bluuebunny/crossref_metadata_2025 huggingface dataset:
An approach to efficacy screening of mouthrinses: studies on a group of French products
Authors: Harper P. Renton , Milsom S. , Wade W. , Addy M. , Moran J. , Newcombe R. G.
Published: December 2005

Abstract. The aim of this study was to determine the value of screening studies to assess the efficacy of antiseptic mouthrinse products relative to proven products. The products tested were 6 antiseptic mouthrinses available in France. 4 contained chlorhexidine (Eludril Hibident, Parodex and Prexidine) with Hibident considered the positive control. 1 product contained cetylpyridinium chloride (Alodont) and 1 hexetidine (Hextril). Saline was used as the negative control. The 1st study assessed the persistence of action of the products by recording salivary bacterial counts before and up to 7 h after single rinses. The 2nd study measured the inhibition of plaque regrowth, from a zero baseline, in the absence of tooth‐brushing over a 4‐day period. Both studies used blind randomised crossover designs balanced for residual effects. Salivary bacterial count reductions with time were highly significantly different between products. Compared to saline, decrements were only significantly greater for Parodex to 5 h and Hibident and Prexidine to 7 h; There were no significant differences between the latter three chlorhexidine rinses except at 3 h, when decrements were significantly less with Parodex. Despite a mean trend in favour, Alodont. Eludril and Hextril were not significantly different from saline. Plaque inhibition by area and index was highly significantly different between products. Hibident, Parodex and Prexidine showed similar plaque inhibition and were significantly more effective than all other rinses. Eludril and Hextril were significantly more effective than saline but Alodont was not. Taken with the associated study in vitro and published reports on the same or similar products, it is apparent that efficacy of a product cannot be assumed merely because it contains a known active plaque inhibitor. Studies in vitro can provide supportive evidence but should not stand alone. Clinical investigations similar to these should be a minimum requirement for any oral hygiene product before claims of efficacy comparable to established products are made.
The effect of a commercially available triclosan‐containing toothpaste compared to a sodium‐fluoride‐containing toothpaste and a chlorhexidine rinse on 4‐day plaque regrowth
Authors: Binney A. , Addy M. , McKeown S. , Everatt L.
Published: December 2005

Abstract Many compounds could be added to toothpaste to assist plaque inhibition, but ionic interactions can cause formulation difficulties. Moreover, the actual chemical action of a plaque inhibitory agent added to a toothpaste is difficult to assess when the product is used in the conventional manner, i.e., in addition to toothbrushing. The non‐ionic antimicrobial triclosan has been incorporated in toothpastes and shown to have variable plaque inhibitory activity both alone and in conjunction with certain polymers or metal ions. Little is known of the efficacy of triclosan toothpastes compared to conventional fluoride toothpastes. The aim of this study was to compare a commercially available toothpaste containing 0.3% triclosan/co‐polymer with a sodium fluoride toothpaste for chemical plaque inhibitory effects over a 4‐day period. The study was designed to stratify the relative efficacy plaque inhibitory action of the products, comparisons were made with a positive control, chlorhexidine rinse and a negative control, saline. The study design was a randomised single blind crossover design balanced for first‐order carryover. A total of 18 healthy, dentate volunteers participated in the study. On day i of each period the volunteers suspended toothcleaning and rinsed 2 X daily with the allocated mouthrinse or toothpaste slurry. On day 5, the plaque on the teeth was disclosed and scored by index and area. Increasing plaque scores were in the order chlorhexidine, triclosan toothpaste, fluoride toothpaste, and saline. Chlorhexidine was significantly more effective than all the other agents tested, and both toothpaste preparations were significantly better than the saline rinse. There was no significant difference between the two toothpaste rinses. Consistent with other studies the triclosan toothpaste offers only moderate plaque inhibitory properties when compared to a conventional toothpaste.
Antibody responses to suspected periodontal pathogens in elderly subjects with periodontal disease
Authors: McArthur Willam P. , Bloom C. , Taylor M. , Smith J. , Wheeler T. , Magnusson N. Ingvar
Published: December 2005

Abstract Little is known about the relationship of aging to periodontal disease. The immune response undergoes aging‐related changes resulting in loss of functional capacity. The aim of this study was to investigate the relationship between levels of serum IgG antibodies against suspected periodontal pathogenic microorganisms to the presence or absence of periodontal disease in an elderly (65‐75 yrs) population. From this study, we obtained information concerning: (1) the ability to differentiate elderly individuals without disease from those with disease by their levels of antibodies against periodontal pathogens and (2) which periodontal pathogen(s) triggered those responses. IgG anti‐ Porphyromonas gingivalis (strains W83 and 381) levels in the serum of elderly patients with severe periodontal disease were the only antibody responses measured which were elevated compared to the elderly control group of subjects with no periodontal disease. Anti‐ Prevoiella intermedia IgG levels in both elderly patient groups were depressed compared to anti‐ P. intermedia levels in the young normal control subjects. Serum IgG antibody levels to six other plaque microorganisms did not differentiate between diseased and normal, elderly or young subjects. This data suggested that P. gingtvalis was associated with periodontal disease in this elderly group of individuals and that those elderly individuals were able to respond with a normal IgG immune response.
Putative periodontal pathogens colonizing oral mucous membranes in denture‐wearing subjects with a past history of periodontitis
Authors: Danser M. M. , van Winkelhoff A. J. , de Graaff J. , van der Velden U.
Published: December 2005

