bluuebunny/crossref_metadata_2025 huggingface dataset:
A new measure of teeth‐cleaning efficiency and periodontal disease
Authors: Maizels Alfred , Sheiham Aubrey
Published: December 2005

Abstract This paper presents a new measure of teeth‐cleaning efficiency based on information from a random sample of 400 factory employees and a separate (non‐random) sample of some 400 skilled manual workers and their wives. Regression analysis showed that only 1/3 of the variance in calculus levels in the random sample was explained by age, frequency of visits to a dentist, socio‐economic group and smoking habits (other variables tested ‐ gender, date of last dental visit, frequency of teeth‐brushing and sugar consumption ‐ were not significant). The corresponding regression for the skilled manual sample gave a broadly similar result, though the proportion of explained variance (1/5) was lower than for the random sample. These results indicated the presence of one or more additional factors, of which teeth‐cleaning efficiency is likely to be the most important. A new measure of cleaning efficiency was then constructed by expressing the actual calculus level as a proportion of the level estimated from the regression equation, and deducting this proportion from unity.

If this new measure is, indeed, a genuine indicator of teeth‐cleaning efficiency, then one should expect it to be an important element in an explanation of the level of periodontal disease, but not of dental caries (which is a resultant essentially of dietary habits). This hypothesis was tested and confirmed by multiple regression analysis. Though the new measure of teeth cleaning efficiency is essentially experimental, and has yet to be validated by clinical testing, the results strongly suggest that efficient cleaning can have a major beneficial impact on the level of periodontal disease, thus underlining the importance which effective dental health education could have in reducing the level of this disease.
The effect on healing of the application of citric acid during replaced flap surgery
Authors: Moore J. A. , Ashley F. P. , Waterman C. A.
Published: December 2005

Abstract The aim of this double‐blind controlled clinical trial was to assess the effect on healing following conditioning the root surface with citric acid during replaced flap surgery. Healing was assessed in 18 pairs of sites in 12 patients before surgery and after 3 months; healing was also assessed in 13 pairs of these sites in 10 of the patients after 9 months. During surgery, the root surface at 1 site from each pair was treated with citric acid pH 0.6 for 3 min and the contralateral site was exposed to sterile saline. Healing was assessed by measuring attachment levels, probing depths and recession; in addition, gingival crevicular fluid flow‐was measured, as was the degree of bleeding on probing. The mean gain of attachment (mm) in the acid and control groups were 1.0 and 1.2. respectively, at 3 months and 1.1 and 0.9 respectively, at 9 months. The results of this study indicate, both clinically and statistically, that the difference in healing between the acid and the non‐acid sites is not significant. Thus no additional benefit is shown by using citric acid in conjunction with replaced flap surgery on anterior teeth.
Computerized evaluation of the effectiveness of subgingival scaling in jaw models
Authors: Lie Tryggve , Hoff Ivar , Gjerdet Nils Roar
Published: December 2005

Abstract The purpose of the present study was to improve the quality and the effectiveness of subgingival scaling managed by dental students. A training program was developed and the scaling was performed in jaw models. The teeth of these models were modified in order to ensure a quick inspection of the scaled root surfaces. Artificial “calculus”, consisting of a mixture of shellac, umbra, pumice and plaster dissolved in ethanol, was painted on the root surfaces. Following the completion of the scaling test, remaining “calculus” was evaluated by adoption of a grading system. This system had scores from 0 to 3 and was defined by illustrated and described criteria. A menu‐directed computer program was developed in order to ensure a rapid transformation of surface scores into clinically‐related variables. The output from this program gave valuable information about the proficiency of individual students, as well as about the whole class of students as one body. Other advantages and potentials of this system are described.
The effect of 2 teaching programs on the gingival health of 15‐year‐old schoolchildren
Authors: Søgaard Anne Johanne , Tuominen Risto , Hoist Dorthe , Gjermo Per
Published: December 2005

Abstract The present study evaluated the effect of 2 different dental health education programs on schoolchildren's gingival health and identified the subgroups best reached with these programs. The traditional program was the same as the yearly recurrent Dental Health Week (DHW) ‐ comprising an informational package submitted to the teachers. The comprehensive program was in addition to the DHW‐package, based on principles in social learning theory and research. Data from 15 schools in 5 municipalities, comprising 1167 students, were used. 1/3 of the children made up a reference group. Each subject was clinically examined 3 weeks before and 3 weeks after the intervention, and rated by using the non‐bleeding papillae index (NBP). A questionnaire was completed by each of the 15‐year‐olds at the time of the second examination. The overall increase in NBP‐index scores was from 38.9% to 43.1% in the traditional program and from 45.4% to 52.1% in the comprehensive one. The difference between the programs was not significant. After adjusting for social status variables, sex and initial bleeding, an effect of the comprehensive program appeared (p < 0.01). The strongest effect of the comprehensive program was found among the schoolchildren with poor initial gingival health. Our findings support the theory of active participation, visualization and involvement of parents.
Longevity: a critical factor in evaluating the effectiveness of periodontal therapy
Authors: Moskow Bernard S.
Published: December 2005

