Abstract: Smoking exerts detrimental effects on dental treatment and oral health. Our goal was to evaluate effectiveness in terms of the abstinence rate in smoking-cessation intervention delivered by dental professionals. Individuals who were willing to quit smoking were randomly assigned to either an intervention or a non-intervention group. Intensive intervention was provided, consisting of 5 counseling sessions, including an additional nicotine replacement regimen. Reported abstinence was verified by the salivary cotinine level. Thirty-three persons in the intervention and 23 in the non-intervention group started the trial. On an intent-to-treat basis, 3-, 6- and 12-month continuous abstinence rates in the intervention group were 51.5%, 39.4%, and 36.4%, respectively, while the rates in the non-intervention group were consistent at 13.0%. Adjusted odds ratios (95% confidence interval) by logistic stepwise regression analyses were 7.1 (1.8, 28.5), 8.9 (1.7, 47.2), and 6.4 (1.3, 30.7), respectively. Intensive smoking-cessation intervention in the dental setting was therefore effective.
Abstract: ABSTRACT: Many epidemiological evidences have proven the association between smoking and periodontal disease. The causality can be further established by linking findings of traditional epidemiological studies with the developments in molecular techniques that occurred in the last decade. The present article reviews recent studies that address the effect of smoking on molecular and genetic factors in periodontal disease. Most findings support the fact that tobacco smoking modulates destruction of the periodontium through different pathways: microcirculatory and host immune systems, connective tissue, and bone metabolism. Although smokers experience an increased burden of inflammatory responses to microbial challenges compared to non-smokers, understanding the association between smoking and periodontal diseases involves substantial problems with respect to accuracy of measurements, and particularly, sampling of many subjects. It remains unclear whether genetic susceptibility to periodontal disease is influenced by exposure to smoking or the effect of smoking on periodontal disease is influenced by genetic susceptibility. Employment of molecular techniques may play a key role in further elucidation of mechanisms linking smoking and periodontal destruction, the direct relationship as environmental factors and indirect relationship through genetic factors.
Abstract: AIM: Dental professionals have the potential to influence global smoking rates. This study evaluated the impact of a tobacco curriculum on smoking behaviour and attitudes toward smoking in dental students. METHODS: Immediately before and three years after the implementation of a tobacco curriculum with a no-smoking policy, a questionnaire was administered to students to obtain information about their smoking behaviour and attitudes toward smoking. RESULTS: The number of students who responded to the questionnaire was 580 in 2003 and 554 in 2006. The smoking rate decreased significantly from 35% in 2003 to 26% in 2006; however, analysis of data for each school year suggested that this was due to the prevention of smoking initiation rather than quitting smoking. Attitudes toward patient smoking and public policy were more positive in non-smokers than in current smokers. Improvement in attitudes toward patient smoking was smaller in current smokers than in non-smokers. Little improvement occurred in attitudes toward public policy in both non- and current smokers. CONCLUSIONS: Implementation of a tobacco curriculum was effective in preventing smoking initiation and improving attitudes toward patient smoking in students. Further measures are necessary to improve attitudes toward public policy and to discourage smoking among students.
Abstract: An association has been suggested between environmental tobacco smoke and oral disease. The present study examined the relationship between early childhood caries (ECC) and parental smoking, particularly paternal smoking, using records of 711 36-month-old children. The smoking status of parents as an independent variable was entered in the multivariable logistic regression model for caries experience as the dependent variable with confounders: sex, residential location, and possible risks of ECC such as order of birth, type of main drink, frequency of daily intake of sugar-containing snacks, daily toothbrushing by parents and use of fluoridated toothpaste. About 65% of children were caries free. Children whose parents did not smoke (CN), those in whom only the father smoked (CF), and those whose mother smoked regardless of the smoking status of the father (CM) comprised 33%, 33% and 34% respectively. The adjusted mean number [95% CI] of decayed teeth and caries experience prevalence for CN, CF and CM were 1.2 [0.8, 1.6], 1.6 [1.2, 2.0] and 2.1 [1.7, 2.5], and 25.6%, 35.3% and 45.7% respectively. The relationship between caries experience and parental smoking was significant on multivariable analysis. The adjusted OR [95% CI] of CF and CM relative to CN was 1.52 [1.01, 2.30] and 2.25 [1.51, 3.37] respectively. These results indicate the association of ECC with parental smoking, although the association with paternal smoking was weaker than with maternal smoking.
Abstract: Many studies have shown the effects of chewing xylitol gum on mutans streptococci (MS) over short- and long-term periods in children; however, few studies have addressed long-term periods in adults. The objective of this investigation was to examine for 6 months the effects of chewing xylitol gum on MS in saliva and plaque in 127 adults (mean age 28.0 years). The participants were assigned to three groups according to gum type, in part taking preference for flavor into account and in part at random: xylitol (XYL), maltitol (MAL) and control (CR); 33, 34 and 27 subjects in each group, respectively, completed the trial. Daily gum use of the XYL and MAL groups was 7.9 and 7.1 g, respectively. MS levels, which declined significantly in saliva (p < 0.05) and plaque (p < 0.001) in the XYL group after 6 months, exhibited a significant increase in plaque in the MAL group (p < 0.001). Differences in relative changes of MS levels in plaque during the experimental period were significant between the XYL group and the CR (p < 0.05) and MAL groups (p < 0.001). Differences in relative change of amount of plaque during the experimental period were not statistically significant between the groups. The present study demonstrated that chewing xylitol gum for 6 months continued to inhibit the growth of mutans streptococci in adults.
Abstract: OBJECTIVE: Various factors may be associated with edentulism in elderly people. Association of total tooth loss with smoking, alcohol intake and nutrition in non-institutionalised elderly Japanese was assessed utilising national database. MATERIALS AND METHODS: Records of independent surveys, the Survey of Dental Diseases (SDD) and the National Nutrition Survey (NNS) in 1999 were electronically linked using the household identification number. RESULTS: Among the records of 6903 subjects in the SDD and 12 763 subjects in the NNS, 6805 records were successfully linked. Overall, prevalence of total tooth loss in adults was very similar in males and females at approximately 7.0%, and the smoking rate was 47.6% and 9.9% respectively. Total tooth loss was a rare phenomenon (<2%) in age groups of <60 years. According to the multiple logistic regression analysis involving 2200 subjects aged 60 years or older, significant variables were age, current smokers and vitamin C intake in males, and age and current smokers in females. The variable for current drinkers was significant in females but the odds ratio was <1.0. No significant relationship was detected with respect to former smokers and drinkers, body mass index, vitamin E intake and blood glucose level. CONCLUSIONS: Current smoking was associated with total tooth loss, although smoking rate was low in females. Gender difference in the association was suggestive with respect to drinking alcohol and vitamin C intake.