Abstract The prevalence of selected putative periodontal pathogens colonizing oral mucous membranes was investigated in 26 denture‐wearing subjects with a history of periodontitis. The microbiota of the oral cavity of these subjects was examined on average 9.3 years after extraction (range: 1‐40 years). Samples were taken from several locations on the oral mucous membranes, from saliva and from plaque attached to the upper and lower denture. Actinobacillus actinomycetemcomitans was not detected in any of the 26 edentulous subjects. Porphyromonas gingivalis was detected in 2 subjects (proportion of cultivable flora: 0.002% and 12.5%). Prevotella intermedia was recovered from 7 subjects with a mean proportion of 0.5% (range < 0.001%‐6.3%). Analysis showed that subjects harbouring P. intermedia were wearing full dentures for a longer period of time (mean: 20.2 years) than subjects in which P. intermedia could not be detected (mean: 6.6 years). This result suggests that the absence of P. intermedia shortly after extraction may reflect only a temporary event. Other Prevotella species were found in 22 subjects, constituting < 2% of the total cultivable flora (range 0.01%‐10.5%)). In conclusion, the low prevalence of P. gingivalis and the absence of A. actinomycetemcomitans, suggest that the oral cavity of edentulous subjects may not be regarded as a habitat for these species. The preferable habitat of the Prevotella spp. seems to be the oral mucous membranes, possibly with the exception of P. intermedia.
Response to intracrevicular controlled delivery of 25% tetracycline from poly(lactide/glycolide) film strips in SPT patients*
Authors: Maze Glenn I. , Reinhardt Richard A. , Agarwal Rajesh K. , Dyer John K. , Robinson Dennis H. , DuBois Linda M. , Tussing Gerald J. , Maze Connie R.
Published: December 2005

Abstract Controlled local delivery of antibiotics has been shown to reduce periodontopathic micro‐organisms with minimal side‐effects. Clinical studies in our laboratory have shown that 25% tetracycline HCl delivered from poly(D,L‐lactide/glycolide) film strips (25 TTC‐PLGA) released therapeutic concentrations of tetracycline for 10 days. The present pilot study compared the intracrevicular delivery of 25% tetracycline HCl incorporated in these biodegradable film strips to scaling and root planing (SRP) in 10 adult periodontitis patients, who in spite of therapy and regular supportive periodontal treatment (SPT), continued to possess 5 bleeding periodontal pockets at least 5 mm deep. Sites were randomly selected to receive the following treatments: (1) 25 TTC‐PLGA, (2) control strips without TTC (PLGA), (3) SRP, and (4) untreated control. Film‐strip retention was augmented with a suture/cement technique, followed by strip removal after 2 weeks. Clinical parameters and subgingival bacterial morphotypes (darkfield analysis) were evaluated over time (0, 2, 4, 8, 12, 26 weeks). Results indicated that, compared to baseline, 25 TTC‐PLGA film strips caused significant (p < 0.01): (1) probing depth reduction for 26 weeks, (2) a clinical attachment level gain for 12 weeks. (3) lower %S of spirochetes for 4 weeks and motile rods for 8 weeks (p < 0.05), and (4) an accompanying increase in cocci for 4 weeks. In the scaled and root planed sites, probing depth was the only finding that demonstrated a significant change from baseline (p < 0.01). Controls and PLGA showed isolated reductions in probing depth and % of motile organisms. From these findings, applications of intracrevicular 25 TTC‐PLGA, when compared to scaling and root planing, appears to have an enhanced antibacterial effect and a similar clinical effect in SPT patients. The results of this study indicate further investigation of 25 TTC‐PLGA film strips should be undertaken using more subjects and sophisticated microbiological and clinical measurements.
Crevicular fluid osteocalcin and pyridinoline cross‐linked carboxyterminal telopeptide of type I collagen (ICTP) as markers of rapid bone turnover in periodontitis
Authors: Giannobile William V. , Lynch Samuel E. , Denmark Robert G. , Paquette David W. , Fiorellini Joseph P. , Williams Ray C.
Published: December 2005

Abstract The objective of this study was to correlate the levels of 2 putative markers of bone metabolism, namely osteocalcin and pyridinoline cross‐linked carboxyterminal telopeptide of type I collagen (ICTP). to the progression of experimental alveolar bone loss in the beagle dog, 36 control sites and 36 experimental sites in 2 beagle dogs were assessed longitudinally at 2‐week intervals for gingival crevicular fluid (GCF) osteocalcin and ICTP levels during a 6‐month observation period. Analysis of osteocalcin and ICTP in GCF was performed by RIA. During the study, bone‐seeking radiopharmaceutical uptake (BSRU) of 99mTc‐MDP was assessed monthly; standardized radiographs were taken al 2‐week intervals. The results showed osteocalcin and ICTP levels in GCF increased significantly (p<0.05) by 2 weeks following initiation of disease. This increase preceded significant increases in BSRU by 2 weeks and radiographic evidence of bone loss by 4 weeks, BSRU was significantly elevated (p<0.05) at experimental sites as compared to controls at 4 and 8 weeks post‐disease initiation. Osteocalcin in GCF peaked 8 and 10 weeks after ligature placement in experimental sites at levels nearly 10‐fold greater than contralateral paired control sites. ICTP levels in GCF remained elevated throughout the entire disease progression phase. Following the removal of ligatures, both GCF ostocalcin and ICTP levels dropped precipitously approaching control values. Osteocalcin revealed overall a positive predictive value (PPV) and negative predictive value (NPV) for future bone loss during disease progression of 0.87 and 0.34. respectively, while ICTP showed both high PPV and NPV of 0.87 and 0.91 respectively. Results from this study in the dog model indicate that osteocalcin and especially ICTP relate to indices of active periodontal bony destruction and suggest that these molecules may serve as predictive markers for future alveolar bone loss.
The efficacy of an anti‐gingivitis chewing gum
Authors: Smith A. J. , Moran J. , Dangler L. V. , Leight R. S. , Addy M.
Published: December 2005

