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  • 1
    Electronic Resource
    Electronic Resource
    Copenhagen : Munksgaard International Publishers
    Journal of clinical periodontology 27 (2000), S. 0 
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background, aims: Between 4 and 8% of periodontitis patients are reported to respond poorly to conventional therapy. In these cases, adjunctive use of systemic antibiotics might be a reasonable therapeutic approach. The purpose of this study was to evaluate the effects of systemic amoxicillin/clavulanate as adjunct to periodontal surgery on the predominant subgingival microorganisms in patients not responding to mechanical therapy. Furthermore, the bacterial susceptibility to amoxicillin/clavulanate was analyzed before and after therapy in order to assess the clinical validity of pre-therapeutic susceptibility testing.Methods: In 10 periodontitis subjects with no subgingival detection of Actinobacillus actinomycetemcomitans, the predominant subgingival organisms were identified using the identification system Rapid ID 32 A as well as antibiotic susceptibility was tested utilizing the E test.Results: Porphyromonas gingivalis and Prevotella oralis were detected in 7/10 subjects and could no more recovered after therapy. Fusobacterium nucleatum and Peptostreptococcus micros were present in 5/10 patients before treatment, but could be detected in 6/10, resp. 3/10 after therapy. In 4/10 subjects harboring F. nucleatum and in 3/10 with P. micros, those organisms were not targeted by amoxicillin/clavulanate, although post-treatment testing revealed their alleged susceptibility (MICs varied from 0.023 to 0.032 μg/ml, resp. from 0.125 to 2.0 μg/ml).Conclusions: The results of this study suggest that the outcomes of conventional methods of susceptibility testing have to be interpreted very carefully when being used for treatment of plaque-related diseases. Furthermore, since the endpoint of systemic antibiotic treatment as adjunct to conventional therapy is elimination of F. nucleatum or P. micros in patients harboring these organisms, the use of amoxicillin/clavulanate appears not to be justified.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Munksgaard : Munksgaard International Publishers
    Journal of clinical periodontology 26 (1999), S. 0 
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract. A. actinomycetemcomitans (Aa) can be transmitted among family members. The purpose of the present study was, to evaluate, whether A. actinomycetemcomitans is able to persist for a prolonged period of time in periodontally healthy subjects following elimination of this pathogen from diseased family members. In 14 periodontitis patients harboring Aa as well as in their 37 family members, the clinical (PPD, PAL, PlI, GI) and microbiological status (TSBV) was evaluated. After study patients received mechanical, surgical and antibiotic (3×375 mg amoxicillin+3×250 mg metronidazole/7 d) treatment, they, as well as their family members, were reassessed 3, 6, 9 and 12 months following therapy. From 13 spouses, 4 (31%) had periodontitis associated with Aa, 4 (31%) had periodontitis and no Aa, 2 (15%) were periodontally healthy and harbored Aa, 3 (23%) were healthy with no detection of Aa. From 24 off-springs, one (4%) had periodontitis associated with Aa, 8 (33%) were healthy and harbored Aa, 15 (63%) were healthy with no detection of Aa. In the 2 spouses and in 7 of the 8 offsprings being healthy, but harboring Aa, this pathogen still persisted at the 12-month appointment, after it had been eliminated from the diseased family members. Only one child became negative for Aa after 12 months. The results of this study indicate that A. actinomycetemcomitans is able to persist in the oral habitats of periodontally-healthy subjects for at least 12 months, after this pathogen had been eliminated from diseased family members. This might suggest that also in healthy family members, A. actinomycetemcomitans as a source of transmission should be eliminated to prevent reinfection.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Munksgaard : Munksgaard International Publishers
    Journal of clinical periodontology 26 (1999), S. 0 
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract. In the present study, the antibiotic susceptibility of most prevalent micro-organisms in advanced periodontitis patients was evaluated. In 56 patients, pooled subgingival plaque samples were taken from the deepest site of each quadrant and were cultivated anaerobically. From each patient, the 4 most frequently encountered types of bacterial colonies were subcultured and identified (Rapid ID 32 A). From all bacterial species identified in the 224 subcultures, the 4 most prevalent were used for susceptibility testing to tetracycline, metronidazole and amoxicillin/clavulanate using the E Test. The most prevalent microorganisms were Fusobacterium nucleatum (38/214), Peptostreptococcus micros (33/214), Prevotella oralis (33/214) and Porphyromonas gingivalis (32/214). Regarding antibiotic susceptibility it could be shown that minimal inhibitory concentration (MIC) in all cases was below antibiotic concentrations achievable in gingival crevicular fluid. However, antibiotic resistance was seen in 3 to 29% of the investigated microorganisms.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of periodontal research 24 (1989), S. 0 
    ISSN: 1600-0765
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The purpose of the present study was to investigate whether functionally different macrophages are present in clinically healthy gingiva and during human experimental gingivitis. Eight male probands were introduced to an oral hygiene program until all reached mean Plaque and Gingival Index scores approaching zero. During the following 19 days all oral hygiene was abandoned. At d –14, 0, 2, 4, 7, 11 and 19 clinical indices and gingival biopsies were taken. Cryostat sections were incubated with monoclonal antibodies against mature macrophages (25F9), inflammatory macrophages (27E10) and anti-inflammatory macrophages (RM 3/1). Positive cells were counted in the inflammatory infiltrate (IF) and the connective tissue (CT). At d – 14 elevated numbers of 27E10-positive cells were observed which decreased significantly at d 0 (p 〈 0.018) and increased again at d 19 (p 〈 0.026). Significant differences in the number of RM 3/1-positive cells were found between d 0 and d – 14, 2, 4 and 7 (p 〈 0.05) while no differences in the number of 25F9-positive cells were observed throughout this study. It was concluded that experimental gingival inflammation is characterized by the appearance and disappearance of functionally different macrophage subpopulations.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of clinical periodontology 17 (1990), S. 0 
