bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and antimicrobial effect of stannous fluoride on periodontitis
Authors: Mazza John E. , Newman Michael G. , Sims Thomas N.
Published: December 2005

Abstract The antimicrobial effect of stannous fluoride (SnF2) on suspected pathogenic morphotypes of bacterial plaque in chronic periodontal disease was assessed. Alterations in morphological groups of subgingival and supragingival plaque bacteria from three diseased sites and one periodontally healthy site were, determined by darkfield microscopy in 10 male patients with advanced periodontitis. In addition, clinical indices were also measured. The three diseased sites received either 1.64% SnF2, 0.4% SnF2 or sterile saline by subgingival irrigation. The healthy site received sterile saline only. The patients were seen weekly over a 10‐week period and at each appointment bacterial sampling and clinical indices were measured. Results indicated that 1.64% SnF2 caused a dramatic and sustained decrease of subgingival motile bacteria and spirochetes following irrigation. By the sixth week these bacteria returned to 50% of their original concentration. Bleeding index scores, which were significantly reduced, correlated positively to the reduction in motile bacteria and spirochetes. Sites irrigated with 0.4% SnF2 also demonstrated a similar pattern of reduction of motile bacteria and spirochetes but without their total elimination and a more rapid return to original levels. In the diseased sites receiving sterile saline there was a decrease in motile bacteria and spirochetes, corresponding with saline irrigation, which rapidly returned to baseline levels. The healthy control sites were unchanged. Supragingival plaque index scores did not correlate with the bleeding index, motile bacteria and spirochetes, or with subgingival irrigation.
Comparison of the bisbiguanide antiseptics alexidine and chlorhexidine. I. Effect on plaque accumulation and salivary bacteria
Authors: Roberts W. R. , Addy M.
Published: December 2005

Abstract A blind crossover trial was carried out to compare the effects of a 0.2% chlorhexidine gluconate mouthrinse and a 0.035% alexidine mouthrinse on plaque accumulation and salivary bacteria in a group of volunteers. The subjects refrained from all forms of oral hygiene during two 10‐day periods and rinsed twice a day with the mouthwash randomly allocated to the respective period. Prerinse, day 4 and day 10 total salivary aerobic and anaerobic bacterial counts were determined during each period. Plaque scores were recorded at the end of each 10‐day period. Significantly more plaque accumulated in subjects rinsing with alexidine when compared with chlorhexidine. Significant and comparable reductions in salivary bacterial counts were observed with both chlorhexidine and alexidine on day 4 and day 10 when compared with pre‐rinse counts. Although at the concentrations used alexidine was less effective than chlorhexidine, it may be of value as a short‐term adjunct to oral hygiene.
Comparison of the bisbiguanide antiseptics alexidine and chlorhexidine. II. Clinical and in vitro staining properties
Authors: Addy M. , Roberts W. R.
Published: December 2005

Abstract A blind cross‐over trial was carried out to compare the tooth and tongue staining associated with the use of a 0.035% alexidine and a 0.2% chlorhexidine mouthrinse. Twenty‐two volunteers were divided into two groups termed “tea drinkers” and “non‐tea drinkers”. All volunteers were requested to refrain from oral hygiene measures throughout two 10‐day periods when they rinsed twice a day with the preparation randomly allocated for the respective period. During both periods the members of the groups excluded coffee, red wine and port from their diet. The tea drinking group consumed seven cups of tea per day. Tooth and tongue staining was recorded for extent and severity at the end of each period. The amount of stain accumulating in the two groups was similar following the use of chlorhexidine and alexidine. However, for both chlorhexidine and alexidine the extent and severity of tooth and tongue staining were significantly increased in the tea drinking group. An in vitro study of tea staining of perspex blocks exposed twice a day to 0.035% solutions of alexidine or chlorhexidine throughout a 5‐day period demonstrated significantly more staining with alexidine when measured spectrophotometrically. Visually however, the differences in the specimens were minimal. Saliva treatment the perspex did not significantly alter the staining by alexidine or chlorhexidine. The results provide further evidence for a dietary aetiology to the staining associated with cationic antiseptics. However, alexidine at the concentration used offered no advantage in reducing the side effect of staining when compared with chlorhexidine.
Four years of monthly professional toothcleaning and topical fluoride application in Brazilian schoolchildren.
Authors: Bellini Hamilton Taddei , Campi Rosanne , Denardi José Luiz
Published: December 2005

Abstract The effect on gingivitis of monthly professional toothcleaning, without oral hygiene instruction, was evaluated in 103, 7‐ to 11‐year‐old Brazilian children.

Plaque and gingivitis (P1I and GI) were recorded initially and after 1, 2, 3 and 4 years.

The baseline examination showed a similar high level of plaque (P1I ∼ 1.55) and low level of gingivitis (GI ∼ 0.32) around permanent teeth of both lest and control groups. The test children were given monthly professional toothcleaning followed by topical application of fluoride gel (APF), totaling 32 sessions.