Abstract A 47‐year‐old male patient with an advanced form of adult periodontitis presented for evaluation and treatment in 1963. There were several angular bony lesions and 3 molar teeth had an extremely questionable prognosis. The patient was treated by scaling, root planing and gingivectomy, with no attempt to alter the existing morphology of the effected alveolar bone. 23 years following periodontal therapy, there were marked changes of the contour of the marginal bone crest throughout, minimal pocket depth and acceptable gingival form. The patient was seen at regular 5–6 months intervals for maintenance therapy and his home care regimen was exemplary. Advanced cases of periodontitis can be treated successfully by simplistic methods if the “repair potential” of the patient is good and if regular maintenance visits and meticulous plaque control are carried out.
A clinical, demographic and microbiologic study of ANUG patients in an urban dental school
Authors: Falkler W. A. , Martin S. A. , Vincent J. W. , Tall B. D. , Nauman R. K. , Suzuki J. B.
Published: December 2005

Abstract 35 ANUG patients were examined and compared clinically and demographically. Plaque removed from ulcerated sites in 20 patients was cultured using quantitative anaerobic procedures and examined by electron and darkfield microscopy. Patients were classified as having ANUG when presenting with ulceration and necrosis of interproximal papillae, pain and bleeding. The clinical symptoms of fetid odor, pseudomembrane formation, lymphadenopathy and elevated body temperature were present in 97%, 85%, 61% and 39% of the ANUG patients, respectively. 83% of the patients were smokers. The ANUG patients demonstrated a lower average age (24 years) than the general clinic population (32 years). There was a slightly higher % of male (54%) than female (46%) and the % of Caucasian (51%) and black (49%) ANUG patients were almost equal. Cultural studies revealed that gram‐negative rods were the predominant cultivable micro‐organisms present in the plaque, representing 78.2% of the total recoverable count. Of these, nearly half were strict anaerobes with Bacteroides gingivalis and Fusobacterium nucleatum accounting for 7.8% and 3.4%. respectively. Anaerobic and facultative gram‐positive cocci (15.5%), gram‐negative cocci (3.5%) and gram‐positive rods (2.8%) were also isolated. Microscopic analysis of the morphologic composition of plaque revealed that rods (43%) constituted the greatest % of the total microorganisms observed followed by spirochetes (30%) and cocci (27%). 8 distinct types of spirochetal periplasmic flagellar arrangement were observed by electron microscopy, the “2‐4‐2” periplasmic flagellar arrangement being most numerous.
Clinical and microbiological effects of fixed orthodontic appliances
Authors: Diamanti‐Kipioti Anthoula , Gusberti Francesco A. , Lang Niklaus P.
Published: December 2005

Abstract The purpose of this clinical and microbiological study was to evaluate longitudinally the changes occurring in the sub gingival microbiota in children following the placement of orthodontic bands in the absence of a prophylactic oral hygiene program. A total of 12 children in the age between 10 and 15 years were selected for the study. The experimental group (E) consisted of 6 subjects scheduled for orthodontic treatment including the placement of fixed appliances. They were seen 1 week before and just prior to the placement of orthodontic bands. The control group (C) involved 6 children in the maintenance phase of orthodontic therapy in which removable retainers were used. All subjects were examined at 3–5 week intervals for a period of 4 months. At each examination, microbiological sub gingival plaque samples were collected by means of sterile paper points. Plaque and gingival index scores as well as pocket probing depth at the site of sampling were determined. The microbiological samples were processed using continuous anaerobic culturing techniques and were plated on non‐selective and selective media. Differential counts and biochemical characterization of isolates were performed according to the methods described by Kornman and Loesche. Following tooth‐banding, an increase in pocket probing depth was observed, while the P1I and GI scores remained unaffected. A statistically significant increase from baseline values (p<0.05) was found for the %s of black‐pigmented bacteroides, the B. intermedius and A. odontolyticus species, concomitantly with a decrease of the anaerobe/facultative bacteria ratio in the experimental, but not the control sites. These results document the potential of subgingivally placed orthodontic bands in changing the sub gingival ecosystem in subjects without special oral hygiene instructions favoring the dominance of periodontopathic micro‐organisms.
Periodontal conditions of teeth adjacent to extraction sites
Authors: Grassl Markus , Tellenbach Roger , Lang Niklaus P.
Published: December 2005

Abstract The purpose of the present clinical study was to evaluate the effect of tooth extractions on the periodontal conditions of adjacent teeth. 40 patients were selected for the study. Prior to the extractions, baseline data of the adjacent teeth were obtained. Plaque (PII) and gingival indices (GI), pocket probing depths and probing attachment levels were scored. In addition, the alveolar bone height was determined radiographically in relation to the CEJ adjacent to the extraction sites. The contralateral side of the jaw. where no tooth had to be removed, was examined as a control. A limited hygienic phase (scaling and root planing of all surfaces examined) was performed immediately prior to the extractions. Using the same parameters, all sites were reexamined 2–4 months and 6–9 months following the extractions.

