bromochloroacetic-acid and Dental-Plaque

Soft tissue grafting for the purposes of increasing the width of keratinized tissue (KT) is an important aspect of periodontal treatment. A systematic review was analyzed, focusing on non-root coverage tissue grafts. The references were updated to reflect the current literature.. To formulate the consensus report, group members submitted any new literature related to the topic that met criteria fitting the systematic review, and this information was reviewed for inclusion in this report. A consensus report was developed to summarize the findings from the systematic review and to guide clinicians in their treatment decision-making process.. Forty-six articles met the criteria for inclusion in the final analysis, and two articles were added that were used to formulate this consensus report. A list of eight clinically relevant questions was posed, and consensus statements were developed.. The evidence suggests that a minimum amount of KT is not needed to prevent attachment loss (AL) when optimal plaque control is present. However, if plaque control is suboptimal, a minimum of 2 mm of KT is needed. The standard procedure to predictably gain KT is the autogenous gingival graft. There is limited evidence for alternative treatment options. However, additional research may offer promising results in certain clinical scenarios.. Before patient treatment, the clinician should evaluate etiology, including the role of inflammation and various types of trauma that contribute to AL. The best outcome procedure (autograft) and alternative options should be reviewed with the patient during appropriate informed consent. Proper assessment of the outcome should be included during supportive periodontal care.

Topics: Autografts; Dental Plaque; Gingiva; Gingival Diseases; Gingivoplasty; Guided Tissue Regeneration, Periodontal; Humans; Keratins; Patient Satisfaction

To analyze the influence of the width of keratinized mucosa (KM) on the development and resolution of experimental peri-implant mucositis lesions at abutments with different microstructures in humans.. In a randomized, controlled study, a total of 28 patients had received 28 target implants exhibiting a KM ≥2 mm. These were randomly connected with either partially microgrooved- (test) (n = 15) or machined (control) (n = 13) healing abutments. The study protocol included a wound healing period (WH) following implant placement (12 weeks), a plaque exposure phase (EP) of 21 days (EPd21) and a resolution phase (RP) including visits at 2, 4, and 16 weeks (RPw2; RPw4; RPw16) following plaque removal. Linear regression analyses were used to analyze the relationship between the width of KM and clinical outcomes (i.e., modified plaque index [mPI], modified gingival index [mGI], bleeding on probing [BOP], and probing depth [PD]).. Mean and median KM values (end of WH) were 5.9 ± 2.6 and 5.0 mm (min: 2 mm; max: 10 mm; interquartile range: 5 mm) at test- and 5.5 ± 2.6 and 4.0 mm (min: 3 mm; max: 11 mm interquartile range: 4 mm) at control abutments. The linear regression analysis revealed significant correlations between the width of KM and mPI (test: RPw2; control: RPw16), mGI (test: RPw16), BOP (both: RPw16), and PD (test: RPw16; control: EPd21, RPw2, RPw4, RPw16) scores.. The width of KM (≥2 mm) had some effects on the development (i.e., at 21 days) and resolution of experimental peri-implant mucositis lesions at both abutment types.

Topics: Adult; Dental Abutments; Dental Implantation, Endosseous; Dental Plaque; Dental Plaque Index; Female; Humans; Keratins; Male; Mouth Mucosa; Peri-Implantitis; Periodontal Index; Stomatitis

The question of the importance of keratinized mucosa around dental implants for the prevention of peri-implant disease could not be answered in the relevant literature so far.. To investigate the influence of peri-implant keratinized mucosa on long-term peri-implant soft-tissue health and stability over a period of 5 years.. A total of 386 mandibular dental implants were placed in 73 completely edentulous patients, and subsequently restored with fixed full-arch prostheses. At prosthesis delivery (baseline) and after 3, 6, 12, 18, 24, 36, 48 and 60 months, modified plaque index (mPlI), modified sulcus bleeding index (mBI), distance between implant shoulder and mucosal margin (DIM) and width of peri-implant keratinized mucosa (KM) were recorded. Statistical analysis included multivariate logistic regression, multivariate ordinal logistic regression, generalized estimating equations and Bonferroni's correction.. Fifty-eight patients with 307 implants completed the 5-year study. Statistically significantly higher plaque accumulation on lingual sites (mean mPlI 0.67, SD 0.85), bleeding tendencies on lingual sites (mean mBI 0.22, SD 0.53) and larger soft-tissue recession on buccal sites (mean DIM -0.69 mm, SD 1.11 mm) were found when the width of KM was <2 mm, compared to sites with>or=2 mm of KM (mean mPlI 0.40, SD 0.68, P=0.001; mean mBI 0.13, SD 0.41, P<0.01; mean DIM -0.08 mm, SD 0.86 mm, P<0.001). The width of keratinized mucosa had no effect on bleeding tendency or plaque accumulation on buccal sites (P>0.05).. In patients exercising good oral hygiene and receiving regular implant maintenance therapy, implants with a reduced width of <2 mm of peri-implant keratinized mucosa were more prone to lingual plaque accumulation and bleeding as well as buccal soft-tissue recession over a period of 5 years.