Abstract: OBJECTIVE: We investigated the association of lip pigmentation with smoking and melanin pigmentation in the gingiva. DESIGN: Case-control study. Setting: Health check-up in an institute. SUBJECTS AND METHODS: Photos of 213 males employed in an institution were assessed in terms of pigmentation in lip and gingiva. MAIN OUTCOME MEASURES: Prevalence and scores of lip and gingival pigmentation and smoking status. RESULTS: Among subjects displaying lip and gingival pigmentation, 73% and 87% respectively, were current smokers, whereas 33% and 27% of individuals lacking pigmentation were current smokers respectively. Odds ratios of current smoking relative to lip and gingival pigmentation were 5.6 (95% confidence interval: 2.8-11.1) and 17.0 (8.1-36.0) respectively. Daily consumption, duration of smoking and lifetime exposure exhibited significant correlation with scores of lip and gingival pigmentation (P<0.0001). Odds ratios increased in lip and gingival pigmentation upon exposure. In current smokers, scores of lip and gingival pigmentation demonstrated meaningful correlation (P<0.0001); moreover, 95% of participants with lip pigmentation were positive for gingival pigmentation. CONCLUSION: These results indicated the presence of a striking association between smoking and pigmentation in the lip and gingiva, which was stronger with respect to gingival pigmentation. Health professionals could educate smokers, utilizing visible symptoms in the lip and gingiva.
Abstract: OBJECTIVES: The effectiveness of a brief intervention by dental professionals utilizing feedback of oral symptoms and dental treatments specifically relevant to smoking was examined in terms of it being a motivating factor to quit smoking. METHODS: Information pertaining to the present study was mailed to 208 dental clinics and 45 dentists agreed to participate. Dental patients who currently smoked were assigned consecutively to either an intervention (IG) or nonintervention group (NG) in each clinic during the 6-month experimental period. In IG, dental professionals provided brief explanations regarding oral symptoms and dental treatments specifically relevant to smoking. The effectiveness of intervention was evaluated with respect to attempts to quit and progression through the stages of behavioral changes involved in quitting using the standardized questionnaire. RESULTS: Dropout was considerable; 10 clinics terminated their participation. Questionnaires of 797 patients (IG, 416; NG, 381) were received from 35 clinics and the records of 497 patients (IG, 248; NG, 249) were analyzed. Among patients in IG and NG, 12.1% and 4.8% reported attempts to quit, respectively. Odds ratios of quitting attempts and progression and regression through the stages of behavioral changes adjusted for sex, age, and stage at the first visit were 2.2 (95% confidence interval: 1.04, 4.5), 1.7 (1.1, 2.8), and 0.28 (0.15, 0.53) for all patients, respectively, and 3.1 (1.3, 7.5), 2.1 (1.3, 3.4), and 0.21 (0.11, 0.44), respectively, for patients who were not ready to quit. Trends in the movement through stages differed because of the stage at the first visit. CONCLUSIONS: As a result of the limitation imposed by the considerable dropout number, we concluded that a brief intervention by dental professionals potentially motivates smokers with respect to their attempts to quit smoking and promotes behavioral changes involved in quitting.
Abstract: BACKGROUND: Various factors affect tooth loss in older age including cigarette smoking; however, evidence regarding the association between smoking and tooth loss during young adulthood is limited. The present study examined the association between cigarette smoking and tooth loss experience among adults aged 20-39 years using linked data from two national databases in Japan. METHODS: Two databases of the National Nutrition Survey (NNS) and the Survey of Dental Diseases (SDD), which were conducted in 1999, were obtained from the Ministry of Health, Labor and Welfare with permission for analytical use. In the NNS, participants received physical examinations and were interviewed regarding dietary intake and health practices including cigarette smoking, whereas in the SDD, participants were asked about their frequency of daily brushing, and received oral examinations by certified dentists. Among 6,805 records electronically linked via household identification code, 1314 records of individuals aged 20 to 39 years were analyzed. The prevalence of 1+ tooth loss was compared among non-, former, and current smokers. Multiple logistic regression models were constructed including confounders: frequency of tooth brushing, body mass index, alcohol consumption, and intake of vitamins C and E. RESULTS: Smoking rates differed greatly in men (53.3%) and women (15.5%). The overall prevalence of tooth loss was 31.4% (31.8% men and 31.1% women). Tooth loss occurred more frequently among current smokers (40.6%) than former (23.1%) and non-smokers (27.9%). Current smoking showed a significant association with 1+ tooth loss in men (adjusted OR = 2.21 [1.40-3.50], P = 0.0007) and women (1.70 [1.13-2.55], P = 0.0111). A significant positive exposure-related relationship between cigarette smoking status and tooth loss was observed (P for trend < 0.0001 and 0.0004 in men and women, respectively). Current smoking was also associated with the prevalence of decayed teeth (1.67 [1.28-2.20], P = 0.0002). CONCLUSION: An association between cigarette smoking and tooth loss was evident among young adults throughout Japan. Due to limitations of the available variables in the present databases, further studies including caries experience and its confounders should be conducted to examine whether smoking is a true risk of premature tooth loss in young adults.
Abstract: BACKGROUND: A causal association between cigarette smoking and periodontal disease has been established. The present study examined the association between smoking and tooth loss using national databases in Japan. METHODS: Records of the Survey of Dental Diseases and the National Nutrition Survey in 1999 were linked electronically using common identification. Records of 3,999 subjects aged older than 40 years were analyzed using logistic regression models, controlling for confounding factors, such as age, frequency of tooth brushing, body mass index, alcohol consumption, and intakes of vitamin C and E. RESULTS: Prevalence of tooth loss in terms of having less than 19 existing teeth was 37.3% overall. Smoking rates differed in males (45.6%) and females (7.8%). The prevalence of tooth loss in nonsmokers, former, and current smokers was 28.5%, 38.6%, and 36.9% in males, and 38.6%, 34.3% and 38.9% in females, respectively. Adjusted means of existing teeth controlling for confounders by smoking status were 21.5, 19.7 and 18.2 in males and 19.0, 19.2 and 16.4 in females, respectively. The association of tooth loss was non-significant in former smokers but significant in current smokers: adjusted odds ratios (95% confidence intervals) relative to nonsmokers in males and females were 1.29 (0.92-1.80) and 0.86 (0.46, 1.60) for former smokers and 2.22 (1.61-3.06) and 2.14 (1.45-3.15) for current smokers, respectively. A dose-response relationship between lifetime exposure and tooth loss was seen (P for trend <0.0001). CONCLUSION: The findings of this cross-sectional study of a nationwide population of Japanese indicated an association between smoking and tooth loss.