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract Multiple periodontal abscesses were reported in medically compromised patients. We examined patients with a non-contributory medical history referred for the treatment of numerous periodontal abscesses. All patients had taken oral broad spectrum antibiotics 1 to 3 weeks prior to the outburst of the abscesses (8 patients: penicillin, 2 patients: tetracycline). The patients suffered from advanced periodontal disease, 82% of the examined sites showed probing depths 〉 3 mm, 56% attachment loss 〉 3 mm. Subgingival plaque samples were analysed from 2 different abscess sites. Bacteroides gingivalis (19/20), Fusobacterium nucleatum (13/20) and Streptococcus intermedius (13/20) were the most prevalent anaerobic microbiota. Strains resistant to the prescribed antibiotic were found in 55% (11/20) of the subgingival plaque samples. It was concluded that in patients with advanced periodontal disease, systemic antibiotic therapy without subgingival debridement may change the composition of the subgingival micro-biota, thus favouring the outburst of multiple periodontal abscesses.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract In the present study, a total of 619 subgingival and extracrevicular samples from 66 early-onset periodontitis, 42 adult periodontitis/gingivitis and 36 treated Actinobacillus actinomycetemcomitans-associated periodontitis patients were selectively cultivated for presence of A. actinomycetemcomitans. The organism was recovered from 68% cases with early-onset periodontitis, 24% cases with adult periodontitis/gingivitis and 50% of treated patients. Associations between recovery from pooled subgingival plaque and samples from extracrevicular locations as well as between different extracrevicular samples, were not heterogeneous with regard to different groups with the exception for cheek/saliva comparisons (odds ratios: early-onset periodontitis 825; adult periodontitis 8.1; treated patients 117; 0.05〈p〈0.1). For associations between recovery of A. actinomycetemcomitans from pooled subgingival plaque/extracrevicular samples, Mantel-Haenszel's odds ratios of between 12.2 and 21.6 were calculated (p〈0.0001). The organism was isolated from 17 cheek mucosa samples of 18 patients identified as still harboring the organism after therapy. Present results point to the considerable value of cheek mucosa samples especially in treated patients to diagnose persistent A. actinomycetemcomitans colonization of the oral cavity.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of clinical periodontology 1 (1974), S. 0 
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract Free palatal grafts were transplanted into the alveolar mucosa area in 12 patients. Smears were taken daily from the graft surface for 9 days and then weekly until the 5th week; smears were taken from the palatal wound only weekly. In addition 5 to 8, 8 to 12 and 12 to 29 months respectively after grafting, cytology was studied at the recipient, palatal donor and control sites, in alveolar mucosa and attached gingiva areas.Degenerative changes in the epithelial cells of the graft were observed during the first few days in the most superficial and the intermediate layers. On the 7th day no degenerated superficial cells were present in the smears. Five weeks postoperatively the superficial cell index had increased to 100 % and the keratinization index to 57 %. It is concluded that the transplanted basal, parabasal and intermediate epithelial cells were active in the healing process which, up to 21/2 half years postoperatively, resulted in cytological smears typical for the palatal but not the alveolar mucosa.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of clinical periodontology 22 (1995), S. 0 
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract In the present study, data from more than 550 periodontally diseased patients with more than 1100 furcation invasions were retrospectively analysed. There were apparent differences in the distribution of different furcation degrees in patient populations treated by 2 differently experienced operators. However, treatment modality patterns were rather similar. Scaling during periodontal flap surgery was the most often performed treatment procedure in degree I (97–98%) and II (75–83%) involvements. About 44% of degree III involved teeth were extracted. In order to determine the influence of degree of furcation involvement, tooth type and operator variability on treatment modality, logistic regression analysis was applied. Degree of furcation involvement was an important indicator variable in all models, Scaling as a sole measure was mainly performed in relation to degree I of furcation involvement. With every increase in degree, the odds of scaling decreased by factor 12.7. The odds of root resection was upper 1st molars 46x higher than in wisdom teeth or lower 2nd molars with the same degree of involvement, but only 3.3x higher than in lower 1st molars. Tunnel preparation as well as regenerative procedures were mainly confined to lower molars. Operator variability was only introduced as a covariate in the extraction model. Hence, despite of different operator skill and severity of periodontal disease in treated populations, decision for one or the other treatment modality seems to depend essentially on degree of furcation involvement as well as tooth type.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of clinical periodontology 16 (1989), S. 0 
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract The main ecological niche of Actinobacillus actinomycetemcomitans (A.a.) seems to be the periodontal pocket, but it can also be isolated from supragingival plaque, buccal and tongue mucosa, or saliva. We examined toothbrushes from 21 patients, all identified as harbouring moderate to large numbers of A.a. in subgingival plaque, for contamination with this organism. 29% of the toothbrushes presented by our patients yielded detectable numbers of A.a. Immediately after toothbrushing this figure rose to 62%, but dropped to 50% after 1 h. Numbers of isolated A.a. on toothbrushes were weakly correlated with the degree of periodontal destruction, and significantly more numbers of A.a. on toothbrushes could be detected if the organism was found on mucous membranes or in saliva. There was no association with gingival inflammation, supragingival plaque nor mean numbers of isolated subgingival A.a.
    Type of Medium: Electronic Resource
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