After the hygienic phase, the teeth adjacent to the extraction sites indicated a decrease in the pocket probing depths by 0.5 to 1.5 mm. In shallow pockets (1–3 mm), this decrease was less pronounced than in moderate to deep pockets (4–9 mm), where it was composed of shrinkage of the gingival tissues and gain of probing attachment. The radiographic level of the bony alveolar crest in relation to the CEJ of the adjacent teeth was not altered by the extraction procedure. The oral hygiene performances of the patients were not influenced during the 9‐month observation period. Therefore, neither PII nor GI scores showed relevant improvements. Although the extraction had n beneficial effect on the periodontal conditions of the adjacent teeth, decisions for or against removing teeth for periodontal reasons must be made in the light of a comprehensive treatment plan and on the basis of individual patient considerations.
Effect of folate on phenytoin hyperplasia
Authors: Drew Howard J. , Vogel Richard I. , Molofsky Walter , Baker Herman , Frank Oscar
Published: December 2005

Abstract There have been some reports that folic acid inhibits phenytoin‐induced gingival hyperplasia. The purpose of this double‐blind study was to quantify clinically the effects of both systemic and topical administration of folic acid on phenytoin‐induced gingival overgrowth in man. For a period of 6 months, one group of phenytoin patients received 2 daily topical applications of a folate solution. An additional group received 2 daily doses of systemic folate while a control group received placebo medication. Results indicate that throughout the 180‐day period of the study, the topical folate significantly inhibited gingival hyperplasia to a greater extent than either systemic folate or placebo groups.
The effect on early plaque formation, gingivitis and salivary bacterial counts of mouthwashes containing hexetidine/zinc, aminefluoride/tin or chlorhexidine
Authors: Hefti Arthur F. , Huber Brigitte
Published: December 2005

Abstract This study was designed to investigate the effectiveness of mouthwashes containing hexetidine/zinc (HZA) or tin (ASF) in inhibiting plaque formation and gingivitis in humans. 24 dental students and assistants participated in the study (latin square design) with 7‐day test periods. They rinsed twice daily for 1 min with one of the following formulations: HZA = 750 ppm hexetidine/750 ppm zinc acetate, ASF = 100 ppm aminefluorid/310 ppm stannous fluoride, CHX=0.1% chlorhexidine and M = negative control. Plaque accumulation was determined planimetrically and gravimetrically. Gingivitis was evaluated with the papillary bleeding index. Total colony forming units and S. mutans counts were estimated from saliva samples.

The results showed that HZA and CHX almost completely inhibited plaque accumulation and gingivitis. ASF was less effective than HZA and CHX but still reduced plaque significantly compared to the negative control. Furthermore. CHX reduced salivary S. mutans counts.
The choice of computational unit in the statistical analysis of unbalanced clinical trials
Authors: Osborn John
Published: December 2005

Abstract Clinical periodontal research often involves the treatment of patients who have disease at several sites in the mouth. Should the units of analysis he the patients, the sites, or a combination of both? These strategies are explored and a worked example given.
On the bias caused by regression toward the mean in studying the relation between change and initial value
Authors: Blomqvist Nils
Published: December 2005

Abstract In studies of treatment effects in clinical trials and longitudinal follow‐up investigations, it is not unusual to inquire as to whether a relationship exists between the change of a variable and its initial value, for example pocket depth. Such studies must be carried out with great care, since the results are biassed by the regression towards the mean (RTM) effect. Examples are presented, the magnitude of the RTM effect is estimated and means of dealing with the RTM problem are discussed. RTM also appears as a selection phenomenon, emphasizing the need to include control groups in order to make possible adjustments for the bias caused by RTM.
Attachment loss in primary molars
Authors: Keszthelyi G. , Szabó I.
Published: December 2005

Abstract The view that primary teeth are only rarely affected by periodontitis has been generally adopted. The aim of the present work was to measure attachment loss and to establish its prevalence. Severity and distribution in stained, extracted primary molars. The material consisted of 4 groups of 50 teeth each: first and second upper and first and second lower primary molars. Teeth were selected to fulfill 2 criteria: (1) a carious cavity not extending beyond the cemento‐enamel junction and involving only 1 of the proximal surfaces, the other 3 surfaces being sound: (2) root resorption, if present, not affecting more than the apical third of the roots. The teeth were stained in 1 % aqueous crystal violet and examined under a stereomicroscope fitted with an ocular micrometer. The distance between the cemento‐enamel junction and the most coronal attachment fibres was measured in the mid‐line of each surface. Attachment loss was found in 94% of the teeth and on ⅔ of the surfaces. This indicates that periodontitis in primary teeth is not a rare phenomenon. The mean loss of attachment was 0.26±0.32 mm, which cannot be regarded as clinically important. The maxillary molars and the first molars, and, the proximal surfaces showed more loss of attachment than did the mandibular molars and the second molars, and the buccal and lingual surfaces taken together. This pattern of attachment loss is similar to that seen in permanent molars. On the carious proximal surfaces, significantly more attachment loss was noted than on the sound proximal surfaces.
Neutrophil chemotaxis in refractory cases of periodontitis
Authors: Oshrain Herbert I. , Telsey Bernard , Mandel Irwin D.
Published: December 2005