At all annual follow‐up examinations, the mean P1I in the test group was significantly lower than in the control group. However, even in the test group, at least 20% of the tooth surfaces harbored plaque. In spite of this, no child in the test group showed overt gingivitis (mean individual GI ≥ 1.0) and the distribution of “GI score = 2” was very low. In the control group the percentage of children with overt gingivitis increased from 3% at the baseline to 20% at the final examination and areas scoring GI = 2 doubled in number.

It is suggested that for young children, monthly thorough removal of plaque is sufficient to prevent the development of gingivitis.
Dental prophylaxis for youths in their late teens
Authors: Hamp Sven‐Erik , Bergendal Biegitta , Erasmie Thord , Lindström Gunnel , Mellbring Solweig
Published: December 2005

Abstract A study of the knowledge about dental health and diseases of youths in their late teens has been conducted. A 10‐class questionnaire relating to dental caries and gingivitis/periodontitis was answered by three test groups (A, B, C) totalling seventy‐eight 19‐year‐olds who, during a 3‐year period, had undergone professional prophylaxis at different intervals. Nineteen young people of the same age without organized preventive measures since their last attendance at the public dental service constituted a control group (D).

The test groups were found to have a significantly better knowledge of factors relating to gingivitis/periodontitis than the control group. In questions relating to caries there were no differences among the groups. Higher points were scored in knowledge of therapy and prevention than of the causes and symptoms of the dental diseases. Several regularly repeated sessions for professional prophylaxis did not lead to better knowledge than only a few.

No consistent correlation was found for any of the groups between knowledge and both quantitative tooth cleaning, i.e. type and frequency of use of oral hygiene aids, and qualitative tooth cleaning, expressed as the occurrence of plaque and gingivitis. Nor were significant differences found in these respects between individuals with and without a caries increment during the observation period regardless of grouping.
Effects of subgingival chlorhexidine irrigation on periodontal inflammation
Authors: Soh L. L. , Newman H. N. , Strahan J. D.
Published: December 2005

Abstract The purposes of this study were to investigate the effect of direct application of chlorhexidine to periodontal pockets and the practicability of patient self‐therapy using a technique of subgingival irrigation. Patients received no other oral hygiene instruction. After initial assessment of parameters, patients were given scaling and polishing and then instruction in the irrigation of designated pockets with chlorhexidine or a placebo using a disposable syringe and blunt needle. During the 28‐day irrigation period with chlorhexidine there was a highly significant reduction in periodontal inflammation which was maintained at levels significantly below the baseline values for a further 28‐day period without irrigation. There was a deterioration in the periodontal state of those patients who had used the placebo. The irrigation technique itself caused no discernible injury in this group of routine periodontal patients. Also, staining in the chlorhexidine group was minimal. It is concluded that subgingival irrigation with chlorhexidine is effective in reducing periodontal inflammation and in controlling subgingival plaque. Intermittent treatment of this kind by the patient at home might reduce to more manageable levels the frequency of hygiene visits and the need for rigorous interdental oral hygiene.
The role of keratinized gingiva in plaque‐associated gingivitis in dogs
Authors: Wennström Jan , Lindhe Jan , Nyman Sture
Published: December 2005

Abstract The present experiment was designed to examine if a dento‐gingival unit with a wide zone of keratinized gingiva (KG) provides a more efficient seal against plaque infection than a unit with a narrow zone of KG or lack of such gingiva. Five beagle dogs were used. In a preparatory experiment three categories of gingival units were established in each dog, namely (1) regenerated gingiva with a wide zone of KG (healed following a “flap” procedure), (2) regenerated gingiva with an “insufficiently” wide zone of KG (healed following a “gingivectomy” procedure), and (3) non‐operated control gingiva with a normal zone of KG. Clinical and histological examinations carried out at the end of the preparatory period revealed that all gingival units, non‐operated as well as regenerated units, met the criteria of health. All tooth‐cleaning measures were abolished. After 40 days of plaque accumulation the clinical examination (Plaque Index, Gingival Index and Gingival Exudate) was repeated and biopsies were sampled. Following preparation the biopsy material was subjected to histometric and morphometric analysis. The results showed that the free gingiva of units with wide and narrow zones of KG responded to microbial colonization by an inflammatory reaction, the location and extension of which did not vary with the width of the keratinized gingiva. It was concluded that, in the presence of plaque, a dento‐gingival unit with a narrow zone of, or with lack of, gingiva has an equal capacity for inflammatory response against plaque infection as a unit with a wide zone of KG.
Free gingival grafts for the treatment of gingival recession
Authors: Matter Jacques
Published: December 2005

Abstract Free gingival grails can be utilized, alone or in combination with a coronally positioned flap, for the prevention and the treatment of gingival recession. The graft can be placed directly over the denuded root, as first described by Sullivan & Atkins (1968). This technique will provide adequate results, especially in cases with relatively little recession. After placing a free gingival graft in such an area, one can often observe bridging and or creeping attachment. In the case of bridging, some of the grafted tissue will remain vital over the avascular zone, i.e. the root. Creeping attachment is the result of coronal migration of the grafted gingiva and will take place during the years following surgery. Bridging and creeping are most likely to occur in cases of narrow recession where the grafts had been placed directly over the denuded zone. In a second type of surgical procedure, an enlargement of the attached gingiva is first obtained through the graft. The area of recession is later covered by a coronally positioned flap. Several cases are presented which illustrate the results obtained with this procedure. In children, when there is insufficient attached gingiva. it is often desirable to place grafts before orthodontic therapy.