Abstract: BACKGROUND AND OBJECTIVE: The association between cigarette smoking and periodontitis was examined employing two nationally representative samples of adults in Japan. MATERIAL AND METHODS: Data were derived from the Survey of Dental Diseases (SDD) and the National Nutrition Survey (NNS) in 1999. In the SDD, periodontal conditions were evaluated by calibrated dentists utilizing the Community Periodontal Index (CPI), whereas in the NNS, participants were interviewed on the basis of smoking status by enumerators. Among 6805 records electronically linked via a household identification code, 4828 records of individuals aged 20 yr or older were analyzed. RESULTS: The prevalence of periodontal disease varied significantly by smoking status (p < 0.0001): 39.3%, 49.5% and 47.3% (CPI > or = 3), and 7.9%, 11.7% and 12.4% (a more severe form of periodontitis, CPI = 4), for nonsmokers, former smokers and current smokers, respectively. In adults aged > or = 40 yr (n = 3493), logistic regression models revealed greater probabilities (approximately 1.4 times higher) of periodontitis [CPI > or = 3, odds ratio = 1.38 (1.12-1.71), p = 0.0024] and a more severe form of periodontitis [odds ratio = 1.40 (1.04-1.89), p = 0.0288] in current smokers compared with nonsmokers, following adjustment for possible confounding factors. CONCLUSION: Based on the findings of this study and other numerous reports, cigarette smoking leads to deterioration of periodontal conditions in Japanese adults.
Abstract: OBJECTIVES: The study investigated the relationship between smoking in the household and dental caries in Japanese children using nationally representative cross-sectional data. METHODS: This study included 925 children aged 1-14 years. A child was considered to have decayed and/or filled teeth if a dentist diagnosed these conditions in deciduous or permanent teeth. Smoking in the household was defined as positive if someone in the household reported smoking cigarettes. RESULTS: No statistically significant relationship was observed between household smoking and caries experience. However, smoking in the household was independently associated with an increased prevalence of decayed teeth. The adjusted mean of filled teeth among children exposed to household smoking was higher than that among non-exposed children. CONCLUSIONS: The results of the study failed to substantiate a positive association between passive smoking and caries experience in Japanese children.
Abstract: OBJECTIVES: The objectives of the present study include investigation of the relationship between attitudes and desires with respect to oral health at initial office visit and compliance with supportive periodontal treatment (SPT) and identification of prognostic factors with respect to low-compliance with SPT. MATERIALS AND METHODS: Four hundred thirty-one patients were evaluated. Subjects completed a questionnaire concerning attitude and desire with respect to oral health and subjective symptoms prior to periodontal treatment. Survival probabilities of SPT were estimated by the Kaplan-Meier method and compared between answers for each item of the questionnaire via the Cox-Mantel test. Finally, a multivariate Cox proportional hazards regression model was constructed, which included age and gender. RESULTS: Greater than 95% of participants desired toothbrushing proficiency and lifelong retention of teeth at the initial office visit; however, the overall survival probabilities of SPT were only 52.7% after about 5 years. Patients exhibiting unfavourable attitudes toward oral health at the initial office visit, in comparison with those displaying favourable attitudes, exhibited greater tendency to abandon SPT. A Cox regression model revealed that lack of brushing on the gingival margin, non-use of an inter-dental brush or dental floss, non-use of fluoride toothpaste and frequent consumption of sugar-containing drinks were significant independent prognostic factors for low-compliance with SPT (p<0.05; Hazard ratios=2.27, 2.00, 2.56 and 2.06, respectively). CONCLUSIONS: Desire for satisfactory oral health is not related consistently to continuation of SPT. Unfavourable attitudes toward oral health were correlated to low-compliance with SPT. Clinicians may wish to establish methods for improvement of patient compliance employing behavioural approaches applicable to the attitudes of potential low-compliance individuals.
Abstract: BACKGROUND: Currently, no biochemical assay involving gingival crevicular fluid is utilized routinely as a screening test for periodontal disease. OBJECTIVE: The objective of the present study was to evaluate the potential of gingival crevicular fluid assay as a screening methodology. METHODS: The subject population was comprised of 27 volunteers. Nine participants were classified as 'subject with periodontal destruction' (SPD) exhibiting at least one site with pocket depth and attachment loss>3.5 mm, whereas the remaining individuals were categorized as 'subject with minimal periodontal destruction' (SMD). Gingival crevicular fluid was collected from fixed sites via a standardized method. Biochemical assays of 12 substances (hemoglobin, albumin, transferrin, alpha(1)-antitrypsin, fibronectin, IgA, IgG, IgM, lactoferrin, myeloperoxidase and neutrophil elastase) were conducted at a commercial laboratory. Power transformation of total quantities in gingival crevicular fluid was performed for statistical analysis. RESULTS: Relationships between total quantity of each substance and periodontal disease status were unclear. Logistic regression analysis yielded six predictive models, which consisted of substance pairs: neutrophil elastase/IgA, neutrophil elastase/hemoglobin, neutrophil elastase/alpha(1)-antitrypsin and neutrophil elastase/IgG, and IgA/albumin and IgA/transferrin (p<0.05). Regression lines for SPD and SMD on a scattergram of IgA and neutrophil elastase were nearly parallel within the range of amounts in gingival crevicular fluid. The predictive model derived from both substances afforded sensitivity and specificity of 88% and 94%, respectively. CONCLUSIONS: These results indicated that the combination of IgA and neutrophil elastase in gingival crevicular fluid may be crucial for prediction of periodontal disease status. Furthermore, these data suggested that biochemical assays employing both substances in gingival crevicular fluid may provide a satisfactory screening test for periodontal disease.
Abstract: PURPOSE: Potential effects of brief intervention for smoking cessation were evaluated by examination of stage progression with respect to quitting the habit in dental patients. METHODS: Stage progression was retrospectively evaluated in 25 patients undergoing brief interventions since April 2001 at a university dental hospital. Stage of cessation was requested prior to and following interventions (June to December 2003) according to the modification method of Prochaska's model. Brief interventions were conducted by indication of effects of smoking in the mouth and on dental treatment at each visit. Cessation techniques were explained in instances where subjects displayed an interest in smoking cessation. RESULTS: The intervals between dental visits varied (1-6 months). Prior to intervention, numbers of patients in the pre-contemplation, contemplation and preparation stages were 15, 5 and 5, respectively; this changed to 6, 2 and 1, respectively, following intervention, with 16 participants attempting smoking cessation, and 9 reporting continued abstinence. Stage progression was noted in 18 subjects. In the remaining 7 patients, 6 in the pre-contemplation and 1 in the contemplation stage, no change was registered. More than half of the patients (11/20) who had not prepared for cessation prior to intervention and all patients (5/5) in the preparation period reported smoking cessation following the brief interventions. CONCLUSION: Brief interventions in dental practice can induce smoking cessation in patients.
Abstract: OBJECTIVE: The association between gingival pigmentation and active smoking has been established. This investigation is the first to address the relationship between gingival pigmentation in children and passive smoking. METHODS: A case-control study was performed involving 59 nonsmoking children who were selected from patient records of a dental clinic in a rural town in Japan. The number of subjects was based on a power calculation. Two calibrated examiners independently observed labial gingiva via oral photographs. RESULTS: An interview determined that 61% of children had at least 1 smoking parent. Gingival pigmentation was observed in 71% to 78% of children. Interexaminer agreement was satisfactory (kappa = 0.73). Percentage of smoking parents was higher in children with gingival pigmentation (70-71%) than in those who lacked pigmentation (35%). Odds ratios of parental smoking adjusted by age and gender were 5.6 (95% confidence interval: 1.5-20.0) and 5.4 (1.4-21.2) for the 2 examiners. CONCLUSION: These findings suggest that excessive pigmentation in the gingiva of children is associated with passive smoking. The visible pigmentation effect in gingiva of children could be useful in terms of parental education.
