Periodontal Tissue Regeneration Using Fibroblast Growth Factor -2: Randomized Controlled Phase II Clinical Trial

Background: The options for medical use of signaling molecules as stimulators of tissue regeneration are currently limited. Preclinical evidence suggests that fibroblast growth factor (FGF)-2 can promote periodontal regeneration. This study aimed to clarify the activity of FGF-2 in stimulating regeneration of periodontal tissue lost by periodontitis and to evaluate the safety of such stimulation. Methodology/Principal Findings: We used recombinant human FGF-2 with 3% hydroxypropylcellulose (HPC) as vehicle and conducted a randomized double-blinded controlled trial involving 13 facilities. Subjects comprised 74 patients displaying a 2- or 3-walled vertical bone defect as measured ?3 mm apical to the bone crest. Patients were randomly assigned to 4 groups: Group P, given HPC with no FGF-2; Group L, given HPC containing 0.03% FGF-2; Group M, given HPC cotaining 0.1% FGF-2; and Group H, given HPC Containing 0.3% FGF-2. Each patient underwent flap operation during which we administered 200 μL of the appropriate investigational drug to the bone defect. Before and for 36 weeks following administration, patients underwent periodontal tissue inspections and standardized radiography of the region under investigation. As a result, a significant difference (p = 0.021) in rate of increase in alveolar bone height was identified between Group P (23.92%) and Group H (58.62%) at 36 weeks. The linear increase in alveolar bone height at 36 weeks in Group P and H was 0.95 mm and 1.85 mm, respectively (p = 0.132). No serious adverse events attribute to the investigational drug were identified. Conclusions: Although no statistically significant differences were noted for gains in clinical attachment level and alveolar bone gain for FGF-2 groups versus Group P, the significant difference in rate of increase in alveolar bone height (p = 0.021) between Groups P and H at 36 weeks suggests that some efficacy could be expected from FGF-2 in stimulating regeneration of periodontal tissue in patients with periodontitis

Symptomatic periesophageal vagal nerve injury by different energy sources during atrial fibrillation ablation

BackgroundSymptomatic gastric hypomotility (SGH) is a rare but major complication of atrial fibrillation (AF) ablation, but data on this are scarce.ObjectiveWe compared the clinical course of SGH occurring with different energy sources.MethodsThis multicenter study retrospectively collected the characteristics and clinical outcomes of patients with SGH after AF ablation.ResultsThe data of 93 patients (67.0 ± 11.2 years, 68 men, 52 paroxysmal AF) with SGH after AF ablation were collected from 23 cardiovascular centers. Left atrial (LA) ablation sets included pulmonary vein isolation (PVI) alone, a PVI plus a roof-line, and an LA posterior wall isolation in 42 (45.2%), 11 (11.8%), and 40 (43.0%) patients, respectively. LA ablation was performed by radiofrequency ablation, cryoballoon ablation, or both in 38 (40.8%), 38 (40.8%), and 17 (18.3%) patients, respectively. SGH diagnoses were confirmed at 2 (1–4) days post-procedure, and 28 (30.1%) patients required re-hospitalizations. Fasting was required in 81 (92.0%) patients for 4 (2.5–5) days; the total hospitalization duration was 11 [7–19.8] days. After conservative treatment, symptoms disappeared in 22.3% of patients at 1 month, 48.9% at 2 months, 57.6% at 3 months, 84.6% at 6 months, and 89.7% at 12 months, however, one patient required surgery after radiofrequency ablation. Symptoms persisted for >1-year post-procedure in 7 patients. The outcomes were similar regardless of the energy source and LA lesion set.ConclusionsThe clinical course of SGH was similar regardless of the energy source. The diagnosis was often delayed, and most recovered within 6 months, yet could persist for over 1 year in 10%

High Concentrations of Pyridinoline in Gingival Crevicular Fluid of Patients with Periodontitis and Gingivitis

骨コラーゲンに特有の架橋物質であるビリジノリン,デオキシピリジノリンのELISA法による微量測定が可能になり,骨吸収マーカーとして骨粗鬆症などの骨疾患の診断に用いられている.本研究は歯肉溝滲出液サンプルを採取してピリジノリンを測定し,歯槽骨吸収活性マーカーとしての評価を行うことを目的とした.歯肉炎には本学学生12名を被験者とした.前歯あるいは小臼歯部頬側から滲出液採取を行った.歯周炎には成人性歯周炎と診断された歯周病の患者11名,急性歯周膿瘍症状を呈する9名から滲出液を採取した.採取部位を簡易防湿後, Micro Capillary Tubeにて滲出液を採取した後, ELISA法を用いたキットにて吸光度を測定し,標準曲線よりピリジノリン値を算出した.滲出液中のピリジノリン量は,急性歯周膿瘍>歯周炎>歯肉炎の順で高値を示した.滲出液ピリジノリンが高い確率で歯槽骨吸収活性を示す指標になる事が判明したことから歯肉炎から歯周炎への移行を判断する有力な材料となるものと考えられる.Serum and urinary concentrations of pyridinoline (PYD) are used as specific markers of bone resorption in various systemic diseases. The purpose of the present study was to determine PYD levels in gingival crevicular fluid (GCF) of patients with periodontitis and gingivitis. GCF was collected from the buccal gingival sulcus of the study tooth from patients with periodontitis (n=11), periodontitis with periodontal abscess (n=9) and gingivitis (n=12) using microcapillary tubes. PYD was measured by the inhibition ELISA method. The mean PYD concentration in patients with periodontitis (4.2±0.6 nmol/L, ±SD) was significantly higher than in those with gingivitis (2.5±0.8 nmol/L, p<0.01). The highest levels were found in GCF of patients with periodontitis associated with abscess formation (6.6±0.9 nmol/L, p<0.01). Our results suggested that PYD levels in GCF could be a potentially useful marker of alveolar bone remodeling in human periodon tal diseases.11KJ00004267166原著ORIGINAL ARTICLEdepartmental bulletin pape

Plaque Removal by Electric Toothbrushing Compared with Manual Toothbrushing

手用歯ブラシ,音波歯ブラシ,超音波歯ブラシを用いて,ブラッシング時間がプラーク除去効果ならびに歯周組織に与える影響を,10名の被験者を用いて検討した.被験者には3日間ブラッシングを停止させることによって,プラークを蓄積させ,軽度の歯肉炎症を惹起させた.その後各種歯ブラシによるプラーク除去効果を検討した.1分間と2分間の異なったブラッシング時間では,全ての歯ブラシともプラーク除去効果はほぼ同様であった.さらに,4分間のブラッシングを1日3回食後14日間行わせた結果では,歯周組織の改善は全ての歯ブラシに認められ,特に音波歯ブラシが他の歯ブラシよりも効果的であることが示唆された.The aim of this study is to assess the efficacy of a manual toothbrush, a sonic toothbrush and an ultrasonic toothbrush in bacterial plaque removal and periodontal conditions. For this study, 10 subjects were selected. All subjects received a oral prophylaxis where plaque and calculus were removed and the teeth were polished so that all subjects started with equally clean teeth. Before the experiment, the subjects refrained from brushing for 72h. These results that with a brushing time of 1 to 2 min that was no statistically significant difference in the plaque removal efficacy of all toothbrushes. However, the use of sonic toothbrush in 4 min over 2 weeks demonstrated the most improved periodontal conditions.8KJ00004293438原著ORIGINAL ARTICLEdepartmental bulletin pape