Clinical and microbiological effects of subgingival application of a chlorhexidine gel in chronic periodontitis. A pilot study.

Clinical and microbiological effects of subgingival application of a 1% chlorhexidine gel were studied. Eleven patients with chronic periodontitis participated in the study. In each patient two pairs of single rooted teeth with at least 20% attachment loss and probing depth > 4 mm were selected. Contralateral sites were randomly allocated to test and control groups receiving chlorhexidine or placebo gel respectively. The gels were applied once daily for two consecutive days. The clinical parameters comprised plaque index, gingival index, probing pocket depth and bleeding on probing. The composition of the subgingival microbiota was estimated with use of dark field microscopy. Baseline measurements were taken two weeks prior to chlorhexidine application. Microbiological and clinical parameters were further monitored 2, 7, 14 and 28 days after the last gel application. Chlorhexidine gel application did not significantly change the composition of the microflora compared to placebo application. There were no major differences in plaque and gingival indices. Effects on probing pocket depth of the chlorhexidine gel application may have been disguised by an influence from the diameter of the needle with which the application was performed. Needles with a diameter of 25G resulted in increases in probing pocket depth which indicates a possible mechanical trauma. This effect was not observed when needles with a diameter of 23G were used.

Crevicular and salivary fibronectin before and after gingivitis treatment.

The aims of this study were to assess crevicular fibronectin concentrations before and after conventional gingivitis treatment and to determine whether fibronectin concentration in whole saliva would be affected concomitantly. 10 subjects with generalized gingivitis were selected. Examinations were made before and after treatment and included measurements of clinical parameters as well as collection of samples of unstimulated saliva, stimulated saliva and crevicular material. The concentration of fibronectin was studied by an ELISA assay. Fibronectin was found in gingival crevices and in unstimulated as well as paraffin-stimulated whole saliva in pre- and post-treatment samples. There were no statistically significant differences between pre- and post-treatment concentrations of fibronectin, whether expressed as micrograms fibronectin/micrograms protein or as micrograms fibronectin/ml saliva.

Absorption of fibronectin from human saliva by strains of oral streptococci.

Freshly collected human submandibular/sublingual saliva contained between 1.0 and 26.1 micrograms/ml of fibronectin as determined by ELISA. 10(9) organism of 12 oral streptococcal strains tested removed between 2.6 and 89.4% of the fibronectin present in 400 microliters saliva. Fibronectin was retained in bacterial pellets after washings in buffer but could be eluted using 1 M NaCl.

Fluctuations in crevicular and salivary anti-A. viscosus antibody levels in response to treatment of gingivitis.

Experimental gingivitis studies support a pathogenic rôle for Actinomyces viscosus because of its numerical predominance in disease-associated plaques. The aims of the present investigation were to quantify specific crevicular IgG against A. viscosus before and after conventional gingivitis treatment and to determine whether salivary IgA and IgG against A. viscosus and A. naeslundii would be affected concomitantly. 6 subjects with generalized gingivitis were selected. Examinations were made before and after treatment and included collection of unstimulated saliva, paraffin-stimulated saliva and crevicular material as well as measurements of clinical parameters. The immunoglobulins were estimated by an ELISA assay using whole bacterial cells as antigen. Crevicular IgG against A. viscosus WVU 627 was demonstrated in pre- and post-treatment samples with a tendency towards increased values in the post-treatment samples. Salivary IgA and IgG against A. viscosus were also demonstrated in pre- and post-treatment samples. There were tendencies towards increased IgA values for paraffin-stimulated saliva and increased IgG values for unstimulated saliva in the post-treatment samples. Salivary IgA and IgG values against A. naeslundii ATCC 12104 were either not detected or barely detectable in both pre- and post-treatment samples. A. naeslundii B 74 IgG values were also rather low. As for A. viscosus WVU 627, anti-B 74 IgA values demonstrated a post-treatment increase for most subjects, especially for unstimulated saliva for which all post-treatment values were elevated. It is interesting to note that saliva samples showed changes similar to crevicular material, considering that salivary IgA is most likely derived from a different source. Together, elevated crevicular and salivary antibody concentrations might account for some of the beneficial effects of periodontal therapy by scaling.