Abstract: PURPOSE: To compare twin-motor sonic toothbrushes (TST) with conventional sonic (CST) and electric (CET) toothbrushes in terms of plaque removal efficacy. METHODS: A single-blind, triple-treatment cross-over study was conducted involving 36 participants. Each subject refrained from brushing for 24 hours; subsequently, subjects were screened for dental plaque in premolars and molars with the Rustogi Modified Navy Plaque Index. Plaque removal efficacy was determined according to percentage of plaque score reduction in a single toothbrushing under supervision for 2 minutes at the base of whole tooth surfaces and approximal areas. RESULTS: 35 subjects completed this study. No meaningful difference in pre-brushing plaque score was observed among the three toothbrushes. In molars, TST (48.3+/-3.3%) was higher in plaque removal efficacy relative to CST (40.4+/-2.4%, P= 0.0064) and CET (36.7+/-2.8%, P= 0.0001). This trend was obvious in approximal areas of the lingual aspect of the mandible; 24.8% for TST versus 13.4% for CST (P= 0.0048) and 15.0% for CET (P= 0.0168). In premolars, TST displayed the greatest plaque removal efficacy, although the difference was significant exclusively for comparison with CET. These findings indicate that TST is more efficacious than CST and CET in terms of removal of plaque from molars, in particular, at approximal areas in the lingual aspect of the mandible, possibly due to new functions such as floating bristles and twin magnetic motors, which produce sonic vibration.
Abstract: This study examined the effect of follow-up intervention on periodontal health of workers on the basis of clinical assessment and a laboratory test. Toothbrushing instruction was given to 26 workers (41.4 +/- 7.8 yr of age). In the experimental group (EG), 13 workers received re-instruction and reminder messages after the initial intervention. The remaining 13 workers, who served as a control group (CG), underwent no follow-up. Brushing skill was assessed on the basis of plaque scores for the whole mouth (Plaque Control Record, PCR) and for eight representative teeth (Plaque Index, PLI). Periodontal health was evaluated with the Community Periodontal Index (CPI). Assessment of gingival inflammation (Modified Gingival Index, MGI), measurements of pocket depth (PD) and attachment level (AL), and collection of gingival crevicular fluid (GCF) were performed at the representative sites. Aspartate aminotransferase (AST) in GCF was determined. Periodontal assessments were conducted prior to and three months after the first examination. Data were analyzed on site- and subject-bases. Both groups exhibited a significant reduction in PLI and MGI. PCR and PD significantly decreased exclusively in the EG. No significant change was observed in the CPI or AL. A significant reduction in PD in shallow pockets (PD<=3 mm) and declines in AL and AST in deeper pockets (PD>=4 mm) were detected in EG. A reduction in PD in deeper pockets was significant in the CG. These results indicate that intervention with follow-up is more effective with respect to periodontal health of workers than is a single intervention; moreover, the laboratory GCF test could be employed to ascertain the outcome of behavioral change.
Abstract: BACKGROUND: It has recently been accepted that periodontal disease is a risk factor for not only tooth loss but also systemic diseases. An effective system of public intervention for periodontal health to enable continuous intervention of dental professionals has been sought. We developed a Web-based intervention system regarding periodontal health and evaluated the effects of the system in the workplace. METHODS: The system was capable of storage and display of personalized oral health records including video images pertaining to toothbrush manipulation within their own oral cavities based on instructions by dental professionals. The system enabled clients to view movement of their own skill, and repeatedly. Thirteen workers of a company were randomized to either an experimental or control group. The control group received face-to-face toothbrushing instruction at the company and follow-up via telephone. The experimental group received follow-up through our system in addition to those components employed in the control group. MAIN RESULTS: The workers in the experimental group benefited in terms of improvements of not only plaque removal but also periodontal health over 3 months. CONCLUSIONS: These results indicate that implementation of an Web-based approach for periodontal health affords the possibility of remote instruction and produces additional public benefit.
Abstract: OBJECTIVE: Floating action toothbrush bristles have been incorporated into a V-shaped sonic toothbrush. The base of the bristles moves down or up according to the pressure of the toothbrush being applied to a tooth surface. It was thought that this floating action with sonic vibration may generate new motion for increased plaque removal efficacy through increased contact between bristles and tooth surfaces. The objective of this investigation was to compare the plaque removal efficacy of a sonic toothbrush with floating bristle action (Float-Brush) to either a conventional V-shaped sonic toothbrush (Techno-Brush) or a manual toothbrush. MATERIALS AND METHODS: A single-blind, three-treatment cross-over study was performed on 42 subjects. Each subject refrained from brushing for 24 hours, followed by assessment for dental plaque on the Ramfjord teeth employing the Rustogi Modified Navy Plaque Index. Plaque removal efficacy was determined by the percentage of plaque score reduction in a single-use toothbrushing under supervision for two minutes. RESULTS: Forty participants completed this study. No significant difference in pre-brushing plaque scores was detected among the three toothbrushes. In the comparison of whole mouth mean scores, plaque removal efficacy of the Float-Brush (65.0%) was significantly higher than that of the Techno-Brush (59.1%, p = 0.0487) and the manual toothbrush (50.9%, p < 0.0001). Superiority of the Float-Brush was similar to whole mouth scores, when comparing the gumline and interproximal tooth area scores. CONCLUSION: These findings indicate the superiority of the Float-Brush for plaque removal compared to the Techno-Brush and the manual toothbrush.
Abstract: BACKGROUND, AIMS: The purpose of this investigation was to evaluate the degree of compliance for supportive periodontal therapy (SPT) and to determine factors in relation to patients who failed to continue SPT programs. METHOD: A sample of 1896 patients who were treated between 1988 and 1999 was studied. The patients were classified by gender, age group and the distance between their house and the hospital. The number of visits was counted based on an electronic patient record for SPT. Data were analyzed by survival analysis. Survival probabilities in SPT were estimated by the Kaplan-Meier method and compared by the generalized Wilcoxon test. RESULTS: 28% of patients did not comply with the first visit for SPT. The older patients had higher tendencies to continue the SPT program than the younger patients. No significant differences in compliance were found between males and females or between short-distance and long-distance groups. However, when these factors were adjusted by age, significantly different patterns were shown on the curves of survival probability: in males, significant differences were found between the 20 s and 30 s (p<0.00001) and between the 50 s and 60 s (p<0.01). In females, significant differences were found between the 40 s and 50 s (p<0.001) and between the 60 s and 70 s (p<0.001). The differences of the survival probability by age group were greater in the short-distance group than in the long-distance group. CONCLUSIONS: The results suggest that age is the most important factor for compliance of the patients with SPT, not only alone but also in relation to the other factors.
