Abstract:
BACKGROUND:Clinical attachment level (CAL) and bone height (radiographic or clinical) are two well-accepted endpoint measures for periodontal clinical trials; however, neither one has been shown to be more predictive of long-term success than the other. We propose using a composite endpoint analysis combining clinical and radiological parameters to assess the beneficial effects on both hard and soft tissues following periodontal therapy using a single statistical test. To address this need, two composite endpoint alternatives are offered as a yardstick for clinical success; each includes the improvement in CAL and either improvement in linear bone growth or percent bone fill. METHODS:The data for composite endpoint analyses were derived from a clinical trial evaluating two concentrations of recombinant human platelet-derived growth factor-BB (rhPDGF-BB) with beta-tricalcium phosphate (beta-TCP) compared to beta-TCP plus buffer as follows: group I, beta-TCP + 0.3 mg/ml rhPDGF-BB; group II, beta-TCP + 1.0 mg/ml rhPDGF-BB; and group III, beta-TCP + buffer. The construction of composite endpoints was based on the greatest values for change, accepted by the U.S. Food and Drug Administration (FDA), for clinical attachment level (DeltaCAL), mean change in radiographic linear bone gain (LBG), and mean radiographic percent bone fill (%BF), with the following dual standards defining a successful clinical result: CAL gain > or =2.67 mm and radiographic LBG > or =1.1 mm at 6 months and CAL gain > or =2.67 mm and radiographic %BF > or =14.1% at 6 months. RESULTS:Group I (beta-TCP + 0.3 mg/ml rhPDGF-BB) demonstrated statistically significant differences from group III (active control) for both composite endpoints. For the CAL/LBG composite endpoint, 61.7% of sites in group I versus 30.4% of sites in group III met the composite endpoint benchmarks (P <0.001). For the CAL/%BF composite endpoint, 70% of sites in group I versus 44.6% of sites in group III met the composite endpoint benchmarks (P = 0.003). A non-significant trend was observed for group II versus group III with 37.9% (P = 0.20) and 55.2% (P = 0.13) of sites meeting the CAL/LBG and CAL/%BF composite endpoints, respectively. These results are further emphasized by findings demonstrating a low correlation between the individual efficacy endpoints (DeltaCAL and %BF; DeltaCAL and LBG) for each of the three treatment groups. CONCLUSIONS:Composite endpoints are advantageous in periodontal clinical trials where no single efficacy endpoint has been established as the most important. A composite endpoint, combining outcome measures of both hard and soft tissue components of the periodontium, may be preferable for assessing efficacy of periodontal regenerative therapies. Two composite endpoints are offered to meet this need.
journal_name
J Periodontoljournal_title
Journal of periodontologyauthors
Lynch SE,Lavin PT,Genco RJ,Beasley WG,Wisner-Lynch LAdoi
10.1902/jop.2006.050275subject
Has Abstractpub_date
2006-08-01 00:00:00pages
1314-22issue
8eissn
0022-3492issn
1943-3670journal_volume
77pub_type
杂志文章abstract::Fourteen intrabony periodontal defects and six furcation defects (Class II) were treated by a flap procedure which included the use of a polytetrafluoroethylene membrane to allow guided tissue regeneration. After 4 to 6 weeks of healing, the membranes were retrieved and examined by scanning electron microscopy for the...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1990.61.8.515
更新日期:1990-08-01 00:00:00
abstract:BACKGROUND:Considering xenogeneic collagen matrix (CM) and enamel matrix derivative (EMD) characteristics, it is suggested that their combination could promote superior clinical outcomes in root coverage procedures. Thus, the aim of this parallel, double-masked, dual-center, randomized clinical trial is to evaluate cli...
journal_title:Journal of periodontology
pub_type: 杂志文章,随机对照试验
doi:10.1902/jop.2017.170126
更新日期:2017-12-01 00:00:00
abstract::A review of the 2006 and past American Dental Association (ADA) studies on the distribution of dentists provides information on the evolving number of periodontists. Despite an overall increase in the number of periodontists, major differences continue in practitioner/population ratios in different geographic areas. A...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2009.080592
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:In patients with severe peridontitis, lower incisors are prone to terminal breakdown. This study assessed the longevity of composite-bonded resin/natural teeth (reinforced only with a stainless steel mesh) as replacements for periodontally lost lower incisors. METHODS:Besides the longevity of the restoratio...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1999.70.2.205
更新日期:1999-02-01 00:00:00
abstract::Studies of the inductive properties of human dentin and cementum have yielded differing results. Comparisons are difficult to draw because of variations in time, donor tissue, host immunologic status, implant site, decalcifying agents and degree of decalcification. Analysis of the many experiments intimates that the a...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1985.56.11.699
更新日期:1985-11-01 00:00:00
abstract:BACKGROUND:This study examines: 1) alveolar bone loss (ABL), a hallmark of periodontitis, in anti-citrullinated protein antibody (ACPA)-positive rheumatoid arthritis (RA) patients versus control patients with osteoarthritis (OA); and 2) the association of ABL with RA disease activity and ACPA concentrations, including ...
