluate the effect of a collagen matrix on periodontal healing. The defects (6x4 mm) were created through the buccal cortical plates of the maxillary canine teeth following elevation of mucoperiosteal flaps. The collagen was fitted to the defects on one side, while contralateral defects served as controls. Raps were repositioned and sutured. Dogs were sacrificed 4 weeks after surgery …

Periodontal Repair In Dogs : Part I : Evaluation Of The Natural Disease Model ; Part Ii : Eptfe Barrier Membranes Support Wound Stabilization And Enhance Bone Regeneration, James Marc Haney

Loma Linda University Electronic Theses, Dissertations & Projects

Animal models are frequently consulted for histometric analysis of reconstructive periodontal therapy. Statistical analysis of induced lesion defects and surgically created defects from our laboratory suggest defect size homogeneity is critical for the model to discriminate treatment effects. This study characterizes natural disease defects in beagle dogs. Buccal-lingual histologic sections from the 2nd, 3rd, and 4th mandibular premolar teeth (P2, P3, P4) from 6 aged beagle dogs with natural disease defects were evaluated for variation in defect height between pair matched tooth types, and jaw quadrants, as well as estimated confidence intervals for treatment differences between left and right pair …

Reproducibility Of Periodontal Probing, Su-Fang Wang

Loma Linda University Electronic Theses, Dissertations & Projects

This study evaluated reproducibility of periodontal probing by conventional manual and automated force-controlled electronic probes. A total of 1206 sites (6 sites per tooth including maxillary and mandibular incisor/canine, premolar, and molar sites) in 15 patients with history of moderate or advanced chronic periodontal disease were examined. Probings included probing pocket depths (PD), as well as probing attachment levels (PAL) from a reference stent. Measurements were recorded to the nearest 0.5 mm with both methods. Patients were examined twice, 7 to 10 days apart. At each visit, all sites were probed first with the conventional probe and then with the …

Transforming Growth Factor-Beta 1 Expression In Developing Ovine Teeth As Visualized By In Situ Hybridization, Søren Jepsen

Loma Linda University Electronic Theses, Dissertations & Projects

Recently we demonstrated that human dentin contained relatively high amounts of transforming growth factor beta (TGF-ß) and proposed that dentin TGF-ß originated from odontoblasts. Because of the suggested role of TGF-ß in mediating cellular interactions in dental cell development by paracrine mechanisms, we studied the expression of TGF-ß message in developing teeth by in situ hybridization. 5 µm serial sections of neonatal sheep mandibular third molars that had been fixed in glutaraldehyde and paraffin-embedded were used for in situ analysis. An [³⁵S]-labeled cRNA probe, complementary to TGF-ß1 mRNA, was constructed from human TGF-ß1 cDNA. Northern analysis of total …

The Periodontal Intraosseous Defect Following Root Conditioning With Citric Acid And Wound Closure Including A Ptfe Membrane : An Experimental Study, Betty Glaser Kersten

Loma Linda University Electronic Theses, Dissertations & Projects

Treatment of the intrabony or intraosseous periodontal defect has rendered much attention over the last few decades. Numerous approaches have been advocated; however, overall comparisons between treatments do not exist. This review summarizes and discusses outcomes of therapeutic modalities in the intrabony periodontal lesion from controlled clinical studies. The modalities reviewed include scaling and root planning, gingival flap surgery, gingival flap surgery including wound closure with interdental denudation, root-biomodification, placement of autologous, allogenic, or xenogeneic bone grafts, placement of alloplastic grafts, and placement of tissue guiding barrier membranes. In addition histologic observations of healing in the intrabony periodontal lesion are …

The Effect Of An Anti-Osteoclastic Agent And A Collagen Sponge On Root Resorption Following Regenerative Periodontal Surgery In The Dog, Rudolf Hahn

Loma Linda University Electronic Theses, Dissertations & Projects

Previous studies indicate that root resorption is a frequent sequela to significant amounts of periodontal repair following experimental regenerative periodontal surgical procedures in animal models. To study if root resorption can be reduced or prevented, periodontal repair was evaluated in large horizontal circumferential defects in the dog in the absence of influence from the oral environment. Diphosphonate (Cl₂ MDP) applied topically to the root surfaces prior to wound closure as well as the use of a collagen sponge membrane (Helistat®) draped over the root surfaces and a control with no additional treatment after defect creation were the modalities employed. …

Treatment Of Periodontal Furcation Defects, Michael Martin, Bernard Gantes

Loma Linda University Electronic Theses, Dissertations & Projects

[Note: Three parts in one.]

I. Review of the Literature and Description of a Regeneration Surgical Technique

This report provides an abbreviated review of the literature on treatment and prognosis of periodontal furcation lesions. In addition, it describes a surgical technique designed to accomplish bone regeneration in class II furcation defects, together with the rationale for the development of this procedure. Results of treatment of 30 defects with this technique are presented in a subsequent report (Gantes et al. 1987).