Abstract: BACKGROUND: The substance P (SP) level in human gingival crevicular fluid (GCF) was studied in relation to clinical periodontal variables and to various indicators of host response in the GCF. METHODS: GCF was collected from periodontal sites with gingival inflammation and shallow or moderately deep pocket in 48 subjects. The total amount of SP and the substances based on host response factors in a 30-s sample were determined by ELISA and enzymatic methods. RESULTS: Significant correlation was found between SP and probing depth (r= 0.637, p<0.001), while correlation was weak between SP and either gingival (r= 0.177, p=0.23) or plaque index (r=0.008, p=0.96). SP also showed significant correlation with the indicators of host response: prostaglandin E2, aspartate aminotransferase, alkaline phosphatase, myeloperoxidase, interleukin-1beta, tumor necrosis factor-alpha, interleukin-8 and monocyte chemoattractant protein-1 (r=0.434-0.867, p<0.01-0.001). CONCLUSION: These results indicate that neuropeptide SP in GCF may have a potential as an indicator of periodontal inflammation and the host response.
Abstract: BACKGROUND: Smoking is associated with destructive periodontal disease. Pocket oxygen tension (pO2) is likely to be a major environmental determinant of the subgingival microflora, which is a primary etiological factor of the disease. This study aimed to compare the pocket pO2 in smokers and non-smokers with periodontal disease. METHODS: Pocket oxygen tension was compared in 27 smokers and 34 non-smokers by considering 2 confounding factors, probing depth and oxygen saturation of hemoglobin (S(O2)), in the gingiva. The pO2 was determined using oxygen microelectrode by polarographic method with an electronic compensation circuit for subgingival temperature. Gingival S(O2) was determined using tissue reflectance spectrophotometry. RESULTS: No significant difference was found in the modified gingival index and the plaque index between smokers and non-smokers. The pO2 was significantly lower in smokers (21.9+/-9.6 mmHg) than in non-smokers (33.4+/-8.4 mmHg). The difference was highly significant (P <0.0001) and was consistent when the confounding factors were considered. Correlation between the PO2 and probing depth approached statistical significance in smokers (r = -0.36, P = 0.0674) and significance in non-smokers (r = -0.41, P = 0.0174). Correlation of the PO2 to the gingival S(O2) was highly significant in non-smokers (r = 0.57, P = 0.0005), but no association was found in smokers (r = -0.08, P= 0.6975). CONCLUSIONS: These findings indicate that pO2 is lower in smokers than in non-smokers, and that the pO2 in smokers is not influenced by gingival oxygen sufficiency. The present study may provide the basis of understanding environmental factors possibly associated with microbial flora in the pockets of smokers.
Abstract: BACKGROUND: Epidemiological studies have demonstrated deteriorating effects of smoking on periodontal tissue. The aims of this study were to compare oxygen saturation of hemoglobin in the gingiva (GSo2) of smokers and non-smokers and to evaluate the chronic effect of smoking on gingival oxygen sufficiency. METHODS: GSo2 was determined using tissue reflectance spectrophotometry in 110 papillary gingival sites of 62 smokers and 100 sites of 60 non-smokers. RESULTS: No significant difference was found in GSo2 between smokers and non-smokers. In the model of ANOVA with covariates, age (P= 0.0048) and probing depth (P= 0.0012) had significant effects on GSo2. No significant effect was found in either smoking status (P= 0.3557) or the modified gingival index (MGI) (P= 0.3824). The interaction effect between smoking status and the MGI was highly significant (P = 0.0003) indicating that the effect of smoking status on the GSo2 should be compared at each level of the MGI score. GSo2 in healthy gingiva was significantly lower in smokers than non-smokers (P = 0.0014), while smokers showed higher GSo2 than non-smokers in moderately inflamed gingiva (P = 0.0356). The GSo2 in inflamed gingiva was significantly decreased compared with healthy gingiva in non-smokers (P = 0.0044), while smokers showed no significant difference between healthy and inflamed gingiva (P= 0.2772 to 0.8665). GSo2 in smokers was consistently and significantly lower than that of healthy gingiva of non-smokers (P = 0.0391 to 0.0004). CONCLUSIONS: Smokers exhibit possibly lower function of oxygen sufficiency in healthy gingiva and reduced ability to adapt the function in inflamed gingiva than non-smokers. This suggests that smokers have functional impairments in the gingival microcirculation.
Abstract: BACKGROUND/AIMS: The purpose of this study was to evaluate the possible relationship between the motility of subgingival microflora and 5 clinical parameters commonly used in dental clinics. METHOD: The clinical parameters were pocket depth, gingival inflammation, plaque accumulation, bleeding on probing and pus discharge. The motility of human subgingival microflora was estimated as the number of pixels remaining after subtraction of serial video frames using a high speed shutter camera and image analysis system, and was defined as the sum of pixels of 10 successive subtractions per sample over a 10-s time period. RESULTS: The bacterial motility showed significant positive, moderate or low associations with the five clinical parameters. The highest correlation was observed between the bacterial motility and pocket depth (r=0.36, p=0.0001). Furthermore, clinically defined periodontal healthy and diseased sites were significantly different with respect to the bacterial motility (p<0.0001). To determine whether the bacterial motility was dependent or independent of the other clinical variables, the data were analyzed based on common factor analysis. Three factors were extracted and explained about 75% of the variance of the original 6 clinical parameters. Only the bacterial motility had a positive coefficient for all these three factors. The plot of bacterial motility was placed separately from those of other variables in the scatterplot of the loadings of factor 2 versus factor 1 and factor 2 versus factor 3. CONCLUSIONS: This suggests that bacterial motility may be an independent variable among the clinical parameters. Taken together, these data indicate that bacterial motility provides unique information about the clinical periodontal condition and may be a useful tool for the monitoring of subgingival plaque in relation to periodontal disease.
Abstract: Experimental bristle arrangements were applied to a conventional V-shaped bristle-design toothbrush in an effort to improve plaque removal efficacy in interproximal areas. A single-blind cross-over study was performed to evaluate the plaque removal efficacy of this new bristle arrangement by comparing it to either a more conventional V-shaped toothbrush or a flat-headed toothbrush. Plaque removal efficacy was determined by assessing the percentage of plaque score reduction following a single controlled brushing. The new toothbrush bristle arrangement had a significantly higher plaque removal percentage efficacy than both the V-shaped toothbrush (59.1% vs. 48.5%; p = 0.0092) and the flat-headed toothbrush (65.3% vs. 55.3%; p = 0.0260) in interproximal areas. These differences were also consistent with whole mouth comparisons. When the subjects were asked about their preferences for the three different bristle formats used in this study, there was no significant difference of opinion found. These findings indicated a superiority of the new toothbrush to the other two, more conventional toothbrush bristle styles on plaque removal efficacy with these study subjects, but no particular preference for bristle design.
