bluuebunny/crossref_metadata_2025 huggingface dataset:
The result of periodontal treatment in relationship to various background factors
Authors: Glavind Leif
Published: December 2005

Abstract The aim of the present study was to investigate (1) whether various background factors of patients play a role for the result of periodontal treatment and (2) whether their attitudes towards prevention change during treatment. The study was carried out as a retrospective analysis using data obtained during periodontal treatment of 143 patients. The result of the treatment was assessed by the recording of presence or absence of gingival bleeding by probing prior to treatment and after 3, 6 and 12 months. The background factors were assessed by letting the patients answer a questionnaire about their dental history, tooth cleaning habits and knowledge about their own dental health situation. Moreover, they responded to statements regarding their attitudes to and general knowledge about prevention of dental diseases. 89 of the patients were asked again 3 months later to respond to these statements. After treatment, 3 groups were formed on the basis of the 12‐month gingival score: (1) a successful treatment group (S) comprising 79 patients with a gingival bleeding score of 20% or less, (2) a non‐successful treatment group (N) comprising 49 patients with more than 20% tooth surfaces showing bleeding and (3) a drop‐out group (D) of 15 patients who did not appear for the 12‐month examination. No statistically significant difference was found in the various background factors of patients with a successful or a non‐successful treatment result. However, dropping out showed a significant relationship to infavorable dental beliefs and young age (P < 0.005). Following treatment, the patients responded more favorably to statements about oral hygiene as a preventive means.
Subgingival microflora in bleeding and nonbleeding pockets
Authors: Baab D. A. , Opsvig E. J.
Published: December 2005

Abstract The subgingival flora of bleeding and nonbleeding 4–6 mm pockets was investigated using phase‐contrast microscopy. Subgingival plaque was sampled from 11 patients with generalized moderate periodontitis. 4 subgingival samples were obtained from each patient, 2 from sites that bled upon standardized probing force and 2 from sites that did not. The amounts of gingival inflammation, supragingival plaque, attachment level and pocket depth were also assessed at each site. The %s of 4 bacterial morphotypes were assessed using phase‐contrast microscopy.

No significant differences were found in the %s of cocci, motile rods, or spirochetes between bleeding and nonbleeding sites. Significant correlations were found, however, between the % of spirochetes and probing depth, attachment level, and gingival inflammation. The observations indicate that the use of bleeding on probing may not be justified as an indicator of infection by those “periodontopathic” bacteria identifiable by phase‐contrast microscopy. However, limitations in the microscopic method may have prevented us from observing differences between the 2 types of sites on a species level.
Treatment of the periodontal component of Papillon‐Lefèvre syndrome
Authors: Tinanoff Norman , Tanzer Jason M. , Kornman Kenneth S. , Maderazo Eufronio G.
Published: December 2005

Abstract A 9‐year‐old girl was treated for the periodontal component of Papillon‐Lefevre syndrome, an autosomal recessive disease characterized by palmar‐plantar hyperkeratosis and premature loss of teeth. Initially, the patient was found to have a polymorphonuclear leukocyte chemotactic dysfunction, defective leukocyte adherence, and deep periodontal pockets harboring presumptive periodontopathic bacteria. After unsuccessful treatment with combined mechanical therapy and 2 different antibiotics, all of the patient's erupted teeth were extracted in an attempt to minimize the chance of infection of teeth yet to erupt. At age 16 years, the now‐erupted teeth have normal gingiva and crevice depths, radiographs show no evidence of periodontal pathology, no periodontopathic bacteria are detected in gingival crevices, and leukocyte function is normal.
The occurrence of gingival brushing lesions during 3 phases of the menstrual cycle
Authors: Niemi Maija‐Liisa , Ainamo Jukka , Sandholm Leena
Published: December 2005

Abstract Since hormonal changes during the menstrual cycle may alter the vulnerability of the female gingiva, the present study was undertaken to investigate whether there are any differences in the number of toothbrushing lesions occurring during different phases of the menstrual cycle. 45 women of 20–35 years of age and with healthy gingiva were examined for overt signs of gingival laceration or ulceration. Such signs were recorded as a brushing injury. Dental plaque was assessed using the visible plaque index (VPI) and gingival inflammation using the gingival bleeding index (GBI). The examinations were made on the 1st day of menstruation (MD), on the estimated ovulation day (OD), and on the day with the predominance of progesterone secretion (PD). The examinations were made during 1–3 menstrual cycles for each individual; the study includes 78 cycles.

