Aspartat aminotransferase--a marker of periodontal disease activity.

Active and inactive periodontal pockets exist in periodontal disease and the progression of periodontitis is episodic and cyclical. Current diagnostic tests do not distinguish between active and inactive lesions. Objective assessment of disease activity could significantly affect periodontal therapy. Aspartat aminotransferase (AST) activity in gingival crevicular fluid is a potential quantitative marker of periodontal disease activity. Thirty-six patients with periodontitis, twenty with adult periodontitis and sixteen with rapidly progressive periodontitis were evaluated clinically prior to treatment and AST activity in periodontal pockets was determined prior to and after initial therapy. Clinical measures included plaque index, gingival inflammation degree and attachment loss. The results show that AST levels do not correlate with clinical indices and that they decrease after treatment. AST is a possible novel biochemical marker of periodontal disease activity independent of commonly used clinical measures. It could also be useful for early monitoring of treatment success.

Inflammatory mediators in saliva of patients with rapidly progressive periodontitis during war stress induced incidence increase.

Rapidly progressive periodontitis (RPP) results from the interaction between the periodontal microflora and the host. Stress is believed to play an important role in determining host responses, and it has been proposed that hyperactivity of host defense mechanisms significantly increases tissue destruction typical for this disease. During a period of four months we have diagnosed 20 patients with acute RPP, all of them active participants in battles of the Croatian liberation war with posttraumatic stress disorder (PTSD) related symptoms. In these patients we analyzed biochemical parameters in unstimulated saliva and performed microbiological analyses of periodontal pockets. These findings were compared with those of patients with adult periodontitis (AP), edentulous and healthy persons, none of whom participated in the war. Persons with AP had reduced concentrations of host humoral defense factors in saliva (C-reactive protein, C3 component of complement, and aplha alpha 2-macroglobulin), while patients with RPP had increased concentration of interleukin-6 (IL-6). IL-6 is released by host inflammatory cells and is a mediator of bone resorption. Actinobacillus actinomycetemcommitans and Peptostreptococcus were more frequently isolated from patients with RPP. We interpret these results as indicators of the importance of stress in the causation of RPP, with host inflammatory hyperactivity playing an important role in tissue destruction, specially alveolar bone resorption possibly caused by increased local levels of IL-6.

CPITN assessment of periodontal treatment needs in the population of Zagreb, Croatia.

The aim of this study was to assess the prevalence and required treatment of periodontal disease in Zagreb using the CPITN system. A total of 3176 subjects of both sexes, divided into reference age groups, was studied using the methods and standards recommended by the World Health Organization, the Community Periodontal Index of Treatment Needs (CPITN). A very high prevalence of periodontal disease in the population of Zagreb was recorded. Gingivitis was found in the entire population of school children and deep pockets were present even in those aged 20 years, the prevalence progressively rising with age. The need for oral hygiene instruction was recorded in almost all subjects examined, and the highest need for specialist periodontal treatment was registered in more than 56 per cent of the oldest subjects, over the age of 64. The data suggests the need for better organisation of preventive services and a more conscientious approach to treatment.

Oral health in SFR Yugoslavia in 1986.

A pilot oral health epidemiological survey using WHO assessment forms was conducted in Yugoslavia in the year 1986. The study population consisted of 2600 persons aged 6, 12, 15, 18, 35-44, and over 65 yr. The survey included 22 towns (11 developed and 11 underdeveloped) in the six Republics and two Provinces of Yugoslavia. The results showed the prevalence of dental caries in the Yugoslav population to be very high (98.7% in 12-yr-olds). The mean decayed, missing, and filled teeth (DMF) scores were as follows: 6.1 at age 12 yr, 9.6 at age 15, 10.9 at age 18, 18.0 at age 35-44, and 28.0 in persons aged over 65 yr. Assessment of the periodontal status showed calculus to be the predominant disorder in the age groups 18 and 35-44 yr, while loss of sextants prevailed in persons aged over 65 yr.

Increase of gingival hydroxyproline and proline by improvement of ascorbic acid status in man.

The 4-hydroxyproline and proline content of periodontal tissue was measured in 24 adult volunteers with initially low and partially even deficient plasma vitamin C values, before and after peroral supplementation with 70 mg ascorbic acid daily for six weeks. The latter caused a statistically significant rise and normalization respectively of plasma ascorbic acid and simultaneously a statistically significant increase of the hydroxyproline and proline in periodontal tissue (p less than 0.01) but not before the plasma vitamin C level was above 0.9 mg/dl. The optimal plasma vitamin C level which was associated with the highest hydroxyproline and proline content in periodontal tissue ranged between 1.00-1.30 mg/dl corresponding to the total daily dietary ascorbic acid intake of about 100 mg.

The effect of ascorbic acid supplementation on periodontal tissue ultrastructure in subjects with progressive periodontitis.

In an attempt to determine the optimal daily ascorbic acid requirement, the effect of different levels of ascorbic acid intake on collagen synthesis was studied in a double-blind experimental design. By use of electron microscopy, interproximal gingival tissue sections in subjects consuming between 20 to 35 mg of ascorbic acid daily were examined before and after the administration of tablets containing 70 mg of ascorbic acid. The results showed that practically all subjects were affected by progressive periodontitis with marked changes in the connective tissue of the gingival lamina propria. After six weeks of supplementation with ascorbic acid, differences in the shape and activity of fibroblasts in the regenerative tissue of lamina propria were observed. This has resulted in the increased number of collagen bundles in fibroblasts' periphery, increased tonofibril content and an enlarged number of desmosomes between adjacent cells. It is concluded that the obtained results, though suggesting that the optimal daily ascorbic acid intake should be set above the presently recommended 30-50 mg, have to be quantified by a more objective analytical method.

[Cytological findings of the buccal mucosa of the rat without and with ovulation inhibitor]. / Zytologische Befune der bukkalen Rattenschleimhaut ohne und mit Ovulationshemmer.

PIP: The appearance of Papanicolaou-stained buccal smears from cycling rats and rats treated with the oral contraceptive Aconcen, Etalontin, or Lyndiol is described and their keratinization compared. The steroids were administered in doses of 1-1.5 mg/day on Days 1-2, with a pause on Day 5, for 10 months. In normal rats 90% of the cells were keratinized. In the preovulatory phase, cells were predominantly single , small, rectangular, had a transparent acidophilic red or gold cytoplas m, and an undetectable nucleus. In the postovulatory phase cells were m ore often grouped, large, folded along their lenght or rolled on their edges, with acidophilic red, transparent cytoplasm. In the menstrual phase the buccal cells were irregular, long and randomly grouped with transparent acidophilic gold and green cytoplasm. The kertin index according to Muhlman's method was high on Days 2 and 3 and lowest on Days 5 and 1. During steroid treatment, 95% of the cells were keratinized and more mature. No differences in structure occurred throu ghout the cycle, but the degree of keratinization was proportional to es trogen dose in the pills.^ieng