Topics: Adaptation, Physiological; Adult; Aged; Dental Health Surveys; Dental Implants; Dental Plaque; Dental Prosthesis, Implant-Supported; Denture, Complete, Lower; Female; Gingival Recession; Humans; Jaw, Edentulous; Keratins; Longitudinal Studies; Male; Mandible; Middle Aged; Mouth Mucosa; Oral Hygiene; Prospective Studies; Statistics, Nonparametric; Treatment Outcome

To: (1) investigate the clinical efficacy of acellular dermal matrix allograft to achieve increased peri-implant keratinized mucosa around implants, and (2) evaluate the effect as to whether the increase of keratinized mucosa has a positive effect on oral hygiene.. There were 10 male patients, ranging from 43 to 53 years of age, with attached gingiva < or = 2 mm on the buccal aspect included in this study. Acellular dermal matrix allograft was used to increase the keratinized mucosa on the buccal side.. The change of peri-implant pocket depth showed statistical differences among 3 measurements. The modified plaque index at 3 and 6 months showed statistical differences compared with the baseline measurements. The modified gingival index did not show any significant differences among all measurements. The width of peri-implant keratinized mucosa increased from a mean of 0.8 +/- 0.6 to 3.2 +/- 0.9 mm at 3 months and 2.2 +/- 0.6 mm at 6 months.. It is concluded that the acellular dermal matrix allograft could be applied as a grafting material to increase the width of peri-implant keratinized mucosa. Its procedure appears to have some benefits for oral hygiene. Further randomized controlled trials over long periods of time are necessary to establish whether this procedure offers long-tem benefits to patients.

Topics: Adult; Collagen; Dental Implantation, Endosseous; Dental Implants; Dental Plaque; Dental Plaque Index; Humans; Keratins; Male; Middle Aged; Mouth Mucosa; Single-Blind Method; Skin, Artificial; Statistics, Nonparametric

Topics: Administration, Oral; Adult; Biguanides; Chlorhexidine; Clinical Trials as Topic; Dental Plaque; Drug Evaluation; Gingiva; Humans; Keratins; Male; Mouth Mucosa; Palate; Time Factors

Subgemmal neurogenous plaques (SNP) are composed of neural structures found in the posterolateral portion of the tongue, rarely biopsied as most of them are asymptomatic or eventually only clinically managed. We aimed to investigate a case series of possible correlation of symptomatic subgemmal neurogenous plaque (SNP) with coronavirus disease 2019 (COVID-19).. Eleven formalin-fixed paraffin-embedded cases from patients with previous confirmed COVID-19 (by RT-PCR) were retrieved from two pathology files. Histological sections were morphologically studied, and then submitted to immunohistochemical reactions against S-100 and neurofilament proteins, neuron-specific enolase, Glial fibrillary acidic protein (GFAP), synaptophysin, CD56, Ki67, cytokeratins (7, 8-18, 19, 20), nucleocapsid and spike proteins (SARS-CoV-1; and -2) and epithelial membrane antigen (EMA) antibodies. Clinical data were retrieved from the patients' medical files, including the symptoms and the complete history of the progression of the disease.. The patients who had COVID-19 included in this study experienced painful lesions in the tongue that corresponded to prominent or altered SNP. Microscopically, neural structures were positive for S-100, GFAP and neurofilament protein. And the cellular proliferative index (by Ki-67) was very low.. Thus, based on the current results, we hypothesize that symptomatic SNP may be a late manifestation of COVID-19 infection.

