bluuebunny/crossref_metadata_2025 huggingface dataset:
An evaluation of proximal surface cleansing agents
Authors: Wolffe G. N.
Published: December 2005

Abstract The effectiveness of the Interspace® brush, Inter‐Dens®, and waxed dental floss as proximal surface cleansing agents was compared in 35 subjects. Each subject used all three methods of cleansing in random order of selection.

Statistical analysis of the results showed that there was no difference in the effectiveness of any one of these three agents. However, proximal surfaces of anterior teeth where cleaned more effectively than posterior teeth. The coronal half of the proximal surfaces was cleaned more effectively than the apical half and the facial half more effectively than the lingual half when Inter‐Dens was used. Comparison of cleansing effectiveness between facial and lingual halves of proximal surfaces for the Interspace brush and waxed dental floss showed no significant difference. Mesial and distal proximal surfaces were cleaned with similar effectiveness. Plaque control was only satisfactory on approximately half of the proximal surfaces, though a wide variation occurred. Significantly lower plaque scores were found 1 week after the initial instruction session, irrespective of the agent used. The majority of subjects preferred Inter‐Dens whilst waxed dental floss was the least‐liked method of cleansing.
Use of palatal mucosa and lyophilized dura mater to create attached gingiva
Authors: Schoo W. H. , Coppes L.
Published: December 2005

Abstract Gingival extension procedures using free palatal mucosal autografts or homologous lyophilized dura were compared clinically. Palatal mucosa was transplanted in 68 cases and lyophilized dura in 16 cases. The width of the zone of attached gingiva was measured before surgery and at regular intervals up to 2 years postoperatively. The width of the attached gingiva remained relatively constant in the mucosal transplant group from 1 month postoperatively, with an average relapse of about 20 %. In the dura group the width of attached gingiva showed a marked decrease until 3 months after surgery with an average relapse of approximately 63 %. If a preset minimal width of the attached gingiva is considered to be the criterion of success, the superiority of the palatal mucosa grafting procedure is demonstrated.
Control of plaque by non‐chemical means
Authors: Strahan J. D. , Bashaarat A. , Greenslade R. N.
Published: December 2005

Abstract Bacterial plaque at the dento‐gingival margin is always associated with gingivitis. Measures which keep the area free from plaque will maintain health or encourage healing of existing gingivitis.

Scaling and polishing at 6‐month intervals may be sufficient for those patients who practice near‐perfect oral hygiene but it is not an effective way of promoting the resolution of established gingivitis.

A change to effective oral hygiene measures by the patient is the major factor in resolving gingivitis, but the association with scaling and polishing provides the ideal combination.

Toothbrushing may only clean the oral and facial aspects of the teeth so interdental cleaning is necessary where gingivitis is established. There is no clear evidence that any particular oral hygiene routine is better than any other for all patients. It is generally agreed that thoroughness is extremely important.

There is a variety of ways of motivating patients to practice effective oral hygiene but all reports indicate that it is most likely to be effective on a person‐to‐person basis. Motivation itself is not enough and must be associated with education and instruction. Long‐term failure is likely unless the message is reinforced at regular intervals.
Antibacterial properties of Hibitane
Authors: Hennessey T. D.
Published: December 2005

Abstract The key features of the interaction of chlorhexidine with bacteria leading to death are adsorption, damage to permeability barriers and precipitation of the cytoplasm. The bacteriostatic profile indicates that Streptococcus mutans is highly susceptible but it is not known whether bacteriostatic or bactericidal activity is crucial to antiplaque activity. Although some correlation overall was found between bactericidal and bacteriostatic susceptibility amongst more than 80 strains of various species, reference to the minimum inhibitory concentration alone gives no firm indication about the possible lethal action of chlorhexidine.

The effects of saliva and pH on antibacterial activity are given. In human studies reported by others, repeated oral application of chlorhexidine reduced the numbers of salivary organisms recoverable and this was accompanied by slight (seemingly clinically insignificant) alterations in the sensitivity of certain salivary organisms. Daily application of a chlorhexidine dental gel in a 6‐week trial did not result in detectable changes of susceptibility of the salivary flora. Rats dosed daily in drinking water (5‐10 mg chlorhexidine base per kg) over a 2‐year period yielded buccal organisms with reduced sensitivity: this was not reflected amongst faecal bacteria. The faecal flora changed quantitatively in a dose‐dependent manner and coliform organisms particularly were reduced in number.

Caution is required in interpreting relative sensitivities of different bacterial strains or species from data obtained using agar‐diffusion methods.
Safety of Hibitane I. Laboratory experiments
Authors: Case D. E.
Published: December 2005

Abstract The safety evaluation of chlorhexidine (Hibitane) in animal species will be briefly reviewed. The relevance of these studies to human use will be discussed, and species comparisons made where possible.

Animal studies with chlorhexidine were begun more than two decades ago and the evaluation of its safety has been under continual review ever since. Chlorhexidine is poorly absorbed after oral administration, well tolerated after parenteral administration and its percutaneous absorption is absolutely minimal. No clinical or histological effects have been obtained in any animal study to cause hesitation in the light of proliferating applications of chlorhexidine in human use.