No statistically significant differences were found between the numbers of brushing injuries on the 3 days of examination (MD, OD & PD). During PD, a significantly positive correlation (p < 0.01) was observed between VPI and GBI scores, but on OD and MD, the correlations were highly significant (p < 0.001). A weak significant positive correlation (p < 0.05) was found between GBI scores and the number of brushing injuries on the 1st day of menstruation, while during other phases of the menstrual cycle, no such correlation was found. The present study gave little evidence that the hormonal status of women could be of clinical significance in the development of soft tissue trauma from habitual toothbrushing.
Periodontal attachment responses to surgical injury in the cat*
Authors: Tal Haim , Stahl S. Sigmund
Published: December 2005

Abstract Recently, PDL progenitor cells were claimed essential for the establishment of new connective tissue attachment to root surface. To further test new periodontal attachment after surgical injury, portions of the buccal alveolar plate were removed from the canines of 4 cats. Removal of bone was carried out with or without removal of the underlying PDL, and in half of the experimental sites, dental amalgam was placed at ligament periphery. Tissue blocks were prepared for routine histologic evaluation (H & E) and specific collagen stains (Mallory Trichrome and Mallory PATH). Exfoliation of amalgam was noted in 6 experimental sites during the healing period. At all sites, plaque accumulation and marginal gingivitis were observed before sacrifice. Histologic observation demonstrated limited new connective tissue attachment to root surfaces at PDL periphery where bone, PDL and cementum had been removed. Where PDL was retained, connective tissue attachment was present which appeared to be the result of fiber interdigitation between root‐inserted fiber ends and gingival wound edge fibers. “Blockage” of PDL cell migration by amalgam could not be well controlled. However, the placement of amalgam seems to have interfered with new connective tissue attachment and/or cementogenesis. In 5 specimens, root resorption had progressed into dentin. At these sites, collagen tufts appeared to arise from dentin. These tufts were in intimate contact with zones of dense inflammatory cellular infiltrate and connective tissue elements. We suggest that this observation may be a further tissue response to injury, namely: root resorption with the unmasking of dentinal collagen, which may finally lead to fiber interdigitation.
Effectiveness of children's habitual toothbrushing
Authors: Honkala E. , Nyyssönen V. , Knuuttila M. , Markkanen H.
Published: December 2005

Abstract Individual toothbrushing habits are usually consistent. Frequency, pattern and duration are different aspects of the toothbrushing habit. The aim of this study was to analyze the effect of habitual toothbrushing in children. The schoolchildren (n= 110) aged 13, were examined clinically before and after brushing their teeth in the habitual way; the brushing procedure was filmed without the children's knowledge. From the film, the pattern of brushing was assessed by three dentists, and the duration measured in seconds. Frequency of toothbrushing was assessed by postal questionnaire 2 months after the clinical examination. The examination included both photographed plaque and disclosed plaque diagnosed clinically. From the photographs, plaque was measured by computer planimeter as a % of plaque area and clinically by the oral debris index recommended by WHO. Subjects who had little plaque before toothbrushing were excluded from the analyses. Frequency seemed to affect plaque removal only in boys and only in the maxillary teeth. The pattern affected plaque removal in girls, but for boys, this aspect of toothbrushing affected only the left side of the jaws. Duration had produced the strongest effect on plaque removal. Therefore, duration of toothbrushing should be emphasized more in dental health education.
The effect of mouthririses on parameters characterizing human periodontal disease
Authors: Wennström Jan , Lindhe Jan
Published: December 2005

Abstract The objective of the present clinical trial was to assess the efficacy of mouthwashes containing antiseptic agents on established and developing plaque and periodontal disease in adult subjects using a newly described clinical research model. The study was carried out in 21 patients with periodontal disease. At the baseline examination, all tooth surfaces‐sites were studied with regard to dental plaque, gingivitis, bleeding on probing to the base of the pocket and probing pocket depths. The patients were subsequently randomly assigned to 1 of 3 groups, each consisting of 7 individuals. Group A rinsed with a 0.01% solution of Sanguinarine, group B rinsed with a 0.2% solution of chlorhexidine and group C rinsed with a placebo solution. No instructions regarding mechanical plaque control measures or information regarding the etiology and pathogenesis of periodontal disease were given to any of the patients during the course of the 6‐weeks of trial. The clinical examination was repeated after 2 weeks use of the mouthwash preparations. Following the re‐examination, all patients were subjected to scaling and root planing in 2 jaw quadrants chosen at random. After another 2 weeks, the 2nd re‐examination was performed and the teeth in the 2 remaining jaw quadrants were thoroughly scaled. The final examination was performed 2 weeks later.

During the 4 weeks of rinsing, without adjunctive professional mechanical debridement, the frequency distribution of plaque Index scores 2 + 3 did not change in the group of patients using the placebo solution, but was significantly reduced in both the chlorhexidine and the Sanguinarine groups. The gingival index scores and the probing depths were not, however, significantly affected by the 4 weeks use of any of the 3 mouthrinse preparations tested.

Professional debridement made the tooth surfaces free from plaque accumulations. In the placebo group, about 32% and 29% of the tooth surfaces received a PII score of 2 + 3 at the 2 and 4 week examinations, respectively. The corresponding figures for the chlorhexidine group were 2.4% and 2.8% and for the Sanguinarine group 9.6% and 8.1%.

