bluuebunny/crossref_metadata_2025 huggingface dataset:
The plaque‐removing ability of some common interdental aids. An intraindividual study
Authors: Bergenholtz Axel , Bjorne Assar , Vikström Bert
Published: December 2005

Abstract An intraindividual study was performed on 23 (15 male and 8 female) patients suffering from periodontal disease, in order to investigate the plaque‐removing ability of denial floss and of round, triangular and rectangular toothpicks. Only teeth in contact with neighbouring teeth and with open interdental spaces were included in the study. The plaque‐removing ability of the interdental aids used was registered by estimating the amount of plaque at the end of each experimental period (14 days) according to a modified Plaque Index (Silness & Löe 1964) in which plaque was registered on ten surfaces around each tooth.

The results show that round and rectangular toothpicks remove plaque only from the buccal part of the proximal surfaces, but that triangular toothpicks and dental floss are effective on both the buccal and lingual parts of the proximal and axial surfaces.
Assessment of the effect of dentifrices on the growth of dental plaque
Authors: Harrap G. J.
Published: December 2005

Abstract A new technique for assessing the effects of dentifrices on the growth of human dental plaque is described. Laboratory personnel brushed their teeth with the dentifrices and a new plaque index, the Gingival margin Plaque Index, was used to measure plaque growth over the next 16 hours. The index estimates the proportion of the length of the buccal gingival margin in contact with disclosed plaque on the surface of each tooth. Dentifrices containing 0.4, 0.8 and 1.2% chlorhexidine digluconate caused a lower plaque growth than a placebo paste. The differences were highly significant (P < 0.001). The size of the reduction depended on the concentration of chlorhexidine in the dentifrices. The disclosing reagent had no major effect on plaque growth. The coefficient of linear correlation between results from two examiners was 0.89 for the measurement of plaque growth. Dentifrices containing a quaternary ammonium salt also reduced plaque growth.
Prevalence and distribution of alveolar bone loss in a population of 15‐year‐old schoolchildren
Authors: Lennon M. A. , Davies R. M.
Published: December 2005

Abstract The prevalence and distribution of bone loss, as assessed by the measurement of loss of attachment, was determined in a group of 15‐year‐old schoolchildren living in an industrial area in the North‐West of England. A total of 46% of the population had loss of attachment ≥ 1 mm, including 11% who had loss of attachment ≥ 2 mm, on at least one tooth. Children of West Indian or Indo‐Pakistani origin were most severely affected. Among children of European origin, those attending non‐grammar schools showed the higher prevalence. Diagnostic criteria may explain some of the differences between this and previous reports on British teenage populations. The presence of early destructive periodontal disease may represent a useful measure of the need for periodontal treatment in such populations.
Healing of periodontal defects with ceramic implants
Authors: Evin Marvin P. L , Getter Lee , Adrian James , Cutright DuaneE.
Published: December 2005

Abstract Periodontal defects were created in all four quadrants of six monkeys. The areas were filled with biodegradable tricalcium phosphate ceramic. Specimens were examined historically from 1 to 9 weeks after placement of the material. The results indicate that the ceramic is well tolerated by the tissues and that lost periodontium is regenerated. Also, the used ceramic may be a stimulator of bone formation.
An evaluation of the applicability of the Rosenstock‐Hochbaum health behaviour model to the prevention of periodontal disease in English schoolgirls
Authors: Smith JoyceM.
Published: December 2005

Abstract Middle‐class schoolgirls who attended their dentists regularly were questioned about their knowledge and behaviour relating to periodontal disease. The girls had very little knowledge about their susceptibility to periodontal disease, its consequences and the early sign of the disease, namely bleeding. Nevertheless they brushed their teeth regularly. (Details are given in Tables 1–8.) These findings cast some doubt on the applicability of the Rosenstock‐Hochbaum model of health behaviour to preventive dental behaviour related to periodontal disease.
Experimental gingivitis in young and elderly individuals
Authors: Holm‐Pedersen Poul , Agerbæk Nina , Theilade Else
Published: December 2005

Abstract The development of experimental gingivitis was studied in young and elderly humans during a 21‐d period of oral hygiene abstention. The state of the gingiva was assessed by the Gingival Index and by measurements of the amount of gingival exudate on filter paper strips placed at the entrance of the gingival sulcus of the lower lateral incisors and cuspids. Soft deposits were assessed by the Plaque Index and by differential counts of microorganisms in gram stained smears of dento‐gingival plaque. At the end of the plaque growth period, the patients were given a thorough dental prophylaxis. Gingival condition and plaque were assessed at regular intervals during a subsequent period of controlled oral hygiene. The development of gingivitis during the oral hygiene abstention period was more rapid and more severe in old than in young individuals. Plaque accumulation was greater in the older persons. A definite difference in plaque consistency was also observed. However, microscopic counts of various types of microorganisms did not reveal any differences throughout the period of plaque accumulation. When active oral hygiene was reinstituted, the state of the gingiva rapidly returned to pre‐experimental levels in both groups. The findings of this study indicate that with age there is an altered host response to the microorganisms of the plaque.
The effect of plaque control and surgical pocket elimination on the establishment and maintenance of periodontal health. A longitudinal study of periodontal therapy in cases of advanced disease
Authors: Lindhe Jan , Nyman Sture
Published: December 2005

