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Background: To investigate the periodontal disease status in a multi-center cross-sectional study in Germany. Associations of dental, socio-economic, blood and biomedical variables with periodontal outcome parameters were evaluated. Methods: From 4 different centers N = 311 persons were included, drawn randomly from the registration offices. Maximal pocket depth (PD) was used as primary indicator for periodontitis. It was classified as: no/mild ≤3 mm, moderate 4-5 mm, severe ≥6 mm. Associations between socioeconomic (household income, education), lifestyle, and biomedical factors and PD or bleeding on probing (BOP) per site (“Yes”/”No”) was analyzed with logistic regression analysis. Results: Mean age of subjects was 46.4 (range 20-77) years. A significantly higher risk of deeper pockets for smokers (OR = 2.4, current vs. never smoker) or persons with higher BMI (OR = 1.6, BMI increase by 5) was found. Severity of periodontitis was significantly associated with caries lesions (p = 0.01), bridges (p < .0001), crowns (p < .0001), leukocytes (p = 0.04), HbA1c (p < .0001) and MCV (p = 0.04). PD was positively correlated with BOP. No significant associations with BOP were found in regression analysis. Conclusions: Earlier findings for BMI and smoking with severity of PD were confirmed. Dental variables might be influenced by potential confounding factors e.g. dental hygiene. For blood parameters interactions with unknown systemic diseases may exist. [ABSTRACT FROM AUTHOR]

Background: Topical application of active substances offers an additional option in periodontal therapy. The aim of this study was to examine the influence of the administration of a novel, biodegradable 14% doxycycline gel on microbiological findings, in connection with scaling and root planing. Methods: One hundred ten patients in three centers (Frankfurt and Heidelberg, Germany; Nijmegen, The Netherlands) with moderate to advanced periodontitis were evaluated in this randomized, double-masked, split-mouth clinical trial. In each patient, three test teeth were randomly assigned to one of three treatment modalities: 1) scaling and root planing (SRP) alone; 2) SRP with subgingival placebo gel (VEH); or 3) SRP and 14% doxycycline gel (DOX). Subgingival plague samples were analyzed at baseline and 3 and 6 months after therapy for Actinobacillus actinomycetemcomitans (A.a.), Tannerella forsythensis (T.f.), Porphyromonas gingivalis (P.g.), and Treponema denticola (T.d.) using a RNA probe. Samples from 10 patients were tested for resistance against doxycycline, amoxicillin/clavulanic acid, cefoxitin, clindamycin, and metronidazole using agar diffusion testing. Results: The largest decrease in pathogens was found after 3 months, with the most pronounced differences between DOX and SRP (P<0.05). At 6 months, pathogens were still reduced markedly in all groups. Treatment results were consolidated for VEH and DOX, with a slight deterioration for SRP (DOX versus SRP: P<0.001). Resistance was observed to amoxycillin/clavulanic acid, cefoxitin, clindamycin, and metronidazole (four isolates) but not to doxycycline. Conclusion: The addition of subgingival instillation of a 14% doxycycline gel resulted in pronounced reduction of periodontal pathogens after 3 months and stabilizing results up to 6 months after therapy. Resistance to doxycycline was not induced. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to evaluate defect width and two different definitions of defect depth as prognostic factors of periodontal healing in infrabony defects treated by regenerative therapy 6 and 24 months after surgery. Methods: In 32 patients with moderate to advanced periodontitis, 50 infrabony defects were treated by the guided tissue regeneration (GTR) technique using non-resorbable or bioabsorbable barriers. Clinical parameters were assessed, and 50 triplets of standardized radiographs were taken before surgery and 6 and 24 months after surgery. Using a computer-assisted analysis, the distances cemento-enamel junction (CEJ) to alveolar crest (AC), CEJ to bony defect (BD), horizontal projection of the most coronal extension of the bony wall to the root surface to BD, width, and angle of the bony defects were measured. Depth of the bony defect was 1) calculated as CEJ-BD minus CEJ-AC (INFRA1) and 2) measured as horizontal projection of the most coronal extension of the bony wall to the root surface to BD (INFRA2). Results: Whereas statistically significant vertical clinical attachment level gains (CAL-V: 3.36 +/- 1.59 mm/ 3.41 +/- 1.72 mm; P < 0.001) could be found both 6 and 24 months after surgery, bony fill (0.70 +/- 2.52 mm; P = 0.056/1.21 +/- 2.55 mm; P < 0.005) was significant 24 months post-surgically only. In a multilevel regression analysis, CAL-V gain was predicted by bioabsorbable membrane (P = 0.005), baseline probing depths (PD) (P < 0.001), and actual smoking (P < 0.05). Bony fill could be predicted by baseline depth of the infrabony component as determined by INFRA2 (P < 0.05), angulation of bony defect (P < 0.005), and gingival index at baseline (P < 0.001). In narrow (< 37 degrees) and deep (> or = 4 mm) infrabony defects, bony fill was more pronounced than in wide and shallow defects (P < 0.001). Conclusions: Improvement achieved by GTR in infrabony defects can be maintained up to 24 months after surgery. Narrow and deep infrabony defects respond radiographically and are to some extent clinically more favorable to GTR therapy than are wide and shallow defects. The infrabony component of bony defects, as determined by the distance from the most coronal extension of the lateral bony wall to BD (INFRA2), is a better predictor of bony fill than that determined by AC-BD (INFRA1). [ABSTRACT FROM AUTHOR]