In the prevention or treatment of gingival recessions, four possibilities may be considered: 1)no treatment, 2)placement of a graft to prevent recession, 3)stabilizing an existing recession. 4)attempt to cover the denuded root.
Healing following surgical non‐surgical treatment of periodontal disease
Authors: Lindhe Jan , Westfelt Elisabeth , Nyman Sture , Socransky Sigmund S. , Heijl Lars , Bratthall Gunilla
Published: December 2005

AbstractA clinical trial was undertaken to study the effect of one surgical and one non‐surgical treatment modality in patients with advanced periodontal disease. Fifteen patients were selected for the study. Following aBaseline examinationcomprising assessments of oral hygiene status, gingival conditions, probing depths and attachment levels, all participants were subjected to treatment. In each patient, scaling and root planing were carried out in conjunction with the modified Widman flap procedure in two jaw quadrants while in the contralateral quadrants the treatment was restricted to scaling and root planing. During the phase of active treatment, i.e. the period between the first and last operation, and for the subsequent 6 months of healing, the patients were subjected to “professional toothcleaning” once every 2 weeks. From this time until the end of the trial which was 24 months after active treatment, the patients were recalled for prophylaxis once every 3 months. Reexaminations were performed 6, 12 and 24 months after the completion of active treatment.

The results demonstrated that scaling and root planing used alone were almost equally effective as their use in combination with the modified Widman flap procedure in establishing clinically healthy gingiva and in preventing further loss of attachment. Both treatment modalities prevented recurrence of periodontal disease for the 24 months of observation. The analysis of the probing depth data revealed that both methods of treatment resulted in a high frequency of probing depths of <4 mm. The probing depth reduction was more pronounced in initially deep than in initially shallow pockets and, for initially deep pockets, more marked in sites subjected to surgery than in sites exposed to scaling and root planing alone. The measurements also showed that sites with initially deep pockets exhibited more pronounced gain of clinical attachment than sites with initially shallow pockets. Significant loss of attachment did not occur in sites treated with scaling and root planing alone while attachment loss was found following Widman flap surgery in sites with initial probing depth of <4 mm.
Traumatic ulcerative gingival lesion
Authors: Axéll Tony , Koch Göran
Published: December 2005

Abstract Gingival ulcers caused by tooth brushing in 13 patients with an average age of 29.9 years are presented. The lesions show characteristic clinical features not compatible with simple traumatic ulcers, e. g. running a more chronical course, the duration averaging 6.5 months. Repeated trauma and, in some cases, infection might explain the chronicity. The lesion is suggested to be designated traumatic ulcerative gingival lesion. As treatment, cessation of tooth brushing for 2 weeks and concomitant mouthrinses with chlorhexidine are recommended.
Relationship between restorations and the level of the periodontal attachment
Authors: Than A. , Duguid R. , McKendrick A. J. W.
Published: December 2005

Abstract Two hundred and forty stained extracted teeth with a restoration on one proximal surface and with no restoration on the opposite surface were investigated for the position and quality of the restoration and the position of the periodontal attachment. Only 27% of restorations were of good quality, 60% had overhangs and 13% deficiencies. The mean difference in loss of periodontal attachment (LOA) between the two surfaces for all teeth was 0.36 mm when the distance from the cemento‐enamel junction to the periodontal membrane on the un‐restored surfaces was subtracted from that on the restored surfaces. If allowance is made for those restorations located apical to the cemento‐enamel junction, the LOA difference was 0.18 mm.
New attachment following surgical treatment of human periodontal disease
Authors: Nyman Sture , Lindhe Jan , Karring Thorkild , Rylander Harald
Published: December 2005

Abstract The present experiment was undertaken to test the hypothesis that new connective tissue attachment may form on a previously periodontitis involved root surface provided cells originating from the periodontal ligament are enabled to repopulate the root surface during healing.