Abstract Chlorhexidine is a well‐established agent used for the control of supragingival plaque but is not without disadvantages, such as tooth staining, which limits its clinical applications to short‐term use. This clinical trial studied the clinical effectiveness and stain‐forming potential of chlorhexidine in a chewing gum base. Subjects (151) were screened for baseline plaque and gingival indices before receiving a dental prophylaxis and randomized into 3 treatment groups: group 1 chewed 2 pieces of chlorhexidine diacetate gum for 10 min 2× a day (total daily chlorhexidine=20 mg). group 2 chewed 2 pieces of placebo gum for 10 min 2× a day and group 3 rinsed with 10 ml of 0.2% chlorhexidine gluconate mouthwash for 1 min 2× per day (total daily chlorhexidine=40 mg). Plaque, gingivitis and stain evaluations were made at 4 and 8 weeks. Plaque and bleeding scores were significantly lower at 4 and 8 weeks in the chlorhexidine gum group compared to the placebo gum group and similar at 8 weeks to the rinse group. Stain intensity at week 8 was significantly less for the chlorhexidine gum than rinse. The staining measured by extent was also Jess with the chlorhexidine gum than the rinse, but the difference was not significant at week 4. At week 8, stain extent was significantly lower in the chlorhexidine gum group than chlorhexidine rinse. In conclusion, the results of this study demonstrate that this chlorhexidine chewing gum used with normal tooth cleaning provides similar adjunctive benefits to oral hygiene and gingival health as a 0.2% chlorhexidine rinse.
Examiner agreement on periodontal indices during dental surveys of elders
Authors: Mojon Philippe , Chung Jean‐Pierre , Favre Philippe , Budtz‐Jörgensen Ejvind
Published: December 2005

Abstract Indices used to evaluate periodontal health have been widely accepted in epidemiological studies, yet their reliability cannot be guaranteed. The aim of this study was to evaluate the reliability of periodontal indices applied on elders. 19 elderly subjects, 73‐years‐old on average, were examined at a 1st appointment by 2 independent examiners. They were re‐examined 2 weeks later during a 2nd session. The examinations were performed in a dental chair with good illumination. Periodontal health was evaluated using the community periodontal index of treatment need, and tooth mobility was evaluated using 2 different indices. Inter‐ and infra‐examiner agreements were evaluated using k statistics. Taken as an overall measurement, the CPITN was a reliable assessment of periodontal treatment need in elders. Disagreement occurred mainly on the evaluation of bleeding and shallow pockets. The detection of fairly mobile teeth was reliable: however, the performance of the more sensitive scale was deceptive. It seems that, in the case of tooth mobility, a choice has to be made between sensitivity or reproducibility. It can be concluded that examiners should be trained carefully since the reliability of the CPITN and tooth mobility evaluation were good but close to a critical level for which an agreement is classified as poor.
Supportive care after active periodontal treatment
Authors: Echeverria José J. , Manau Garcia Carolina , Guerrero Adrian
Published: December 2005

Abstract This review concerns the most significant questions regarding supportive (maintenance) care after active periodontal treatment: the effectiveness and ideal frequency of maintenance appointments, the adecuacy of the supportive therapy according to patient needs, the possible alternatives to currently accepted protocols, and the relative value of personal oral hygiene in the overall context of supportive care. Periodontal diseases are infections with a high potential for recurrence, progressive loss of attachment and eventually, tooth loss. Current therapies for periodontal diseases are highly predictable in arresting disease activity. Supportive periodontal care has been shown to be very effective in maintaining support when adapted to each particular case. Nevertheless, current maintenance therapies may be unsuccessful in preventing further loss of attachment in a small number of sites for some patients. Tests aiming at bacterial identification and the subgingival application of antimicrobials may be helpful in the management of such cases, however the practical value in a specific setting is not known. There is growing evidence of the fundamental role of personal oral hygiene in supportive periodontal care. In cases with rapid and severe periodontal destruction and where local and/or systemic risk factors are present, personal oral hygiene becomes a key factor in the long‐term preservation of periodontal support.
The effect of supragingival plaque control on the subgibgival microflora in human periodontitis
Authors: Hellström M.‐K. , Ramberg P. , Krok L. , Lindhe J.
Published: December 2005