II. Bone Regeneration in Mandibular Class II Defects

A total of 30 mandibular, buccal class II furcation defects were treated …

Effects Of Oral Hygiene Measures On Clinical And Microbiological Parameters Of Periodontal Disease, Bruno Loos

Loma Linda University Electronic Theses, Dissertations & Projects

The effects of a 12-week period of oral hygiene alone on gingival conditions and subgingival microflora in 15 patients with severe periodontitis were investigated. In addition, subgingival microsamples were compared during this oral hygiene phase with those obtained 1 week after debridement. Clinical measurements and subgingival samples from selected sites were taken at week 0 (baseline), week 6, and week 12. Microbial samples were also taken at week 13, that is, one week following debridement. At week 0 the patients were instructed in supragingival plaque control and at week 6 the hygiene regimen was supplemented with the subgingival use of …

Treatment Of Periodontal Furcation Defects, Bernard Gantes

Loma Linda University Electronic Theses, Dissertations & Projects

This report provides an abbreviated review of the literature on treatment and prognosis of periodontal furcation lesions. In addition, it describes a surgical technique designed to accomplish bone regeneration in class II furcation defects, together with the rationale for the development of this procedure. Results of treatment of 30 defects with this technique are presented in a subsequent report (Gantes et al. 1987).

Predictions Of The Effects Of Nonsurgical Periodontial Therapy : Prospective And Retrospective Identification Of Deteriorating Sites, Rik Achille Vanooteghem

Loma Linda University Electronic Theses, Dissertations & Projects

Clinicians rely mostly on clinical signs of disease and radiographic information to evaluate the periodontal condition of patients before and after initial, nonsurgical periodontal therapy. The results of their evaluations lead to decisions that determine the need for further periodontal therapy, often surgical, and may also provide guidelines for subsequent dental restorative treatment.

Thirteen subjects with moderate to advanced periodontal disease received oral hygiene instruction and one single episode of root planing. Three experienced clinicians made made[sic] independent predictions in individual tooth sites of the outcome of this initial therapy. They identified sites that in their opinion probably would not …

Healing Following Two Different Surgical Approaches To Treating Deep Periodontal Intraosseous Defects, A. Durwin H. Chamberlain

Loma Linda University Electronic Theses, Dissertations & Projects

Surgical treatment of deep periodontal pockets associated with intraosseous defects has traditionally been performed either with or without resection of the osseous defect. A non-resective approach may provide more gain of attachment while a resective approach may give better pocket reduction. The increased pocket reduction following osseous resection is probably accomplished at the expense of some attachment loss in areas involved by the surgical procedure. Previous studies have compared periodontal surgery with and without osseous resection (i.e. Rosling et al. 1976, Knowles et al. 1979 and Smith et al. 1980). However, the effect of osseous resection does not seem to …

Histologic Probe Position In Treated And Untreated Human Periodontal Tissues, Clifford Fowler

Loma Linda University Electronic Theses, Dissertations & Projects

This study was designed to histologically determine the relationship of the periodontal probe tip to the periodontal tissues during probing of untreated periodontal pockets and periodontal pockets treated with oral hygiene and root planing. Human, condemned, single rooted teeth with buccal probing pocket depth at least 6 mm were used. Two groups of specimens were included; 12 untreated teeth from 6 patients and 15 treated teeth from 10 patients.

In the treated group, the effects of therapy were monitored clinically every two weeks until maximum improvement had taken place. A periodontal probe tip was then inserted on the buccal aspect …

The Effect Of Mechanical Plaque Control On The Clinical Parameters Of Human Periodontal Disease, John F. Cercek Jr.

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this investigation was to determine the degree of healing which takes place in the periodontal tissues as a result of supragingival and subsequent subgingival plaque control attempts without any associated supra- or subgingival instrumentation and root planing.

Seven patients with moderate to severe periodontitis were finally selected for the study. Measurements were made on maxillary and mandibular incisors, cuspids and premolars to establish base line plaque scores, bleeding scores, probing pocket depths, and probing attachment levels. The patients were then instructed in the use of toothbrushes, dental floss and interdental brushes where indicated. Measurements were repeated at …

The Effects Of Palatal Expansion Therapy On The Periodontal Supporting Tissues, Kenneth R. Greenbaum, Bjorn U. Zachrisson, John K. Pearson, Roland D. Walters, Jan Egelberg, James R. Wise, Grenith Zimmerman

Loma Linda University Electronic Theses, Dissertations & Projects

Four periodontal parameters were examined to determine the effect of rapid and slow palatal expansion techniques on the supporting structures at the buccal aspect of the maxillary first permanent molars. The parameters examined included the levels of crestal alveolar bone and soft tissue attachment (relative to the cemento-enamel junction), the depth of the gingival sulcus, and the height of the attached gingiva. The area between the buccal roots was inspected for possible furcation involvement. Twenty-eight patients had experienced a rapid technique utilizing a tissue-born, fixed, split-acrylic appliance, while thirty-three patients had been treated with the quad-helix appliance associated with slow …

Changes Of The Marginal Periodontium As A Result Of Labial Tooth Movement In Monkeys, Gregory G. Steiner, J. K. Pearson, J. Ainamo

