Alveolar bone loss in patients with long-term supportive care.

Radiographic record audits were conducted on 63 patients diagnosed as having periodontitis who had been treated and maintained for 10 years or longer in dental school clinics. Acceptable bite-wing radiographs were available for 50 of these patients. Bite-wing radiographs taken 8 to 34 years apart (mean 14.9 years) were assessed for bone loss. Recall maintenance had been accomplished for 60% of these patients at 6 to 9 month intervals, while 24% had been seen more frequently. The mean annual rate of bone loss was 0.037 mm (range of -0.19 to 0.20). There were no significant differences in bone loss between maxillary/mandibular, molar/premolar, or mesial/distal sites respectively. Alveolar bone loss in this dental school population compares well with other reported studies. Progression of disease as assessed by radiographic bone loss in treated and maintained periodontitis patients is minimal.

The effectiveness of subgingival scaling and root planning. I. Clinical detection of residual calculus.

This study evaluated the ability of clinicians to detect residual calculus following subgingival scaling and root planing and compared the clinical detection to the microscopic presence and surface area occupied by calculus found on teeth extracted after instrumentation. Interexaminer and intraexaminer reproducibility in clinically detecting subgingival calculus was also determined. One hundred one extracted teeth with 476 instrumented tooth surfaces were evaluated stereomicroscopically for the presence of calculus and the percent surface area with calculus was determined by computerized imaging analysis; 57% of all surfaces had residual microscopic calculus and the mean percent calculus per surface area was 3.1% (0 to 31.9%). Shallow sites had greater surface area of calculus than moderate and deep sites. The difference was not significant. The interexaminer and intraexaminer clinical agreement in detecting calculus was low. There was a high false negative response (77.4% of the surfaces with microscopic calculus were clinically scored as being free of calculus) and a low false positive response (11.8% of the surfaces microscopically free of calculus were clinically determined to have calculus). This study indicates the difficulties in clinically determining the thoroughness of subgingival instrumentation.

Tooth loss in patients with moderate periodontitis after treatment and long-term maintenance care.

Records of 63 patients diagnosed as having moderate periodontitis who had been treated and maintained by scaling and root planing for 10 years or longer (mean 13.6 years, range 10 to 34 years) in dental school clinics were reviewed for tooth loss. The patients averaged 45 years of age (range 24 to 67 years) at the initial appointment, and 41 were female. Record audit determined type of periodontal treatment, total tooth loss, periodontally related tooth loss, loss of teeth with furcation invasion, plaque scores, and maintenance interval. Results of therapy were evaluated by groups on the basis of number of teeth lost. At the completion of active periodontal therapy 1,607 teeth were present in the patients. During the maintenance period, 115 teeth (7.1%) were lost and of these 88 (5.0%) were lost due to periodontal reasons. Maxillary and mandibular molar teeth, particularly maxillary second molars, were the teeth lost most frequently to periodontal disease. Of the 164 teeth initially indicated as having furcation invasion, 23% were subsequently lost. This retrospective study confirms the low rate of tooth mortality occurring when patients with periodontal disease are treated and kept on a maintenance program. Canines were the teeth least frequently lost.

Surgical versus non-surgical treatment and recurrent periodontal disease in beagle dogs.

The present study was designed to compare clinical, microbiologic and histometric parameters of recurrent periodontal disease in areas which had been treated either surgically (SU) or nonsurgically (NS). Periodontal disease was induced for 6 months in 3 quadrants in each of 6 beagle dogs. 2 of the 3 diseased quadrants were treated by definitive surgical or nonsurgical therapy followed by plaque control for 4 months. 2 dogs were then sacrificed to provide histometric data. Periodontal disease was reinduced in the remaining 4 dogs by allowing plaque accumulation for 6 months after which the dogs were sacrificed for histometric analysis. Clinical parameters were recorded and darkfield microscopic analysis of subgingival plaque samples was performed at regular intervals. Following 6 months of plaque accumulation during disease reinduction, there were significant changes (p less than 0.05) in the pocket depths, bleeding scores and attachment levels in both the SU and NS areas. These changes were accompanied by significant increases (p less than 0.05) in the proportions of spirochetes and motile rods and decreases in the proportions of coccoid cells in both the SU and NS areas. There were, however, no significant differences between the SU and NS areas when clinical and microbiologic parameters were compared. At the end of disease reinduction phase, the length of inflammatory cell infiltrate and % inflamed connective tissue had increased significantly in both the SU and NS areas.(ABSTRACT TRUNCATED AT 250 WORDS)

Effectiveness of sodium fluoride on tooth hypersensitivity with and without iontophoresis.

Effectiveness of iontophoresis with and without electric current and sodium fluoride on tooth hypersensitivity was evaluated. In eleven volunteers, teeth received a 2% neutral sodium fluoride solution applied using an electrode phoresor. Test teeth received the solution with current and control teeth received the solution without current. The subjects were tested at Day 0 and 7 by means of a mechanical stimulating device and a temperature probe. The data were then analyzed using X2 analysis. Statistically, the test teeth demonstrated more improvement than the control teeth.