Abstract The present clinical study was initiated in 1969 to test the hypothesis that microbial plaque is the cause of periodontal disease and that hence even advanced cases of periodontitis can be cured in patients willing to exercise optimal plaque control. The material consisted of 75 patients with severe destruction of the periodontal tissues. The patients were selected for the study because of their ability to maintain plaque‐free dentition. Following an initial examination, a preliminary treatment plan was presented to the patients. This plan included detailed instructions in plaque control measures, scaling, root planing and emergency dental care, including endodontic therapy and extractions. Three to six months after the termination of the so‐called presurgical treatment, surgical elimination of pathologically deepened pockets was performed. The patients were recalled every 3 to 6 months after the end of the treatment. At these reexaminations the following parameters were assessed: Plaque Index, Gingival Index, Pocket Depths, Marginal alveolar bone topography and height.

The results demonstrate that it is possible to treat periodontal disease successfully, even in advanced stages, in patients willing to maintain plaque‐free dentition.
A comparative clinical study of three periodontal surgical techniques
Authors: Zamet J. S.
Published: December 2005

Abstract A comparative 4‐month trial was performed after initial preparation. The procedures used were curettage, replaced flap and apically repositioned flap procedures with osseous recontouring respectively in a split‐mouth technique in 17 male and 23 female patients, 22 to 65 years old. Changes were assessed with plaque and gingival indices, and measurements of pocket depths, attachment levels and tissue contours.

All procedures reduced pocket depths. Apically repositioned flaps were the most successful, reducing overall mean pockets from 3.5 to 1.9 mm. Changes in attachment levels post‐operatively showed only a small degree of variation among the three surgical procedures, and would not affect the choice of the apically repositioned flap as the most effective method for pocket reduction.

A marked improvement in tissue contour was obtained in those areas treated by apically repositioned flap procedures and osseous recontouring.

Despite failure to improve tissue contour, replaced flap procedures showed an equal degree of success in maintaining plaque control when compared to apically repositioned flaps, as evidenced by static plaque indices. Replaced flap procedures were also the only group to show improved gingival health over the 4‐month post‐operative period with lower gingival indexes. It would seem that good healing, followed by a high standard of oral hygiene, may overcome the presence of gingival and marginal osseous deformities.
Follow‐up studies of free gingival grafts
Authors: Egli Ueli , Vollmer Werner H. , Rateitschak Klaus H.
Published: December 2005

Abstract Vestibuloplasties with free gingival grafts were performed on 42 teeth in 12 patients exhibiting gingival recession. The tendency toward recurrence was studied after postoperative intervals of 1, 6 and 12 months. The extensions (vestibuloplasties), which were always wider than the transplant, recurred up to the transplantation margin. The transplant itself underwent shrinkage averaging 25 per cent. The vestibular depth, which had been increased by the operation, showed a 25 per cent reduction within 1 month, but then had a tendency to deepen again from 1 to 12 months postoperatively. The marginal free gingiva and sulcus depth were not influenced by the operation.
Effect of chlorhexidine on gingival wound healing in the dog. A histometric study
Authors: Hamp Sven‐Erik , Rosling Bengt , Lindhi Jan
Published: December 2005

Abstract Wound healing after gingivectomy was studied in five 1‐year‐old dogs (Beagles). During a preparatory period of 4 months, the teeth of the dogs were brushed twice a day using a toothbrush and dentifrice. At the end of this period, ail gingival units appeared healthy. All mechanical tooth cleaning procedures were then terminated. Following a period of 2 weeks without oral hygiene, six gingival units, taken bilaterally from the maxillary first molar and posterior premolar areas, were subjected to standardized gingivectomies. Subsequently, the biopsied areas of the left half of the jaws were treated twice a day with a 0.2% aqueous solution of chlorhexidine digluconate for 42 days, while corresponding areas of the right jaws were given saline treatment.

Tissue specimens were obtained after healing periods of 42, 28, 14, 7, 4 and 2 days. They were then immediately placed in a Karnovsky fixative, and afterwards decalcified in EDTA. The rate of tissue regeneration and degree of inflammatory cell infiltration were evaluated with histometric methods. It was found that while gingival wounds treated with saline regenerated with extensive inflammatory reactions, corresponding chlorhexidine‐treated wounds healed with only minor signs of inflammation.
Fluorescein angiography of free gingival autografts
Authors: Mörmann W. , Bernimoulin J.‐P. , Schmid M. O.
Published: December 2005

Abstract The capillary blood circulation of free gingival autografts during healing was studied by means of 45 fluorescein angiographs taken over a postoperative period of 14 days in 10 female patients, 21 to 36 years old. The surgical technique commonly used for transplanting gingiva was slightly modified in that no surgical dressings and, in 3 cases, not even sutures were employed to immobilize the grafts.