Abstract The aim of the present trial was to study if carefully practiced supragingival plaque control influenced the subgingival microbiota at periodontal sites with suprabony, infrabony, or furcation pockets. 12 subjects, 5 males and 7 females aged 44 to 69 years (mean age 55 years) participated in the study. None of the participants had during the last 12 months received periodontal therapy, and none of the subjects had used antibiotics during a 3‐month period preceding the study. Following a screening examination. 6 to 8 sites per subject were selected which had a probing depth of 5 mm. Among these sites. 1–3 sites had a supra‐bony location. 1–3 sites had an infrabony location, and 1–3 sites were associated with a furcation defect. The selected sites were exposed to a baseline examination at which the following parameters were recorded: plaque, gingivitis, probing pocket depth and probing attachment level. A bacterial sample was obtained from each of the selected sites: 2 sterile paper points were inserted into the pocket and kept in place for 30 seconds. The paper point samples were removed, placed in a vial containing an anaerobically prepared transport medium, and processed using routine procedures. Following the baseline examination, each subject was given a case presentation, received thorough supragingival scaling and was instructed to practice proper plaque control with the use of toothbrush and dentifrice. During the subsequent 30 weeks they were recalled 2–3 × per week for professional tooth cleaning. Each session was handled by a dental hygienist and required about 15 min. Re‐examinations were performed after 30 weeks. The findings indicated that professionally delivered and frequently repeated supragingival tooth cleaning, combined with careful self‐performed plaque control had a marked effect on the subgingival microbiota of moderate to deep periodontai pockets. Thus, at sites with suprabony and infrabony pockets, as well as at furcation sites, the meticulous and prolonged supragingival plaque removal reduced the total number of microorganisms that could be harvested, as well as the % of sites with P. gingivalis.
An evaluation of an antiadhesive copolymer agent on plaque inhibition by chlorhexidine
Authors: Claydon N. , Addy M. , Ridge D. , Jackson R.
Published: December 2005

Abstract The high molecular weight copolymer M239144 has proven antiadhesive action in vitro but clinically lacked effect, even when combined with chlorhexidine. This latter result was thought to arise from inactivation of chlorhexidine by the copolymer. The aim of this study was to determine whether improved activity might arise if the copolymer and chlorhexidine were applied sequentially rather than combined. The study was a double‐blind, randomised crossover design balanced for carryover using a 24‐h plaque regrowth method. 2 groups of 25 subjects from a zero plaque baseline rinsed 1 x with 15 ml volumes of the allocated paired rinses for 60 s. Subjects abstained from toothcleaning for 24 h and were scored for plaque by area. The paired regimens were: 1. placebo: placebo; 2. placebo: 0.03% chlorhexidine; 3. 1% co‐polymer and 0.03% chlorhexidine: 4. placebo: 1% co‐polymer; 5. placebo: 0.12% chlorhexidine. Plaque regrowth was greatest with regimen 1 and least with regimen 5. However, regimens 3 and 4 were not significantly different from regimen 1, whereas regimen 2 was significantly more effective than regimen 3. The results indicate that the copolymer alone is ineffective, and even delivered sequentially, inactivates chlorhexidine.
Dimension of the periimplant mucosa
Authors: Berglundh T. , Lindhe J.
Published: December 2005

Abstract The objective of the present study was to determine the dimension of the mucosal‐implant attachment at sites with insufficient width of the ridge mucosa. 5 beagle dogs were used. Extractions of all mandibular premolars were performed and 3 months later. 3 fixtures of the Brånemark System® were installed in each side. Following 3 months of healing, abutment connection was carried out. On the right or left side of the mandible, abutment connection was performed according to the Brånemark System® manual ‐ (control side). On the contralateral side (test side), an incision not extending through the periosteum was made at the crest of the ridge. The soft tissue was dissected and a critical amount of connective tissue on the inside of the flap was excised. The periosteum was subsequently incised, abutment connection performed, and the trimmed flaps sutured. The sutures were removed after 10 days. After a 6‐month period of plaque control, the animals were sacrificed, biopsies sampled and processed for light microscopy. The length of the junctional epithelium varied within a rather narrow‐range: 2.1 mm (control side) and 2.0 mm (test side). The height of the suprabony connective tissue in this model varied between 1.3±0.3 mm (test side) and 1.8±0.4 mm (control side). At sites where the ridge mucosa prior to abutment connection was made thin (≤2 mm), wound healing consistently included bone resorption. This implies that a certain minimum width of the periimplant mucosa may be required, and that bone resorption may take place to allow a stable soft tissue attachment to form.
Risk indicators for periodontal disease in a racially diverse urban population
Authors: Alpagot T. , Wolff L.F. , Smith Q.T. , Tran S.D.
Published: December 2005

