bluuebunny/crossref_metadata_2025 huggingface dataset:
Subgingival irrigation in the maintenance phase of periodontal therapy
Authors: Schlagenhauf Ulrich , Stellwag Peter , Fiedler Andreas
Published: December 2005

Abstract The purpose of this study was to evaluate the effect of subgingival scaling versus subgingival pocket irrigation with 0.1% chlorhexidine or saline controls on the repopulation of subgingival periodontal sites with disease‐associated micro‐organisms following a single procedure of scaling and root planing. Additionally, pertinent clinical parameters (attachment level, plaque index, bleeding on probing) were also recorded. 375 sites in 30 individuals with previously untreated periodontal disease were thoroughly scaled and subsequently either rescaled, irrigated, or not treated at all for the following 6 months at 1‐month intervals. The results show that the initial scaling and root planing procedure led to significant clinical and microbiological improvements in all experimental groups. These improvements were maintained in all but the untreated sites. Based on the observed clinical and microbiological changes, subgingival irrigation of periodontal pockets at 1‐month intervals was equally effective as scaling and root planing performed at the same pace. 0.1% chlorhexidine however, being used as test irrigant, was not more effective than saline controls.
Actinobacillus actinomycetemcomitans and Bacteroides intermedius in human periodontitis: age relationship and mutual association
Authors: Slots Jørgen , Feik Diane , Rams Thomas E.
Published: December 2005

Abstract This study examined age relationships and mutual interrelationships between cultivable Actinobacillus actinomycetemcomitans and Bacteroides intermedius in 1624 periodontitis patients, 15 to 89 years of age. Each subject contributed a pooled subgingival sample, obtained from 3 deep periodontal pockets with paper points. A. actinomycetemcomitans occurred with higher prevalence (74%) and mean recovery (7% in culture‐positive patients) in patients less than 25 years old than in adult and geriatric patients (prevalence about 31%; mean recovery about 1%). The organism was detected in 85% of localized juvenile periodontitis patients. B. intermedius was recovered from 45% of the study subjects, averaged about 7% of total isolates in positive patients, and showed no predilection for any age group. As determined from predicted and observed values for A. actinomycetemcomitans and B. intermedius, occurring alone and in combination, no synergistic or antagonistic relationships between the organisms could be delineated with respect to subgingival colonization. The therapeutic implication of these findings is discussed.
Clinical, microbiological and immunological studies on recurrent periodontal disease
Authors: Choil J.‐I. , Nakagawa T. , Yamada S. , Takazoe I. , Okuda K.
Published: December 2005

Abstract. The present study was performed to evaluate the clinical, microbiological and immunological aspects in the early stages of recurrent periodontal disease. After clinical monitoring of pockets with recent evidence of disease recurrence, microbiological samples for cultural analysis, serum and gingival crevicular fluid (GCF) samples were taken for IgG antibody analysis from 14 sites, 7 in 6 recurrent periodontitis patients and 7 in 7 periodontally healthy control subjects. IgG responses of serum antibody to 8 gram‐negative bacterial strains were compared with those of GCF sampled from the recurrent site. The results clearly demonstrated the predominance of Bacteroides gingivalis in most subgingival plaque samples during the early stages of disease recurrence; the mean proportions of B. gingivalis were significantly different from those of the healthy sites (p<0.05). 4 out of 6 serum samples showed the elevated antibody responses to B. gingivalis 381: and this was closely correlated to homologous infection by this micro‐organism in recurrent sites. Elevated serum antibody responses were also noted to Eikenella corrodens 1073 and Actinobacillus actinomycetemcomitans Y4. However, no relationship with homologous infection was found for A. actinomycetemcomitans. 3 out of 6 GCF samples had greater antibody titers than the serum, suggesting local antibody synthesis by the gingival cells in the recurrent pockets. The present study showed that B. gingivalis might play an important role in the pathogenesis of disease recurrence in its early stages.
Relation of baseline microbial parameters to future periodontal attachment loss
Authors: Haffajee A. D. , Socransky S. S. , Smith C. , Dibart S.
Published: December 2005

Abstract The relationship between the level of subgingival species at baseline and subsequent attachment loss in a subject was examined. 38 subjects (14–71 years) with prior evidence of periodontal destruction were monitored 2 × for pocket depth and attachment level at 6 sites per tooth at baseline and 2 months. A subject was considered to exhibit new attachment loss if 1 or more sites increased 3 mm or more in attachment level in 2 months. Subgingival plaque samples were taken at the baseline visit from the mesial aspect of each tooth (28 sites) using Gracey curettes. Samples were dispersed, diluted and plated on Trypticase soy agar supplemented with 5% sheep blood. After 7 days of anaerobic incubation, the colonies were lifted onto nylon filters, lysed and the DNA fixed to the filters. Digoxygenin‐labeled DNA probes were used to enumerate 14 subgingival species. 17 of 38 subjects (44.7%) exhibited new attachment loss in 2 months. The % of the total viable count of each species was averaged for each subject. The species enumerated and the mean % of the total cultivable microbiota averaged across the active and inactive subjects were as follows; B gingivalis 2.3, 1.2; W. recta 1.3, 0.6; B. intermedius I.2.5, 2.0; B. forsythus 1.5, 1.2; A. actinomycetemcomitans serotype a 1.1, 0.8; F. nucleatum ss vincentii 1.1, 1.0; S. intermedius 2.0, 1.9; P. micros 1.5, 1.5; B. intermedius II 1.6, 1.7; A. actinomycetemcomitans serotype b 0.4, 0.6; S. sanguis I 1.8, 2.1; S. sanguis II 2.7, 3.0; V. parvula 3.9, 4.2; C. ochracea 0.9, 1.8. Significantly higher levels of B. gingivalis and W. recta and significantly lower levels of C. ochracea were found in active subjects prior to breakdown. Odds ratios were computed at different threshold levels for each species. Significant ratios for new disease were B. gingivalis 5.6, W. recta 3.8, V. parvula 0.16 and C. ochracea 0.08. When subjects were subset into those with localized (< 30% affected sites) and widespread disease groups, B. gingivalis and B. intermedius I were elevated in active localized disease subjects and C. ochracea in inactive subjects. P. micros and W. recta were elevated in active widespread disease subjects. Discriminant analysis using the significantly related species was useful in predicting subjects at risk for new attachment loss overall and in both groups. Such data suggest that levels of microorganisms may be useful indicators of future attachment loss.
Periodontal condition of pregnant women assessed by CPITN
Authors: Miyazaki H. , Yamashita Y. , Shirahama R. , Goto‐Kimura K. , Shimada N. , Sogame A. , Takehara T.
Published: December 2005