Topics: COVID-19; Dental Plaque; Humans; Keratins; Taste Buds; Tongue

To test the hypothesis of the outcome of complete arch flapless guided implant surgery mandibular rehabilitations in the presence or absence of a residual band of keratinized mucosa (KM) < 6 mm wide in the vestibular-lingual aspect, with and without a modification of the surgical protocol.. Thirty-nine patients were included in this study (12 men and 27 women), with a mean age of 62.5 years (range, 42 to 79 years), divided into 3 groups of 13 patients according to the status of residual band of KM: group 1, KM < 6 mm rehabilitated through a modified guided surgical protocol with flap opening to preserve KM; group 2, KM ≥ 6 mm; and group 3, KM < 6 mm; patients from both groups 2 and 3 were rehabilitated through flapless guided implant surgery without modification of the protocol. Group 2 and 3 patients were age- and sex-matched with group 1. Outcome measures were clinical attachment loss (CAL) ≥ 2 mm after 1 year (backward conditional regression), incidence of dehiscences, dental plaque, bleeding, and implant infections. The level of significance chosen was 5%.. Thirty-nine patients with 156 implants were followed for 1 year, and no dropouts occurred. Absence of a residual band of KM ≥ 6 mm in the vestibular-lingual aspect was significantly associated with CAL (odds ratio, 39.1; P = .036) and dehiscences (P = .003).. Within the limitations of this study, the absence of a residual band of KM ≥ 6 mm wide in the vestibular-lingual aspect in patients rehabilitated in the complete edentulous mandible with flapless guided implant surgery may be associated with CAL and a higher incidence of dehiscences after 1 year of follow-up. This possible association needs to be confirmed in studies with stronger designs and longer follow-ups.

Topics: Adult; Aged; Case-Control Studies; Dental Implantation, Endosseous; Dental Plaque; Female; Follow-Up Studies; Gingiva; Gingival Hemorrhage; Humans; Immediate Dental Implant Loading; Jaw, Edentulous; Keratins; Male; Mandible; Middle Aged; Patient Care Planning; Peri-Implantitis; Periodontal Attachment Loss; Pilot Projects; Postoperative Complications; Surgery, Computer-Assisted; Surgical Flaps; Surgical Wound Dehiscence; Treatment Outcome

Unfavorable conditions at the soft tissues adjacent to a recession defect may preclude performing pedicle flaps (advanced or rotational) both as a root coverage procedure, and as a covering flap for a connective tissue graft. Free gingival grafts may not be recommended because of the low root coverage predictability and the poor esthetic outcome. The goal of the present case report is to suggest modifications of the two-stage surgical technique aimed at improving root coverage and esthetic outcomes, and reducing patient morbidity.. In the first case report, a Miller class II gingival recession, associated with a deep buccal probing depth, affecting a lower central incisor was treated. In the first step of the surgery an epithelized graft with an apical-coronal dimension equal to the keratinized tissue height of the adjacent teeth was sutured apical to the bone dehiscence. Four months later, a coronally advanced flap was performed to cover the root exposure. In the second case report, a Miller class III gingival recession, complicated with a deep buccal probing depth affecting the mesial root of the first lower molar was treated. In the first step of the surgery, a free gingival graft was positioned mesially to the root exposure to create keratinized tissue lateral to the recession defect. This was adequate to perform the laterally moved, coronally advanced flap that was used as a second-step root coverage surgical procedure.. In the first case report complete root coverage, an increase (4 mm) in keratinized tissue height and realignment of the mucogingival line were achieved 1 year after the surgery. The reduced dimension of the graft permitted to minimize patient's discomfort and to obtain good esthetics of mucogingival tissues. These successful outcomes were well maintained for 5 years. In the second case report successful root coverage, increase (3 mm) in keratinized tissue height and good harmony of mucogingival tissues were achieved 1 year after the surgery. These outcomes were well maintained 5 years after the surgery.. The present study suggested that modifications of the two-stage procedure by minimizing the dimension of the graft and by standardizing the surgical techniques allowed successful results to be achieved in the treatment of gingival recessions characterized by local conditions that otherwise preclude the use of one-step root coverage surgical techniques.