During the first 3 postoperative days, fluorescent plasmatic diffusion of increasing intensity was observed. In one case, fluorescing capillary circulation was detected as early as 24 hours after surgery. Four days after surgery, fluorescent capillaries became evident in all graft sites and increased steadily in number. Between 9 and 14 days after surgery, an even capillary loop pattern was established.
Plaque‐free zones on human teeth in periodontitis
Authors: Saglie Reinaldo , Johansen Jan R. , Tollefsen Tore
Published: December 2005

Abstract The surface morphology of the pocket area of extracted, periodontally involved, human teeth was studied with the stereomicroscope. A plaque‐free zone was found to be present in all specimens.

The width of the plaque‐free zone was found to decrease as the pocket depth and loss of attachment increase.
The zone of completely and partially destructed periodontal fibres in pathological pockets
Authors: Saglie Reinaldo , Johansen Jan R. , Fløtra Leiv
Published: December 2005

Abstract The morphology, the width and the appearance frequency of the zone of completely and partially destructed periodontal fibres on human teeth were studied in the stereomicroscope. This zone was present between the most apical border of identifiable, epithelial attachment remnants and the most coronal intact periodontal fibres, and consisted of only a few fibres without any specific orientation. The mean width of the zone was 0.43 mm, and the appearance frequency almost 100%. The results of the comparison between clinical and laboratory pocket depths indicated that the pocket depths measured in the laboratory were always less deep than those recorded clinically. There seemed to be a relationship between these findings and the presence of a zone of completely and partially destructed periodontal fibres.
A radiographic study of the prevalence of chronic periodontitis in 14‐year‐old English schoolchildren
Authors: Hull P. S. , Hillam D. G. , Beal J. F.
Published: December 2005

Abstract The prevalence of chronic periodontitis was investigated in six hundred and two 14‐year‐old English schoolchildren using a standardised radiographic technique. The inter‐proximal spaces on the mesial and distal aspects of the first molar teeth were examined. Oral cleanliness and gingivitis for the anterior teeth and caries prevalence were also recorded. Radiographic evidence of chronic periodontitis was detected in 51.5 % of the children examined. No significant relationship was demonstrated between bone loss associated with the first molars and any of the other parameters measured.
The effect of two commercial antibacterial mouthrinses on plaque growth in vivo
Authors: Saxén L. , Harjola O. , Ainamo J.
Published: December 2005

Abstract An experimental study was designed to compare the claimed antibacterial effect of Betadine® and Blend‐a‐med® Fluid with the known plaque growth inhibiting effect of a 0.2% aqueous solution of chlorhexidine digluconate (Hibitane®). Before the test period 21 dental students refrained from all active oral hygiene measures for 5 days. During the following week they cleaned their teeth mechanically with toothbrush and toothpicks. For the third week the students were divided into three experimental groups. Following closely the manufacturers' recommendations, one group rinsed their mouths four limes daily with 10 ml of Betadine, one group every 2 hours with a glassful of water containing 5–8 drops of Blend‐a‐med Fluid, and the control group twice daily with 10 ml of the 0.2 % chlorhexidine solution. Mechanical cleaning of the teeth was not allowed during the experimental week. The Plaque Index scorings decreased significantly from the end of the no‐hygiene to the end of the mechanical cleaning period. During the experimental period a further decrease of the mean PII score was recorded in the control group using chlorhexidine while in the two test groups the PII scores returned to the level recorded after the no‐hygiene period. As neither Betadine nor Blend‐a‐med Fluid proved able to prevent plaque growth in vivo, there seems to be no indication for their use in treatment of gingivitis.
Use of food colourants as plaque disclosing agents
Authors: Kieser J. B. , Bryan Wade A.
Published: December 2005

Abstract The effectiveness of plaque disclosure by several liquid food colourants and disclosing agents was compared in a group of eight subjects. The subjects refrained from all forms of oral hygiene for a 48‐hour period prior to rinsing with 5 ml of each dye in turn at weekly intervals. Kodachrome film records were taken and projected for the assessment of plaque staining efficacy by a panel of 38 assessors. Acceptability with respect to taste, extent and duration of mucosal staining and any side effects was also evaluated.

The food colourants were as effective as the disclosing agents. Ability to stain plaque appears to be related not only to the constituents of each dye, but also to their concentrations and relative proportions. Other desirable properties of an ideal disclosing agent tended to be fulfilled to a level equivalent to, or better than, that reached by the proprietary disclosing agents. Difficulty in obtaining proprietary disclosing agents should not act as a handicap to achieving better levels of oral cleanliness as inexpensive food colourants of equal effectiveness to the best proprietary agent are readily available.
The healing potential of the periodontal tissues following different techniques of periodontal surgery in plaque‐free dentitions
Authors: Rosling Bengt , Nyman Store , Lindhe Jan , Jern Barbro
Published: December 2005

Abstract A clinical trial was undertaken to study the healing capacity of the periodontal tissues following different modes of periodontal surgery in patients whose oral hygiene was professionally maintained at an optimal level. Fifty patients, distributed into five groups, participated in the study. Following an initial examination and presurgical treatment, the various patient groups were subjected to one of the following surgical procedures: 1) the apically repositioned flap operation including elimination of bony defects, 2) the apically repositioned flap operation including curettage of the bony defects but without removal of bone, 3) the “Widman flap” technique including elimination of bony defects, 4) the “Widman flap” technique including curettage of the bony defects but without removal of bone, 5) gingivectomy including curettage of the bony defects but without removal of bone. After surgery, all patients received oral hygiene instruction and professional cleaning of the teeth once every 2 weeks during a 2‐year period.