The professional debridement markedly reduced signs of gingivitis. Compared to the baseline data, the frequency of gingival index scores 2 + 3 was after 4 weeks reduced by 55% in the Sanguinarine group and by 63% in the chlorhexidine group. The corresponding figure for the placebo group was 35%. For all 3 groups of patients, scaling and root planing resulted in the establishment of a larger number of shallow pockets and a lower number of deep pockets.
Probing considerations in relation to susceptibility to periodontal breakdown
Authors: Van der Velden U. , Abbas F. , Winkel E. G.
Published: December 2005

Abstract Both epidemiological and clinical studies indicate that not all individuals are equally susceptible to periodontal breakdown. Therefore, the clinical differences were investigated between subjects highly susceptible and subjects insusceptible to periodontal breakdown. The highly susceptible group consisted of patients with a diagnosis of juvenile periodontitis. The insusceptible group consisted of older individuals with gross amounts of plaque and no periodontal breakdown. Results indicated that a high value of the bleeding/plaque ratio may possibly act as a prognostic indicator for periodontal breakdown. However, longitudinal data are indispensable for substantiation of this hypothesis. Since longitudinal research takes many years, the experimental gingivitis model was chosen for further investigation. 4 groups of individuals were selected on the basis of a different history of inflammatory periodontal disease: 2 younger age groups without periodontal breakdown, having either a low or a high bleeding/plaque ratio—a hypothetically susceptible and a hypothetically insusceptible group, respectively; one older age group with presence of gross amounts of plaque, no periodontal breakdown and a low bleeding/plaque ratio—an insusceptible group; and an adult group who previously suffered from severe periodontal disease—a susceptible group. Results of the experimental gingivitis studies indicated that the older insusceptible group developed only small amounts of bleeding, whereas the younger hypothetically insusceptible group developed a comparable low bleeding index. The younger hypothetically susceptible group developed a much higher bleeding index comparable to that of the susceptible group, the periodontal patients. In conclusion, comparison of the results of the experimental gingivitis studies in subjects with differing histories of inflammatory periodontal disease supports the concept that the bleeding/plaque ratio may act as a prognostic indicator for periodontal breakdown.
Dark ground microscopy in relation to 3 clinical parameters of chronic inflammatory periodontal disease
Authors: MacPhee I. T. , Muir K. F.
Published: December 2005

Abstract This paper examines the relationships between 3 clinical parameters: pocket depth, gingival index, and bleeding index and 2 laboratory parameters: spirochaete counts and motility counts on the basis of analysis of 883 observations made in the mouths of 41 patients. The results were consistent with the findings of other studies in that deeper pockets tended to harbour higher %s of spirochaetes and motile organisms. The same overlap between all the parameters in general and between spirochaetes and pocket depth in particular as existed in our previous study was demonstrably evident. 8% of shallow pockets had spirochaete counts in excess of 20% and 79% of deep pockets had spirochaete counts of less than 20. 18% having no demonstrable spirochaetes. These results are consistent with those of our previous study and with the findings of Evian et al. that even in pockets of the order of 7 mm, the proportions of spirochaetes found varies from what may be expected at healthy sites to what may be expected at diseased sites.
Bacterial specificity in adult periodontitis
Authors: Slots Jörgen
Published: December 2005

Abstract 3 studies investigated the importance of Actinobacillus actinomycetem‐comitans, Bacteroides gingivalis and Bacteroides intermedius in progressive adult periodontitis. A total of 196 adults with advanced periodontitis and 475 periodontal sites were examined. The periodontal disease activity was assessed by changes in probing periodontal attachment level and crestal alveolar bone level. The composition of the subgingival microflora was determined by nonselective and selective culturing and indirect immunofluorescence of direct smears. A. actinomycetemcomitans occurred in 50% of progressing lesions and in only 6% of nonprogressing sites. B. gingivalis was detected in 42–52% of progressing lesions and in 14% of nonprogressing sites. The median B. gingivalis recovery in culture‐positive sites was more than 10‐fold higher in progressing than in non‐progressing sites. B. intermedius was recovered from 59–89% of progressing lesions and from 36–53% of nonprogressing sites. B. intermedius averaged 5–10 higher recovery in infected progressing lesions than in infected nonprogressing sites. 1 progressing lesion only failed to reveal any of the above organisms Assessment of the overall results indicates that A. actinomycetemcomitans. B. gingivalis and B. intermedius are major suspected pathogens in destructive periodontal disease in adults.
The combined effects of plaque and physical stress on periodontal tissues
Authors: Ericsson Ingvar
Published: December 2005