Abstract: The purpose of this investigation was to quantitatively estimate bacterial motility by image analysis, and to apply this method for the measurement of motility of human subgingival microflora. We developed a semi-automated method for the quantification of bacterial motility using video microscopy, digitization and image processing. Moving images of both authentic bacterial samples and clinical samples were recorded using a phase contrast microscope with a high speed (1/100 s) shutter camera. The motility was evaluated by measuring the total number of pixels remaining after the subtraction of 2 serial video images. The total number of pixels was significantly correlated with both the sum of the velocity of each bacterial cell and the number of motile bacteria on the same original images. Motility of subgingival microflora from 140 clinical samples tested was measured at 0 pixels to 3600 pixels, whereas the effect of Brownian movement was less than 150 pixels. The motility of subgingival microflora estimated with this image analysis system did not differ much from objective judgments by the naked eyes of experts. These results suggest that a semi-automated image analysis system may be useful in the evaluation of the motility of human subgingival microflora.
Abstract: The effect of mechanical toothbrush stimulation on gingival microcirculatory functions was examined with and without removal of supragingival plaque in inflamed gingiva of 6 dogs. After removal of the ligatures, 4 treatment modalities: mechanical stimulation by vibration (MS), removal of supragingival plaque (PR), combination (MS+PR) and no treatment (NT), were administered to each quadrant for 2 weeks. Both quadrants with plaque removal showed a marked decrease in the gingival index score, while slight and moderate decreases were observed in NT and MS quadrants, respectively. Changes in gingival crevicular fluid flow, pocket oxygen tension and hemoglobin oxygen saturation in the gingiva were significant in the MS, PR and MS+PR quadrants. Significant treatment-by-time effects were found for all of the parameters of microcirculatory function between NT and MS quadrants, and gingival crevicular fluid flow between PR and MS+PR quadrants, respectively. These findings suggest that mechanical stimulation with a toothbrush may offer an additional benefit to gingival microcirculatory functions in inflamed gingiva.
Abstract: The present study investigated the association of lifestyles to periodontal health status of workers in a manufacturing company in Japan. In a annual health checkup, periodontal health status was assessed by using the Community Periodontal Index (CPI) criteria and analysed by modified Miller's CPI score. Lifestyle information was also obtained by a self-administered questionnaire. Bivariate and multivariate analyses were used to examine the relationship between lifestyle and oral health care variables and 2 indicators of periodontal health status. These were the modified Miller's CPI score and the probability of subjects in the upper 25th percentile of CPI distribution as an indicator of poor periodontal health. The modified Miller's CPI score was found to increase with age, but to vary according to the workers' lifestyles. In bivariate analyses, significant variables were age, smoking, alcohol consumption, toothbrushing frequency, toothbrushing method, and use of interdental cleaners. In multivariate analyses, age, smoking, and use of interdental cleaners had significantly independent effects. Amount of smoking or alcohol consumption was associated with periodontal health status. Excessive use of alcohol may contribute to the development of periodontal disease, although further investigations are required to confirm this finding. The data from this study indicate that lifestyles which include smoking and insufficient oral health care have an independent association with periodontal disease.
Abstract: The objective of this study was to investigate the association of the oxygen tension in the periodontal pockets with clinical parameters of gingival inflammation of the maxillary anterior teeth of 32 patients. The pocket oxygen tension (pO2) was measured by a polarographic method with electronic compensation for temperature change. The oxygen saturation of hemoglobin (SO2) in the gingiva was determined with tissue reflectance spectrophotometry. Gingival crevicular fluid flow (GCF) was measured with electronic impedance. No significant association was found between pocket pO2 and the modified gingival index, the plaque index, and GCE Pocket pO2 showed significant correlation with probing depth (r = -0.57, P = 0.0005). Significant correlation was observed between pocket pO2 and gingival SO2 (r = 0.69, P < 0.0001). When all variables were entered into a multiple regression model, only gingival SO2 had a significant independent effect on the pocket pO2 (P = 0.0005). These results indicate that the oxygen sufficiency in the gingiva has a significant independent influence on the pocket oxygen tension. These studies provide the basis for understanding the oxygen tension in the periodontal pocket, which likely is a major determinant of the subgingival microflora. The studies may also lead to the development of methods for diagnosing and monitoring periodontal diseases.
Abstract: Mechanical stimulation with a toothbrush was applied to each quadrant of 10 dogs at a force of 200 g for 10 s using following modalities: vibration at attached gingiva, pressurization at attached gingiva, vibration at marginal gingiva and no treatment as a control. Hemoglobin oxygen saturation (SO2) in the gingiva was measured by non-invasive tissue reflectance spectrophotometry. Simultaneously, oxygen tension (pO2) in gingival tissue was monitored with an oxygen microelectrode. Both SO2 and pO2 increased within 10-20 min after stimulation and then slowly returned to the initial level at all treatment sites. The response was most prominent after vibration at attached gingiva. SO2 and pO2 increased by 12% and 42%, respectively, and significant increase continued for 75-85 min. Response after vibration at marginal gingiva was moderate in pO2 and transient in SO2. Pressurization at attached gingiva caused moderate response in SO2, but the increase in pO2 was slight. Control showed little change in both indices. These results suggest that vibration with a toothbrush at attached gingiva may cause a maximal response in improving oxygen sufficiency to gingival tissue.
Abstract: A single-blind, randomized triple crossover study was conducted to compare the plaque removal effectiveness of three toothbrushes: Sunstar Do New Type, Reach Compact Head, and New Dental-H. Thirty-three female students were recruited from a dental school and a dental hygiene school. All subjects brushed with a control toothbrush for the first week and with each one of the three test toothbrushes in each subsequent one-week period. Plaque removal efficacy was determined by subtracting the plaque score for the test toothbrush from that of the control toothbrush. The Sunstar Do New Type toothbrush had a significantly (p<0.05) higher plaque removal efficacy than the other two toothbrushes. The differences were prominent on the distal line angle of the second molars. Differences in plaque removal efficacy between the Reach Compact Head and the New Dental-H toothbrushes were not statistically significant (p<0.05) in this study.
Abstract: In this study, we characterized the binding of transferrin to Porphyromonas gingivalis using a classical receptor-binding assay, and examined the relationship between the binding and availability of transferrin for the growth of P. gingivalis. The binding of 125I-labeled human transferrin to P. gingivalis occurred rapidly, reversibly and specifically. Scatchard analysis yielded a Kd of 1.37 +/- 0.16 microM and an apparent number of 1.13 +/- 0.26 x 10(5) receptors per cell. The binding of transferrin was much increased when organisms were grown in iron-limited conditions. Among the species of black-pigmented anaerobic.rods, those strains of P. gingivalis which had high transferrin-binding activity exhibited unrestricted growth following the addition of transferrin to the hemin-free culture medium. On the other hand, the presence of transferrin in the culture medium did not support unrestricted growth of organisms that had low transferrin-binding activity. These results suggest that the binding of transferrin to P. gingivalis cells may be a preliminary step in iron acquisition, which allows them to survive in the healthy periodontal environment.