The results showed that periodontal disease can be cured and further destruction of the periodontal tissues avoided irrespective of the surgical technique utilized for pocket elimination. Different surgical techniques, however, promoted varying degrees of regeneration of the supporting tissues. The most favourable healing was obtained when resection of bone was avoided and when complete coverage of the alveolar bone was ensured.
The effect of systematic plaque control on bone regeneration in infrabony pockets
Authors: Rosling Bengt , Nyman Sture , Lindhe Jan
Published: December 2005

Abstract A clinical trial was undertaken to test the hypothesis that periodontitis can be cured and that bone regeneration occurs in infrabony pockets in patients maintained on an optimal standard of oral hygiene.

The material comprised 24 patients with advanced periodontal disease. After an initial examination, the patients were randomly distributed into one test group and one control group. All the patients were given instruction and practice in a proper oral hygiene technique, and then subjected to periodontal surgery using the modified Widman flap procedure. Following treatment, during a 2‐year period the patients of the test group were recalled once every second week for professional tooth cleaning. The control patients were recalled once every 12 months for prophylaxis.

The results showed that all osseous defects of the patients of the test group were refilled with bone. The control patients, on the other hand, could not maintain a high standard of oral hygiene, and exhibited a progressive deterioration of the periodontal tissues during the postsurgical observation time.
The effect of periodontal dressings on the healthy periodontium
Authors: Heaney T. G. , Appleton J.
Published: December 2005

Abstract Twenty‐seven proprietory periodontal dressings were applied to the lower labial segments of 18 subjects showing low levels of gingival inflammation when assessed by the Gingival Index system at the time of application. Specimens of each dressing type were subsequently removed at intervals ranging from 3 h to 5 days. The material adhering to the deep surface of the dressing was examined by light, transmission and scanning electron microscopy and was shown to be a complex heterogeneous structure consisting of large intact epithelial cell sheets and oral bacteria in a proteinaceous matrix. Possible mechanisms which could contribute the epithelial cell and protein components to this structure were discussed. It was concluded that the dressings themselves caused little damage to the normal periodontium but could be associated with increased levels of inflammation at longer time intervals because of bacterial growth. The significance of these findings to current clinical practice is discussed.
Traumatization of teeth and gingiva related to habitual tooth cleaning procedures
Authors: Sangnes Gudrun
Published: December 2005

Abstract . Traumatization of oral hard and soft tissues connected with mechanical oral hygiene procedures has been reported in the dental literature. Definitions, classifications and localization of such lesions are listed, and in vivo and in vitro experiments within the field are reviewed. Existing literature suggests that hard tissue lesions are mainly due to abrasives in dentifrices, whereas gingival lesions may be caused by toothbrushing per se. Factual knowledge about the prevalence, severity and critical significance, as well as relevant and reliable experiments, is scarce and further research on these topics seems to be indicated.
Intraoral cancellous bone autografts in the treatment of infrabony pockets
Authors: Carrako Juan J. , Sznajder Norma , Alonso Carlos A.
Published: December 2005

Abstract One hundred infrabony pockets with one‐ and two‐wall bony defects were treated for reattachment. Mucoperiosteal flaps were raised, the tooth surfaces were scaled and planed, and the defects curetted. Flaps were sutured tightly and the sites protected with a surgical dressing. Antibiotic coverage was used in each case. Pre‐ and postoperative measurements were taken by the same clinician from the cemento‐enamel junction to the base of the pocket.

In 56 defects cancellous bone from the same patient was placed in the defect, and in 44 defects the treatment consisted only of open curettage without bone grafts. The results showed a trend towards more favourable clinical results using bone grafts; especially in the two‐wall bony defects.
Ultrasonic scaling of maxillary teeth causing tinnitus and temporary hearing shifts
Authors: Möller Per , Grevstad Anders O. , Kristoffersen Tore
Published: December 2005

Abstract The possible effects of ultrasonic scaling of all maxillary teeth for a total of 5 min on the inner ears of 20 healthy young adults, 22‐36 years of age, were investigated by means of pure tone audiometry. Audiograms were obtained just before and immediately after scaling. Temporary shifts in hearing threshold (TTS) of 10‐20 dB, mostly at 7‐8 kHz, persisting for up to 30 min, were recorded in eight of the individuals. Three patients reported high‐pitched tinnitus lasting for 20‐30 min after ultrasonic scaling. When audiograms were obtained 3‐5 weeks later in the same 20 individuals before and immediately after they had kept their mouths open for 5 min, but with no scaling performed, TTS was recorded in three of the individuals. TTS after opening only was less pronounced than TTS after ultrasonic scaling, both with regard to severity and duration.
A comparison between conventional gingivectomy and a non‐surgical regime in the treatment of periodontitis
Authors: Waite Ian M.
Published: December 2005