A mandibular incisor with advanced periodontal disease of long standing (the distance between the cemento‐enamel junction and the alveolar bone crest was 9 mm) was subjected to periodontal surgery using a technique which during healing prevented the dentogingival epithelium and the gingival connective tissue from reaching contact with the curetted root surface. Preference was hereby given to the periodontal ligament cells to repopulate the previously diseased root surface. After 3 months of healing a block biopsy containing the incisor and surrounding tissue was sampled. The histological analysis revealed that new cementum with inserting principal fibers had formed on the previously diseased root surface. This new attachment extended in coronal direction to a level 5 mm coronal to the alveolar bone crest. This finding suggests that new attachment can be achieved by cells originating from the periodontal ligament and demonstrates that the concept that the periodontitis affected root surface is a major preventive factor for new attachment is invalid.
Extrinsic dental stain caused by chlorhexidine and other denaturing agents
Authors: Ellingsen Jan Eirik , Rølla Gunnar , Eriksen Harald M.
Published: December 2005

Abstract Experiments were performed in a standardized rabbit model for examination of the potential of chlorhexidine and other denaturing agents to induce dental stain together with ferric ions. The studies supported the view that denaturation may be a major aspect of the mechanism of stain formation and that iron sulphide may be one important cause for extrinsic dental stain. Analytical microprobe analysis showed high amounts of Fe and S in the stain. The stain formation could be inhibited by SnF2, possibly by a red‐ox reaction. Established stain could be removed by an oxidizing agent.
Location of probe tip in bleeding and non‐bleeding pockets with minimal gingival inflammation
Authors: van der Velden U.
Published: December 2005

Abstract In the present study the location of the probe tip was studied on human teeth scheduled for extraction for periodontal reasons. Prior to extraction all teeth were subjected to initial treatment consisting of plaque control and removal of supra‐ and subgingival deposits. Results showed that:

) 43% of the pockets examined were still bleeding on probing after treatment

) bleeding pockets were deeper than non‐bleeding pockets

) in non‐bleeding pockets the probe tip was located more accurately at the attachment level than in bleeding pockets.
Periodontal pocket measurements with a modified Plast‐o‐Probe and a metal probe
Authors: Sanderink R. B. A. , Mörmann W. H. , Baruakow F.
Published: December 2005

Abstract Two types of periodontal probes used to measure pocket depths, i.e. a modified Plast‐o‐Probe (PoP) and a metal probe (MP), were compared, Periodontal pocket depths in 5 volunteers were determined by 5 clinically trained investigators using each of the probes. The average periodontal pocket depth was found to be the same for both probes and was independent of the degree of gingival inflammation and the localisation of probing. The results obtained by J of the 5 investigators were influenced by the type of probe. 4 investigators found that PoP permitted a 2.8–11.0% greater degree of reproducibility while MP exhibited a 0.9–12.2% higher inter‐investigator agreement. In vivo and in vitro radiological and histometrical analysis on another group of patients showed a similar degree of penetration into the connective tissue zones with both probes. The investigators considered PoP a precise instrument but suggested that its readability should be improved for routine clinical use.
Relative effects of plaque control and instrumentation on the clinical parameters of human periodontal disease
Authors: Cercek John F. , Kiger Robert D. , Garrett Steven , Egelberg Jan
Published: December 2005

Abstract The healing events of 7 patients with generalized chronic periodontitis were monitored clinically during 3 consecutive phases of treatment: 1) tooth brushing and flossing, 2) subgingival use of the Perio‐Aid®, and 3) supra and subgingival instrumentation. The clinical parameters evaluated were plaque score, bleeding score, probing pocket depth, probing attachment level, and gmgival recession. Each phase continued until maximum effects were achieved (5,3, and 9 months respectively) determined by minimal or no changes in bleeding scores and probing pocket depths between 3 successive examinations. The results showed limited improvement in the bleeding scores and probing pocket depths with tooth brushing and flossing only (Phase 1). During use of the Perio‐Aid (Phase2), there was no additional improvement, but the initial limited gains made during Phase 1 were maintained. By the end of Phase 2, however, a slight loss of probing attachment level was noticeable. After instrumentation (Phase 3), there was further and more pronounced improvement in bleeding scores and probing pocket depths, as well as a reversal of the probing attachment loss. The results of this study indicate that significant improvement in periodontal pockets should not be expected following home care procedures alone, and that instrumentation may account for the bulk of improvement seen following a combined therapy of plaque control and instrumentation.
Evaluation of various feedback mechanisms in relation to compliance by adult patients with oral home care instructions
Authors: Glavind Leif , Zeuner Ella , Attströum Rolf
Published: December 2005

Abstract The purpose of the present study was to examine the effect on oral hygiene and gingival health of plaque scoring and the performance of a “tooth brushing test” at each visit during initial periodontal treatment, A total of 63 adult periodontal patients (22–67 years of age) was allocated to 4 matched groups: Brushing test group (B), open scoring group (0), minimal feedback group (M) and control group (C). The oral hygiene instruction for groups B, O and M was provided by handing out a self‐educational manual on oral home care, while the patients of control group (C) received a short brochure describing the Bass brushing technique and the use of toothpicks. Feedback on the improvement of oral hygiene performance was delivered to groups B and O by scoring of plaque and gingival bleeding by probing while this feedback was avoided in the 2 other groups (M, C). The patients of group B performed a tooth brushing test at each of 3 visits. After 3 months the plaque scores of groups B (27%) and O (22%) had improved more than those of the 2 other groups (35%). However, the improvement in gingival bleeding scores was similar in all 4 groups (from 55% initially to 17% at 3 months). At later examinations only minor differences in plaque and gingival bleeding scores were recorded between the various groups. The findings show that, irrespective of the mode of instruction, a considerable improvement occurs and that this improvement is not related to open scoring of plaque or the tooth brushing test.
Comparison of plaque accumulation after topical application and mouth rinsing with chlorhexidine gluconate
Authors: Addy M. , Mohan J.
Published: December 2005