Topics: Adult; Alveolar Bone Loss; Anti-Infective Agents, Local; Chlorhexidine; Dental Plaque; Esthetics, Dental; Female; Follow-Up Studies; Gingiva; Gingival Recession; Gingivoplasty; Humans; Incisor; Keratins; Molar; Periodontal Pocket; Surgical Flaps; Suture Techniques; Tooth Root; Treatment Outcome

Aim of the present study was to evaluate the influence of orthognathic surgery on the development of periodontal and microbiological changes.. Fifteen consecutively treated patients with a mean age of 24.9±7.7 years receiving orthognathic surgery were included in the present study. Plaque index (PI) and concentrations of 11 periodonto-pathogenic bacteria were recorded one day prior to surgery (t(0)) and one week (t(1)) and six weeks (t(2)) post-surgery. In addition, a complete periodontal examination including pocket probing depth (PPD), gingival recession (GR), clinical attachment level (CAL), bleeding on probing (BOP) and width of keratinized gingiva (WKG) was conducted at t(0) and t(2). For statistical analysis, general linear model and paired t-test were applied.. A significant increase of PI (t(0)-t(1), p=0.037) was followed by a significant decrease (t(1)-t(2), p=0.017). Apart from Eikenella corrodens (p=0.036), no significant microbiological changes were recorded. PPD significantly increased on oral sites (p=0.045) and GR especially on buccal sites (p=0.001). In the incision area the development of GR was significantly higher on the test (buccal) than on the control sites (oral). Both gingival biotypes were affected by GR.. Orthognathic surgery causes statistically significant changes of periodontal parameters, but these changes do not necessarily impair the aesthetic appearance of the gingival margin.

Topics: Aggregatibacter actinomycetemcomitans; Bacteroides; Campylobacter rectus; Capnocytophaga; Dental Plaque; Dental Plaque Index; Eikenella corrodens; Eubacterium; Female; Follow-Up Studies; Fusobacterium nucleatum; Gingiva; Gingival Hemorrhage; Gingival Recession; Humans; Keratins; Male; Orthognathic Surgical Procedures; Osteotomy, Le Fort; Osteotomy, Sagittal Split Ramus; Peptostreptococcus; Periodontal Attachment Loss; Periodontal Diseases; Periodontal Pocket; Periodontium; Porphyromonas gingivalis; Prevotella intermedia; Treponema denticola; Young Adult

The aim of the present paper was to analyse, on patient and implant basis, factors related to peri-implant lesions.. Two hundred and eighteen patients treated with titanium implants were examined for biological complications at existing implants 9-14 years after initial therapy. The effects of several potentially explanatory variables, both on patient and on implant levels, were analysed.. On the implant level, the presence of keratinized mucosa (p = 0.02) and plaque (p = 0.005) was associated with mucositis (probing depth > or =4 mm + bleeding on probing). The bone level at implants was associated with the presence of keratinized mucosa (p = 0.03) and the presence of pus (p < 0.001). On the patient level, smoking was associated with mucositis, bone level and peri-implantitis (p = 0.02, <0.001 and 0.002, respectively). Peri-implantitis was related to a previous history of periodontitis (p = 0.05).. Individuals with a history of periodontitis and individuals who smoke are more likely to develop peri-implant lesions.

Topics: Aged; Alveolar Bone Loss; Dental Implants; Dental Plaque; Disease; Female; Follow-Up Studies; Humans; Keratins; Male; Middle Aged; Mouth Mucosa; Periodontal Diseases; Periodontal Pocket; Periodontitis; Risk Factors; Smoking; Suppuration; Titanium

The need for keratinized mucosa (KM) or immobile keratinized mucosa (i.e., attached mucosa [AM]) for the maintenance of osseointegrated endosseous dental implants has been controversial. The purpose of this study was to investigate the significance of KM in the maintenance of root-form dental implants with different surfaces.. A total of 339 endosseous dental implants in place for at least 3 years in 69 patients were evaluated. The width of KM and AM, modified plaque index (mPI), gingival index (GI), modified bleeding index (mBI), probing depth (PD), and average annual bone loss (ABL) were measured clinically and radiographically by a masked examiner. Based on the amounts of KM or AM, implants were categorized as follows: 1) KM <2 mm (KL); 2) KM > or =2 mm (KU); 3) AM <1 mm (AL); and 4) AM > or =1 mm (AU). Implants were further subdivided into the following four subgroups based on their surface configurations: 1) smooth surface implants (SI) with KM <2 mm (SKL); 2) SI with KM > or =2 mm (SKM); 3) rough surface implants (RI) with KM <2 mm (RKL); or 4) RI with KM > or =2 mm (RKM); or 1) SI with AM <1 mm (SAL); 2) SI with AM > or =1 mm (SAM); 3) RI with AM <1 mm (RAL); or 4) RI with AM > or =1 mm (RAM). The effect of KM or AM on clinical parameters was evaluated by comparing the different KM/AM groups. In addition, the significance of the presence of KM on implant prostheses types (i.e., fixed versus removable) and on implant locations (i.e., anterior versus posterior) was evaluated.. Comparison of ABL among the four subgroups in KM or AM failed to reveal statistically significant differences (P >0.05); however, statistically significantly higher GI and mPI were present in SKL or SAL compared to the other three subgroups (P <0.05). GI and mPI were significantly higher in KL (0.94 and 1.51) than KU (0.76 and 1.26) and higher in AL (0.95 and 1.50) than AU (0.70 and 1.19) (P <0.05), respectively. The difference in GI between posterior implants with or without an adequate amount of KM was also significant (P <0.05).. The absence of adequate KM or AM in endosseous dental implants, especially in posterior implants, was associated with higher plaque accumulation and gingival inflammation but not with more ABL, regardless of their surface configurations. Randomized controlled clinical trials are needed to confirm the results obtained in this retrospective clinical study.