Abstract The periodontal conditions of 2424 pregnant and 1565 non‐pregnant women were assessed according to the community periodontal index of treatment needs (CPITN). The aim of this survey was to obtain information which is necessary for the planning of preventive programs of periodontal disease for pregnant women. 95% of the pregnant women and 96% of the non‐pregnant women had some signs of periodontal disease. The % of pregnant women having 4 or 5 mm pockets was significantly higher than that of non‐pregnant women, increased with the month of pregnancy, reached a maximum of 31%) in the 8‐month group, but decreased to the control level in the 9‐month group. These changes were interpreted to suggest that the increase of pocket depth during pregnancy was caused by gingival enlargement rather than by periodontal destruction. The results show that pregnant women had a healthier periodontal condition when compared with non‐pregnant women, i.e., the number of sextants with healthy periodontal tissues was higher, the % of people having deep pockets (6 mm or deeper) was lower, and the need for prophylaxis was lower in pregnant than in non‐pregnant women. These findings suggest that a special program of periodontal disease prevention for pregnant women is not necessary.
Application of matched pair procedures to site‐specific data in periodontal research
Authors: Donner Allan , Eliasziw Michael
Published: December 2005

Abstract Application of standard statistical procedures to site‐specific data in periodontal research is invalid unless site‐to‐site dependencies are accounted for. In this paper, we present the adjustments required for valid application of matched pair procedures, including the paired r‐test and McNemar's χ2 test for correlated proportions. Examples are given involving data arising from: (1) the comparison of pre‐ and post‐treatment clinical measurements; (ii) split‐mouth protocols.
Relation of counts of microbial species to clinical status at the sampled site
Authors: Socransky S. S. , Haffajee A. D. , Smith C. , Dibart S.
Published: December 2005

Abstract The purpose of the present investigation was to relate clinical characteristics at a site to the frequency of detection, absolute counts and proportions of 14 subgingival species. Subgingival plaque samples were removed by curette from the mesial surface of 2299 teeth in 3 healthy and 87 subjects with periodontal attachment loss. Samples were dispersed, diluted and plated on Trypticase soy agar supplemented with 5% sheep blood. After 7 days of anaerobic incubation, colonies were lifted onto nylon filters, lysed and the DNA fixed to the filters. Digoxygenin‐labeled DNA probes were used to identify colonies of each test species. Measurements of pocket depth, attachment level, recession, redness, bleeding on probing and suppuration were made at each sampled site. Total viable counts at sites ranged from 103 to > 108 and were strongly related to pocket depth. Mean total counts at sites < 3 mm averaged 4.6 × 106, while mean counts at sites > 7 mm averaged 2.0 × 107. Species enumerated and % of sites colonized were as follows; V. parvula 44; S. sanguis 11 36; B. intermedius I 33; C. ochracea 31; B. intermedius II 30; S. sanguis I 29; B. gingivalis 27; S. intermedius 25; P. micros 24; W. recta 23; F. nucleatum ss vincentii 18; B. forsythus 15; A. actinomycetemcomitans serotype a 10; A. actinomycetemcomitans serotype b 8. Counts of B. intermedius II were higher at sites which exhibited gingival redness while B. intermedius I was higher at sites which bled on probing. A. actinomycetemcomitans serotype b was more frequent and at higher mean % at sites without recession. The opposite was true for S. sanguis II. B. gingivalis was somewhat more prevalent and at higher levels at suppurating sites. B. gingivalis, B. intermedius I and II and B. forsythus were found more frequently and at higher levels at sites with deeper pockets, while V. parvula was less prevalent at sites with pocket depths < 4 mm. B. gingivalis, B. intermedius I and A. actinomycetemcomitans serotype b increased with increasing pocket depth in both localized and widespread disease subjects, but mean counts were higher in the localized disease subjects at any pocket depth. Only W. recta was found at higher levels at deep sites in widespread disease subjects when compared with similar sites in localized disease subjects. No suspected pathogens were detected in 38% of shallow sites, 31% of intermediate sites and 22% of deep sites. 2/3 of deep pockets, but less than 1/2 of shallow pockets harbored at least 2 of the suspected pathogens.
Cell populations and episodic periodontal attachment loss in humans*
Authors: Zappa U. , Reinking‐Zappa M. , Graf H. , Espeland M.
Published: December 2005