Abstract This study measured plaque accumulation on anterior teeth after topical or mouth rinse application of 0.2% chlorhexidine gluconate. Compared with water plaque scores were highly significantly reduced. There was no significant difference in plaque scores between topical application or mouth rinsing. The importance of locally adsorbed chlorhexidine is emphasised and the relevance of an oral reservoir effect questioned.
Initial observation that cyclosporin‐A induces gingival enlargement in man
Authors: Rateitschak‐Plüss E. M. , Hefti A. , Lörtscher R. , Thiel G.
Published: December 2005

Abstract In the Medical Clinic at the University of Basle, the immunosuppressive drug cyclosporin‐A has been employed recently for kidney transplant patients. A side effect of this drug appears to be pronounced gingival enlargement. This report documents 3 such cases, with a discussion of etiology and possible treatment modalities
Effects of gingival curettage when performed 1 month after root instrumentation
Authors: Echeverria Jose J. , Caffesse Raul G.
Published: December 2005

Abstract The purpose of the present study was to evaluate biometrically the periodontal response to gingival curettage. 15 subjects having suprabony pockets were selected. Gingival Index (GI) was initially determined for the selected teeth. Measurements of probing depth, and the distance from the free gingival margin to the cemento‐enamel junction were also taken at that time, as well as immediately after scaling and root planing of the selected teeth. 4 weeks after scaling and root planing, the clinical parameters were recorded‐ A split mouth design was used to select 2 quadrants of the mouth in which gingival curettage was to be performed. Immediately after, experimental measurements were again recorded. 5 weeks after gingival curettage, gingival inflammation, probing depth and the location of the tree gingival margin were recorded for the last time. All data were analyzed statistically. It was shown that gingival inflammation, the distance from the free gingival margin to the cemento‐enamel junction, and the probing depth were reduced after 4 and 9 weeks. The level of clinical attachment improved after 9 weeks. All these changes were statistically significant. These results were observed after scaling and root planing, as well as after scaling, root planing and gingival curettage. No differences were found between both treatment modalities in any of the parameters analyzed. Gingival curettage did not improve the condition of the periodontal tissues more significantly than scaling and root planing.
Efficacy of paracetamol in reducing post‐operative pain after periodontal surgery
Authors: Seymour R. A.
Published: December 2005

Abstract In a double‐blind, placebo‐controlled study, the efficacy of 2 doses of paracetamol (500 and 1000 mg) was assessed in post‐operative pain after periodontal flap surgery. Both doses of paracetamol provided greater analgesia than placebo, however, significant analgesia (P < 0.05) was only noted in the early post‐operative period. The analgesia from both doses of paracetamol did not differ significantly throughout the 3‐day observation period, however, greater analgesia was attributable to 1000 mg paracetamol in the immediate post‐operative period. The results from this study suggest that paracetamol is an effective analgesic for controlling posi‐operative pain after periodontal flap surgery, with 1000 mg dose being more effective than 500 mg immediately after surgery.
Cross‐sectional study of the effects of immunosuppressive drugs on chronic periodontal disease in man
Authors: Sutton R. B. O. , Smales F. C.
Published: December 2005

Abstract Oral examinations were performed on 102 patients receiving immunosuppressive drug therapy following renal transplantation. A further III control patients matched for age and sex, were also examined. The severity of dental caries of the 2 groups was compared by considering their decayed, missing and filled teeth (DMF‐T), and the severity of periodontal disease was compared in terms of pocket depths, Plaque, Calculus and Sulcular Bleeding Indices, and Russell's Periodontal Index. When comparing the 2 groups, note was made of restorations involving the gingival margins, the presence of partial dentures and recent and current antibiotic therapy.

No significant differences were found between the groups with regard to age, sex distribution, plaque levels, DMF and Russell's Periodontal Index. The immunosuppressed group had significantly less calculus, fewer restorations involving the gingival margins and significantly lower mean pocket depth. However, they did have more gingival recession than the controls and also a higher Sulcus Bleeding Index. All differences seen were maintained even when patients from both groups on antibiotics were eliminated from the analysis. Within the immunosuppressed group no relationship was found between the length of time the drugs were taken and the periodontal variables. The study indicates that patients on immunosuppressive therapy show no change in susceptibility to destructive periodontal disease.
Revascularization of gingival autografts placed on different receptor beds
Authors: Busschop J. , de Boever J. , Schautteet H.
Published: December 2005

Abstract The revascularization of gingival autografts. placed either on fenestrated periosteum or on non‐fenestrated periosteum, has been compared by means of 12 fluorescein angiographs, taken 8, 10 and 12 days postoperatively on 12 patients, 18–32 years of age.