Abstract The treatment of periodontitis by scaling and oral hygiene instruction was compared with the same regime augmented by conventional gingivectomy. The procedures were allocated randomly to contralateral sides of the maxillary arches of 28 patients. Following both regimes there was significant reduction in Plaque Index, Gingival Index, crevicutar fluid and depths of pockets. There was slight gain in attachment on the non‐surgical sides, and a minor loss of attachment on the surgical sides. Comparing the two regimes, over the second half of the study there was no significant difference in Plaque Index or crevicular fluid; however, on the surgical sides there was significantly greater reduction in Gingival Index and depths of pockets. Residual pockets after either technique were associated with more inflammation than where sulcus depths were less than 2 mm. Retrospective comparisons of the initial depths of pockets with the final gingival status indicated that, when initial depths of pockets had been 3 mm or over, surgical treatment was more effective than non‐surgical in reducing the final values of both depths of pockets and inflammation; this finding was statistically significant for some, but not all of the parameters. Treatment of shallow pockets by either technique was more effective than the treatment of deep pockets. Final Plaque Index values of zero were associated with significantly less inflammation and pocketing than where plaque deposits could be detected.
The periodontal management of a patient with a profound immunodeficiency disorder
Authors: Roberts W. R. , Walker D. M.
Published: December 2005

Abstract A case of severe, uncontrolled periodontal disease in a patient with a profound immunodeficiency disorder is reported. The periodontal disease was noted before the age of 1.0 years and is generalized, with marked associated alveolar bone loss, even threatening a mandibular fracture. Severely involved teeth were allowed to exfoliate, and extractions were avoided. At the age of 17 years, the patient now has only nine remaining teeth. The management adopted and alternative approaches are critically reviewed. The implications of the dental findings for current concepts of the pathogenesis of periodontal disease and dental caries are discussed.
Development of bacterial plaque in the oral cavity
Authors: Theilade Jørgen
Published: December 2005

Abstract Dental plaque may be defined as bacterial aggregations upon the teeth and other solid structures inserted in the oral cavity. It is formed by oral microorganisms which attach to the teeth in sheltered areas along the gingival margin, on the approximal surfaces, and in pits and fissures on the masticatory surfaces. The plaque increases in quantity either by multiplication of already attached organisms, or by continuous addition to the deposits of bacteria from the saliva. Structural analyses indicate that the organisms are held together in an extracellular matrix partly produced by the organisms and partly derived from saliva. The microflora of plaque is complex and shows great individual variation. There are also characteristic differences in plaque from different sites on the teeth. Thus dento‐gingival plaque is qualitatively different from that of the occlusal fissures. Furthermore, the relative proportion of different types of microorganisms may vary with the age of the deposit. Such information must be taken in consideration when attempts are made to develop chemical agents for the purpose of inhibiting plaque formation in order to prevent periodontal disease and caries.
Control of plaque by chemical agents
Authors: Ainamo Jukka
Published: December 2005

Abstract The bacteria forming pathogenic dental plaque on the tooth surfaces have long constituted a challenge for researchers with an interest in chemical degerming agents. As the plaque grows outside the vascularized tissues, most trials have been conducted with locally applied antibiotics and antiseptics. When these are introduced into the oral cavity, they will, if effective, reduce the amount of supragingival plaque. No means have so far been demonstrated for chemical control of the plaque growing underneath the gingival margin. The results obtained from trials with various antibiotics have not been very promising, especially when compared to the risks involved. Also many antiseptics with an excellent degerming effect in vitro have been tried. Most of them have proved inactive in the human mouth. Failure may be due to the protective properties of mucus and other constituents of the saliva and, apparently, (o the short retention time of the antimicrobial agent in the oral cavity. Good retentive properties have been observed with chlorhexidine (CHX). Two daily 1‐min rinses with a 0.2 % aqueous solution of CHX digluconate totally prevents growth of supragingival plaque and even when CHX has been included in. gels and dentifrices, a both statistically and clinically significant reduction in the amount of plaque has been demonstrated. At present CHX seems to be agent of choice in chemical control of supragingival dental plaque. However, due to some secondary side effects, it is mostly used only for short period treatments.
Oral pharmacology of chlorhexidine
Authors: Bonesvoll P.
Published: December 2005

Abstract The paper concerns factors which affect the binding and plaque‐inhibiting effect of chlorhexidine‐digluconate (CH) in the human oral cavity.

About one‐third of the administered dose was retained after mouth rinses (0.05‐0.40 % w/v) and after toothbrushing with a CH gel (1 % w/w) measured by [14C]‐chlorhexidine. The following CH concentration in saliva showed an almost logarithmic fall during the first 4‐8 h, followed by a more steady low concentration, with CH still present after 24 h.

The amount retained after mouth rinses increased almost linearly with the increase in the concentration. Time studies showed that about 55 % of the amount retained after 60 sec was retained after the first 15 sec.

Lowering the pH of the rinsing solution reduced the retention, and increase in ionic strength of after‐rinses increased the release of CH.