Abstract A cross‐sectional study of 117 subjects from a dental clinic serving a diverse population (i.e., Whites. African‐Americans. Native‐Americans, and Asians) was performed to evaluate risk indicators of periodontal disease. Gingival crevicular fluid (GCF) and subgingival plaque were taken at the same visit from 4 posterior sites of the most diseased sextant in each subject. Age, smoking packyears. β‐glucuronidase (βG). neutrophil elastase (NE). myeloperoxidase (MPO). Fusobacterium nucleatum (F. nucleatum), and Porphyromonas gingivalis (P. gingivalis) were significantly (p <0.05–0.005) correlated with attachment loss. Probing depth was significantly correlated with smoking packyears, βG, NE, MPO. F. nuclealum and Prevotella intermedia (P. intermedia) (p < 0.05–0.005). Mean NE value of Whites was lower than the mean NE values of African‐Americans, Native‐Americans and Asians (P < 0.05). Whites had a lower mean βG value compared to African Americans, and a lower mean MPO value compared to African Americans and Native Americans. The %s of patients positive for F. nucleatum. P. intermedia and Eikenella corrodents (E. corrodents) were higher in Native Americans compared to Whites. Step‐wise multiple regression analysis was performed to construct models for the estimation of probing depth and attachment loss. The most parsimonious regression models which had the best R 2 values included the following variables and accounted for the indicated % of variability: models 1 and 2: βG. race, and F. nucleatum accounted for 50% of the variability in mean probing depth and 39% of the variability in a single site (first molar) for probing depth, respectively: model 3: age. βG. and F. nuclealum accounted for 53% of the variability in mean attachment loss: model 4: age. NE. and F. nuclealum explained 35% of the variability in a single site (first molar) for attachment loss. The results suggest that age. race, smoking packyears, βG, NE. MPO. F. nuclealum, P. gingivalis and P. intermedia are risk indicators for periodontal disease in this racially diverse urban population. Regression models which include multiple variables (i.e., demographic factors, GCF enzymes and periodontopathic bacteria) can be used to estimate periodontal disease status.
Predominant cultivable supragingival plaque in Chinese “rapid” and “slow” plaque formers
Authors: Zee Kwan‐yat , Samaranayake Lakshman P. , Attström Rolf
Published: December 2005

Abstract The aim of this study was to compare the predominant cultivable bacterial flora in supragingival plaque samples of Chinese “rapid” and “slow” plaque formers, using the experimental gingivitis model. 11 Chinese subjects (5 “rapid” and 6 “slow” plaque formers) were selected from 49 healthy young adults. The selection was based on the plaque index on the buccal surfaces of all the canines, premolars and 1st molars after 3‐days without plaque control. The 11 subjects began a 14‐day no oral hygiene period after prophylaxis. Plaque samples were collected on day 1. day 3, day 7 and day 14 from the buccal surface of upper right canine. 2nd premolar. 1st premolar and 1st molar, respectively. The samples were then dispensed into a tryptic soy broth, and cultured anaerobically to obtain pure isolates which were then identified by conventional means. Results showed similar trends in plaque development in the two groups; gram‐positive bacteria were the predominant cultivable species (“rapid”: 71–37%; “slow”: 53–63%) and gram‐negative species increased in proportion to the plaque age (“rapid”: 9–47%. “slow”: 13–28%). “Rapid” plaque formers showed a statistically significant higher percentage of gram‐negative rods (38%) than the “slow” group (17%) in the 14‐day samples. The difference in the proportions of other groups of bacteria between the “rapid” and “slow” plaque formers were also found to be statistically significant using the MANOVA test (p=0.0162). Most of the cultivable gram‐negative rods belonged to Fusobacterium and Capnocytophaga species. Besides the quantitative difference observed clinically, there seems to be a qualitative difference in the cultivable flora between subjects with different rates of plaque formation.
Occurrence of Actinobacillus actinomycetemcomitans in patients wearing orthodontic appliances
Authors: Paolantonio Michele , di Girolamo Gianni , Pedrazzoll Vinicio , di Murro Carlo , Picciani Carla , Catamo Giovanni , Cattabriga Marcello , Piccolomini Raffaele
Published: December 2005

Abstract The aim of the present study was to assess: (1) the occurrence of Actinobacillus actinomycetemcomitans (Aa) in subgingival plaque from young patients undergoing orthodontic treatment with fixed appliances; (2) a possible relationship between the presence of Aa and the clinical conditions; (3) a relation between the duration of orthodontic treatment and the microbiological and clinical parameters; (4) whether differences exist when taking into consideration the different type of appliances, i.e., bands or brackets. 34 subjects aged between 12 and 20 years participated in the study. Of these, 20 subjects had worn orthodontic appliances (test group), while the remaining 14 subjects served as matched control (control group). 4 to 8 sites in each patient were available for clinical and microbiological examination. Clinical parameters consisted of presence/absence of plaque and gingival bleeding index (GBT), Microbiological sampling was performed in the same sites as in the clinical examination. A statistically significant difference was present when comparing %s of GB1 positive scores between teeth from the test group (57.5%) and teeth from the control group (25%). Plaque was present in 53% of test sites and 37% of control sites, but this difference was not statistically significant. Aa was detected, from at least one site in 85% of test subjects and in 15% of the control subjects (p<0.001). Among the subjects, 41% harboured Aa at a concentration between 0.1% and 1.0%, whereas another 40% yielded Aa at a concentration greater than 1.0%. Finally, a positive correlation was noted between the % of sites positive for Aa and the % of sites displaying a positive GB1 score (r=0.41; p<0.005). No relation was found between the duration of orthodontic treatment and the microbiological or clinical parameters; neither were statistically significant differences found when we compared results from sites wearing bauds or brackets. In conclusion, the present study showed that young subjects wearing orthodontic appliances harbour Aa with a remarkable frequency of detection, although plaque levels do not significantly differ from those of a matched control group.
Root cleaning or root smoothing An in vivo study
Authors: Oberholzer Rainer , Rateitschak Klaus H.
Published: December 2005