The grafts placed on periosteum (P‐zone) showed a mean increase of fluorescence of 10.6% between the 8th and 10th day and of 19.4% between the 10th and 12th day. At that time the circulatory system in the graft seemed to be established for 97.7%.

The grafts placed on fenestrated periosteum (B‐zone) showed a mean increase of fluorescence of 13.2% between the 8th and the 10th day and of 13.5% between the 10th and 12th day. The revascularization reached 96.1% at that time.

Between both groups no statistically significant difference has been found. It can be concluded that a periosteal receptor side is not a prerequisite for the formation of an even circulatory pattern in gingival autografts.
Effect of variation in dietary sucrose intake on plaque removal by mechanical means
Authors: Jalil R. A. , Cornick D. E. R. , Waite I. M.
Published: December 2005

Abstract The influence of dietary sucrose on the rate of plaque formation was investigated for 22 dental personnel. The subjects were instructed to continue their normal oral hygiene procedures throughout the study period, It was found that an increase in the frequency of sucrose intake resulted in an enhancement of plaque deposition and an increase in gingival inflammation. The restriction of dietary sucrose for this group of subjects had a minimal effect on either plaque retention or levels of gingival inflammation; this result might have been caused by the habitual diet of these particular subjects being relatively low in sugar. The results of this study would suggest that an assessment of sucrose intake of patients might be appropriate when planning an oral hygiene programme, consideration being given to modifying the diet as an aid to plaque removal for individuals having a relatively high intake.
Phase contrast microscopy of microbial aggregates in the gingival sulcus of Macaca mulatta
Authors: Leggott Penelope J. , Anderson A. W. , Punwani I. , Sabet T. , Murphy R. , Crawford J.
Published: December 2005

Abstract The objective of this study was to study the relationship of microbial aggregates in the subgingival crevice to changes m periodontal health in Macaca mulatta.

The sample included 68 oral sites from 17 Rhesus monkeys of various ages. The periodontal health of each site was evaluated using Plaque and Gingival Indices and crevice depth measurement. The subgingival plaque samples were examined by phase contrast microscopy and recorded on 16 mm film.

A Microbial Index was developed based on a qualitative estimate of the numbers of organisms, morphology of predominant organisms, and the presence or absence of motility. The Microbial Index was demonstrated to be simple in use and highly reproducible.

The findings indicate that changes in the Microbial Index are consistent with tissue changes seen in the periodontal status in M. mulatta.

From this preliminary study, the oral flora of adult M. mulatta appears to have sufficient similarities to human oral flora to be used as a microbial model for experimental periodontal disease research.

Future studies to refine and confirm the validity of the Microbial Index are warranted. It may prove to be a useful tool to monitor the effect of various treatment modalities on the periodontal flora and to determine the presence or absence of active disease.
Cementum hypoplasia in teeth affected by juvenile periodontitis
Authors: Llndskog Sven , Blomlöf Leif
Published: December 2005

Abstract The cemental surface of teeth affected by juvenile periodontitis was examined using scanning electron microscopy. Molars affected by chronic marginal periodontitis and healthy molars were included as controls. The entire mesial root of teeth affected by juvenile periodontitis showed extensive areas of cementum hypoplasia with exposed dentinal tubules. The hypoplasias were found also on the infracrestal part of the root indicating that they had not been caused by exposure to the oral environment or by any treatment. Cementum hypoplasias were not found in any teeth from the control material. The impaired periodontal attachment in the hypoplasia may facilitate penetration by the special motile bacteria which have been found in plaque from teeth with juvenile periodontitis. Based on the findings in the present study and the hereditary background of juvenile periodontitis it was suggested that development of the disease is initiated by a hereditary developmental disturbance of the Cementum.
Effect of long‐term tetracycline therapy on human periodontal disease
Authors: Lindhe J. , Liljenberg B. , Adielsson B.
Published: December 2005

Abstract The present investigation was performed to study the effect of long‐term, low dosage tetracycline therapy on advanced periodontal disease in humans. 14 volunteers participated in the trial. Each of the participants had at least 4 pairs of diseased sites around contralateral premolars and incisors with deep pockets and advanced bone loss. The trial extended over a 50‐week period and was designed as a double‐blind split‐mouth study. A Baseline examination included assessments of oral hygiene, gingival conditions, probing depth, attachment level and analysis of the composition of the subgingival microbiota in samples obtained from 8 selected diseased sites. All participants received oral hygiene instruction. In each patient 2 quadrants of the mouth, chosen at random, were treated by scaling and root planing. The 2 remaining quadrants were left unsealed. Following the Baseline examination the patients were randomly distributed into 2 groups of 7 members each. In one of the groups the patients received tetracyline on a daily basis during a 50‐week period. The participants of the control group received placebo. Reexaminations were performed 2, 10, 20, 30 and 50 weeks after the Baseline examination.