Abstract Refractory cases of periodontitis were assayed for chemotaxis of polymorphonuclear neutrophilic leukocytes using an in vivo assay. 9 refractory patients and 9 normal patients were studied. When cell counts were plotted against time, normal patients showed a single peak at 25–30 min after casein (chemo‐attractant) challenge, whereas refractory patients showed 2 and 3 peaks of PMN's at varying time intervals. 5 of the refractory patients showed this pattern in tests of normal sulci as well as deep periodontal pockets. 4 of the refractory cases showed a double peak in tests of deep periodontal pockets. This suggests that some refractory cases have an intrinsic chemotactic defect of polymorphonuclear neutrophils while in others the defect may be a secondary phenomenon. It appears that patients with refractory periodontitis have the characteristic cell response that was reported for LJP.
Electrosurgery – a biological approach
Authors: Krejci Robert F. , Kalkwarl Kenneth L. , Krause‐Hohenstein Udo
Published: December 2005

Abstract Electrosurgery has been used in dentistry for more than 50 years. Both opponents and advocates of electrosurgery have presented a variety of clinical studies in favour of their respective opinions, which are discussed in the following review. In some studies, wounds created by electrosurgical techniques were observed through the healing stages, in comparison to those following incision by a surgical blade, with no significant difference being discovered. Other studies reported that the histologic response of oral connective tissue to electrosurgery was adverse in some animal and human models. However, neither of these groups used methods that allowed documentation or control of operating variables. A critical evaluation of controlled clinical studies shows that adverse responses of (connective) tissue, epithelium, bone, cementum, and periodontal attachment are related to an excessive lateral heat production during the procedure. With electro surgery, the clinician can control the inherent variables. Waveform, frequency, size of the electrode, time of contact and cooling periods are some of those considered to be of importance in the studies. On the basis of the research reports, clinical guidelines have been developed to give practical advice to the clinician using electrosurgery. Providing that these safeguards are adhered to, scientific evidence supports the biological compatibility of electrosurgery for intraoral surgical procedures.
Juvenile periodontitis: an epidemiological study in the west Midlands of the United Kingdom
Authors: Saxby M. S.
Published: December 2005

Abstract The prevalence of juvenile periodontitis was studied in a sample of 7266 school children in the cities of Coventry arid Birmingham. The subjects were aged 15 to 19 years, and represented the range of different ethnic groups seen in the population of the West Midlands. A two‐stage diagnostic procedure was used, whereby subjects were screened initially by assessment of probing depths around the incisors and first molars. Positive subjects were then diagnosed definitively by full clinical and radiographic examination. In both Coventry and Birmingham, there was an overall prevalence of juvenile periodontitis of 0,1%, with 95% confidence, which gives a range between 0.03 and 0.17‐ There was a highly significant difference in prevalence between ethnic groups, with overall prevalence figures of 0.02% for the Caucasian group, 0.8% for the Afro‐Caribbean group and 0.2% for the Asian group. There was no difference in prevalence between male and female.
The comparative effects of azathioprine and cyclosporin on some gingival health parameters of renal transplant patients
Authors: Seymour R. A. , Smith D. G. , Rogers S. R.
Published: December 2005

Abstract The periodontal health of 24 adult renal transplant patients was investigated in a longitudinal study. Post‐transplant patients were receiving either azathioprine or cyclosporin to prevent graft rejection. No significant difference (P>0.05) was observed for plaque scores on gingival inflammation, either between treatment groups or throughout the investigation period. However, patients on cyclosporin therapy had significantly more gingival hyperplasia and probing sites greater than 3 mm than those on azathioprine (p<0.05). In the cyclosporin group, u significant increase in hyperplasia and probing sites greater than 3 mm was observed at 3 and 6 months post‐transplant. A significant correlation (r8= 0.55, P<0.05) was observed between mean plasma concentrations of cyclosporin throughout (he 6–month investigation period and the increase in gingival hyperplasia. The finding from this study would suggest that azathioprine has no unwanted effects on the periodontal helath of post‐renal transplant patients. Cyclosporin therapy caused an increase in gingival hyperplasia, which may be related to plasma concentrations of the drug.
Development of gingivitis around different types of composite resin
Authors: van Dijken Jan W. V. , Sjöström Staffan , Wing Kenneth
Published: December 2005

Abstract Earlier studies have demonstrated signs of gingivitis around conventional composite resin restorations. Newly developed resin types differ considerably in composition and surface characteristics. The purpose of this study was to compare the initiation of gingival inflammation around aged restorations of 3 types of composite resins and around enamel, during a 7‐day period of experimental gingivitis. Plaque index, gingival index and crevicular exudate were registered at days 0 and 7. There was significantly less exudate around the intact enamel surfaces than around the composite fillings at both registration times. The plaque and gingival indices showed no significant differences among the composite resins and enamel. The results indicate that differences among the resins with regard to surface roughness and composition did not result in clinically measurable differences in the development of plaque and gingivitis.
Effect of sanguinaria extract on established plaque and gingivitis when supragingivally delivered as a manual rinse or under pressure in an oral irrigator
Authors: Parsons L. G. , Thomas L. G. , Southard G. L. , Woodall I. R. , Jones B. J. B.
Published: December 2005