Abstract The purpose of the present study was to assess possible associations between episodic probing attachment loss and cell populations in the supracrestal connective tissue in humans. 10 systemically healthy adult patients with untreated advanced periodontitis were monitored during a period of 10 months. At baseline and every month thereafter, probing attachment levels were measured at 6 sites of every tooth using an electronic pressure sensitive probe and flexible stents. Corresponding contralateral sites were identified where 1 site had lost 2 mm or more attachment within the previous month (P), and the other site had not (C). Supracrestal soft tissue biopsies were taken from these sites, processed and cut into 1 μm sections. Cell populations were identified in superficial and deep connective tissue areas by counting fibroblasts, macrophages, plasma cells, mast cells, granulocytes, lymphocytes, endothelial cells and the total number of inflammatory cells. Analysis of variance assessed differences in cell populations between P‐ and C‐sites. There were statistically significantly higher numbers of fibroblasts in the standard areas of C‐sites (p < 0.0001). In P‐sites, the numbers of macrophages, plasma cells, mast cells, lymphocytes and total inflammatory cells were significantly higher as compared to C‐sites (p= 0.05–0.0001). There were no differences in cell populations between superficial and deep connective tissue areas within P‐and C‐sites (p > 0.2). Clinically assessed episodes of periodontal disease progression may be associated with site‐specific shifts in inflammatory cell populations.
Prevalence of juvenile periodontitis in Chile
Authors: López Néstor J. , Ríos Vilma , Pareja Marco A. , Fernández Olaya
Published: December 2005

Abstract The aim of this survey was to study the prevalence of juvenile periodontitis in schoolchildren aged 15–19 years in Santiago, Chile. A random sample of 2500 schoolchildren (1318 male, 1182 female) that represented the full range of different socio‐economic strata and ethnic groups seen in the population of Santiago, was used. Initially, the children were screened clinically at school by assessment of probing depths around the incisors and first molars with a WHO 621 pattern probe. Children with 2 or more teeth with 5.5 mm or deeper pockets were invited for a radiographic examination comprising bitewing radiographs of molars, and periapical radiographs of incisors. Any subject with 2 mm or more alveolar bone loss was invited for a full clinical and radiographic examination. After screening, 27 subjects had a tentative diagnosis of juvenile periodontitis. 4 of these refused radiographic examination and only accepted a thorough clinical examination. 23 subjects presented themselves for the radiographic and complete clinical examination. Of the 27 subjects selected for detailed examination, 8 subjects (7 female, and 1 male) were diagnosed as having juvenile periodontitis. There was an overall prevalence of juvenile periodontitis of 0.32% with 95% confidence, which gives a range of +0.10%. When prevalence was assessed by socio‐economic status, juvenile periodontitis was found more commonly in low socio‐economic group. The results of the current study suggest that in Chile, there might be a relationship between socio‐economic status and prevalence of juvenile periodontitis, and that this disease is more frequent in women.
Histologic studies on the extension of the inflammatory infiltrate in human periodontitis
Authors: Moskow Bernard S. , Poison Alan M.
Published: December 2005

Abstract This study was undertaken to re‐examine early and recent morphologic descriptions of gingival and periodontal inflammation based on a study of gingival biopsies and block sections of human jaws. A collection of 350 autopsy and surgically retrieved jaw sections containing multiple teeth and displaying various stages of periodontal inflammation were subjected to routine histologic preparation and analyzed with step serial sections. 105 gingival biopsies, serially sectioned, including 15 clinically normal specimens, were also studied. The results of these investigations suggest that the inflammatory lesion extends into the alveolar process and elicits a response, often before evidence of crestal resorption or connective tissue attachment loss has occurred. Similarily, deep penetrations of inflammatory cells into the alveolar bone, periodontal ligament and periapical tissues, along with fibrosis and enlargement of the marrow spaces, were common findings with advancing disease. More widespread distributions of inflammatory cells than previously described were found in clinically normal gingiva, while in more inflamed gingiva, the inflammatory cell types found and their pattern of distribution varied greatly from individual to individual. These observations cast doubt on the perception of human periodontitis as a localized and marginal disease and suggest that its effects may be much more pervasive than previously thought.
Associations between subgingival plaque bacterial morphotypes and clinical indices?
Authors: Omar A. A. , Newman H. N. , Bulman J. , Osborn J.
Published: December 2005