The findings demonstrated that in patients with advanced periodontal disease long‐term tetracycline therapy in the absence of scaling resulted in the establishment of a subgingival microbiota almost devoid of motile bacteria and in markedly reduced signs of gingivitis, probing depth and attachment loss. In fact, the alterations observed as a result of tetracycline administration to patients with excellent self‐performed plaque control were similar to those obtained by conventional scaling and root planing in the control group.
Repair of periodontal tissues In vivo and in vitro
Authors: Lindskog Sven , Blomlöf Leif , Hammarström Lars
Published: December 2005

Abstract. Repair of experimental cavities in dental roots and of periodontal wounds was studied in vivo and in vitro. Incisors from monkeys were extracted and experimental cavities were made in the roots. The teeth were either replanted immediately or cultured for 1–12 weeks in tissue culture medium. After 8 weeks the tissue reaction around the replanted teeth was evaluated on demineralized histological sections and undecalcified freeze‐sections incubated for histochemical demonstration of certain enzymes. The cultured teeth were evaluated on decalcified histological sections.

In the experimental cavities of the replanted teeth reparative cementum was found. It was frequently separated from the denuded dentin while a firm attachment was always established to the intermediate cementum and dental cementum at the periphery of the cavities. The reparative cementum was also firmly attached to some small areas on the exposed dentin surface where resorption had taken place. The activity of alkaline and acid phosphatase was lower in the connective tissue in the experimental cavities than in the surrounding PDM, suggesting an incomplete regeneration of the periodontal membrane in these areas. A loose connective tissue devoid of demonstrable collagen fibers was found in the cavities in vitro

The reparative cementum did not fill the experimental cavities in the replanted teeth. The alveolar bone extended into the experimental cavities and made the width of the PDM normal also in the experimental cavities. Epithelial and endothelial cells were numerous in the connective tissue separating the reparative cementum from the alveolar bone in the experimental cavities, It is possible that they contribute to the integrity of the PDM and prevent resorption of the dental root.
Role of attached gingiva for maintenance of periodontal health
Authors: Wennström Jan , Lindhe Jan
Published: December 2005

Abstract. The present study was undertaken to analyze the role of attached gingiva for the maintenance of periodontal health in sites with normal and reduced height of the supporting apparatus. Furthermore, the effect of excision and grafting of gingiva on some parameters describing dimensions and location of the periodontal tissues was evaluated. 7 beagle dogs were used. A baseline examination comprised assessments of dental plaque, gingival conditions, attachment level, position of the gingival margin and width of the keratinized and the attached gingiva. In the right side of the jaws (experimental side) a 6month period of periodontal tissue breakdown was followed by surgical excision of the entire zone of the gingiva. After another 4‐month period of healing with daily plaque control, a gingival graft was inserted in one quadrant of the experimental side to regain a zone of attached gingiva while the other quadrant of the experimental side was left ungrafted. In the left side of the jaws (control side), the teeth were subjected to daily meticulous plaque control during the entire study. In one of the control quadrants the entire zone of the keratinized and attached gingiva was excised at a time point corresponding to the grafing procedure in the experimental side, while the gingiva in the remaining control jaw quadrant was left unoperated. Clinical examinations of all control and experimental tooth units were repeated at certain time intervals during the course of the study. The final examination was carried out 4 months after grafting.

The results of the experiment showed that in sites exposed to careful plaque control measures gingival health could be established and maintained without sign of recession of the gingival margin or loss of attachment, independent of (1) presence or absence of attached gingiva, (2) width of keratinized gingiva or (3) height of the supporting attachment apparatus. Following surgical excision of the entire gingiva, all buccal sites regained a zone of keratinized gingiva. but most sites were lacking attached gingiva. Furthermore, grafting of gingival tissue significantly increased the width of the keratinized and the attached gingiva but had no obvious effect on the position of the gingival margin or the level of the attachment.
Effect of nonsurgical periodontal therapy III. Single versus repeated instrumentation
Authors: Badersten Anita , Nilveus Rolf , Egelberg Jan
Published: December 2005

Abstract Healing events following nonsurgical periodontal therapy were studied, comparing the effect of a single initial instrumentation to the effect of 3 instrumentations, each separated by 3 months. Incisors, cuspids and premolars with periodontal pockets up to 11 mm deep in 13 patients were treated by plaque control and supra‐ and subgingival debridement using ultrasonic instruments. A split mouth approach was used to compare the 2 frequencies of instrumentation. The results were evaluated by recording of plaque scores, bleeding on probing, probing pocket depths and probing attachment levels. A gradual and marked improvement of the periodontal conditions took place during the initial 9 months following start of therapy. During the remaining 15 months of the 24‐month experimental period no further changes of the recorded parameters were noted. No differences in results could be observed when comparing the effects of a single versus repeated instrumentation. Thus, it appears that deep periodontal pockets in incisors, cuspids and premolars may be successfully treated by plaque control and 1 episode of instrumentation. The results also suggest that reccurrence of disease due to subgingival recolonization by microorganisms during the healing phase may not be a major clinical problem.
Demographic and clinical data associated with acute necrotizing ulcerative gingivitis in a dental school population*
Authors: Stevens Alvin W. , Cogen Ronald B. , Cohen‐Cole Steven , Freeman Arthur
Published: December 2005