Calcium in a 250 mM concentration significantly reduced the retention and increased the release when present in after‐rinses. The detergent sodium dodecyl (lauryl) sulphate greatly reduced both the retention and the plaque‐inhibiting effect.

Comparative studies between CH and quaternary ammonium compounds showed that 60‐65 % of the quaternaries was retained, compared to 32 % of CH. When used four times daily, the plaque‐inhibiting effect of the quaternaries approached that of CH. Their concentration in saliva fell more rapidly than that of CH.
Hibitane in periodontal disease
Authors: Gjermo Per
Published: December 2005

Abstract It is generally accepted that gingivitis and periodontal disease can be prevented by means of an effective daily plaque control‐ Also in the treatment of periodontitis plaque control seems to be essential.

The plaque‐inhibiting capacity of Hibitane is well documented, and the ability of the agent to prevent gingivitis for a relatively short time has been shown. Thus Hibitane is a valuable drug in dentistry in cases when conventional plaque control is difficult or impossible for a limited period of time. The longterm effect of the drug is less known in humans. However, a few studies in selected populations indicate that the effect is preserved after continuous use for several years. Established destructive periodontitis with pocket formation and subgingival plaque seems unaffected by chlorhexidine, but healthy gingival conditions may probably be maintained by two daily applications of the agent. The indications for long‐term use of Hibitane in the mouth are still not satisfactorily clarified. Such use must be regarded and controlled as experiments. Although systemic side effects seem to be rare, some embarrassing local adverse effects have been frequently reported. The staining of teeth and fillings constitutes a serious obstacle to a more generalized use of the agent in dental practice.

Several modes of application of Hibitane in the mouth have been suggested. However, the pharmacodynamic properties of chlorhexidine as a plaque‐inhibitor are dependent on a series of complicated chemical reactions and may in several ways be jeopardized by components of a vehicle. Therefore, reliable clinical investigations proving the effect of commercial products containing Hibitane are indispensable before advocating their use.
Hibitane in the treatment of aphthous ulceration
Authors: Addy M.
Published: December 2005

Abstract In the absence of a known aetiology the management of recurrent aphthous ulceration is symptomatic with the removal of predisposing factors where possible. Since the severity and duration of ulcers may be increased by bacterial contamination, the effect of chlorhexidine gluconate in mouthwash and gel forms on the natural history of the condition has been studied. The mouthwash study employed a 0.2 % chlorhexidine gluconate solution, a 0.5 % astringent solution and a control mouthwash. Each mouthwash was used by all of the patients, with 5 ml of each preparation being diluted with 5 ml of water for use three times a day.

The gel study employed a 1 % chlorhexidine gluconate and a placebo gel with approximately a 1 inch length of the gel from the tubes being placed in the mouth three times a day.

Both studies were carried out in the double‐blind crossover manner with each preparation used for 5 weeks with a 2‐week interval between preparations.

In the mouthwash trial chlorhexidine gluconate significantly reduced the incidence, duration and severity of ulcers, whereas in the gel trial chlorhexidine significantly reduced the severity and duration but not the incidence of ulceration. Since the dosage regimes for chlorhexidine in the two studies were comparable, the mode of delivery would appear to be important in the therapeutic effectiveness.
Use of Hibitane following periodontal surgery
Authors: Davies R. M.
Published: December 2005

Abstract A number of studies have assessed the effect of chlorhexidine on the postoperative healing of periodontal wounds. Available data suggest that rinsing with a 0.2 % chlorhexidine gluconate solution does not influence healing while a conventional dressing is in place, but once this is removed healing is enhanced by either a chlorhexidine rinse or gel. Dressings incorporating chlorhexidine also hasten wound healing. Studies undertaken in dogs clearly demonstrate that the beneficial effect of this agent is due to its ability to remove existing plaque deposits and prevent new plaque formation.
Outlook for Hibitane in dental caries
Authors: Emilson C. G.
Published: December 2005

Abstract The association between S. mutans and dental caries in humans has focused the interest on the possibility to suppress or eliminate this microorganism from the oral cavity, In this respect chlorhexidine seems to be a valuable adjunct, since S. mutans is highly sensitive to the drug. In hamsters and rats infected with S. mutans topical applications of chlorhexidine have been highly effective in lowering the caries activity. In long‐term studies in students, a certain caries inhibiting effect has also been demonstrated. The decrease in the prevalence of S. mutans by chlorhexidine treatment suggests that the drug can be used for directed and controlled antimicrobial therapy in subjects highly infected with S. mutans.
Plaque control in the treatment of juvenile periodontitis
Authors: Waerhaug Jens
Published: December 2005

Abstract With the purpose of establishing to what extent “periodontosis” responds to total plaque control, 21 such patients were observed over periods ranging from 8 to 34 years. Total plaque control in the present context means complete removal of all supragingival plaque by the patient and complete removal of all subgingival plaque by the dentist. The results were evaluated in terms of the number of lost teeth and the percentage of lost attachment during the observation period.