Abstract Experiments have been performed in beagle dogs in attempts to evaluate the effect of orthodontic‐ and jiggling‐type trauma on the supporting structures of premolars. The results reported have unanimously demonstrated that in situations where orthodontic or jiggling forces were inflicted on teeth with a normal periodontium, or on teeth with overt signs of gingivitis, the periodontal ligament tissue reacted by transitory signs of inflammation. These phenomena occurred without a concomitant loss of connective tissue attachment and development of pathologically deepened periodontal pockets. If the jiggling trauma was inflicted on teeth with an ongoing plaque‐associated, destructive periodontitis, the resulting inflammatory reactions caused enhanced loss of attachment and angular bony defects. Furthermore, orthodontic tilting movements of teeth (intrusion) in a plaque‐infected dentition may shift a supragingivally located plaque into a subgingival position resulting in periodontal tissue breakdown.
The relative importance of plaque and occlusion in periodontal disease
Authors: Polson Alan M.
Published: December 2005

Abstract A series of studies has investigated interactions between periodontal trauma and marginal periodontitis in relation to the initiation, progression and treatment of periodontal disease. Lesions of trauma in the periodontal ligament do not initiate the loss of connective tissue attachment characteristic of marginal periodontitis. Studies conducted in squirrel monkeys and beagle dogs in which jiggling forces were superimposed upon an established marginal periodontitis reported increased loss of alveolar bone, but the accelerated loss of attachment which occurred in the dog model did not occur in the monkey model. In order to clarify the relative importance of inflammation and tooth mobility in the treatment of advanced periodontal disease, periodontal responses were evaluated after removing combinations of traumatic and inflammatory components. Elimination of trauma in the presence of existing marginal inflammation did not reduce tooth mobility or increase bone volume. Osseous regeneration and decreased tooth mobility occurred after resolving both components; however, similar findings occurred after resolving inflammation in the presence of continued tooth mobility. After resolution of inflammation, remaining tooth mobility does not result in increased loss of connective tissue attachment. On a clinical level for periodontal disease treatment, the findings place decreased emphasis upon management of tooth mobility and increased emphasis upon resolution of marginal inflammation.
Is antibiotic therapy justified in the treatment of human chronic inflammatory periodontal disease?
Authors: van Palenstein Helderman Wim H.
Published: December 2005

Abstract New insight into the possible involvement of specific bacteria in the etiology of periodontal disease has stimulated interest in antibiotic therapy. However, current knowledge does not allow the designation of one or more pathogens in periodontal diseases. Some bacteria are considered suspected periodontal pathogens due to their predominance in the pocket and their potential pathogenicity, yet they all appear to be indigenous bacteria. For this reason, one can question the rationale for the use of antibiotics in the treatment of periodontal disease since the theoretical basis for their application seems small. Several reports of clinical trials in which antibiotics were administered as an adjunct to scaling and rootplaning in adult periodontitis conclude with encouraging statements concerning bacterial inhibition and the cure of inflammatory periodontal disease. However, the data are conflicting and mostly negative. Antibiotic treatment in combination with scaling and rootplaning in juvenile periodontitis and refractory adult periodontitis has shown some benefit, but the clinical trials were not sufficiently controlled to permit conclusions. So far, antibiotics have been applied as a last resort in order to supplement the non‐specific approach of mechanical root debridement, but it can be doubted whether this approach offers any benefit in the long run.
A follow‐up study 3 years after metronidazole therapy for chronic periodontal disease
Authors: Joyston‐Bechal S. , Smales F. C. , Duckworth R.
Published: December 2005

Abstract In a previous study, a double‐blind between subject comparison of the effects of metronidazole and placebo tablets was completed over 22 weeks in 45 subjects with chronic periodontal disease ranging in severity from moderate (PI=2.0–3.9) to high (PI=4.0–6.0). The results showed a significantly greater reduction in the mean probing depth of pockets with the use of metronidazole, but this reduction was apparent only in subjects with severe periodontal disease (PI=4.0–6.0). 3 years later. 28 subjects attended. All groups still showed statistically significant improvements in all parameters when compared with those at the first visit. However, when compared with those at the end of the trial, there were statistically significant increases in gingival bleeding and calculus scores. An increase in plaque levels was also observed but this was not statistically significant. When subjects with moderate and severe periodontal disease were grouped together, there were no significant differences in any of the parameters between test and control groups. Moreover, the significantly greater reductions in mean probing depth of pockets, achieved with the use of metronidazole in the severe group at the end of the trial, had disappeared after 3 years. However, in subjects with mild disease, statistically significant reductions in pocket probing depth, not originally apparent, were observed 3 years later.
Chemotherapy in juvenile periodontitis
Authors: Gjermo Per
Published: December 2005

