The present study was undertaken to compare the efficacy of two antibiotics, spiramycin and tetracycline, with a placebo when used adjunctively with scaling and root planing in the treatment of advanced adult chronic Periodontitis. This was a double‐blind, parallel, randomized trial with one factor (drug) at three levels. Ninety–six patients (mean age 46 ± 1) were randomly assigned into one of three groups. All groups were scaled and root planed with each respective group receiving either spiramycin, tetracycline, or a placebo for 2 weeks. Two sites with probing depth of at least 7 mm were evaluated and the following clinical parameters were measured at baseline, 2, 8, 12, and 24 weeks: plaque index, bleeding on probing, crevicular fluid, probing depth, and change in the attachment level. The changes in the subgingival bacteria were monitored also using a differential staining technique. Seventy–nine patients completed the study. At the end of 24 weeks, although all three groups had shown clinical improvement when compared to the baseline data, there were no significant intergroup differences in any of the clinical parameters measured. While the proportion of spirochetes were significantly decreased (P < 0.05) at 2‐ and 8‐week intervals in both tetracycline and spiramycin groups (26% to 0.04% and 28% to 0.04%, respectively), compared to the placebo group (30% to 7%), only in the spiramycin group was the proportion of spirochetes significantly lower than the placebo group at the 24–week interval (3% and 11%, respectively). At week 24, the proportion of spirochetes in the tetracycline group had rebounded to 7%, which was not significantly different from the placebo group. We concluded that mechanical debridement with or without adjunctive spiramycin was effective in improving clinical parameters. Although the adjunctive use of antibiotics aided in preventing recolonization of spirochetes, the data did not support any short‐term clinical benefit since no statistical intergroup differences existed. (J Periodontol 1989;60:533–539)

This study was undertaken to determine whether defects in leukocyte function or in genes at the MHC play a role in the etiology of either localized (LJP) or generalized (GJP) juvenile periodontitis. Thirteen LJP and five GJP patients (ranging in age from 13 to 22 years) and their matched controls were compared with respect to selected leukocyte functions and HLA phenotypic frequencies. The results of these studies indicated that there were significant decreases in the phagocytic and chemotactic abilities of polymorphonuclear leukocytes (PMN) in both LJP and GJP. All JP patients displayed intrinsic cell defects in chemotaxis compared with controls; in addition, some patients displayed multiple defects, including those which were serum-associated. Also, there appeared to be a significant association between JP and HLA-DR2 and HLA-A33 phenotypes. Fifty percent of the JP patients were HLA-DR2-positive, whereas only six percent of the matched controls were positive. Thirty-six percent of JP patients were HLA-A33-positive, whereas none of the controls was positive. The association seen with DR2 may be due to sampling, since there were no significant differences between the JP cases and a larger unmatched control sample which was not evaluated for periodontal disease. We conclude from these data that increased susceptibility of some patients to a very aggressive and destructive form of periodontal disease (JP) is based on defects in PMN responsiveness. Further investigations are necessary to determine whether these defects are under genetic control.

Four strains of oral treponemes and Treponema phagedenis Reiter synthesize and secrete phospholipase C (PLC), which was detected by the hydrolysis of p-nitrophenylphosphorylcholine. PLC was detected in gingival crevicular fluid from diseased but not from healthy sulci. The initiation and progression of periodontal lesions may begin with the hydrolysis of membrane phospholipids by PLC.

Human teeth extracted because of advanced periodontal disease were obtained. The portions of the roots which had been exposed in periodontal pockets were either untreated or were treated with root planing or citric acid, or root planing followed by citric acid. Human gingival fibroblasts were then added to the roots so treated and were allowed to incubate for 72 h. The ability of cells to attach to and grow onto these roots was assessed by means of gross evaluation of staining intensity and by histologic and scanning electron microscopic observation. The results of multiple experiments in each root-treatment category indicated that only roots which had been planed, whether or not citric acid demineralization was used, promoted cell attachment and growth. In addition, there were no discernible morphologic differences in the cells which were plated onto roots which were root planed only, compared to those which were root planed and citric-acid treated. In both situations too, the cells displayed morphology typical of human gingival fibroblasts in culture.

ECS: The efficacy of a new dentifrice in treating dentin sensitivity: Effects of sodium citrate and sodium fluoride as active ingredients. Journal of Periodontal Research 1987; 22: 89-93.The purpose of this clinical trial was to study the effectiveness of three new test and one control dentifrice. A total of 120 subjects participated in the study. Measurement of dentin sensitivity consisted of three clinical tests (saturated sucrose solution, cold air blast, and tactile) and a subjective patient assessment. The patients were first stratified by previous treatment attempts and presence of a history of periodontal surgery. Patients were randomly assigned into four groups: 1) dentifrice containing precipitated silica abrasive; 2) dentifrice containing 0.2% sodium citrate buffer in a pluronic gel with precipitated silica abrasive; 3) dentifrice containing 0.2% NaF with precipitated silica abrasive; 4) a formula containing both the 0.2% NaF and the 2% citrate buffer. Neither patients nor examiners were aware of the group assignments. The patients were examined at baseline and after 2 and 4 wk, and 2 months. The efficacy of the new dentifrice system was not established in this investigation nor were the separate efficacies of the major components of the dentifrice. Although subjective and chnical assessments demonstrated a placebo effect, it was present to the same extent for all products, including the placebo.