Abstract This study was undertaken to determine the prevalence of demographic and clinical factors of patients diagnosed as having ANUG as determined by the presence of painful, bleeding, necrotic and ulcerated interproximal gingival papillae. Results showed that ANUG patients were evenly divided between males and females relative to the general clinic population. 58% of the patients with ANUG were under 25 years of age as compared to 31 % under 25 in the general clinic population. Overall, the ANUG group accounted for 1.4% of the under 34 age group in the general clinic population. 76% of the ANUG group had a high school education or less with 67 % having less than $5,000 annual income. Only 20% presented with elevated temperature. Only 6% of the patients with ANUG were non‐smokers as compared to 63% in a matched control group. Of great significance was the fact that only 1 patient with ANUG was black as compared to a 41% black population in the clinic population.
New attachment formation as the result of controlled tissue regeneration
Authors: Gottlow Jan , Nyman Sture , Karring Thorkild , Lindhe Jan
Published: December 2005

Abstract The present study was designed to examine whether new attachment forms on root surfaces previously exposed to plaque by preventing the oral epithelium and the gingival connective tissue from participating in the process of healing following treatment.

4 roots in each of 3 monkeys were used as test units while the roots of contralateral teeth served as controls. A surgical procedure was first used to expose the coronal half of the buccal root surfaces. Plaque was allowed to accumulate on the exposed surfaces for a period of 6 months. Subsequently, soft tissue flaps were raised and the root surfaces were carefully scaled and planed. The crowns of the test and control teeth were resected and the mucosal Haps were repositioned and sutured in such a way that the roots were properly covered. Immediately prior to suturing, membranes (Millipore® filter or Gore‐tex® membrane) were placed over the denuded root surfaces of the test teeth in order to prevent granulation tissue from the soft tissue flaps from reaching the roots during healing. The monkeys were sacrificed 3 months later. The jaws were removed and histological sections of test and control roots including their periodontal tissues were produced.

New cementum with inserting collagen fibers was observed on the previously exposed surfaces of both test and control roots. However, the test surfaces exhibited considerably more new attachment than the control surfaces, indicating that the placement of the membrane favoured repopulation of the wound area adjacent to the roots by cells originating from the periodontal ligament.
Role of the polymorphonuclear leukocyte in periodontal health and disease
Authors: Miller Danette R. , Lamster Ira B. , Chasens Abram I.
Published: December 2005

Abstract This review presents evidence for lysosomal enzymes being at least partly responsible for the tissue destruction seen in periodontal disease. However, many other inflammatory and immunologic mechanisms have been identified that can contribute to tissue destruction (Nisengard 1977).

The relationship of PMN to the periodontal tissues is equivalent to the proverbial double‐edged sword. The localized tissue destruction that may be due to the extracellular release of PMN enzymes in individuals with normal cell function must be weighed against the role of PMN in containment of gingival bacteria and their products. The consequences of qualitative and/or quantitative abnormalities of neutrophils are far more undesirable for the periodontium. It therefore seems logical to propose that the role of polymorphonuclear leukocytes in the gingival tissues is primarily a defensive one.

The presence of neutrophils in the gingival crevice has been shown to reflect the inflammatory condition of the tissues. Due to their availability it may prove beneficial to use gingival crevicular PMN activity as a reliable clinical index of disease activity. The development of appropriate tests to measure PMN may eventually lead to better diagnostic criteria, including the definition of active versus inactive disease.
Connective tissue reattachment as related to presence or absence of alveolar bone
Authors: Lindhe Jan , Nyman Sturu , Karring Thorkild
Published: December 2005

Abstract The present study was designed to examine if alveolar bone, located adjacent to a root surface deprived of its periodontal ligament and cementum layer, can stimulate the reformation of a connective tissue attachment. The maxillary and mandibular incisors in 3 monkeys were extracted. Immediately after tooth extraction, the buccal root surfaces of the incisors from the left side of the jaws were planed by means of curettes to a level corresponding to half the root length. All teeth were then reimplanted into their original sockets. However, before tooth reimplantation, the buccal alveolar bone plate was removed in 2 of the monkeys to a level corresponding to half the depth of the sockets. The animals were sacrificed 6 months after the reimplantation procedure. The jaws were removed and histological sections of the experimental teeth and adjacent periodontal tissues were produced. The sections were analyzed in the microscope and subjected to histometric measurements.

The results demonstrated that, irrespective of the presence or absence of alveolar bone, a fibrous reattachment failed to form on that part of the reimplanted teeth which had been deprived of their periodontal ligament. This indicates that alveolar bone located adjacent to a root surface may have limited influence on the biological conditions which determine whether periodontal healing results in connective tissue reattachment or new attachment.