Abstract Juvenile periodontitis has been described as a separate entity among the human periodontal diseases. Several forms of the disease based on the number and types of involved teeth as well as the age of the patient have been reported. The present review deals with the “classical” localized juvenile periodontitis (LJP). The etiology of LJP has been explained according to 3 theories: (1) a genetic (hereditary) defect in the host defense mechanism; (2) a specific infection; (3) a combination of 1 and 2. In all 3 alternatives, bacterial infection is the direct cause of the breakdown of the tissues. This is supported by reports of success following therapy aimed at eliminating the microbial challenge. Arguments favoring the use of chemotherapeutic agents as an adjunct to mechanical debridement, or instead of it, as well as arguments against such use are discussed. The conclusion seems to be dependent on which of the 3 theories of etiology the arguments are related to. If antibiotics are to be used, the choice of drug would depend on the sensitivity of the suspected pathogen(s). At present tetracycline seems to be the one suggested by most authors, but routine use of antibiotics in the treatment of LJP does not seem necessary and is not recommended.
Depth‐force‐patterns in periodontal probing
Authors: Mombelli A. , Graf H.
Published: December 2005

Abstract This investigation was undertaken to study penetration‐depth and simultaneous force development during the insertion of a standard periodontal probe tip into a pocket to gain information about the tissue resistance to probing and its relation to the accuracy of depth determination. A piezoelectric force transducer and a linear position transducer were incorporated into a periodontal probe. Depth‐force diagrams were obtained on an x–y plotter. In 5 patients requiring treatment for chronic periodontitis, 50 sites were selected and measured 3 times before and 3 times after a treatment phase consisting of hygiene instruction, systematic deep scaling and root planing. The minimal required probing force for reproducible values within a limit of 0.5 mm up to a force of 1.2 N was determined for each record (“b‐value”) and correlated in a multiple linear regression analysis with a number of clinical parameters of the sites.

Depth‐force diagrams recorded with the probe showed the characteristics of saturation curves flattening off in the range of 1 N and more. When the probing force was increased from 0.41 N up to 1.2 N, 50% of all measurements showed an increase in depth of more than 0.5 mm. However, increasing from 0.9 to 1.2 N resulted in a change of more than 0.5 mm in only 5% of the measurements. Differences in b‐values before and after the treatment were significant (p < 0.01). Differences related to tooth type (M, PM, I) and conventional pocket depth before treatment were also significant (p < 0.05). In general, minimal probing force had to be 0.075 N higher after the treatment and 0.101 N higher in pockets originally deeper than 5 mm to maintain the same depth reading up to a force of 1.2 N.

It was concluded that the influence of probing force on the reproducibility of probing depth was more important after treatment by oral hygiene, deep scaling and root planing.
The effectiveness of a rotary electric toothbrush on oral cleanliness in adults
Authors: Glavind Leif , Zeuner Ella
Published: December 2005

Abstract The effectiveness of an electric toothbrush (Rota‐dent®), which in design and mode of action resembles the rotating instruments used by professionals in tooth cleaning, was assessed. 40 adult periodontal patients were divided into 2 groups matched with regard to oral cleanliness: (1) an electric toothbrush group (EB) comprising 20 patients who received an electric toothbrush as well as instruction in it's use by a dental hygienist; (2) a control group (CO) comprising 20 patients who were provided with an oral hygiene kit containing a conventional toothbrush, an interspace brush, toothpicks, disclosing tablets and a lighted mouth mirror and who received the oral hygiene instruction by means of a self‐teaching manual. All patients received professional mechanical tooth cleaning 1 week prior to the instruction. At a 3‐week follow‐up session, additional instruction was given by a dental hygienist according to needs. The presence or absence of dento‐gingival plaque after disclosing with the Plak‐lite® system and gingival bleeding by gentle probing was recorded on 4 tooth surfaces of all teeth, initially and after 3 months. The findings showed a similar improvement in the status of oral hygiene in both groups, indicating that in the hands of the patients, the electric toothbrush was just as effective as the comprehensive oral hygiene kit.
The effects of a topically‐active non‐steroidal anti‐inflammatory drug on ligature‐induced periodontal disease in the squirrel monkey*
Authors: Vogel Richard I. , Schneider Lawrence , Goteiner David
Published: December 2005

Abstract Prostaglandins are believed to be important mediators of periodontal inflammation and bone resorption. The purpose of the present blind study was to quantify clinically and histologically the effects of a topically applied non‐steroidal prostaglandin synthetase inhibitor, namely a substituted oxazolopyridine derivative (SOPD), on ligature‐induced periodontal disease in the squirrel monkey. For a period of 14 days, one group of ligated animals received 2 daily topical applications of the SOPD. A group receiving systemically administered indomethacin served as a positive control while a group receiving only topically applied vehicle served as a negative control. Results indicate that throughout the 14‐day period of the study, the SOPD significantly inhibited gingival inflammation and loss of attachment as compared to either the placebo or indomethacin groups. Both indomethacin and the SOPD significantly inhibited bone resorption.
Artificial periodontal defects and frequency of tooth brushing in beagle dogs
Authors: Corba N. H. C. , Jansen J. , Fidler V.
Published: December 2005

Abstract This investigation was designed to determine the influence of different frequencies of tooth brushing on artificial periodontal defects in the beagle dog shortly after creation.

