The prevalence of periodontal disease and oral hygiene care in Savannakhet Province, Lao People's Democratic Republic.

The objective of this study was to evaluate the prevalence of periodontal diseases in Savannakhet Province, Lao PDR. This survey was conducted 14 years after the country reformed its economic structure towards the free market. Thirty villages were picked by simple random sampling from a total of 1,560 villages. Two thousand four hundred and fifty-three individuals, aged twelve and over, were interviewed about oral hygiene practice, and were examined for periodontal health status using the community periodontal index of treatment needs (CPITN) index. Forty percent of the sample had regular practices, 56.5% occasional practices and 3.5% were ignorant about oral hygiene. Oral hygiene practices were performed in the morning by using a toothbrush (61.1%) and the index finger (24.8%). The cleaning agent was water alone for 68.6% and salt powder for 28%. The prevalence of healthy gingiva was nearly zero in all age groups. Gingival bleeding was very low. The most common periodontal problem was calculus deposits, found in 3-5 sextants of all age groups. The pocket depth was 4-5 mm on average; however a depth of more than 6 mm was not observed.

A clinical comparison of the new attachment obtained by guided tissue regeneration and coronally positioned flap techniques in the management of human molar furcation defects.

The present clinical trial was designed to evaluate the regenerative potential of the periodontal tissue in Class II furcation defects in mandibular molars using reconstructive surgery based on the guided tissue regeneration (GTR) technique versus the coronally positioned flap (CPF) technique. After the completion of the initial phase of therapy and four to six weeks healing period, 20 furcation-involved molars were examined for baseline data which included plaque index, gingival condition, probing depth (PD), probing attachment level (PAL-V, PAL-H) and radiographs. All parameters were reexamined after three, six and twelve months of healing, except PD, PAL-V and PAL-H which were not measured at three and six months. A nonparametric analysis was used. The study showed that there were no significant differences in the mean baseline measurements between the treatment groups. After 12 months following surgical treatment, both GTR and CPF procedures showed gains in new clinical attachment levels. When comparing parameters between the two surgical procedures, GTR molars showed significantly more improvement in probing depth as well as vertical and horizontal attachment level of the interradicular osseous defect than did the CPF molars (p < 0.05). About 80 per cent of the sites treated with the GTR technique showed complete clinical resolution of the furcation problem. CPF therapy reached the same Treatment goal in about 50 per cent of the cases which were treated. Guided tissue regeneration appeared to be more effective in promoting regeneration than the coronally positioned flap.

Comparison between 2 surgical techniques for the treatment of early-onset periodontitis.

The objective of this study was to compare guided tissue regeneration (GTR) and osseous surgery (OS) in treatment of early-onset periodontitis. Six patients participated in this research, presenting 15 paired defects randomly assigned to 1 of the surgical groups. Pre-operative clinical parameters (probing depth and attachment loss) between the two groups were not significantly different. Results 1 year following surgery showed probing depth reduction (2.60 +/- 1.30 mm) and clinical attachment gain (2.20 +/- 1.42 mm) were significantly greater in the GTR group than in the osseous surgery group (P < 0.05). The gingival recession was -0.53 +/- 0.52 mm and -0.40 +/- 0.74 mm for the osseous and the guided tissue regeneration group, respectively (no significant difference, P > 0.05). Radiographic analysis by two techniques illustrated that the interproximal alveolar bone changes at the margin of the defects in the OS group were slightly decreased (-0.20 +/- 1.15; 0.26 +/- 0.74 mm) and those in the GTR group were slightly increased (0.16 +/- 0.96; 0.26 +/- 0.68 mm), but showed no significant difference (P > 0.05). The base of the GTR-treated defects showed significant increase in bone fill (1.67 +/- 0.68; 1.97 +/- 0.74 mm; P < 0.05). At a follow-up reexamination 1 year following surgery, oral hygiene and gingival conditions in both groups were at satisfactory levels and gingiva was clinically healthy throughout the entire study period, except the first 4 to 6 weeks following surgery.

[Comparison of some subgingival microflora from juvenile periodontitis before and after scaling and root planing].

Actinobacillus actinomycetemcomitans and Capnocytophaga are subgingival bacteria that have correlation with juvenile periodontitis. Studies were carried out in a group of 20 patients with juvenile periodontitis before, after treatment by scaling, root planing, oral hygiene instruction and 20 patients with healthy gingiva as a control group. Gingival index, plaque index, pocket depth were measured. Subgingival bacteria were counted on selective media and compared by phase contrast microscopy. Before treatment all measurements in the patients and the control group were significantly different (P less than 0.05). In the patients before and after treatment all clinical measurements were significantly different (P less than 0.05) but the amount of A.actinomycetemcomitans and Capnocytophaga were not significantly different (P greater than 0.05). These results indicate that treatment of juvenile periodontitis by scaling, root planing and oral hygiene instruction improve the clinical measurements but are not effective in reducing proportions of subgingival bacteria.

Potentials for root resorption during periodontal wound healing.

The present study was undertaken to examine whether (1) the process of resorption, which invariably affects periodontitis involved reimplanted roots facing bone or gingival connective tissue during healing, is a transient phenomenon and, (2) root resorption can be prevented by permitting downgrowth of epithelium along the root surface. A total of 24 teeth in 2 monkeys (Macaca cynomolgus) was subjected to experimental periodontal tissue breakdown by the placement of elastic ligatures around the teeth. The ligatures were left in situ until about 50% of the supporting tissues had been lost. Following removal of the ligatures, the teeth were extracted and the denuded portions of the roots were scaled and planed. The crowns of the teeth were resected and the root canals filled with guttapercha. The roots were subsequently implanted into sockets prepared in the jaw bone in such a way that each root was embedded in bone except for a portion which was in contact with gingival connective tissue. 1 month prior to sacrifice of the animals, the cut surface of the coronal part of the roots was exposed by removal of the covering soft tissue. The epithelium was thereby allowed to migrate into the wound. Implantation of the roots was scheduled to provide healing periods of 1, 2, 3, 4, 8, 12, 16, 20 and 24 weeks before exposure of the roots. The histologic examination of the implant specimens disclosed that replacement resorption was a progressive process which eventually resulted in the elimination of the transplanted roots. It was possible to prevent root resorption in this model by permitting apical downgrowth of epithelium along the root surface during the initial phase of healing. The results are discussed in relation to procedures used in periodontal therapy.