journal_title:Journal of periodontology
pub_type: 杂志文章,多中心研究
doi:10.1902/jop.2014.140425
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Periodontal disease is one of the major oral problems encountered in patients with diabetes mellitus (DM). Vascular changes, neutrophil dysfunction, altered collagen synthesis, and genetic predisposition observed in DM may contribute to periodontitis; and the vascular alterations observed in such patients ma...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2004.75.1.91
更新日期:2004-01-01 00:00:00
abstract::Three wall intrabony defects were produced in 11 dogs using a round bur followed by curettes and hoes. A copper band was fixed to the tooth with stainless steel ligature wire. Six weeks later, the copper band was removed and the defect was treated with an enriched collagen solution (ECS) prepared from acid-extracted d...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1984.55.11.623
更新日期:1984-11-01 00:00:00
abstract:BACKGROUND:Cervical enamel projections (CEPs) have been listed among the tooth-associated risk factors that could lead to isolated furcation defects around molar teeth. This is more likely when Grade III CEPs are present. However, the histologic aspects of the CEP interface with regard to the presence or absence of cem...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2011.110088
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:The aim of this split-mouth study is to compare long-term (18 to 35 years) periodontal conditions of sites treated with gingival augmentation procedures (GAPs) and untreated homologous contralateral sites. METHODS:Forty-seven patients with 64 sites (test group), with lack of attached gingiva associated with...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2016.160284
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The purpose of this 30-day blinded, parallel-design study was to compare the effect of 2 powered toothbrushes, the Rowenta MH700 and the Braun Plak Control Ultra, on reducing plaque accumulation, gingivitis, and gingival bleeding in a cohort of 60 healthy adults. METHODS:After baseline evaluation of plaque,...
journal_title:Journal of periodontology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1902/jop.1999.70.8.840
更新日期:1999-08-01 00:00:00
abstract::Ninety patient records were examined in order to determine radiographically whether an association between open interproximal contacts and increased alveolar bone loss exists. The amount of alveolar bone in the open contact site was compared to the amount of alveolar bone in the contralateral closed contact site. Open...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1981.52.8.447
更新日期:1981-08-01 00:00:00
abstract::A classical treatment for chronic adult periodontitis consists of four to six consecutive sessions of scaling and root planing at a 1- to 2-week interval. Such a so-called "quadrant or sextant therapy" might result in a reinfection of a previously disinfected area by bacteria from an untreated region. The purpose of t...
journal_title:Journal of periodontology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1902/jop.1996.67.12.1251
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Because of bisphosphonate medication, dental implantation with a subsequent infection poses a relevant risk factor to suffer from medication-related osteonecrosis of the jaw. This rat study evaluated different implant materials under systemic bisphosphonate delivery using micro-computed tomography (μCT) imag...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1002/JPER.20-0547
更新日期:2020-11-30 00:00:00
abstract:BACKGROUND:A wide selection of Interdental Oral Hygiene (IOH) aids is available to consumers. Recommendations for selection are, however, limited by the lack of direct comparisons in available studies. We aimed to assess the comparative efficacy of IOH aids using Bayesian Network Meta-Analysis (BNMA). METHODS:Two inde...
journal_title:Journal of periodontology
pub_type: 杂志文章,meta分析,评审
doi:10.1002/JPER.17-0368
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Similarities exist in the epidemiology and immunopathogenesis of periodontitis and rheumatoid arthritis (RA), but the associations between their respective disease activities and severities are less well documented. We evaluated the prevalence and severity of periodontitis in United States (U.S.) veterans wi...
journal_title:Journal of periodontology
pub_type: 杂志文章,多中心研究
doi:10.1902/jop.2009.090309
更新日期:2010-02-01 00:00:00
abstract::The purpose of the study was to compare clinical parameter changes and osseous regeneration in 12 pairs of comparable Class II mandibular molar furcation invasion defects using either a bioabsorbable demineralized laminar bone allograft membrane or a non-resorbable expanded polytetrafluoroethylene (ePTFE) membrane as ...