In 12 beagle dogs, periodontal defects were created using elastic bands placed in the sulci below the gingival margin after having cut the dento‐gingival fibres to the level of the alveolar bone. This active phase of creating defects lasted for 6 weeks. 6 premolars in the lower jaw were used (2P2, 3P3, 4P4). After removal of the elastic bands, the 12 dogs were distributed into 3 groups of 4 dogs each. Each group was brushed with a certain frequency, i.e., 7 times, 3 times or once a week. Plaque index, gingival index and probing depth, using a constant force probe, were assessed interproximally. The experiment lasted for 24 weeks.

For hypothesis testing, a brushing effect was calculated for each dog. Furthermore, an analysis was performed based on the absolute scores at week 24. From the statistical analysis, it was concluded that in artificially‐induced periodontal defects in beagle dogs immediately after creation, brushing 7 times a week is superior to brushing 3 times a week to establish and maintain gingival health.
Gingival health and frequency of tooth brushing in the beagle dog model
Authors: Tromp J. A. H. , Jansen J. , Pilot T.
Published: December 2005

Abstract The aim of this experiment was to study clinical parameters when 3 different frequencies of plaque removal were applied to healthy gingivae in the beagle dog model. The maxillary first, second and third premolars of 12 beagle dogs, at the start of the experiment 2 years of age, were, after a thorough cleaning, submitted to daily plaque removal during a pre‐experimental period of 8 weeks. At the start of the experiment, the dogs were distributed into 3 groups of 4 dogs each: one group was brushed 7 times a week, a second group was brushed 3 times a week and another group was brushed only once a week. Brushing was executed over a period of 24 weeks, on the right sides of the upper jaws. The left upper jaws served as controls. At regular intervals, the plaque index, the gingival index and probing depths were assessed. A “brushing effect” was calculated for each dog, to include information on all within‐dog and between dog variations. Comparison of brushing effects revealed that in this experimental model, plaque removal with a frequency of 3 times a week was sufficient to preserve gingival health, whereas tooth brushing once a week resulted in gingival inflammation. Therefore it can be concluded that 3 times a week is the critical brushing frequency in the beagle dog model with healthy gingiva at baseline.
Semilunar coronally repositioned flap
Authors: Tarnow Dennis P.
Published: December 2005

Abstract A semilunar coronally positioned flap is described. The technique involves a semilunar incision made parallel to the free gingival margin of the facial tissue, and coronally positioning this tissue over the denuded root. This technique has the advantage over other coronally positioned flaps, in that no sutures are required, there is no tension on the flap, there is no shortening of the vestibule, and the existing papillae are not interfered with.
Experimental gingivitis and frequency of tooth brushing in the beagle dog model
Authors: Tromp J. A. H. , van Rijn L. J. , Jansen J.
Published: December 2005

Abstract The aim of this experiment was to study clinical parameters when 3 different frequencies of tooth brushing were applied to sites of experimental gingivitis in beagle dogs. 12 beagle dogs, at the start of the experiment 2 years of age, were used. After a thorough cleaning, the maxillary left and right first, second and third premolars were brushed daily for a period of 8 weeks. Subsequently, for 4 weeks, all brushing was omitted in order to establish an experimental gingivitis. After this pre‐experimental period, the dogs were distributed into 3 groups of 4 dogs each: one group was brushed 7 times a week, a second was brushed 3 times a week and the third group was brushed only once a week. Brushing was carried out for 24 weeks, only on the right sides of the upper jaws, the left upper jaws serving as controls. At regular intervals, plaque index, gingival index and probing depths were assessed. A brushing effect was calculated for each dog, to include information on all within‐dog and between‐dog variations.

The present study demonstrated that only by brushing every day can clinically healthy gingivae be obtained in the beagle dog model with experimental gingivitis at baseline. The state of gingival health at baseline may be used to determine the frequency of brushing necessary to create or maintain healthy gingivae.
Evaluation of a television‐tape demonstration for the reinforcement of oral hygiene instruction
Authors: Glavind Leif , Zeuner Ella
Published: December 2005