Abstract The aim of the present study was to evaluate possible associations between subgingival plaque bacterial morphotypes, as assessed by darkground microscopy, and clinical indices of routine adult chronic periodontitis. Clinical indices were plaque index (PII), gingival index (GI), sulcus bleeding index (SBI), papilla bleeding index (FBI), attachment loss (AL), pocket depth (PD) and probeable pocket depth (PPD). Apical border plaque was sampled in vivo and after extraction to test whether direct or indirect sampling affected any such associations. Similarly, pocket depth and attachment loss were also assessed directly and indirectly on the same teeth, in vivo or after extraction. The influence of the type of index used to record inflammation (GI, SBI, PBI) was also assessed, as were the effects of the numbers of sampled subjects and the method of analysis, which comprised the use of transformed and untransformed data and of parametric and non‐parametric tests. Data were collected in relation to the approximal surfaces of 44 teeth extracted from 22 adults (2 teeth each) and from 1 pair of contralateral upper anterior or premolar teeth in each of 100 adults, all which untreated routine chronic periodontitis. Selected subjects had ≤4 mm probeable pocket depth and/or attachment loss, and radiographic evidence of bone loss in relation to 1 approximal surface on each of 1 pair of contralateral anterior or premolar teeth, or to 2 teeth scheduled for extraction. Plaque preparation and darkground microscopy were as described previously. Insignificant associations (P > 0.05) were demonstrated between supragingival plaque (P1I) and periodontal inflammation (GI, SBI, PBI) or destruction (PPD and AL), as well as between inflammation and attachment level. In contrast, significant moderate associations (r= 0.5–0.77) were demonstrated between each of the 3 morphotype groups; spirochaetes, other motiles and cocci. Spirochaetes showed a significant moderate (r= 0.5) positive association with pocket depth with a 2.43% mean increase of spirochaetes for each 1 mm increase of PPD. Although highly significant associations (r= 0.9) were demonstrable between the 3 inflammation indices (GI, SBI, PBI) themselves, only PBI showed significant positive associations (r= 0.3) with spirochaetes and other motiles. Also, P1I showed significant associations with each of the 4 morphotypes (r= 0.3–0.5). The heterogeneity of spirochaetes and other motiles as well as the multiplicity of possible aetiological microbial agents in plaque may have resulted in underestimated associations between subjects as well as undetectable association within a given mouth using only 4 morphotype groups. Method of plaque sampling, pocket depth, attachment loss or inflammation assessment did not generally affect the results. Nor did data transformation or statistical method used significantly enhance the strength of demonstrated associations.
Histological evaluation of biodegradable and non‐degradable membranes placed transcutaneously in rats
Authors: Galgut P. , Pitrola R. , Waite I. , Doyle C. , Smith R.
Published: December 2005

Abstract The aim of this study was to assess histologically the response to membrane materials that might be used for guided tissue regeneration procedures, using a transcutaneous model on the dorsal surface of the rat. The materials included expanded polytetrafluoroethylene (PTFE) membrane (Gore‐Tex), PTFE Millipore filter, biodegradable polylactic acid (PLA) and polyhydroxybutyrate/polyhydroxyvalerate copolymer membranes. 70 implants were placed in 10 rats under general anaesthesia. At 2 weeks after the operative procedure, the specimens were assessed histologically for the composition of the tissue surrounding the material, the types of cell in the infiltrate and the degree of absorption particularly in the superficial tissues. PTFE was associated with greater epithelial downgrowth and a mainly polymorphonuclear infiltrate. PLA showed a high incidence of absorption, with a mainly monocytic infiltrate. Considerable variation was found between these extremes. It was concluded that the healing responses associated with the membranes were complex and varied, and further work is required to establish the factors which govern the variation in the healing response. The findings are of relevance to regenerative procedures which rely on the guiding influence of artificial membranes on the healing tissues. The PLA material was well tolerated and was gradually absorbed. Further research may enable this material to form the basis of a one stage guided tissue regeneration procedure.
Effect of antiseptic mouthwashes on some clinical and microbiological findings in the mouths of lymphoma patients receiving cytostatic drugs
Authors: Meurman J. H. , Laine P. , Murtomaa H. , Lindqvist Chr. , Torkko H. , Teerenhovi L. , Pyrhönen S.
Published: December 2005

Abstract 51 patients suffering from Hodgkin's disease or non‐Hodgkin's lymphoma participated in this double‐blind, cross‐over study in which 2 antiseptic mouthwashes were tested for their effects on various periodontal index scores and salivary microbial counts. All patients were receiving combination cytostatic treatment based on methotrexate and doxorubicin. The patients (49±14 years old, 28 men, 23 women) were allotted at random to 2 groups. One rinsed with a 0.12% chlorhexidine gluconate (CHX) solution, the other with a 0.025% amine‐stannous fluoride (AmF + SnF) solution 2× daily for 2 weeks. Both groups then continued rinsing with a 0.05% sodium fluoride (F) solution for 2 weeks, before switching over to AmF + SnF or CHX, respectively. All solutions had been prepared in such a way that they had the same colour and taste. Visible plaque index and gingival bleeding index scores were significantly reduced after periods of rinsing with CHX solution (P < 0.001) and AmF + SnF solution (P < 0.05). Microbiological cultivations of saliva specimens revealed significant reductions in mutans streptococci immediately after commencing rinsing, while lactobacilli and yeast counts were not affected.
Assessment of periodontal status with CPITN and conventional periodontal indices
Authors: Almas K. , Bulman J. S. , Newman H.N.
Published: December 2005