Loma Linda University Electronic Theses, Dissertations & Projects

Orthodontic tooth movement was performed on five monkeys (Macaca nemistrina). Oral health was established and exploratory surgery was performed to assess the level of the connective tissue attachment and marginal bone. Measurements of the gingival margin and mucogingival junction were taken and orthodontic forces were applied. The central incisors were moved labially a mean distance of 3.05mm. Post therapy measurements were performed to assess the change which occurred as a result of tooth movement. Significant recession of the gingival margin, connective tissue level and marginal bone was found when compared to an amalgam marker located on the facial surface of …

Evaluation Of New Attachment Following Full Thickness Flap Procedure In Humans, Shaunda S. Steiner

Loma Linda University Electronic Theses, Dissertations & Projects

A study was made to investigate the biological possibility of obtaining new connective tissue attachment to periodontally diseased root surfaces following full thickness flap procedure. Reconstructive surgery was performed on seven teeth involved in advanced chronic periodontal disease. A mucoperiosteal flap was raised and the apical extent of existing subgingival calculus was marked with a notch made into the root just apical to the calculus. Following thorough instrumentation, sterile saline was applied to the root surface for five minutes, and the flap was repositioned and sutured. Four months later the teeth with attached periodontal tissues were removed and processed for …

Ultrastructural Study Of Wound Healing On A Root Planed And Citric Acid Treated Root Surface, Craig Martin Ririe

Loma Linda University Electronic Theses, Dissertations & Projects

It has been shown previously that a root surface which has been scaled, root planed and demineralized by topical application of citric acid in vitro, is dominated by exposed collagen fibrils. The purpose of this study was to examine the mechanism of healing and possible reattachment of soft periodontal connective tissue to the root planed and subsequently acid treated root surfaces and to determine whether new collagen fibrils produced in the connective tissue could attach to these exposed fibrils.

Full thickness tissue flaps were raised and the coronal 4-5 mm of the labial alveolar plate removed over the maxillary incisor …

New Attachment Of Connective Tissues To Human Teeth Involved In Chronic Periodontal Disease : A Histologic Study, Rick Cole

Loma Linda University Electronic Theses, Dissertations & Projects

Reconstruction of the periodontium destroyed by periodontal disease may be considered an ultimate goal of reconstructive periodontal therapy. To date, there has been no concrete evidence demonstrating this phenomenon in humans. Garrett (1978) has shown that citric acid, after application to root planed tooth surfaces, produces a four micron wide demineralized zone which is characterized by exposed collagen fibers. It is impossible that this demineraIization may lead to new attachment by enhancing cementogenesis or by exposing root surface-fibers which by simple fibrogenesis may splint to fibers of the healing surgical wound. Register (1973) and Register and Burdick (1975) have reported …

A Comparison Of A Step-By-Step Versus An All-In-One Approach In Teaching Plaque Control, Charles R. Woofter

Loma Linda University Electronic Theses, Dissertations & Projects

Using plaque scores as the measurement criterion, two different methods of teaching plaque control skills were tested. Based on initial plaque scores, 25 patients with periodontal disease were paired and divided into two groups: a "step-by-step" and "all-in-one" group. The subjects of both groups were given four one-half hour appointments of instruction. Members of the "step-by-step" group were taught in three successive appointments a horizontal scrub toothbrushing method, how to floss and how to use the Perio Aid. All members of the "all-in-one" group were taught how to use all three oral hygiene instruments at the first appointment. No additional …

The Effects Of Topically Applied Citric Acid On Periodontally Diseased Root Surfaces, John S. Garrett

Loma Linda University Electronic Theses, Dissertations & Projects

The goal of reconstructive periodontal therapy is new connective tissue attachment to periodontally diseased root surfaces. Recently Register (1973) and Register and Burdick (1975) have reported accelerated reattachment and cementogenesis when citric acid was applied to surgically created root surface defects. There are apparently no reports in the literature regarding the effects of citric acid on periodontally diseased root surfaces. This study was designed to determine the effects of topically applied citric acid on periodontally diseased root surfaces using the scanning (SEM) and transmission (TEM) electron microscopes.

Twenty three human teeth, nineteen extracted because of periodontal disease and four bicuspids …

Gingival Condition In Areas Of Minimal And Appreciable Widths Of Keratinized Gingiva, Myles C. Miyasato

Loma Linda University Electronic Theses, Dissertations & Projects

This investigation evaluated the gingival condition of areas with minimal (less than or equal to 1.0 millimeter) and appreciable (greater than or equal to 2.0 millimeters) widths of keratinized gingiva.

Sixteen dental, dental hygiene, and dental assisting students and dental faculty who had contralateral or unilateral areas of minimal and appreciable widths of keratinized gingiva on the mid-buccal surface of mandibular bicuspids were examined. Gingival exudate, plaque, gingival inflammation based on color change and/or swelling and bleeding on probing were evaluated. The results showed that all areas examined were plaque free. Three of 32 areas showed clinical gingival inflammation and …