Abstract The effect of using a television‐tape demonstration in order to reinforce the advice given in a self‐teaching oral hygiene program was evaluated in the present study. The teeth of 24 periodontal patients were scaled and 2 weeks later oral hygiene instruction was given by handing out a self‐teaching manual. The patients were divided into 2 groups, matched with regard to the initial status of oral cleanliness. (1) An experimental group (TV) comprising 12 patients who, 1 week after the instruction, were shown a demonstration of proper oral hygiene technique on closed circuit television and (2) a control group of 12 patients who did not receive this reinforcement. The presence or absence of dentogingival plaque and gingival bleeding by gentle probing was recorded initially and after 8 weeks on 4 surfaces of all teeth. In addition, plaque scores were recorded at 2 and 3 weeks to assess the effect of the oral hygiene self‐instruction. At the final examination after 8 weeks, the patients with plaque on more than 20% of the tooth surfaces were subjected to a tooth cleaning test including a subsequent scoring of remaining plaque. The patients in the experimental group (TV) were asked their opinion regarding the television‐tape demonstration. Although the patients in the experimental group expressed a positive opinion about viewing the television‐tape demonstration, the improvement in the plaque and gingival bleeding scores recorded at the 8‐week examination showed no difference between the 2 groups of patients. Similarly, the scoring of plaque after the tooth cleaning test showed no difference between the 2 groups. Only 5 (20%) out of the 24 patients were unable to clean their teeth to a standard of less than 20% plaque‐infected tooth surfaces.
Immunohistological identification of cell subsets in human gingival after local treatment for gingivitis or periodontitis
Authors: Jully Jean Marie , Béné Marie Christine , Martin Gérard , Faure Gilbert
Published: December 2005

Abstract The cellular infiltrate present in human diseased gingiva was analyzed in biopsies from 12 patients with gingivitis or periodontitis. The samples studied had been obtained in the course of surgery at inflammatory sites remaining after institution of periodontal treatment.

Histological and immunological techniques were used to identify macrophages, B‐cells, plasma‐cells, T‐cells and T cell subsets, as well as cells expressing class II HLA membrane antigens.

T‐cells appeared as the predominant population, but plasma‐cells were also visualized in nearly all samples. Both OKT4+ and OKT8+ cells were seen in all cases, the latter being more numerous in periodontitis patients. Interdigitating‐like cells were observed, positively labelled for class II antigens, as well as macrophages which were more numerous in periodontitis patients.

These results suggest the participation of all components of the immune response in gingival disease, in a way resembling chronic recurrent inflammatory diseases.
The habitat of periodontopathic micro‐organisms
Authors: Van der Velden U. , Van Winkelhoff A. J. , Abbas F. , De Graaff J.
Published: December 2005

Abstract The purpose of the present study was to investigate the significance of oral mucosal surfaces as a habitat of periodontopathic micro‐organisms. For this investigation, 7 young adults were selected for an experimental gingivitis study. At the start of the experiment, bacterial samples were taken by means of a sterile swab from 4 oral mucosal surfaces: the buccal mucosa, the vestibular fold, the dorsum of the tongue and a tonsil. All individuals were asked to abstain from oral hygiene procedures in 1 quadrant of the mouth for a period of 23 days. At the end of this period, plaque samples were taken from 4 tooth surfaces by means of a sterile periodontal probe just coronal from the gingival margin. The study included evaluation of spirochetes and motile organisms by means of phase‐contrast microscopy and of black‐pigmented Bacteroides, Fusobacterium, Actinomyces, Actinobacillus actinomycetemcomitans and Capnocytophaga by means of cultural studies. Results showed a relationship between the prevalence of motile organisms and black‐pigmented Bacteroides in samples from both the mucosal surfaces and the 23‐day‐old plaque. In addition, a relationship was found between the presence of motile organisms on the dorsum of the tongue at the start of the experiment and their prevalence in the 23‐day‐old plaque. It was suggested that the dorsum of the tongue may function as a nidus for periodontopathic micro‐organisms.
Current status of indices of gingivitis
Authors: Ciancio Sebastian G.
Published: December 2005

Abstract Gingival indices are used to describe the relative status of the degree of either health, disease, or both, of the gingival tissues. Most of the indices incorporate a graduated scale with definite upper and lower limits. All gingival indices rely on one or more of the following criteria: (1) color, (2) contour, (3) bleeding, (4) extent of involvement, (5) crevicular fluid flow. Some indices have shown a correlation between the various criteria used and histologic signs of inflammation, particularly in the case of bleeding and visual signs of inflammation. In this paper, a number of indices to assess gingival health have been reveiwed their sensitivity varies and the type of index used will be dependent on the objective of the study to be conducted.
A procedure for evaluating the reliability of a gingivitis index
Authors: Kingman Albert
Published: December 2005

Abstract A methodology is presented for assessing the reliability of an ordinally‐scaled index and is illustrated by using data from a clinical trial in which gingival inflammation was assessed with the PMGI index, independently, by 5 examiners. One of the examiners was an experienced examiner, the others newly trained. All subjects were evaluated by each examiner initially and at the end of the study period. The reliability of the average score per subject, maximum score per subject, and the % of affected sites per person are estimated by the intra class correlation coefficient. Procedures are presented that utilize various forms of the weighted kappa statistic for dissecting patterns in examiner agreement for specific sites, types of site, all sites, and for the individual components and categories of the index. It is shown how these procedures can be useful for training and calibrating multiple examiners, who will be using such an index in a clinical study, so that adequate reliability levels can be realized.
Analysis of data from clinical studies of localized juvenile periodontitis
Authors: Christersson Lars A. , Emrich Lawrence J. , Dunford Robert G. , Genco Robert J.
Published: December 2005