Abstract This study compared CPITN with plaque index (PII), gingival index (GI), papilla bleeding index (PBI), and probeable pocket depth (PPD). 52 patients were examined, mean age 43 years. Partial mouth random recording (2 upper and 1 lower or 1 upper and 2 lower sextants) was made by CPITN of 150 sextants, and at 6 sites around each tooth in each sextant for each index using a pressure‐sensitive probe, with Newman tip and Williams markings, and a WHO 621 tip, probing pressure 0.25 N. Ranges of each index were compared with corresponding CPITN data. Most (71%) sextants had CPITN scores of 4, indicating periodontitis. None had CPITN scored 0 or 1. A given CPITN code was found to represent extremes of ranges for all other indices evaluated. There was no relation between CPITN and PII or GI, nor did CPITN reflect the number of sites affected per sextant, but there was a tendency for CPITN to relate with PBI and PPD. It was concluded that CPITN may be used as a general indicator of bleeding and pocket depth, but not of plaque or gingivitis. Other indices are required to reliably assess chronic inflammatory periodontal disease status in a given mouth.
Mouthbreathing, lip seal and upper lip coverage and their relationship with gingival inflammation in 11–14 year‐old schoolchildren
Authors: Wagaiyu E. G. , Ashley F. P.
Published: December 2005

Abstract The gingival health of 201 schoolchildren aged 11–14 years was assessed at 6 sites on all the incisor and first molar teeth by recording separately the presence or absence of redness and bleeding on probing. Crowding of the incisor teeth was recorded as labio‐lingual displacement and mesio‐distal overlap. A 2nd examiner recorded the presence or absence of plaque at these sites and assessed mouthbreathing, lipseal and upper lip coverage of the maxillary incisors. Mouthbreathing, increased lip separation and decreased upper lip coverage at rest were all associated with higher levels of plaque and gingival inflammation. Multivariate analysis indicated that this association was statistically significant for mouth‐breathing and lip coverage but increased lip separation was not independently related to plaque and gingivitis. The relationship of mouthbreathing and decreased upper lip coverage with gingivitis was most evident in the upper anterior segment and was still evident after covariate analysis to take account of variations due to gender, overcrowding and amount of plaque. However, allowance for these factors also suggested that the influence of mouthbreathing was restricted to palatal sites, whereas lip coverage influenced gingival inflammation at both palatal and labial sites.
Periodontal disease in HIV‐infected patients in relation to lymphocyte subsets and specific micro‐organisms
Authors: Lucht E. , Heimdahl A. , Nord C. E.
Published: December 2005

Abstract Visible plaque index (VPI), gingival bleeding index (GBI) and pocket depth (PD) were analyzed in relation to potential periodontal pathogenic microorganisms and peripheral numbers of T4+ and T8+ lymphocyte subsets in 10 patients with human immunodeficiency virus (HIV) infection, 10 patients with AIDS related complex (ARC) and 10 patients with acquired immune deficiency syndrome (AIDS). 10 healthy persons served as controls. Periodontal disease in patients with more advanced stages of HIV infection were related to the severity of the systemic disease, and to decreasing numbers of T4+ lymphocytes in peripheral blood, but not to VPI or the occurrence of periodontal pathogenic micro‐organisms.
Bleeding on probing as it relates to probing pressure and gingival health
Authors: Lang N. P. , Nyman S. , Senn C. , Joss A.
Published: December 2005

Abstract The present study was designed to determine the threshold pressure value to be applied in provoking bleeding on probing (BOP) in clinically healthy gingival units. 12 female dental hygiene students volunteered for the study. They were selected on the basis of excellent oral hygiene standards, absence of probing depths > 3 mm and absence of caries or dental restorations on smooth and proximal tooth surfaces. Applying a probing force of 0.25, 0.5, 0.75 and 1.0 N in one of the 4 jaw quadrants, respectively, on 2 different occasions with an interval of 10 days, bleeding on probing was assessed. Oral hygiene and gingival conditions were determined using the criteria of the plaque control record and the gingival index. On the basis of the BOP values, obtained using the lowest probing force (0.25 N), the subjects were divided into 2 groups: group 1 (“minimal BOP” value) consisted of 6 subjects yielding practically no bleeding (mean BOP = 0.9%) at both examinations, while the subjects of group 2 (“low BOP” value) had slightly higher BOP% (mean BOP =13.4%). Both groups showed significant increase in mean BOP% with increasing probing force (0.9%‐36.1% in group 1 and 13.4%‐47.0% in group 2). Regression analysis revealed an almost linear correlation and a high correlation coefficient between BOP% and probing force. The comparison of the regression lines of the 2 groups showed almost identical slope inclination. However, slight differences in slope inclination were found for different sites: approximal sites clearly yielded steeper regression lines than buccal/oral sites. The results of the study demonstrated that the BOP test using uncontrolled forces may result in a proportion of false positive readings and that a strong possibility exists for the traumatization of clinically healthy gingival tissues if a probing force exceeding 0.25N is applied.
The use of an oxidising mouthwash to reduce staining associated with chlorhexidine
Authors: Addy Martin , Al‐Arrayed Fatiya , Moran John
Published: December 2005

Abstract Discolouration of the teeth, tongue and dental restorative materials associated with the use of cationic antiseptics is still the limiting factor in long‐term usage of antiplaque agents such as chlorhexidine. Oxidising agents have been used sucessfully to remove dental stain in animals, but products and regimens have not been evaluated in humans. These pilot studies in vitro and in vivo assessed a long‐established oxidising mouthwash, based on peroxyborate, for stain removal from teeth and acrylic. The laboratory studies measured chlorhexidine tea stain removal from tooth and acrylic specimens. The oxidising agent markedly reduced staining on specimens. In a short‐term clinical experiment, dental staining was forced over a 21/2‐day period by reciprocal chlorhexidine and tea rinsing. 5 rinses with the oxidising mouthwash during the next 11/2‐ days dramatically reduced staining compared with water after rinses. Additionally, a single rinse with peroxyborate following the 5 water after rinses, again considerably reduced the residual staining. Effects on tongue staining were less impressive. Both experimental models produced findings consistent with those from the animal model. The results suggest proprietary oxidising mouthwashes could have a place in the control of dental stain associated with the use of chlorhexidine. Further studies to evaluate such products in a more conventional chlorhexidine regimen are indicated.
Correlation analysis for clinical and gingival crevicular fluid parameters at anatomically related gingival sites
Authors: Lamster Ira B. , Oshrain Richard L. , Celenti Romanita , Levine Keith , Fine James B.
Published: December 2005