journal_title:Journal of periodontology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1902/jop.1997.68.7.679
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:Through the use of optimal surveillance measures and standard case definitions, it is now possible to more accurately determine population-average risk profiles for severe (SP) and non-severe periodontitis (NSP) in adults (aged 30 years and older) in the United States. METHODS:Data from the 2009 to 2012 Nat...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2016.160013
更新日期:2016-10-01 00:00:00
abstract::The inability to examine initiation and progression of periodontal disease and to assess certain therapies in humans has led to a great interest in the use of animal models in periodontal research. Some of the most prominent animals used are non-human primates. This article reviews the characteristics of non-human pri...
journal_title:Journal of periodontology
pub_type: 杂志文章,评审
doi:10.1902/jop.1993.64.6.497
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:This report describes the surgical treatment of a gingival recession in a hemophiliac HIV-infected patient. To our knowledge, mucogingival surgery has not been described previously in these patients. METHODS:Under the supervision of the patient's hematologist, a subepithelial connective tissue graft procedu...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2004.75.10.1413
更新日期:2004-10-01 00:00:00
abstract::This report is an example of tumor metastasis to the temporomandibular joint and its effect on pain, restriction of jaw movement, and the subsequent inability of the patient to function normally. Neoplasm is not the usual etiology of myofascial pain dysfunctionsyndrome and the muscle sparm component of this patient's ...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1975.46.5.309
更新日期:1975-05-01 00:00:00
abstract:BACKGROUND:Some studies have advocated marrow penetration in guided bone augmentation (GBA), whereas others have shown that bone can be generated without marrow penetration. This study examined the effect of marrow penetration and the optimal rate of penetration. METHODS:In 10 rabbits, the calvarium was exposed, and c...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2007.070086
更新日期:2007-10-01 00:00:00
abstract::In this study, fine structural features of the pocket walls in rapidly progressive periodontitis (RPP) and adult periodontitis (AP) in 20 cases were compared using light and transmission electron microscopy. Gingiva was also obtained from a control group of periodontally healthy teeth. Clinical parameters were assesse...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1998.69.2.195
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:An experimental periodontal sensor probe (SP) equipped with an optical fiber for recording function was developed. The aim was to test the intraexaminer reproducibility of probing using the SP and to assess the consistency with the manual probe (MP). METHODS:The SP was assembled with an external sheath cove...
journal_title:Journal of periodontology
pub_type: 杂志文章,随机对照试验
doi:10.1902/jop.2011.110047
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Despite previous studies addressing the link between preterm or low birth weight infants and maternal periodontitis, extreme preterm births have received far less attention. This study is designed to address the possible association between maternal periodontal disease and preterm or extreme preterm birth. ...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2009.090527
更新日期:2010-03-01 00:00:00
abstract::A role for activated B-lymphocytes in mediating the initiation and/or progression of periodontal diseases has been proposed in previous work. The present study was conducted to: (1) assess the proportion of total lymphocyte blastogenic response to selected oral bacteria which is composed of T-cell and B-cell activatio...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1984.55.6.359
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:One-stage full-mouth scaling and root planing (FM-SRP) in combination with systemically administered azithromycin was shown to be clinically and bacteriologically effective in the treatment of chronic periodontitis. However, FM-SRP requires 2 hours for completion. Azithromycin has a long half-life. Therefore...
journal_title:Journal of periodontology
pub_type: 杂志文章,随机对照试验
doi:10.1902/jop.2009.090067
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:β-glucuronidase (βG) is one of the enzymes involved in the destruction of non-collagenous components of the extracellular matrix. It is also considered an indicator or predictor of periodontal disease activity. The present study was conducted to determine the presence and the levels of βG activity in gingiva...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2000.71.4.618
更新日期:2000-04-01 00:00:00
abstract::The research reviewed in this paper constitutes a series of investigations intended to develop and evaluate a new membrane technique, which provides improved conditions for osteogenesis during healing of bone defects and restitution of earlier existing bone. The technique has also been shown to aid in bone grafting as...
journal_title:Journal of periodontology
pub_type: 杂志文章,评审
doi:10.1902/jop.1993.64.11s.1116
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Guided bone regeneration (GBR) using a non-absorbable barrier has provided clinicians the ability to place implants in sites compromised by insufficient bone, including immediate extraction sites. Recent evidence suggests that successful GBR outcomes may be possible using bioabsorbable polymer barriers. MET...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2001.72.2.250
更新日期:2001-02-01 00:00:00