Abstract: We examined the effect of the concentration of various types of iron molecules on the regulation of growth of Porphyromonas gingivalis. Bacterial growth was monitored spectrophotometrically. The hemin-depleted cells of P. gingivalis 381 were incubated in the basal medium plus test substrates such as hemoglobin, hemin, transferrin and various inorganic iron compounds. The relationship between the specific growth rate of organisms and the concentration of iron-containing compounds was determined. The value of Ks, a parameter analogous to the Michaelis-Menten constant, was estimated. P. gingivalis 381 showed a Ks value of 3.85, 4.91 and 0.0017 microM for hemin, transferrin and hemoglobin, respectively. However, the inorganic iron compounds tested did not support growth of P. gingivalis. These findings suggest that P. gingivalis utilizes hemoglobin as an iron source much more effectively than other iron-containing compounds under an iron-limited environment.
Abstract: Thirty-two typical patients with breast cancer, aged 32-81 years and classified 'high risk' because of tumor spread to the lymph nodes in the axilla, were studied for 18 months following an Adjuvant Nutritional Intervention in Cancer protocol (ANICA protocol). The nutritional protocol was added to the surgical and therapeutic treatment of breast cancer, as required by regulations in Denmark. The added treatment was a combination of nutritional antioxidants (Vitamin C: 2850 mg, Vitamin E: 2500 iu, beta-carotene 32.5 iu, selenium 387 micrograms plus secondary vitamins and minerals), essential fatty acids (1.2 g gamma linolenic acid and 3.5 g n-3 fatty acids) and Coenzyme Q10 (90 mg per day). The ANICA protocol is based on the concept of testing the synergistic effect of those categories of nutritional supplements, including vitamin Q10, previously having shown deficiency and/or therapeutic value as single elements in diverse forms of cancer, as cancer may be synergistically related to diverse biochemical dysfunctions and vitamin deficiencies. Biochemical markers, clinical condition, tumor spread, quality of life parameters and survival were followed during the trial. Compliance was excellent. The main observations were: (1) none of the patients died during the study period. (the expected number was four.) (2) none of the patients showed signs of further distant metastases. (3) quality of life was improved (no weight loss, reduced use of pain killers). (4) six patients showed apparent partial remission.
Abstract: Topical application of Coenzyme Q10 (CoQ10) to the periodontal pocket was evaluated with and without subgingival mechanical debridement. Ten male patients with adult periodontitis participated and 30 periodontal pockets were selected. During the first 3 weeks, the patients did not receive any periodontal therapy except the topical application of CoQ10. After the first 3-week period, root planning and subgingival scaling were performed in all sites. CoQ10 was applied in 20 of the pockets once a week for a period of 6 weeks. Soybean oil was applied to the remaining 10 sites as a control. In the first 3-week period, significant reductions in gingival crevicular fluid flow, probing depth and attachment loss were found only at experimental sites. After mechanical subgingival debridement, significant decreases in the plaque index, gingival crevicular fluid flow, probing depth and attachment loss were found both at experimental and control sites. However, significant improvements in the modified gingival index, bleeding on probing and peptidase activity derived from periodontopathic bacteria were observed only at experimental sites. These results suggest that topical application of CoQ10 improves adult periodontitis not only as a sole treatment but also in combination with traditional nonsurgical periodontal therapy.
Abstract: To determine oxygen tension (pO2) in gingival tissue, an oxygen micro-electrode with a membrane-coated Pt needle was inserted into the gingiva of 12 dogs. Teeth were brushed using a modified Bass technique for 10 s under 200 g pressure. pO2 increased and reached a maximum 15 min after brushing, then gradually returned to the baseline. A significant increase in pO2 persisted for approx. 1 h. These findings suggest that short-term stimulation by tooth brushing increases oxygen tension in the gingiva.
Abstract: A 40-year-old woman presented with profound muscle weakness resulting in failure to wean from a ventilator and persistent lactic acidosis after having recovered from a pneumonia complicated by adult respiratory distress syndrome, myocardial infarction, renal failure and shock. She had a 28 year history of chronic anemia and exercise intolerance. Anemia and thrombocytopenia persisted after admission. Nonobstructive hypertrophic cardiomyopathy was present. A stroke-like episode occurred. A mitochondrial myopathy with deficiencies in complexes IV and II was demonstrated, but no DNA defect has yet been found. This patient represents a distinct clinical presentation of a mitochondrial disorder characterized by late onset mitochondrial myopathy, chronic anemia, cardiomyopathy, and lactic acidosis.
Abstract: We have examined whether the adhesin of Porphyromonas gingivalis which aggregates Streptococcus oralis contributes to its fibrinogen-binding. Various properties of coaggregation between P. gingivalis and S. oralis were compared with those of fibrinogen-binding to P. gingivalis cells. The coaggregation activity was measured by a turbidimetric method and the fibrinogen-binding activity was determined by using 125I-fibrinogen. Both the activities showed maximum values in the pH range from 5.0 to 6.0 and they were inhibited by arginine and lysine. Heating treatment of P. gingivalis 381 cells at 75 degrees C abrogated the activities. However, treatment of P. gingivalis 381 cells with proteinase K considerably reduced the fibrinogen-binding activity but not the coaggregation activity. Metal ions such as Zn2+ and Cu2+ inhibited the coaggregation activity but enhanced the fibrinogen-binding activity. The results also indicated that P. gingivalis strains 381, ATCC 33277 and SU-3 showed relatively higher activities both in coaggregation and fibrinogen-binding, whereas P. gingivalis strains W83, 51 and 165 showing lower fibrinogen-binding activity than P. gingivalis 381 did not coaggregate with S. oralis ATCC 9811. These findings suggest that coadhesin of P. gingivalis with S. oralis is not be associated with its fibrinogen-binding.
Abstract: We studied the immediate effect of mechanical stimulation with a toothbrush on oxygen sufficiency in human gingivae. Teeth were brushed with a modified Bass technique at various forces (100, 200, and 300 g) for various times (5, 10, and 30 s). Hemoglobin (Hb) oxygen saturation was measured before and intermittently for 60 min after brushing, by non-invasive tissue reflectance spectrophotometry. Hb oxygen saturation increased within a few min after brushing and then slowly returned to the initial level. Toothbrushing at 200 g for 10 s caused the longest-lived increase in Hb oxygen saturation; saturation remained about 6% above the baseline level for more than 25 min. Before brushing, Hb oxygen saturation was significantly lower in inflamed gingivae than in healthy gingivae (p < 0.05). After brushing of inflamed gingivae, the Hb oxygen saturation almost reached the level measured in healthy gingivae before brushing. These findings suggest that stimulation with a toothbrush increases oxygen sufficiency in both healthy and inflamed gingivae.
Abstract: The localization of regions of fibrinogen that inhibit coaggregation between Porphyromonas gingivalis and Streptococcus oralis was investigated. The coaggregation was inhibited by A alpha and gamma chains, but not by B beta chain. The inhibitory activity of fragment D was more potent than that of fragment E. Some cyanogen bromide-treated fragments isolated from A alpha and gamma chains including the NH2-terminal 148-207 amino acid residues of A alpha chain (A alpha 148-207) and gamma 1-78 showed inhibitory activities. A alpha 148-207 was further digested with lysyl endopeptidase. A alpha 158-176 and A alpha 192-206 which contained four and two arginine residues, respectively, retained the inhibitory activities. When the arginine residues of these two peptides were modified by phenylglyoxal, the inhibitory activities were much reduced. These findings suggest that the arginine residues of some specific regions of fibrinogen may play an important role in the inhibition of the coaggregation.