Abstract The goal of the present study was to determine whether the clinical treatment results in terms of pocket probing depth reduction and attachment gain would be different following conventional periodontal flap surgery if, on the one hand, root surfaces were smoothed after plaque and calculus removal or, on the other hand, root surfaces were first thoroughly cleaned but then intentionally roughened. 13 adult patients with moderate periodontitis participated: the same patients acted as a unit of control. Evaluations were performed on a total of 224 sites on 81 anterior and premolar teeth. On the 41 test teeth (111 sites). a coarse diamond stone was used following traditional root planing to roughen the root surfaces. The 40 control teeth (113 sites) were cleaned and planed using Gracey curettes. Measurements performed 3 and 6 months post‐surgery revealed significant reductions in probing depths at both “rough” and “smooth” sites. However, no differences between the 2 methods were detected. This was true also with regard to attachment gain. We conclude that striving for root surface smoothness during periodontal surgery appears unnecessary.
Utility of 5 major putative periodontal pathogens and selected clinical parameters to predict periodontal breakdown in patients on maintenance care
Authors: Rams Thomas E. , Listgarten Max A. , Slots Jørgen
Published: December 2005

Abstract The predictive utility of 5 major putative periodontopathic microbial species, “superinfecting” organisms, and several clinical periodontal parameters were assessed relative to periodontitis recurrence over a 12‐month period in 78 treated adult patients participating in a 3‐month maintenance care program. At baseline, pooled subgingival microbial samples were collected from each patient, and whole‐mouth evaluations of probing depth, relative periodontal attachment level, furcation involvement, and indices of plaque and gingival inflammation were carried out. 67 (85.9%) subjects were culture‐positive at baseline for presence of either Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia. Campylobacter rectus or Peptostreptococcus micros, with 48 (61.5%) subjects yielding one or more of these species at or above designated threshold proportions of ≥0.01% for A. actinomycetemcomitans, ≥0.1% for P. gmgivalis, ≥2.5% for P. intermedia, ≥2.0% for C. rectus, and ≥3.0% for P. micros. Subgingival yeasts were recovered from 12 subjects, staphylococci from 7, and enteric rods/pseudomonads from 6; however, no subjects revealed 21.0% baseline proportions of these “superinfecting” organisms in subgingival specimens. Periodontitis recurrence in subjects was defined as any periodontal site exhibiting either a probing depth increase of 2:3 mm from baseline, or a probing depth increase of 22 mm from baseline together with a loss in relative periodontal attachment of 22 mm from baseline. 15 (19.2%) study subjects showed periodontitis recurrence within 6 months of baseline, and 25 (32.1%) within 12 months. The mere baseline presence of the 5 major test species and “superinfecting” organisms were not significant predictors of periodontilis recurrence over 12 months. However, a 2.5 relative risk for periodontitis recurrence over 12 months was found for subjects yielding one or more of the 5 major test species at or above the designated baseline threshold proportions (p=0.022. Mantel‐Haenszel %2 test). The positive predictive value for periodontitis recurrence of a microbiologic analysis encompassing the 5 major test species at or above the designated threshold proportions improved with increasing time from baseline, up to approximately 42% at 12 months. Baseline variables jointly providing in multiple regression analysis the best predictive capability for periodontitis recurrence in subjects over a 12‐month period were recovery of one or more of the 5 major test species at or above designated threshold proportions, the proportion of sites per subject with 25 mm probing depth, and the mean whole‐mouth probing depth. These findings indicate that one or more of 5 major putative periodontal pathogens in elevated subgingival proportions together with increased probing depth predispose adults on maintenance care to recurrent periodontitis.
Comparison of an oscillating/rotating electric toothbrush and a ‘sonic’ toothbrush in plaque‐removing ability
Authors: Van der Weijden G.A. , Timmerman M.F. , Reijerse E. , Snoek C.M. , Van der Velden U.
Published: December 2005

Abstract The purpose of the present study was to compare the Braun/Oral‐B Plak Control® (D7) and Sonicare® (S) in their plaque‐removing efficacy. For this study. 35 university students (non‐dental) were selected. This was a 2‐part study. Prior to each appointment, all subjects were asked to abstain from all oral hygiene procedures for at least 24 h. In Part 1. the efficacy of the toothbrush was studied when one of the investigators brushed the teeth of the panellists. In Part 2. the efficacy of toothbrushing was studied after the students had received professional instruction. The available time for the brushing amounted to a total of 2 min per mouth. Dental plaque was evaluated by means of the Silness and Löe plaque index assessed at 6 sites per tooth. Results showed that both in Parr 2 and Pan I the D7 removed significantly more plaque than the S‐electric toothbrush. The plaque reduction assessed according to Silness and Löe in Part 1 was for the D7. 1.28 and for the S, 1.12. In Pan 2. the reductions were 0.90 and 0.80. respectively. The majority (n=34) of subjects preferred the D7 over the S. In conclusion, the results of the present study show that the oscillating/rotating toothbrush (Braun/ Oral‐B Plak Control®) is more effective in plaque removal than the sonic electric toothbrush (Sonicare®). In addition, given a choice, the panellists preferred the oscillating/rotating electric toothbrush.
Effects of sublethal exposure to an antiseptic mouthrinse on representative plaque bacteria
Authors: Fine D. H. , Furgang D. , Lieb R. , Korik I. , Vincent J. W. , Barnett M. L.
Published: December 2005