Abstract This study was designed to evaluate the relationship of certain clinical and biochemical measures of periodontal pathology at anatomically related gingival sites. The maxillary first molar ‐ second bicuspid region was studied in patients with gingivitis and periodontitis. The mesiobuccal site on the first molar was compared to the mesiopalatal and direct buccal sites on the molar and the distobuccal site on the second bicuspid. Probing depth, attachment level, gingival index, gingival crevicular fluid (GCF) volume, and GCF levels of the lysosomal enzyme B‐glucuronidase (BG), the cytoplasmic enzyme lactate dehydrogenase, IgG and the protease‐inhibitor a‐2‐macroglobulin were studied. For the 3 anatomical pairs that were analyzed, the correlation coefficients for the GCF constituents were generally higher than the correlations for the clinical parameters. The mean correlations for the GCF constituents were higher for the periodontitis patients as compared to the gingivitis patients. For the periodontitis patients, BG activity was correlated at adjacent proximal sites, approached significance at adjacent papillary sites, but was not significantly correlated at adjacent facial‐proximal sites. This data suggests that sampling of BG activity from a mesiobuccal site provides information about the anterior papillary unit. In contrast, IgG in GCF collected from the mesiobuccal site on the first molar was significantly correlated with the total IgG in the 3 other sites. These findings suggest that (1) differences exist in the relationship of different markers of the inflammatory and immune responses in GCF collected from anatomically related sites, (2) sampling of GCF from the mesiobuccal site on a tooth can provide information about the biochemical events occurring in the anterior papillae, and (3) the sampling of mesiobuccal sites may form the basis of an approach to the clinical application of GCF analysis.
Therapeutic effects of combined treatment using tetracycline‐immobilized collagen film and root planing in periodontal furcation pockets
Authors: Minabe Masato , Takeuchi Kayo , Nishimura Toshihiko , Hori Toshio , Umemoto Toshio
Published: December 2005

Abstract46 upper and lower molars with furcation grade II involvement were selected from 16 patients with periodontal disease. The teeth were randomly allocated to the following groups according to treatment; (1) 4 consecutive administrations of tetracycline‐immobilized cross‐linked collagen film (TC film) at intervals of 1 week (TC group); (2) 1 root planing treatment (RP group); (3) combination treatment (TC + RP group); (4) no treatment (control group). The therapeutic effects of each treatment were compared both clinically and micro‐biologically. Records of plaque index, gingival index, bleeding on probing, probing depth, probing attachment level and microscopic counts were obtained at 0, 4, 6 and 8 weeks. The results showed marked decreases in probing depth and density of micro‐organisms in both the RP and TC + RP groups. In particular, the TC + RP group was characterized by a decreased rate of bleeding on pocket probing and an increased probing attachment gain. The above findings demonstrated that root planing is effective in the treatment of furcation involvement and that the effects are enhanced by the local administration of TC films.
Periodontal disease progression in teenagers with no preventive dental care provisions
Authors: Albandar J. M. , Baghdady V. S. , Ghose L. J.
Published: December 2005

Abstract Periodontal disease progression was studied on bitewing radiographs taken at baseline and after 1 year for a group of 422 teenagers who had no access to preventive or therapeutic dental services. Subjects exhibiting one or more proximal surfaces of 1st molars with longitudinal bone loss and/or with vertical bone defects at the 2nd examination were regarded as periodontal risk patients. This group then underwent a further examination in which periapical radiographs of the anterior teeth were taken and the clinical loss of attachment at the proximal surfaces of all teeth was assessed. Subsequently, the radiographic and clinical states of the risk group were compared. Most sites exhibiting bone loss during the study period displayed vertical bone defects and were largely confined to mesial surfaces of first molars. 24% of sites showing alveolar bone loss at baseline demonstrated further loss 1 year later. Girls exhibited significantly higher prevalence and incidence of sites showing bone loss than did boys. 24 children (5.7%) were regarded as periodontal risk patients. The radiographs significantly underestimated the prevalence of periodontal destruction in the risk group as compared to clinical measurements. It was concluded that using 2 bitewing radiographs is adequate for the identification of risk subjects, and that periodontal progression in adolescence occurs mainly in the first molar region and may affect girls more often than boys.
Light and electron microscopic evaluation of biocompatibility, resorption and penetration characteristics of human collagen graft material
Authors: Quteish D. , Singrao S. , Dolby A. E.
Published: December 2005