Abstract Sanguinaria extract (sanguinaria) solutions were evaluated in 44 subjects in a 2‐week, no oral hygiene study as a 300 μg/ml manual rinse, and the results compared to supragingival irrigation with 22.5 μg/ml sanguinaria concentration and supragingival irrigation with water. Both the manual use of sanguinaria and supragingival irrigation of dilute sanguinaria produced significantly less plaque growth than supragingival irrigation with deionized water. In terms of % changes from baseline, manual rinsing and supragingival irrigation with sanguinaria limited plaque growth to 17.7% and 24.2%, respectively, while irrigation with water had a 51.5% growth. For gingivitis, control supragingival irrigation with sanguinarine and with water were statistically different from manual rinsing with sanguinaria. Compared to baseline, the groups irrigating with sanguinaria and with water had gingivitis reductions of 68.7% and 73.3%, respectively, while manual rinsing with sanguinaria had a 29.6% reduction. The results suggest that dilute solutions of sanguinaria delivered via rinsing or supragingival irrigation are effective in controlling plaque as an additional benefit to the use of supragingival irrigation to control gingivitis supragingival irrigation with sanguinaria as part of a home care routine for patients with plaque and gingivitis is suggested.
Effects of citric acid and fibronectin and laminin application in treating periodontitis
Authors: Smith B. , Caffesse R. , Nasjleti C. , Kon S. , Castelli W.
Published: December 2005

Abstract To determine the effect on new connective tissue attachment of citric acid conditioning and fibronectin‐laminin application in treating naturally occurring periodontitis, all 4 quadrants in each of 2 Beagle dogs were used. Each quadrant included: P2, P3, P4, and M1 teeth. 2 treatment modalities were employed and comparatively analyzed for differences in histological healing respponses at 120 days after surgery. The treatments were: (1) surgery (mucoperiosteal flaps) plus citric acid; (2) surgery plus citric acid followed by fibronectin‐laminin application. After scaling and root planing, coronal and root surface reference notches were placed for histometric measurements. Following each of the randomly assigned treatments, flaps were sutured. After sacrifice, tissue blocks of treated areas were decalcified and serially cut, obtaining bucco‐lingual and mesiodistal sections. Using a Filar micrometer. 5 distances were masured on the buccal aspect: (1) from root surface notch to alveolar bone crest; (2) from root surface notch to coronal extent of the cementum; (3) from root surface notch to apical extent of the junctional epithelium; 84) from free gingival margin to apical extent of junctional epithelium; (5) from the coronal notch to the alveolar bone crest. Results showed no differences among the 5 measurements between the 2 treatments tested. On mesiodistal sections, surface area determinations were made in the furcations, evaluating the space occupied by new connective tissue, with or without bone, or by epithelium. For this, images were digitized using a Zeiss IBAS Image analysis system with a 4mB of array processor memory coupled to a Newvicon TV camera and a microcomputer. Significant differences were found, with increased values for both regenerative connective tissue and bone when surgery plus citric acid was followed by fibronectin‐laminin application. Often, these tissues filled completely furcation areas above root surface reference notches.
Effect of nonsurgical periodontal therapy
Authors: Badersten Anita , Nilveus Rolf , Egelberg Jan
Published: December 2005

Abstract Individual sites with gain and loss of probing attachment were identified amongst 1688 proximal sites in non‐molar teeth from 49 patients monitored for 24 months following oral hygiene instruction and root debridement. The distribution of sites with gain and loss of probing attachment was studied within each of the 49 subjects, for each of the 10 different tooth types treated, for teeth with and without root canal fillings, for mesial and distal surfaces, and for surfaces with and without the presence of root con cavity/furcation involvement. Similarly, sites with gain and loss were related to the following measurements of the severity of the initial lesion; initial probing depth, radiographic bone score, depth of radiographic intraosseous defect, and radiographically widened periodontal ligament. The analyses indicated that subjects with a higher proportion of sites with probing attachment gain tended to have a lower proportion of sites with probing attachment loss. Sites with deep initial probing depth demonstrated a high incidence of gain and a low incidence of loss of probing attachment. All other investigated characteristics showed weak or no association with probing attachment change following therapy. This report indicates that the 24‐month outcome of plaque control and root debridement in proximal surfaces of non‐molar teeth is not compromised by the severity of the initial soft tissue or bony lesion.
Lipopolysaccharide (endotoxin) from individual periodontally involved teeth
Authors: Maidwell‐Smith M. , Wilson M. , Kieser J. B.
Published: December 2005

The amount of lipopolysaccharide (LPS) in the root surface‐associated material from individual periodontally‐involved teeth was found in the (surface material from all of the tee ranged from 19‐394 ng/tooth. No significant correlation was found between the associated with the tooth. However, a weak correlation(r=+ 0.0461, 0.05 > p > 0.01) was found between the amount of LPS and the % loss of attachment.
The influence of a dentifrice containing a zinc salt and a nonionic antimicrobial agent on the maintenance of gingival helath
Authors: Svatun B. , Saxton Ca. A. , van der Ouderaa F. , Rölla G.
Published: December 2005