It was observed that “periodontosis” cases responded to total plaque control in the same way as do ordinary cases, but with periodontosis, incomplete plaque control on any teeth led to extremely rapid bone loss and eventually to extraction. The reason for this is the unusually rapid apical migration of the subgingival plaque which is the most typical feature of the juvenile periodontitis.

Some attachment and some teeth were lost in most of the patients, but a sufficient number of teeth with a sufficient amount of supporting tissue were maintained to provide a set of natural teeth that functioned well.

This study shows that the reduced resistance to the invasion of subgingival plaque can be compensated for by a correspondingly strong emphasis on total plaque control.

The term “periodontosis” is misleading, and should be replaced by the name “juvenile periodontitis” as suggested by Lehner et al. (1974).
Influence of “time of day”, pocket depth and scaling on gingival fluid flow
Authors: Suppipat Nophadol , Johansen Jan R. , Gjermo Per
Published: December 2005

Abstract Gingival fluid was sampled from the orifices of the gingival crevices in five male subjects with clinically healthy gingiva. The sampling was performed at 0915 h, 1215 h and 1515 h of the same day. Variation in “time of day” did not seem to influence the rate of gingival fluid flow.

A total of 144 pockets (2 11 mm) in 19 patients were sampled for gingival fluid at the orifices. The adjacent gingiva was evaluated according to the Gingival Index (GI). Gingival fluid flow was much more influenced by the degree of gingival inflammation than by pocket depth.

Scaling with curettes was performed in five patients. Gingival fluid was sampled at the orifices immediately before scaling and on days 1, 14 and 28 after scaling. The flow rate decreased to a minimum on day 14 after scaling for all pocket depths and remained at almost the same level until day 28. Pockets less than 5 mm deep were more frequently without measurable amounts of fluid than pockets deeper than 5 mm on days 14 and 28.
The influence of experimental gingivitis on plaque formation
Authors: Hillam D. G. , Hull P. S.
Published: December 2005

Abstract The rate of plaque growth was assessed using daily Plaque Index measurements over a 7‐day period in eleven dental students with an initial mean Gingival Index of 1.21 (± 0.05). The mean Gingival Index was then reduced to 0.27 (± 0.04) and the rate of plaque growth assessed in the same way. Bacterial smears were taken from the teeth at intervals during both experimental periods and percentage counts of various morphological types of bacteria made. The rate of plaque growth was found to be significantly greater when the Gingival Index was high compared with when the Gingival Index was low (P < 0.001). There was also an earlier development of a complex bacterial flora when the Gingival Index was high. The hypothesis is presented that gingival exudate has no inhibitory action on the formation of dental plaque, but contains substances which enhance bacterial aggregation and the colonization of the tooth surfaces by these aggregates.
Some antibacterial properties of periodontal dressings
Authors: Haugen Ellen , Gjermo Per , ØRstavik Dag
Published: December 2005

Abstract Three commercial periodontal dressings were tested for antibacterial activity against salivary microorganisms after having been stored dry or in liquid for 1 and 2 days. Inhibition of growth of mixed salivary flora was evaluated on blood agar dishes. Also, the ability of Strep, mutatis to colonize the surface of the dressings was tested.

The surface contact test indicated antibacterial activity against salivary microorganisms by freshly made Coe‐pak® and Wondrpak®. Some activity could also be observed after 2 days' storage in about half the experiments. The initial bacteriostatic effect of Peripac® was limited to the setting phase. The plaque accumulation test revealed single cells only on the surfaces of Coe‐pak and Wondrpak whereas Peripac seemed to be colonized by the test bacteria.
Root surface roughness in response to periodontal instrumentation studied by combined use of microroughness measurements and scanning electron microscopy
Authors: Meyer Knut , Lie Tryggve
Published: December 2005

Abstract Root surface roughness, resulting from calculus removal by hand curette, ultrasonic curette and rotating diamond or Roto‐Pro® points, was examined by combined use of microroughness meaurements and scanning electron microscopy (SEM). Mandibular incisors were placed in a jaw model with a rubber “gingiva” in an attempt to simulate a clinical situation. After cleaning with the various instruments, the surface roughness was measured by an industrial profilometer followed by SEM evaluation. A microroughness index (MRI) was developed and showed that the instruments could be separated into three groups, where the hand curette produced least roughness, followed by the Roto‐Pro instrument, while the ultrasonic curette and the diamond left the most uneven surfaces, A SEM roughness index (SRI) based on defined criteria, corresponded well with the results from the profilometer measurements, except that using this index the diamond scored higher than the ultrasonic curette. This was probably due to considerable calculus remnants remaining in the ultrasonic specimens. Characteristic features of the root surface morphology of the cleaned teeth are described. It is concluded that the combined use of microroughness measurements and SEM is of considerable value in this type of studies since more information may be obtained than by any of these methods used separately.
Experimental transient bacteraemias in human subjects with varying degrees of plaque accumulation and gingival inflammation
Authors: Silver John G. , Martin Alexis W. , McBride Barry C.
Published: December 2005

