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Article: Clinical and microbiological effects of subgingival restorations with overhanging or clinically perfect margins.

TitleClinical and microbiological effects of subgingival restorations with overhanging or clinically perfect margins.
Authors
Issue Date1983
PublisherBlackwell Munksgaard. The Journal's web site is located at http://www.blackwellpublishing.com/journals/CPE
Citation
Journal Of Clinical Periodontology, 1983, v. 10 n. 6, p. 563-578 How to Cite?
AbstractThe close association between restorations with overhanging margins and chronic destructive periodontitis has been known for many years. However, the mechanisms by which overhanging restorations will interact in the pathogenesis of periodontal disease are still unknown. Generally it is accepted that overhanging restorations contribute to the promotion of the disease process by virtue of their capacity to retain bacterial plaque. The purpose of the present study was to determine if the placement of subgingival restorations with overhanging margins results in changes in the subgingival microflora. 9 dental students with clean teeth and clinically healthy gingivae (GI less than 0.1) gave their consent to participate in the study. 5 MOD cast gold onlays with 1 mm proximal overhanging margins were placed in mandibular molars for 19-27 weeks. They were replaced in a cross-over design by 5 similar onlays with clinically perfect margins which served as controls. Another 5 onlays were placed in reverse order in the remaining patients. Prior to and every 2-3 weeks after insertion, subgingival microbiological samples were obtained by inserting a fine sterile paper point for 30 sec into the gingival sulcus subjacent to the restoration. The predominant cultivable flora was determined using continuous anaerobic culturing techniques. Following the placement of restorations with overhanging margins, a subgingival flora was detected which closely resembled that of chronic periodontitis. Increased proportions of Gram-negative anaerobic bacteria, black-pigmented Bacteroides and an increased anaerobe: facultative ratio were noted. Following the placement of the restorations with clinically perfect margins, a microflora characteristic for gingival health or initial gingivitis was observed. Black-pigmented Bacteroides were detected in very low proportions (1.6-3.8%). These changes in the subgingival microflora were obvious irrespective of whether the restorations with the overhanging margins were placed in the first period of the experiment or following the cross-over. Clinically, increasing gingival indices were detected at the sites where overhanging margins were placed. Bleeding on gentle probing always preceded the peak level of black-pigmented Bacteroides. Loss of attachment was not detected in any site. Changes in the subgingival microflora after the placement of restorations with overhanging margins document a potential mechanism for the initiation of periodontal disease associated with iatrogenic factors.
Persistent Identifierhttp://hdl.handle.net/10722/153555
ISSN
2015 Impact Factor: 3.915
2015 SCImago Journal Rankings: 1.848
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLang, NPen_US
dc.contributor.authorKiel, RAen_US
dc.contributor.authorAnderhalden, Ken_US
dc.date.accessioned2012-08-08T08:20:21Z-
dc.date.available2012-08-08T08:20:21Z-
dc.date.issued1983en_US
dc.identifier.citationJournal Of Clinical Periodontology, 1983, v. 10 n. 6, p. 563-578en_US
dc.identifier.issn0303-6979en_US
dc.identifier.urihttp://hdl.handle.net/10722/153555-
dc.description.abstractThe close association between restorations with overhanging margins and chronic destructive periodontitis has been known for many years. However, the mechanisms by which overhanging restorations will interact in the pathogenesis of periodontal disease are still unknown. Generally it is accepted that overhanging restorations contribute to the promotion of the disease process by virtue of their capacity to retain bacterial plaque. The purpose of the present study was to determine if the placement of subgingival restorations with overhanging margins results in changes in the subgingival microflora. 9 dental students with clean teeth and clinically healthy gingivae (GI less than 0.1) gave their consent to participate in the study. 5 MOD cast gold onlays with 1 mm proximal overhanging margins were placed in mandibular molars for 19-27 weeks. They were replaced in a cross-over design by 5 similar onlays with clinically perfect margins which served as controls. Another 5 onlays were placed in reverse order in the remaining patients. Prior to and every 2-3 weeks after insertion, subgingival microbiological samples were obtained by inserting a fine sterile paper point for 30 sec into the gingival sulcus subjacent to the restoration. The predominant cultivable flora was determined using continuous anaerobic culturing techniques. Following the placement of restorations with overhanging margins, a subgingival flora was detected which closely resembled that of chronic periodontitis. Increased proportions of Gram-negative anaerobic bacteria, black-pigmented Bacteroides and an increased anaerobe: facultative ratio were noted. Following the placement of the restorations with clinically perfect margins, a microflora characteristic for gingival health or initial gingivitis was observed. Black-pigmented Bacteroides were detected in very low proportions (1.6-3.8%). These changes in the subgingival microflora were obvious irrespective of whether the restorations with the overhanging margins were placed in the first period of the experiment or following the cross-over. Clinically, increasing gingival indices were detected at the sites where overhanging margins were placed. Bleeding on gentle probing always preceded the peak level of black-pigmented Bacteroides. Loss of attachment was not detected in any site. Changes in the subgingival microflora after the placement of restorations with overhanging margins document a potential mechanism for the initiation of periodontal disease associated with iatrogenic factors.en_US
dc.languageengen_US
dc.publisherBlackwell Munksgaard. The Journal's web site is located at http://www.blackwellpublishing.com/journals/CPEen_US
dc.relation.ispartofJournal of Clinical Periodontologyen_US
dc.subject.meshAdulten_US
dc.subject.meshBacteria - Cytologyen_US
dc.subject.meshCrownsen_US
dc.subject.meshDental Cavity Preparation - Methodsen_US
dc.subject.meshGingiva - Microbiologyen_US
dc.subject.meshGingival Diseases - Etiologyen_US
dc.subject.meshGold Alloysen_US
dc.subject.meshHumansen_US
dc.subject.meshPeriodontal Indexen_US
dc.subject.meshTime Factorsen_US
dc.titleClinical and microbiological effects of subgingival restorations with overhanging or clinically perfect margins.en_US
dc.typeArticleen_US
dc.identifier.emailLang, NP:nplang@hkucc.hku.hken_US
dc.identifier.authorityLang, NP=rp00031en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid6581173-
dc.identifier.scopuseid_2-s2.0-0020850773en_US
dc.identifier.volume10en_US
dc.identifier.issue6en_US
dc.identifier.spage563en_US
dc.identifier.epage578en_US
dc.identifier.isiWOS:A1983RT10600001-
dc.publisher.placeDenmarken_US
dc.identifier.scopusauthoridLang, NP=7201577367en_US
dc.identifier.scopusauthoridKiel, RA=6701504615en_US
dc.identifier.scopusauthoridAnderhalden, K=6505572338en_US

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