Abstract This study was initiated to test the biocompatibility, resorption and penetration characteristics of human collagen graft material in vitro and in vivo using light (LM) and electron microscopy (EM). To study this relationship, pieces of glutaraldehyde cross‐linked collagen sponges (1 × 1 × 0.5 cm), were: (1) cultured in sterile Petri dishes with human gingival fibroblasts and human periodontal ligament fibroblasts for 2 weeks; (2) implanted in subcutaneous pockets made in both thighs (total 20 sites) of 10 Sprague‐Dawley rats for 7–56 days. The behaviour of the growth of the fibroblasts was studied by inverted light microscopy (LM), then tissue culture specimens were studied from without and within using low‐temperature scanning electron microscopy (LTSEM). Blocks obtained from the graft sites of the rat were processed for LM and transmission EM. Long‐term LM observations showed attachment and random orientation of cells on and around the collagen sponge in culture during the first 48 h. Between 7 and 14 days, the majority of the cells adjacent to the sponge were orientated at right angles to its margin with their long axes approximately parallel to each other. The LTSEM revealed that large numbers of HGF and HPLF grew onto the collagen sponges, but no cellular penetration to the middle of the sponge was seen. LM and TEM of the rat specimens showed a cellular reaction to the collagen graft, as well as slow resorption, and fibroblast invasion of the graft at 6–8 weeks. It was concluded that the human collagen graft was biocompatible with HGF and HPLF, with penetration first observed at 42 days post‐implantation. In the in vivo study, the collagen underwent slow resorption over a period of 8 weeks.
Plaque‐growth inhibiting effect of chewing gum containing urea hydrogen peroxide
Authors: Etemadzadeh Hossein
Published: December 2005

Abstract The plaque‐reducing effect of a chewing gum containing hydrogen peroxide was assessed. 12 dental hygienist students participated in a double‐blind 3 × randomly crossed‐over study. During the 4‐day test periods, from Monday to Friday, no oral hygiene measures were allowed other than chewing 2 pieces of gum for approximately 10 min 5 × daily. The 800 mg pieces of gum were V6 + regular (V6+) containing 0.4 g sorbitol and 6.3 mg hydrogen peroxide, V6 placebo gum (PLAC) containing 0.45 g sorbitol and no hydrogen peroxide, and only the gum base (GB) as a negative control. The quantity of plaque was assessed using the plaque index and the visible plaque index, and by scraping “all” plaque off the teeth in half the mouth during 2.5 min for determination of plaque wet weight. With all 3 measurements, chewing of the hydrogen peroxide‐releasing gum (V6+) resulted in significantly lower plaque increments, from Monday to Friday, than chewing of the gum base (P < 0.05). Chewing of the V6 placebo gum (PLAC) resulted in plaque scores which differed from neither those recorded after use of the hydrogen peroxide releasing (V6+) nor the placebo (GB) gums. The observed plaque‐growth inhibiting effect of the hydrogen peroxide‐releasing chewing gum in the present study was found to be of limited clinical significance.
An in vivo model for the identification of serum proteins in the acquired subgingival pellicle
Authors: Abbas Dhia K. , Albandar Jasim M. , Messelt Edward B. , Gjermo Per
Published: December 2005

Abstract The present study describes an in vivo model for the collection of the subgingival pellicle adsorbed to tooth surface, and the identification of some serum proteins within this layer. Clean dentin slabs were prepared from freshly extracted teeth, and then placed subgingivally for 2 h. The dentin slabs with their adsorbed pellicle layer were processed for transmission electron microscopy. Thin sections were made from the specimens, and treated with antisera to human immunoglobulins and albumin. The reactions were visualized by means of protein A‐gold complex, which allowed semiquantification of the serum proteins. The indicator proteins were all identified within the pellicle material, but their amounts and distribution varied. Albumin demonstrated higher amounts in the pellicle layer than other proteins, followed by IgA, IgG, and IgM in descending order. The model described seems useful for studying the acquired subgingival pellicle under varying degrees of disease and health.
Fluctuation of the microbiota of the tongue in humans
Authors: van der Weijden G. A. , van der Velden U.
Published: December 2005

Abstract The purpose of this study was to examine whether variations occur in the % of motile micro‐organisms on the dorsum of the tongue during a 1‐month time‐period and further to examine 2 transport fluids: the growth medium BM and reduced transport fluid (RTF), for their ability to conserve motility of microorganisms in comparison to sterile saline. Both transport fluids showed a significant reduction in the % of motile micro‐organisms within 15 min. The use of RTF resulted, during a 60‐min period, in a significantly higher % of motile micro‐organisms compared to sterile saline. Results showed that the % of motile micro‐organisms on the dorsum of the tongue was not constant. A significant reduction in the % of motile micro‐organisms was observed in the course of the month involved in this study.
Superoxide formation and chemiluminescence of peripheral polymorphonuclear leukocytes in rapidly progressive periodontitis patients
Authors: Shapira Lior , Borinski Ruth , Sela Michael N. , Soskolne Aubrey
Published: December 2005

Abstract Previous studies have indicated that in certain types of chronic inflammatory periodontal diseases, polymorphonuclear leucocytes (PMN) functions are impaired. In view of the damage oxygen‐free radicals may cause to the periodontal tissues, the present study focussed on superoxide (SO) formation and luminol‐dependent chemiluminescence (LDCL) by peripheral PMN cells in rapidly progressive periodontitis patients (RPP). PMN cell preparations were stimulated by either opsonized bacteria or phorbol myristate acetate (PMA). The results indicate that PMN cells from RPP patients, stimulated by opsonized bacteria, have significantly enhanced SO formation and LDCL response as compared to healthy subjects. The hyperactivity was cell‐associated. In the presence of PMA, no significant differences were detected between the groups. The results suggest that PMN cells from RPP patients are functionally activated, and produce elevated levels of oxygen radicals. These oxygen radicals may play a role in the pathogenesis of RPP.
Periodontal repair in dogs Healing patterns in large circumferential periodontal defects
Authors: Wikesjö Ulf M. E. , Nilvéus Rolf
Published: December 2005