Abstract Although the mechanism responsible for the clinical antiplaque efficacy of oral antiseptics is generally considered to be primarily one of bactericidal activity, it has been suggested that oral antiseptics may have additional effects on bacteria exposed to sublethal levels. Studies reported herein, investigated the effects of sublethal levels of an essential oil‐containing antiseptic mouthrinse (Listerine Antiseptic, Warner‐Lambert Co., Morris Plains. NJ) on selected activities of representative plaque microorganisms using in vitro models. These studies demonstrated that sublethal exposure to the tested oral antiseptic can have significant effects in reducing intergeneric coaggregation, increasing bacterial generation time, and extracting endotoxin from Gram‐negative bacteria. These in vitro activities can be correlated with features of plaque formation and pathogenicity seen in vivo: however, additional studies will be necessary to confirm that these mechanisms are, in fact, operative clinically.
The choice of controls in toothpaste studies
Authors: Binney A. , Addy M. , McKeowr S. , Everatt L.
Published: December 2005

Abstract Toothpastes have been shown to have an antimicrobial activity both in vitro and in vivo: this activity variably translates into a plaque inhibitory effect in vivo. Commercially available toothpastes have a complex chemical make‐up and some contain additional chemicals for which improved effects against plaque have been claimed. The aim of this study was to assess the plaque inhibitory properties of 5 commercially available toothpastes compared to a rinse of water over 4 days. The study was a randomised, single‐blind, cross‐over design balanced for residual effects. Volunteers were rendered plaque‐free at each baseline and rinsed for 1 min, under the supervision of an assistant, 2× a day with the allocated mouthrinse or toothpaste slurry. At the end of the 4–day test period, the plaque was disclosed and measured by plaque index and plaque area. The plaque measurements indicated a significant difference between the toothpastes. The order of efficacy was Colgate Total. Crest regular. Crest Tartar. Colgate regular. Colgate 0–6 gel and water. This confirms previously reported data confirming the plaque inhibitory properties of certain toothpastes compared to water. These data indicate that the choice of control toothpaste with which to compare toothpastes formulated for plaque control is important and could influence conclusions drawn from clinical trials of such products.
Root surface smoothness or roughness following open debridement
Authors: Schlageter Lando , Rateitschak‐Piüss Edith M. , Schwarz Jean‐Pierre
Published: December 2005

Abstract Consensus has not been reached on the desired characteristics of the root surface following cleaning. It is also not clear what degree of roughness or smoothness results from use of different instruments. In the present human clinical study, various instruments for root surface cleaning were evaluated. 18 teeth destined for extraction for periodontal reasons were utilized. After reflection of soft tissue flaps, the 72 root surface aspects of the 18 teeth were uniformally treated with one of the following instruments: Gracey curette (GC). piezo ultrasonic sealer (PUS). Perioplaner curette (PPC). sonic sealer (SS). 75 μm diamond (75 D) and 15 μm diamond (15 D). The degree of roughness of each surface was measured after extraction. A planimetry apparatus was used to establish the average surface roughness (Ra) and the mean depth of the roughness profile (Rz). It was demonstrated that hand‐ and machine‐driven curettes as well as very fine rotating diamonds created the smoothest root surfaces, while “vibrating” instruments such as sonic and ultrasonic sealers, as well as coarse diamonds, tended to roughen the root surface. Whether the root surface should be rough or smooth in order to enhance tissue healing remains an open question.
Comparison of a sonic and a manual toothbrush for efficacy in supragingival plaque removal and reduction of gingivitis
Authors: Tritten C.B. , Armitage Gary C.
Published: December 2005

Abstract A new sonic electric toothbrush (Sonicare®) and a traditional manual toothbrush were compared for efficacy in removing supragingival plaque and reducing gingival inflammation in a 12‐week, single‐blind clinical trial. 60 subjects with a gingival index (GI) of >1.5 and no probing depths >5 mm were randomly assigned to use either the manual or sonic brush, instructed in its use, and asked to brush each morning and evening for 2 minutes. Plaque scores were taken at baseline and at 1.2, 4. and 12 weeks using the Turesky modification of the Quigley‐Hein plaque index. Gingival inflammation was assessed by the GI. bleeding tendency score, presence or absence of bleeding on probing, volumetric measurements of gingival crevicular fluid (GCF). and aspartate aminotransferase (AST) levels in GCF. Repeated measures multivariate analyses of variance were used to delect time‐ and device‐dependent differences for all clinical assessments between the 2 groups over the 5 visits. Both types of brush were effective in removing supragingival plaque. The sonic brush was statistically superior, on a percentage reduction basis, in removing supragingival plaque from the dentition taken as a whole (F‐statistic; p=0.012) and was particularly better in hard‐to‐reach areas such as posterior teeth (F‐statistic; p=0.003) and interproximal sites (F‐statistic; p=0.004). Both devices were equally effective in reducing gingival inflammation. The sonic brush exhibited less tendency to cause gingival abrasion than the manual brush (1 incident with sonic, 5 incidents with manual), confirming the safely of this product as an oral hygiene device.
The importance of immunoglobulin‐breakdown supporting the growth of bacteria in oral abscesses
Authors: Jansen H.‐J. , van der Hoeven J. S. , Walji S. , Göertz J. H. C. , Bakkeren J. A. J. M.
Published: December 2005