The purpose of the present investigation was to test the concept that a dentifrice containing zinc citrate and Triclosan could maintain gingival health. The gingival health of 101 young predominately female student nurses in Oslo was brought to a high level by professional cleaning supported by oral hygiene instruction. The criterion of gingival health was ≤5 elicited bleeding sites from a full mouth assessment. The mean bleeding value attained for the whole group was 3.5. 2 balanced groups were formed, based on the initial number of elicited bleeding sites and plaque values. One group used the test dentifrice and the other group the placebo for 6 months, with an intermediate assessment after 3 months. The placebo group failed to maintain the standard of oral hygiene and gingival health that had been achieved by professional care. In contrast, the group using the test dentifrice for 6 months exhibited similar levels of plaque and gingival health to that observed at baseline following oral hygiene instruction. After 6 months. <7% of the subjects in the placebo group possessed healthy gingivae in contrast to 60% of the test group. Thus a dentifrice containing a zinc salt and nonionic germicide had successfully maintained gingival health in a group of young adults.
Bacteroides gingivalis, Bacteroides intermedius and Actinobacillus actinomycetemcomitans in human periodontal diseases
Authors: Slots Jergen , Listgarten Max A.
Published: December 2005

Abstract Bacteroides gingivalis. Bacteroides intermedius and Actinobacillus actinomycetemcomitans seem to be major pathogens in advancing periodontitis in man. First, these organisms are recovered in higher prevalence and proportions from progressive periodontitis lesions than from quiescent periodontal sites. Second, antibody levels against 6. gingivalis and A. actinomycetemcomitans are markedly elevated in serum and gingival crevice fluid of periodontitis patients compared to normal controls. Third. B. gingivalis and B. intermedius elaborate potent proteases and A‐ actinomycetemcomitans various noxious substances which have the potential to perturb important host defenses and to disintegrate key constituents of the periodontal tissues. Monitoring these bacteria in advanced periodontal lesions may greatly assist the assessment of treatment efficacy and risk of further periodontal breakdown.
A perspective on periodontal disease activity measurements*
Authors: Hausmann E. , Jeffcoat M.
Published: December 2005

Abstract Studies utilizing serial standardized periapical radiographs for measurements of alveolar bone height and for digital subtraction and changes in clinical probing attachment level have suggested that adult periodontitis may exhibit periods of exacerbation and remission at specific sites. The use of such serial examinations for the determination of disease activity must be interpreted with caution since the different methods for the assessment of disease activity have different levels of sensitivity and specificity and because such sequential methods integrate disease activity and do not provide an instantaneous measure of activity. An ideal test for disease activity would approach an instantaneous measure of disease activity and would not integrate activity over time.
Peripheral PMN cells in juvenile periodontitis
Authors: Åsman Bjöm
Published: December 2005

Abstract In 12 patients with juvenile periodontitis (JP), stimulation of peripheral polymorphonuclear neutrophils (PMN) by opsonized bacteria showed increased release of free oxygen radicals and of elastase activity in relation to that of pair‐matched healthy controls. The elastase increase was not associated with higher intracellular content of elastase, since the measurement of homogenized PMN cells did not differ between the patient group and the control group; nor did the spontaneous elastase activity of nonstimulated cells differ. Release of elastase by contaminating lymphocytes and platelets could be excluded, since no elastase activity from these ceils or interference by these cells could be demonstrated in the assay system used. When formyl‐methionyl‐leucyl‐phenylalanine was used as a stimulant, the chemiluminescence in the patient PMN cells did not differ with Statistical significance from their pair‐matched controls. The increased release of free oxygen radicals and of elastase seems to be a characteristic of the PMN cells in juvenile periodontitis, indicating hyperactive cells with possible pathogenic effects.
Evidence for a role of odontogenic epithelium in maintaining the periodontal space
Authors: Lindskog Sven , Blomlöf Leif , Hammarström Lars
Published: December 2005

Abstract Explants of enamel organ epithelium or squamous epithelium from the oral cavity were placed in experimental cavities in the root surfaces of extracted and subsequently replanted monkey incisors. Control cavities without explants were also prepared. After an observation period of 8 weeks, histological evaluation of the cavities originally containing odontogenic epithelium showed a reparative cementum layer on the dentine surface and islands of epithelium in the periodontal connective tissue in the experimental cavities. Bone was not found in the cavities and the alveolar bone had been resorbed around the epithelial islands to a distance corresponding to the periodontal space adjacent to the cavities. Control cavities and cavities originally containing squamous epithelium also showed repair with reparative cementum, but the alveolar bone had grown into the cavities not, however, into contact with the dentine surface. These findings indicate a physiological rôle for odontogenic epithelium, in particular the epithelial rests of Malassez in the periodontal membrane for maintaining the width of the periodontal space and preventing dento–alveolar ankylosis.
Periodontal ligament cell kinetics following experimental regenerative procedures
Authors: Aukhil I. , Iglhaut J.
Published: December 2005