Abstract Ninety‐six subjects were assigned to one of four groups according to severity of gingival inflammation and bacterial plaque accumulation on the teeth. Following a standardized toothbrushing procedure, blood specimens from a vein in the antecubital fossa were cultured under aerobic and stringent anaerobic conditions. The percentage of positive cultures increased significantly with increasing severity of gingival inflammation, as did the number of species of organisms isolated. Thirty different microbial species indigenous to the oral cavity, including many strict anaerobes, were recovered. The study has implications for standards of oral health which might be considered necessary in patients with congenital or acquired endocardial defects or cardiovascular prostheses.
Effect of monthly professional mechanical tooth cleaning on periodontal health in adults
Authors: Glavind Leif
Published: December 2005

Abstract The beneficial effects of comprehensive dental prophylaxis programs are well recognized. In order to study the factors determining the effectiveness of these programs, 28 periodontal recall patients were subjected to monthly professional mechanical tooth cleanings. Experimental and control teeth were randomly selected according to a split‐mouth cross‐over method. The Plaque and Gingival indices were recorded month prior to the study, at the start, and at 4,8, and 12 months. One month prior to the study calculus and bacterial plaque were thoroughly removed from all teeth. During the study period only the experimental teeth were cleaned. Efforts were made not to influence the oral hygiene of the participants by any other means. Following the initial tooth cleaning and during the preexperimental period the Plaque and Gingival indices decreased to a low level on both the experimental and control teeth (mean PII = 0.4, mean GI = 0.3). This high standard of oral hygiene and gingival health was maintained throughout the study period, and no differences could be observed between experimental and control teeth. This indicates that factors other than the mechanical professional cleaning were responsible for the maintenance of gingival health. It is suggested that participation in the program in itself may have motivated the patients to improve their oral home care.
Lack of effect of trauma from occlusion on the recurrence of experimental periodontitis
Authors: Ericsson Ingvar , Lindhe Jan
Published: December 2005

Abstract The experiments were performed in 15 dogs fed a diet which allowed dental plaque accumulation. A phase of experimental periodontal breakdown was initiated on day 0. After 210 days five dogs were sacrificed. In the remaining 10 dogs the periodontal pockets around the fourth lower premolars (4P and P4) were eliminated. During surgery a notch was prepared in the root at the level of the marginal termination of the alveolar bone in order to facilitate measurements in histological sections. From day 210 to day 450 the teeth of the animals were brushed twice daily. After 60 days of healing, i. e. on day 270, five of the dogs were sacrificed. Trauma from occlusion of the jiggling type was on day 270 produced in the P4 region of the remaining dogs by the installation of a cap splint and a bar device. The final five dogs were sacrificed on day 450. Following sacrifice, tissue sections comprising 3P, 4P, 1M and P3, P4, M1 were produced and subjected to microscopic analysis.

The experiments revealed that, in the dog, forces produced by occlusal trauma are unable to induce a phase of progressive destruction of the periodontal tissues in tooth regions where the supporting tissues are markedly reduced but non‐inflammatory.
Periodontal surgery in plaque‐infected dentitions
Authors: Nyman Sture , Lindhe Jan , Rosling Bengt
Published: December 2005

Abstract A clinical trial was performed to study the result of periodontal treatment following different modes of periodontal surgery in patients not recalled for maintenance care. The material consisted of 25 patients distributed into 5 groups. Following an initial examination, all patients underwent presurgical treatment including case presentation and instruction in oral hygiene measures. This instruction was given once. The various patient groups were then subjected to one of the following surgical procedures: 1) the apically repositioned flap operation including elimination of bony defects 2) the apically reposi‐tioned flap operation including curettage of bony defects but without removal of bone 3) the “Widman flap” technique including elimination of bony defects 4) the “Widman flap” technique including curettage of bony defects but without removal of bone 5) gingivectomy including curettage of bony defects but without removal of bone. Six, 12 and 24 months after completion of the treatment, the patients were recalled for assessment of their oral hygiene standard and periodontal conditions.

The results showed that case presentation and oral hygiene instruction given once, only temporarily improved the patient's oral hygiene habits. Renewed accumulation of plaque in the operated areas resulted in recurrence of periodontal disease including a significant further loss of attachment. All five different techniques for surgical pocket elimination were equally ineffective in preventing recurrence of destructive periodontitis.
Calculus removal and loss of tooth substance in response to different periodontal instruments
Authors: Lie Tryogve , Meyer Knut
Published: December 2005

Abstract The efficiency of calculus removal and the amount of lost tooth substance resulting from the use of hand curette, ultrasonic curette and rotating diamond and Roto‐Pro® points were examined by scanning electron microscopy (SEM). Root surfaces of mandibular incisors placed in a jaw model were cleaned of adhering deposits, photographed by SEM and evaluated at a standard magnification by three examiners. Scores were given for remaining calculus (RCI) and loss of tooth substance (LTSI) according to defined index criteria. The results revealed that calculus removal was most complete following diamond instrumentation, whereas the ultrasonic curette was least efficient in this respect. Hand curette, ultrasonic curette and Roto‐Pro removed about the same amount of tooth substance whereas the diamond removed considerably more than the others. The diamond regularly removed all the cementum and left deep instrumental marks in the dentin; it seems advisable to avoid the use of such instruments in periodontal depuration.