Abstract Oral bacteria play an important role in the causation of oro‐facial abscesses. However, they can also be involved in brain, liver and lung abscesses. To persist, it is essential that these bacteria can grow on those sites. The main source of nutrients for growth in abscesses is likely to be tissue exudate, which is rich in serum‐derived proteins, and relatively poor in free amino acids and carbohydrates. Degradation of intact proteins seems a crucial step in providing the pep‐tides necessary for energy generation. The aim of this study was to investigate the capacity of microorganisms from asscesses to degrade serum proteins, in particular immunoglobulins. To this end, samples were taken by aspiration from 16 odontogenic abscesses. It was found that pus from abscesses differed strongly in the concentration of viable bacterial cells. The ability of the abscess microflora to degrade serum proteins was investigated after growth of the sample in heat–inactivated human serum. The microflora from abscesses with a high concentration (n= 10) of bacteria strongly degraded immunoglobulins, whereas breakdown of immunoglobulins was virtually absent after growth of the microflora from low–bacterial concentration (n= 6) abscesses. Bacteriological analyses revealed the presence of at least one proteinase‐producing species, like Porphyromonas, black‐pigmented Prevotella species, or Actinomyces meyeri, in abscesses with a high density of bacteria, but not in those with low bacterial density. The results indicate that the capacity lo degrade intact proteins, in particular immunoglobulins, is a major determinant of bacterial growth in abscesses.
Evaluation of the frequency of HLA determinants in patients with gingival overgrowth induced by cyclosporine‐A
Authors: Cebeci Irfan , Kantarci Alpdoǧan , Firatli Erhan , Aygün Selvi , Tanyeri Hakki , Aydin Ali Emin , Carin Mahmut , Guç Ulker , Tuncer Özen
Published: December 2005

Abstract This study has been designed to investigate the immunogenetic susceptibility of Cyclosporine‐A (CsA) immunosuppressed renal transplant patients to development of gingival overgrowth, and the amplifying effect of calcium channel blockers on the severity of this clinical entity. 52 renal transplant recipients were selected and initially grouped as follows: group (Gp)1: CsA (n= 7); Gp 2: CsA + verapamil (n= 26); Gp 3: CsA + diltiazem (n=6); Gp 4: CsA + nifedipine (n=13). These groups were not found to be significantly different in age, sex. plaque index (PII). gingival index (GI). calculus index, periodontal probing depth, serum CsA level, or duration of CsA therapy (p > 0.05). No significant (p >0.051 additive effect of the calcium channel blockers on the gingival overgrowth (GO) was assessed. The main group (n=52) was evaluated for the correlations between the clinical and the pharmacological variables and the GO. GI (rs=0.60) and the periodontal probing depth (rs = 0.71) were found to be moderately correlated with the GO. The patients were regrouped based on the severity of overgrowth and recognized as responders (n=26) and nonresponders (n=26). Age, sex, calculus index, serum CsA level, duration of the CsA therapy, were not statistically different among these groups (p >0.05). PII, GI, periodontal probing depth, and GO were significantly higher in the responder group (p > 0.05). Analysis of HLA distribution of the responders and the nonresponders and comparison with the controls (n= 3731) revealed that a statistically significant (p<0.001) % of the nonresponders were positive for HLA‐DR1. These data would indicate that an immunogenetic predisposition should be suspected in the pathogenesis of the entity, and that HLA‐DR1 would have a protective rôle against gingival overgrowth induced by CsA.
Transient effect of a short‐term educational programme without prophylaxis on control of plaque and gingival inflammation in school children
Authors: Ivanovic M. , Lekic P.
Published: December 2005

Abstract The development of chronic inflammatory periodontal diseases is strongly correlated with the growth and maturation of subgingival bacterial colonies. Consequently a major preventive goal should be the control of plaque formation. We conducted a randomized, controlled trial to examine the short‐term effect of an intensive instructional program without professional prophylaxis on the gingival health of 240. 11‐14 year old school children. Plaque index (P1I), gingival index (GI), bleeding index (BI) and probing pocket depth (PD) were examined 4 × by 1 examiner blinded to the instruction. During the period of instruction, subjects in the experimental groups were involved in a plaque and gingivitis prevention program provided in separate educational sessions. One of the experimental groups (E‐l: n=80) was provided with a new toothbrush, toothpaste and instruction while the second experimental group (E‐2: n=80) was provided with toothbrush, toothpaste, dental floss and instruction. In the control group (C; n=80) only dental examinations were provided: no preventive program or oral health measures were conducted. Examinations were conducted every 3 months during the instructional period and at 6 months following the completion of the active preventive programme. During the experimental period there was a significant decrease (p<0.001) in the mean P1I. GI and BI of the experimental groups following the program while in controls there was a slight but not significant increase of mean values (p > 0.05). During the preventive program experimental groups exhibited small but not significant (p > 0.05) reductions of PD. Experimental group 1 showed similar PH. GI. BI and PD scores as experimental group 2 during the study. After the instructional program was completed and a period of 6 months had passed, there was a large and significant (p < 0.001) increase of mean P1I. GI and BI scores in both experimental groups back to the baseline levels. We conclude that a short‐term preventative program without professional instrumentation induces a transient improvement of gingival health of schoolchildren but only during the instructional period. The maintenance of improved gingival health over longer time periods requires prolonged, repeated instruction by professionals. These measures may be difficult to institute and are of questionable cost‐effectivness.