AbstractThis report describes the healing patterns of large circumferential periodontal defects in the beagle dog. Approximately 5 mm large periodontal defects were created around the mandibular premolars (P2, P3 and P4) in 13 animals. The root surfaces were then instrumented to remove all cementum and the wounds immediately closed by replacing and suturing the flaps just coronal to the cemento‐enamel junction. Block biopsies were harvested after 4 weeks. Most of the surgically denuded root surface healed with connective tissue repair. Cementum formation and regeneration of alveolar bone was limited and averaged approximately 30% and 20%, respectively, of the defect height. Almost all teeth exhibited root resorption. Ankylosis was observed in 1/3 of the teeth. There was no difference in the healing response between the 3 premolars or their buccal and lingual surfaces. The range of healing responses indicates that a biological potential exists which makes this model useful for testing the effect of various root and wound conditioners in (1) enhancing cementum formation on the root surface, (2) increasing regeneration of alveolar bone and (3) preventing aberrant healing events such as root resorption and ankylosis. Conversely, whether such agents may compromise wound healing and result in reduced connective tissue repair may concomitantly be tested.
The natural history and clinical course of calculus formation in man
Authors: ÁRnerud ÁR. , Löe H. , Boysen H.
Published: December 2005

Abstract This paper describes levels and progression of supra‐ and subgingival calculus undisturbed by active professional intervention or home care between 1970 and 1985 in Sri Lanka, or when removed at regular intervals between 1969 and 1988 in Norway. In the Sri Lankan tea laborers, both supra‐ and subgingival calculus formation started before age 14 years. At 40 years of age, all participants and almost all teeth and tooth surfaces had calculus. Tea laborers who both smoked tobacco and chewed betel had significantly higher calculus scores than those who only had one of these habits, and those who neither chewed nor smoked had the lowest calculus scores. Teeth with calculus showed a significantly higher rate of loss of attachment than teeth that remained calculus free. For the Norwegians who had enjoyed regular dental care throughout their lives, supragingival calculus did not increase in frequency from adolescence to the forties. Approximately 70% of the interproximal surfaces were calculus free after 40–50 years of age. Subgingival calculus scores, although low, showed some increase with longer times of exposure. On average, each person had 0.4 inter‐proximal surfaces with subgingival calculus as they approached 50 years of age. In this Norwegian population, subgingival calculus had no impact on loss of attachment.
The effects of subgingival irrigation with low dosage metronidazole on periodontal inflammation
Authors: Linden Gerard J. , Newman Hubert N.
Published: December 2005

Abstract The effects on chronic periodontitis of a simplified oral hygiene regimen combined with subgingival irrigation with 0.5% metronidazole were investigated. 19 patients, with 548 pockets ≥4 mm, completed a 3–month randomised double‐blind placebo‐controlled trial. At day 0, prior to treatment, and at days 7, 28, 56 and 84, plaque index, sulcus bleeding index and probeable pocket depth were recorded. The simplified oral hygiene regimen consisted of (1) one episode of root debridement, removal of subgingival approximal overhangs on restorations and subcontact area debridement with abrasive strips and polishing, and (2) instruction in Bass brushing (twice daily) with no stress on interdental cleaning. After baseline debridement, patients were allocated 0.5% metronidazole or a placebo. They were instructed to irrigate subgingivally once daily for 28 days. Treatment resulted in marked improvement in both groups and proportionately more sites improved in the metronidazole group at 28, 56 and 84 days. There were no significant differences between the procedures at any time. It was concluded that a simplified oral hygiene regimen combined with daily subgingival irrigation with 0.5% metronidazole or a placebo was effective in reducing periodontitis for at least a further 8 weeks, and that proportionately more sites improved in the meronidazole group.
Effect of glycyrrhizin‐containing toothpaste on dental plaque reduction and gingival health in humans
Authors: Goultschin J. , Palmon S. , Shapira L. , Brayer L. , Gedalia I.
Published: December 2005

Abstract Glycyrrhizin, the main saponin of licorice, a surfactant producing aqueous gel, was tested for its effect on gingival health, as a supplemental agent in a toothpaste. 40 male and female volunteers brushed their teeth twice daily, with a toothpaste containing 0.25% and 0.50% glycyrrhizin, or a control toothpaste, respectively. All 3 toothpastes contained sodium lauryl sulfate as detergent. The subjects of the 3 groups were examined at days 0, 7, 14, 28, 35 and 42 for plaque, gingival and bleeding indices. The examiner was unaware of subject assignement. None of the brushing regimens with the experimental toothpastes induced significant changes in the examined indices, that were distinct from those observed with the control toothpaste. The decrease (insignificant) in the indices of the study period from 0 to 14 days may be considered as an increased oral hygiene awareness by the subjects examined. Possible explanations for the lack of efficiency in improvement of plaque, gingival and bleeding indices, may have been an insufficient glycyrrhizin concentration and/or chemical incompatibility in a toothpaste containing a mixture of an anionic detergent and an organic antibacterial surface agent.