Abstract The present study analyzed the cell kinetics in periodontal ligament (PDL) apical to curetted root surfaces following an experimental regeneration procedure. 3 mm of the buccal and interproximal bone was removed around the premolars and molars in 4 Macaca fascicularis monkeys. The exposed root surfaces were planed thoroughly. Before replacing the flaps, pieces of Millipore filter were attached to the crowns of 1 premolar and 1 molar in each quadrant to cover the exposed roots. The adjacent teeth had no physical barriers and served as control wounds. The treatment procedure in 4 segments and sacrifice of the monkeys were scheduled to provide observational periods of 1, 2, 3 and 7 days. 1 h before sacrifice, 3‐H thymidine was injected intravenously. Autoradiographs of buccolingual sections were prepared and the labelling index (LI) in the PDL apical to curetted root surface measured in 200 μm increments. The LI remained increased in the first 200 μm of the PDL in both the experimental and control wounds at all observation periods compared to similar zones on the unwounded lingual surfaces. The LI was highest in the first 200 μm zone and decreased to almost normal levels at about 600 μm frotn the curetted root surface. There were no statistically significant differences between the LI for the PDL apical to experimental and control wounds at all observation periods. The present findings suggest that following experimental regeneration procedures in monkeys, a very limited zone of the PDL apical to the wound acts as a source for cells migrating into the wound. Furthermore, there appears to be only 1 peak of activity in the premitotic label uptake by cells in the PDL and the eventual population of curetted root surfaces by cells may depend on the continued amplifying divisions of these cells.
Chemotherapeutic agents for controlling plaque and gingivitis
Authors: Mandel Irwin D.
Published: December 2005

Mandel ID: Chemotherapeutic agents for controlling plaque and gingivitis.

Abstract There has been a vigorous search for many years for chemical agents that could supplement or even supplant patient‐dependent mechanical plaque control and thus reduce or prevent oral disease. 5 categories of agents or approaches have been considered: (1) broad spectrum antiseptics, (2) antibiotics aimed at specific bacteria. (3) single or combinations of enzymes that could modify plaque structure or activity, (4) non‐enzymatic dispersing or modifying agents and (5) agents that could affect bacterial attachment. The success of these approaches can be evaluated clinically by the use of standard scoring methods for measuring plaque and gingivitis and their safety established by soft tissue and microbiologic examination. Antiseptic agents have received the bulk of the attention over the years. At present, only 2 antiseptics, the bis‐biguanide, chlorhexidine gluconate (Peridox) and a combination of phenol related essential oils (Listerine). have developed sufficient supporting data in 6–month (or longer) studies to gain the approval of the Council On Dental Therapeutics of the American Dental Association. On the basis of short‐term studies, cetylpyridinium chloride, zinc and copper salts, sanguinarine and octenidine warrant continued study as does stannous fluoride at an appropriate concentration. On the basis of current research, a new generation of more specific antibacterial agents that interfere with attachment to pellicle can be developed. It is hard to predict, however, that they will affect gingivitis, at least until there is more information on what specific organisms should be targétéd.
Drugs and the periodontium
Authors: Seymour R. A. , Heasman P. A.
Published: December 2005

Abstract The periodontium and periodontal disease activity can be affected by systemic drug therapy. Many drugs can have an adverse effect on the periodontium, i.e., gingival hyperplasia. Alternatively, some drugs can modify the inflammatory and immunological responses of the periodontal tissues to bacterial plaque. The aim of this review is to evaluate the effects of drug therapy on the periodontium and periodontal disease activity, and where possible, to relate such changes to the pharmacodynamics of the drugs considered. Drugs which have been reported to affect the periodontium can be categorised as follows: anti‐epileptics, immunosuppressants, corticosteroids, non‐steroidal anti‐inflammatory drugs and hormones. Those drugs whose pharmacodynamics are clearly established and which affect the rate of periodontal disease activity, may provide information on the mechanisms of periodontal destruction. Finally, the mechanisms of drug‐induced gingival hyperplasia (overgrowth) are discussed in relationship to the drugs' pharmacodynamics and pharmacokinetics.
Morphological changes in the attached and keratinized gingiva and gingival sulcus in the mixed dentition period
Authors: Bimstein Enrique , Eidelman Eliecer
Published: December 2005

Abstract A longitudinal study was undertaken to examine the changes in the sulcus probing depth, keratinized and attached gingiva during the mixed dentition period. 54 children aged 7 to 9 years at the first examination were examined twice, with an interval of 5 years. Sulcus probing depth and keratinized gingiva were examined at the buccal aspect of the incisors, and either right or left cuspids and posterior areas. The width of the attached gingiva was obtained by substracting the probing depth from the width of the keratinized gingiva. When compared to primary predecessors, the permanent teeth had a deeper probing depth, narrower attached gingiva and at the maxillary teeth, a wider keratinized gingiva. When a pennanent tooth was present at both examinations, there was a significant increase in width of the attached gingiva with a corresponding decrease in probing depth, and a slight beginning of an increase in the width of keratinized gingiva.