Topics: Adult; Aged; Aged, 80 and over; Alveolar Bone Loss; Analysis of Variance; Cross-Sectional Studies; Dental Implantation, Endosseous; Dental Implants; Dental Plaque; Dental Plaque Index; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Female; Gingivitis; Humans; Keratins; Male; Middle Aged; Mouth Mucosa; Periodontal Index; Radiography; Retrospective Studies; Surface Properties

The purpose of this study was to analyze the expression of adhesion molecules on endothelial cells in the alveolar ridge mucosa, the gingiva and the periimplant mucosa in humans.. Twelve partially edentulous subjects were included in the study. In each subject, one soft tissue biopsy was harvested from the edentulous alveolar ridge mucosa, one from a tooth site and one from an implant site. After 3 weeks of undisturbed plaque accumulation, an additional biopsy was obtained from one tooth and one implant site in each subject. The tissue samples were snap frozen and prepared for immunohistochemical analysis.. In the alveolar ridge mucosa, smaller proportions of endothelial cells expressing ICAM-1, ELAM-1 and VCAM-1 were observed than in the gingiva. ELAM-1-positive cells occurred in lower numbers than in periimplant mucosa. After 21 days of plaque accumulation, ELAM-1 was increased in tooth sites, but decreased in periimplant mucosa.. The results of the present study indicated that the proportions of activated endothelial cells and the extravasation of leukocytes is larger in gingiva and periimplant mucosa than in alveolar ridge mucosa. This might be due to the less permeable keratinized epithelial layer in the edentulous ridge mucosa, which offers proper protection against microbial pathogens. The greater expression of endothelial cell adhesion molecules during experimental gingivitis, compared to periimplant mucositis, may reflect its longer history of repeated antigenic assaults.

Topics: Aged; Alveolar Process; Antibodies, Monoclonal; Connective Tissue; Dental Implants; Dental Plaque; E-Selectin; Endothelium, Vascular; Epithelial Attachment; Epithelial Cells; Female; Gingiva; Gingivitis; Humans; Immunohistochemistry; Intercellular Adhesion Molecule-1; Jaw, Edentulous, Partially; Keratins; Leukocytes; Male; Matched-Pair Analysis; Middle Aged; Mouth Mucosa; Statistics as Topic; Vascular Cell Adhesion Molecule-1

The present study was performed in order to examine the composition of the connective tissue that forms an attachment to a dental implant. 6 beagle dogs were used. All mandibular premolars were extracted. After 3 months of healing, 6 fixtures--3 in each side of the mandible--(Astra Tech Implants, Dental System TiO blast; Astra Tech AB, Mölndal, Sweden) were installed. After another 3 months of healing, abutment (Uni-abutment 45; Astra Tech AB, Mölndal, Sweden) connection was performed and a plaque control program was initiated. The animals were sacrificed and perfused with a fixative through the carotid arteries. Each implant site, including the implant and the soft and hard peri-implant tissues, was dissected, decalcified in EDTA and further processed using a "fracture technique". The specimens were subsequently embedded in EPON, cut with the microtome set at 3 microm and the sections stained in PAS and toluidine blue. From the EPON-embedded blocks, ultra-thin sections were cut and electron micrographs were prepared. The detailed histologic and morphometrical examinations were restricted to a 200 microm wide zone of connective tissue interposed between the apical border of the junctional epithelium and the bone tissue. In the analysis, this zone was further subdivided into 2 different units; (i) one central, 40 microm wide unit (zone A) located immediately next to the implant surface, and (ii) one lateral, 160 microm wide unit (zone B) that was continuous with the central unit. The implant surface apical of the junctional epithelium and coronal of the bone crest appeared to be in direct contact with a connective tissue. Zone A of this connective tissue was characterized by its (i) absence of blood vessels and (ii) abundance of fibroblasts which were interposed between thin collagen fibers. The more lateral zone B contained comparatively fewer fibroblasts, but more collagen fibers and blood vessels. There are reasons to assume that the fibroblast rich barrier tissue next to the titanium surface plays a rôle in the maintenance of a proper seal between the oral environment and the peri-implant bone.