Abstract Data from 27 subjects with localized juvenile periodontitis were used to compute estimates of the intraclass correlation coefficient for initial periodontal pocket depth measurements and total subgingival Actinobacillus actinomycetemcomitans counts, and for changes from pre‐ to post‐treatment in periodontal pocket depth, probing attachment level and Actinobacillus actinomycetemcomitans counts. The estimates for the clinical parameters were considerably higher than those found in a similar study of adult periodontitis. On the average, the estimates for the intraclass correlation coefficients for Actinobacillus actinomycetemcomitans counts did not differ markedly from the corresponding estimates for the clinical parameters. Although the results of this study indicate that the major component of variability in parameters commonly used in studies of periodontal disease can be attributed to site‐specific factors, sites within subjects cannot be considered statistically independent. For the analysis of data arising from studies of periodontal disease, it is recommended that statistical techniques, like the nested mixed effects analysis of variance model be employed, which account for this dependence. These techniques will allow meaningful biological questions concerning site‐specific phenomenon to be answered. However, changes in clinical and microbiological parameters, when therapeutic measures are employed on localized juvenile periodontitis patients, are often dramatic enough to allow informal data presentation.
The extent and severity index: a simple method for use in epidemiologic studies of periodontal disease
Authors: Carlos James P. , Wolfe Mary D. , Kingman Albert
Published: December 2005

Abstract Periodontal indices such as the PI, PDI and CPITN ignore a substantial amount of the information ordinarily available in epidemiologic studies of periodontal disease. The extent and severity index (ESI) is an attempt to preserve the maximum amount of information from a clinical examination consistent with the need to achieve a reasonable degree of data reduction. The ESI uses estimates of attachment (eve/ from probing measurements of 14 sites in one maxillary quadrant and 14 in the contralateral mandibular quadrant. The index is calculated to summarize jointly the extent and the average severity of disease within the group being studied.

Application of this bi‐variate statistic to a set of epidemiologic data was carried out to illustrate its use. This analysis suggested that disease extent and disease severity are not highly redundant measures and thus provide independently meaningful information.

The ESI is a simple, reproducible method which appears to yield an informative description of the periodontal disease status of a population. Use of the index requires only minimal training of examiners. The index is intended to permit direct comparisons among epidemiologic studies of different populations and by different investigators.
Design and analysis considerations for a longitudinal study of periodontal disease
Authors: Feldman Roy S. , Alman John E. , Chauncey Howard H.
Published: December 2005

Abstract Perception and concern for the health changes in our aging population led the Veterans Administration to initiate an interdisciplinary and longitudinal investigation of the aging process, the Veterans Administration Normative Aging Study, in 1963. A cohort of the 2,280 healthy men of this study self‐selected to enroll in the dental longitudinal study, an investigation of oral health in these healthy males. In 1968, 1,221 men between the ages of 25 and 75 began with a baseline cycle of 5 general series of examinations, including an interim health history and survey of dietary habits; masticatory performance and taste thresholds; salivary analyses; oral cytologic and radiographic survey and comprehensive clinical data on caries and periodontal status.

Design considerations for the Dental Longitudinal Study included prospective planning of specific oral variables to be recorded, and provision of collection techniques to allow for additional analyses based on a wide menu of retrospective data. The volunteer cohort was screened to obtain men who met stringent general health criteria, who represented wide socioeconomic ranges and would likely remain geographically stable. Importantly, enrollment in the parent study was without regard for dental status or oral health.

Administrative design considerations included orderly transfer for exam data to machine‐readable format by use of optical scan forms designed to register specific oral variables, with security preserved for the primary source records and rapid record retrieval. Additional data collection requiring manual coding was designed to transfer spreadsheets of clinical impressions and diagnoses to computer retrieval protocols. Provisions for recording of exceptional circumstances, i.e., salient oral pathology, were recognized and the optical scan forms modified to index and retrieve such cases.

Clinical examination design considerations included independence of oral examination from the radiographic survey and reading, and isolation of each cycle of tests from any other. Attempts to contain examiner variability included use of a solo examiner and radiographic reader with a two‐stage calibration series of exercises to achieve reproducibility. To date, 725 men have been examined over 4 cycles of investigation encompassing baseline and 3 longitudinal examinations, each at 3‐year intervals. The specific indexes scored in this study were designed to evaluate dental and periodontal status on a population of almost epidemiologic proportions while retaining clinically relevant methodologies. The Dental Longitudinal Study continues as an ongoing investigation of the distribution, determinants, changes and interrelationships observed in oral health, function and disease. Cross‐sectional and longitudinal analysis has proceeded to correlate oral health with habit histories, loss of teeth, restorative dental experience, drug intake and other variables of contemporary life.