Previous and the present findings indicate that during the early years after eruption of the permanent tooth, an increase in width of the attached gingiva takes place, without occlusal migration of the marginal gingiva whereas, at later stages, this coronal migration takes place, concomitant to tooth eruption.
Attachment level measurements with a constant force electronic probe
Authors: Magnusson I. , Clark W. B. , Marks R. G. , Gibbs C. H. , Manouchehr‐Pour M. , Low S. B.
Published: December 2005

Abstract The purpose of the present investigation was to evaluate the reproducibility of probing attachment level measurements using a newly developed constant force electronic probe. The probing force was preset at 25 g (probe diameter 0.4 mm) and was connected to a computer through a variable differential transformer. The measurements were performed on 10 patients with minimal signs of periodontal disease, using individually made acrylic stents. When the probe was in place and a foot switch depressed, the measurement was stored on the computer to the nearest 0.1 mm. The measurements were performed by one periodontist and one hygienist during one visit, and were then repeated by the same periodontist and another hygienist during a second visit. The results showed high correlations between the periodontist and the hygienist during one visit, between the two visits for the periodontist, and between the two hygienists at two different visits. The subject threshold for attachment loss was calculated according to Haffajee and co‐workers, and was found to average 0.84 mm for the measurements performed by the periodontist and the hygienist during the same visit. For the periodontist during two separate visits and for the two different hygienists, the average threshold was 0.99 and 1.02 mm, respectively. Duplicate measurements were also performed by one periodontist at one visit on 10 patients with advanced periodontal disease. The average subject threshold for these patients was 0.60 mm. It may be concluded that with the constant force electronic probe, loss of attachment can be detected earlier than when conventional instruments are used.
Treatment of periodontal furcation defects
Authors: Gantes Bernard , Martin Michael , Garrett Steve , Egelberg Jan
Published: December 2005

Abstract A total of 30 mandibular, buccal class II furcation defects were treated in 22 subjects using a regenerative surgical therapy that included citric acid root conditioning and coronally positioned flaps secured by crown‐attached sutures. In addition, grafts of freeze‐dried, decalcified allogenic bone were placed in 16 of the 30 defects. The effect of the therapies was evaluated from a series of soft and hard tissue measurements. These measurements demonstrated notable improvement 12 months following therapy. On the average. 61% of the defect volume became filled with bone. 43% of treated defects were completely closed by bone fill. No difference was observed between defects treated with and without bone grafts.
Furcation topography of the maxillary and mandibular first molars
Authors: Svärdström Gram , Wennström Jan L.
Published: December 2005

Abstract The objective of the present study was to describe the topography of the furcation area of the maxillary and mandibular first molars. By using a photogrammetric method, the furcation areas of extracted teeth were plotted to obtain 3‐dimensional contour maps. By comparing the individual 10 drawings of the maxillary and mandibular first molars, respectively, some morphological characteristics of the furcation areas could be described. Accordingly, the study showed the complexity of the furcation areas with presence of a number of small ridges, peaks and pits forming a mixture of convexities and concavities.
Detection of high‐risk groups and individuals for periodontal diseases
Authors: Johnson N. W. , Griffiths G. S. , Wilton J. M. A. , Maiden M. F. J. , Curtis M. A. , Gillett I. R. , Wilson D. T. , Sterne J. A. C.
Published: December 2005

Abstract It is argued that the periodontal diseases can no longer be regarded as universally prevalent conditions to which all members of the world's population are at equal risk if they fail to practise good oral hygiene. Rather, they should be regarded as a range of different diseases for each of which certain individuals, which together comprise certain minority groups, are at relatively high risk. The epidemiological evidence for the existence of high‐risk groups is reviewed, from which it is concluded that world‐wide the prevalence of severe destructive periodontitis is of the order of only 7–15% of the adult dentate population. A working classification of the different types of gingivitis and periodontitis is offered, as is a summary of the theoretically possible approaches to the detection of high‐risk groups and individuals which are explored in detail in subsequent papers. Successful identification of such individuals will permit scientifically valid, rational and targetted prevention and treatment.
Root surface debridement – an in vitro assessment
Authors: Cheetham W. A. , Wilson M. , Kieser J. B.
Published: December 2005

Abstract Root planing has been advocated to render periodontally involved root surfaces ‘biologically compatible’ with the surrounding soft tissues and thus promote healing. However, recent work has shown that only small amounts of cytotoxic material are likely to be incorporated within the root surfaces, thereby questionning the rationale for the traditional emphasis that is placed upon the removal of ‘diseased cementum’. This investigation assessed by limulus amoebocyte lysate (LAL) assay and Polymyxin B affinity chromatography the extent of residual lipopolysaccharide (LPS) following root surface instrumentation in vitro. A conservative regime was carried out, consisting of 15 instrument strokes per surface designed to ensure complete overlapping of the strokes. This harvested varying amounts of LPS from 18 single‐rooted teeth while leaving behing less than 0.24 ng of LPS per tooth in the majority (72%) of cases. This finding endorses the growing belief that extensive root planing may not be warranted.