Topics: Alveolar Process; Animals; Bicuspid; Biocompatible Materials; Collagen; Connective Tissue; Dental Abutments; Dental Implantation, Endosseous; Dental Implants; Dental Plaque; Dogs; Epithelial Attachment; Fibroblasts; Keratins; Mandible; Microscopy, Electron; Mouth Mucosa; Periodontium; Surface Properties; Titanium; Wound Healing

The occurrence of creeping attachment has been documented with epithelialized autogenous masticatory mucosa grafts (free gingival grafts) and suggested in other root coverage techniques. The purpose of this study was to examine whether or not creeping attachment occurred after a connective tissue with partial-thickness double pedicle graft had been performed. This study examined 22 defects, in 19 patients, treated where less than complete root coverage was obtained at 4 weeks postoperative. Creeping attachment occurred in 21 of the 22 defects (95.5%), in 18 of the 19 patients (94.7%). Complete root coverage occurred in 17 of the 22 defects (77.3%), in 15 of 19 patients (78.9%). The mean creeping attachment obtained was 0.8 mm. Additionally, it was the goal of this study to see if any factor could be associated with creeping attachment. This study did not find any factors that could be associated with the amount of creeping attachment seen. Creeping attachment seems to occur commonly, but complete root coverage is not predictable.

Topics: Adult; Age Factors; Anti-Bacterial Agents; Bucrylate; Connective Tissue; Dental Plaque; Dentin Sensitivity; Epithelial Attachment; Female; Follow-Up Studies; Forecasting; Gingiva; Gingival Pocket; Gingival Recession; Humans; Keratins; Labial Frenum; Male; Periodontal Dressings; Root Planing; Smoking; Surgical Flaps; Tetracycline; Tissue Adhesives; Tooth Cervix; Tooth Root; Transplantation, Autologous; Wound Healing

In 5 monkeys a total of 30 transmucosal endosseous dental implants were inserted in edentulous areas of the mandible with presence or absence of keratinized mucosa. After a healing period of 3 months with optimal plaque control, all implants were exposed to plaque accumulation for periods up to 9 months. To secure abundant plaque accumulation on half the number of the implants, cotton wool ligatures were placed around the implants at the entrance to the peri-implant sulcus. Attachment loss was measured clinically and histometrically, and tissue recession was measured clinically. Ligated implants without keratinized mucosa demonstrated significantly more recession and slightly more attachment loss than the other implants. The results of this study suggest that the absence of keratinized mucosa around dental endosseous implants increases the susceptibility of the peri-implant region to plaque-induced tissue destruction.

Topics: Analysis of Variance; Animals; Dental Implants; Dental Plaque; Dental Plaque Index; Epithelial Attachment; Gingiva; Gingival Recession; Keratins; Macaca fascicularis; Male; Mouth Mucosa; Periodontal Attachment Loss; Periodontal Index; Periodontitis; Statistics, Nonparametric

Topics: Absorption; Dental Abutments; Dental Implantation; Dental Implants; Dental Plaque; Dental Prosthesis Design; Dental Research; Gingiva; Humans; Keratins; Membranes, Artificial; Surface Properties

Topics: Adult; Dental Plaque; Dental Plaque Index; Dentifrices; Female; Gingiva; Gingival Hemorrhage; Humans; Keratins; Male; Oral Hemorrhage; Periodontal Index; Toothpastes

Topics: Animals; Dental Plaque; Dogs; Gingiva; Gingival Crevicular Fluid; Gingivitis; Keratins; Periodontal Index