Abstract: The purpose of this study was to examine changes in oxygen consumption in dog gingiva during induction of experimental periodontitis. The disease was induced in adult mongrel dogs during a 16-week period by placement of silk ligatures around selected teeth. The oxygen consumption rate of gingival tissue was determined in vivo by a non-invasive technique, tissue reflectance spectrophotometry. Changes in such clinical parameters as gingival index, plaque index, pocket depth, attachment level, and gingival crevicular fluid flow indicated acute inflammatory responses during the first three weeks after ligation, followed by the appearance of chronic inflammation during the remaining 13 weeks. The oxygen consumption rate increased during the first seven days after ligation and stayed near the maximum level for 2-7 weeks; this was followed by a gradual decrease during the final nine weeks. These results suggest that gingival oxygen consumption increases rapidly with the increase of acute inflammation responses and then decreases slightly with the gradual development of chronic inflammation. Positive correlations were observed between the oxygen consumption rate and other clinical indices. Thus, the tissue reflectance spectrophotometry is a new, useful method for objective, quantitative, and non-invasive assessment of gingival oxygen consumption.
Abstract: Coenzyme Q10 (CoQ10) is indispensable to biochemical mechanisms of bioenergetics, and it has a non-specific role as an antioxidant. CoQ10 has shown a hematological activity for the human and has shown an influence on the host defense system. The T4/T8 ratios of lymphocytes are known to be low in patients with AIDS, ARC and malignancies. Our two patients with ARC have survived four-five years without any symptoms of adenopathy or infection on continuous treatment with CoQ10. We have newly found that 14 ordinary subjects responded to CoQ10 by increases in the T4/T8 ratios and an increase in blood levels of CoQ10; both by p less than 0.001. This knowledge and survival of two ARC patients for four-five years on CoQ10 without symptoms, and new data on increasing ratios of T4/T8 lymphocytes in the human by treatment with CoQ10 constitute a rationale for new double blind clinical trials on treating patients with AIDS, ARC and diverse malignancies with CoQ10.
Abstract: The purpose of this study was to determine if functional changes in the human gingival vasculature were reversible following the resolution of gingival inflammation. Ten patients with 40 inflamed gingival sites were evaluated before and 2 weeks after the completion of treatment. We determined the hemoglobin concentration and the oxygen saturation of hemoglobin at each site by tissue reflectance spectrophotometry. With the use of treatment including motivation, oral hygiene instruction, and scaling, clinical parameters such as the gingival and plaque indices, the Periotron score, and the probing depth were altered toward a healthier state. With the resolution of gingival inflammation, the increased hemoglobin concentration and decreased oxygen saturation in the inflamed gingiva were restored to normal levels. These findings suggest that reversible changes in the local hemoglobin concentration and oxygen saturation are associated with decreasing gingival inflammation in human subjects.
Abstract: The hemoglobin concentration (Hb index) and oxygen saturation (apparent SO2) in human gingiva were estimated by tissue reflectance spectrophotometry (TRS). The gingiva had significantly lower Hb index and higher apparent SO2 than those in alveolar mucosa, but there was no difference in either parameter among different gingival areas. The reproducibility in repeated measurements was high for both Hb index and apparent SO2 in gingiva. In inflamed gingiva, Hb index was significantly higher than that in clinically healthy gingiva. A lower apparent SO2 was observed in inflamed gingiva. This suggests that the increase in blood supply is insufficient to meet the oxygen demand in inflamed gingiva. There were significant correlations between either the Hb index or the apparent SO2 and the clinical parameters of gingival inflammation such as gingival index, plaque index, Periotron score and probing depth. Thus, TRS may be clinically available to estimate the blood volume and oxygen saturation in inflamed gingiva.
Abstract: Tissue reflectance spectrophotometry (TRS) can estimate hemoglobin concentration (Hb index) and oxygen saturation of hemoglobin (apparent SO2) in tissues. Reflectance spectra were measured in a gingiva-model and in human gingival biopsies by TRS. The gingiva-model was composed of human red cells and white gel in a cuvette placed on a black or white surface. The distance from the bottom surface of the cuvette to the optical probe was decreased from 5.0 to 0.5 mm. The Hb index in the gingiva-model on the black surface was constant before decreasing at less than a 3.0 mm distance. However, the Hb index in the gingiva-model on the white surface showed a decrease at less than a 1.5 mm distance. Apparent SO2 was constant at more than a 1.0 mm distance. Reflectance spectra were measured from human gingival tissue preparations, by slicing them off with microtome and making them less thick each time. Changes in reflectance spectra were observed in less than 1.0-1.5 mm thick specimens. These results suggest that the sensitivity in TRS measurement may exist within 1.0-1.5 mm from the gingival surface, and the limit of depth at which the TRS can measure may be within 3.0 mm.
Abstract: The index of haemoglobin concentration (Hb index) and apparent oxygen saturation (apparent SO2) were determined by a new, non-invasive method, tissue reflectance spectrophotometry. The Hb index was positively correlated with the haemoglobin concentration. The relationship between the apparent SO2 and oxygen partial pressure was a sigmoid curve resembling the haemoglobin oxygen dissociation curve. The Hb index and the apparent SO2 were monitored continuously by tissue reflectance spectrophotometry during the induction of experimental periodontitis with silk ligatures. The Hb index increased rapidly during the first 7 days after ligation and then decreased gradually during the remaining period. The apparent SO2 decreased during the first 7 days but gradually rose during the final 9 weeks. The maximum level of the deoxyhaemoglobin concentration after ligation was elevated about two times over that found before ligation, whereas the increase in oxyhaemoglobin concentration was relatively small. These results suggest that the oxygen supply to inflamed gingiva may increase to some extent, but not sufficiently to compensate for the increased oxygen consumption.
Abstract: Exohemagglutinin was found in the culture medium of Bacteroides gingivalis 381. Exohemagglutinin was purified 3,150-fold from culture fluid by ultracentrifugation followed by gel filtration on Sepharose CL-4B and by affinity chromatography on arginine-agarose. Examination of the final preparation of exohemagglutinin by biochemical analysis and sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed that the isolated exohemagglutinin contained three major proteins but not a detectable lipopolysaccharide. Hemagglutination inhibition experiments showed that the activity of exohemagglutinin was inhibited by L-arginine and the arginine-containing peptides, although the activity was unaffected by the sugars tested. Some protein and glycoproteins that were examined also exhibited the inhibitory activity. When the bovine submaxillary mucin was chemically modified by beta-elimination and bovine serum albumin was modified by guanidination, the inhibitory effects on hemagglutination were significantly enhanced. These results suggest that the hemagglutination of the isolated exohemagglutinin may be involved in arginine residues as components of ligand-binding sites on erythrocytes.