This study was designed to evaluate the effect of mechanical stimulation on the keratinization of the sulcular epithelium in four adult Rhesus monkeys. Each animal received a thorough prophylaxis. One week later, each monkey received one of the following modalities of plaque control: (a) daily intravenous tetracycline and rubber cup prophylaxis, (b) daily rubber cup prophylaxis, (c) daily intravenous tetracycline injections; (d) no treatment, as a control. After sacrifice and tissue processing the histologic sections were evaluated for the presence of sulcular keratinization. The keratin width and length were measured, and an Inflammatory Index determined. It was found that all treatment modalities reduced inflammation significantly, when compared to the control. No differences among the three procedures tested were found. Although all permitted keratinization to develop, sulcular keratinization was significantly increased when daily prophylaxes were performed. It was concluded that mechanical stimulation of the sulcular epithelium, seemingly plays a role in promoting its keratinization.

Topics: Animals; Dental Plaque; Dental Prophylaxis; Epithelium; Gingiva; Injections, Intravenous; Keratins; Macaca mulatta; Male; Tetracycline

Topics: Actinomyces; Bacteroides; Cells, Cultured; Cytotoxins; Dental Plaque; Epithelial Cells; Humans; Infant, Newborn; Keratins; Male; Skin; Subcellular Fractions

Topics: Animals; Dental Plaque; Dogs; Gingiva; Gingivitis; Keratins; Time Factors; Wound Healing

The purpose of this study was to determine if various plaque control regimes would be effective in permitting the gingival sulcular epithelium to keratinize. Three adult Rhesus monkeys had their teeth scaled and were placed on specific plaque control regimes including various combinations of prophylaxes, topical chlorhexidine and systemic tetracycline. Over the 2-month experimental period, weekly Plaque and Gingival Indices were determined. Subgingival plaque samples were obtained during the first 2 treatment weeks and at the end of the 1st month. Block sections of individual teeth from the different experimental regimes were serially sectioned to be evaluated histologically for inflammation and keratinization. Plaque and Gingival Indices were significantly reduced by the end of the 8th week compared to the pretreatment levels for all experimental regimes, except that the regime consisting only of three prophylaxes per week failed to reduce the Gingival Index significantly. Rubber cup prophylaxes were less effective in reducing plaque and inflammation than when the prophylaxes were combined with topical chlorhexidine application or systemic tetracycline administration. However, all experimental regimes were capable of reducing the subgingival bacterial flora to a level permitting sufficient reduction in gingival inflammation so that sulcular keratinization would occur. Some degree of sulcular keratinization was observed for every tooth of all experimental regimes. All regimes caused a significant decrease in the Inflammatory Indices relative to the control values. A negative correlation was found between the Crestal Inflammatory Index and the Keratin Width and Keratin Length, while a positive correlation was apparent between the Keratin Width and Keratin Length.

Topics: Animals; Bacteria; Chlorhexidine; Dental Plaque; Epithelium; Female; Gingiva; Keratins; Macaca mulatta; Male; Periodontal Index

Sixteen dental, dental hygiene, and dental assisting students and dental faculty members who had contralateral or unilateral areas of minimal (less than or equal to 1.0 mm) and appreciable (greater than or equal to 2.0 mm) widths of keratinized gingiva on mid-buccal plaque-free surfaces of mandibular bicuspids were examined. Gingival exudate amounts and clinical inflammation based on color change and/or swelling and bleeding on probing were evaluated. The results showed that gingiva with "appreciable" width as well as gingiva with "minimal" width of keratinized tissue exhibited only minute amounts of gingival exudate. Also, there were generally no clinical signs of inflammation for both types of tissue. From the groups of 16, six subjects were selected who had contralateral pairs of minimal and appreciable keratinized gingiva. They were instructed to cease oral hygiene in the lower bicuspid area for 25 days. At day 0, 4, 7, 11, 14, 18, 21, and 25, plaque, gingival exudate, and clinical gingival inflammation were evaluated. Results revealed increases in plaque, gingival exudate scores and clinical gingival inflammation over the 25-day period with no apparent difference between the areas with minimal and appreciable width of keratinized gingiva.

Topics: Dental Plaque; Gingiva; Gingival Crevicular Fluid; Gingivitis; Humans; Keratins; Oral Hygiene

Topics: Animals; Cricetinae; Dental Plaque; Disulfides; Ear; Gingiva; Keratins; Male; Mice; Microscopy, Electron; Mitosis; Mouth Mucosa; Rats; Skin; Sulfhydryl Compounds; Toothbrushing