The various lexicological studies in animals will be described and in particular the results of a 2‐year study in rats will be outlined. In this, as in an earlier long‐term study, there were no effects whatsoever to suggest that chlorhexidine treatment could give rise to any kind of tumourigenic effect or any other toxic sign.
Safety of Hibitane II. Human experience
Authors: Rushton A.
Published: December 2005

Abstract Chlorhexidine has been widely used in medical practice since its introduction on to the market in the early 1950s. Primarily it has been used for topical antisepsis, e.g. pre‐surgery skin preparation, burns prophylaxis, and prior to obstetrical/gynaecological procedures. This extensive experience has demonstrated the virtual absence of sensitization and a low irritancy potential for the compound. Only one significant adverse effect has been identified during medical use, namely, the production of sensorineural deafness after direct instillation into the middle ear, a property shared by several commonly used antiseptics. The encouraging reports of the use of Chlorhexidine for plaque control prompted further safety investigations, ft has been shown that absorption after oral ingestion is very low, and long‐term oral use has not produced changes in haematological and biochemical parameters. Occasional oral intolerance of mouthrinse formulations has been reported, although no histological abnormalities were present in gingival biopsies taken after 18 months' daily use.

Very occasionally, a reversible swelling of the parotid glands has been reported after use of Chlorhexidine in mouthrinse formulations, but not after other methods of administration. Tooth discoloration, which shows wide inter‐individual variation is seen after ail denial formulations. This undesirable cosmetic effect would appear to represent the only significant argument against everyday prophylactic oral use of Chlorhexidine.
Epidemiology of dental disease
Authors: Barmes David E.
Published: December 2005

Abstract Having addressed the problem of standard methods and comparability of epidemiological data and recognizing the problems which remain, at an intercountry level, even when data have been carefully selected, the Oral Health unit of WHO has been able to develop a global picture of dental caries prevalence and is constructing similar maps for periodontal diseases. Inevitably, the precision and representativeness of such data vary from country to country, but they are nevertheless invaluable for their intended purpose of providing a good approximation of disease prevalence and trends.

It is clear that populations in highly developed countries almost always have high or very high prevalence of dental caries. It is even more striking that developing countries have or have had low to extremely low prevalence of the disease, but are suffering rapid and unmanageable increases in prevalence. At the same time, high to very high prevalence of periodontal diseases persists in all populations, though the problem seems to be greatest in developing countries.

It is extremely disappointing and indeed tragic that this state of affairs can exist in 1976 when, for decades, we have had effective preventive measures available and have new methods appearing almost daily.

The WHO oral health programme has given prevention its top priority position and its approach is based on the premise that we can and must implement the preventive methodology we have, to halt increases in dental caries prevalence, to reduce its prevalence and to control periodontal diseases.
Hibitane in oral disease in handicapped patients
Authors: Storhaug K.
Published: December 2005

Abstract All the problems connected with conservative dental treatment for handicapped patients and the hazards to dental health which many handicaps represent, indicate that preventive measures are of special importance for these patients. Conventional toothcleaning techniques may be difficult or impossible to carry out for a large number of handicapped persons. In these cases chemical plaque control may be the only alternative.

Chlorhexidine gluconate has so far proved to be the chemical agent best suited for removal of dental plaque. Different modes of chlorhexidine application have been tried. Mouthrinse with a 0.1 % or 0.2 % aqueous solution of Chlorhexidine twice a day has proved to give a good plaque‐inhibiting effect. Such mouthrinses are often the treatment of choice for short‐term plaque control for a wide variety of patient groups.

Chlorhexidine‐containing toothpastes have been used in controlled clinical trials on handicapped children. This method of application may be indicated for long‐term use.

Chlorhexidine gel in individually made applicators may be the only possible toothcleaning method in seriously handicapped, uncooperative adult patients.

Side effects of Chlorhexidine application such as discolouration of teeth and fillings and temporary disturbance of taste has so far limited the use of Chlorhexidine in preventive dentistry. These side effects are, however, often overshadowed by the fact that the use of Chlorhexidine may be the only possible solution to the handicapped patient's oral health problems.
Hibitane in the treatment of oral candidiasis
Authors: Budtz‐Jörgensen E.
Published: December 2005

Abstract Denture stomatitis (chronic atrophic candidosis) is a very common complication to the wearing of complete dentures. The infection is due to a contamination of the denture by yeasts. In a number of studies the clinical effect of Hibitane when used as a denture disinfectant has been studied. It was found that Hibitane (0.2‐2 %) caused a significant amelioration of inflamed palatal tissues and a reduction in the number of yeast cells harbored on the palatal mucosa and the fitting surface of the dentures. However, relapse of the infection was frequent after treatment was sustained. It was concluded that Hibitane could not be recommended for routine denture disinfection, first, because it caused staining of the dentures, second, because of the relative resistance of the yeasts to the action of the drug. However, it seems justified to use Hibitane prophylactically as a denture disinfectant in patients who are highly susceptible to developing disseminating or systemic candidosis. Hibitane is a valuable drug in the treatment of denture stomatitis when used as a denture disinfectant.
Caries and periodontal status in patients fitted with removable partial dentures
Authors: Bergman Bo , Hugoson Anders , Olsson Carl‐Olof
Published: December 2005

Abstract A 6‐year follow‐up study was carried out on 28 patients fitted with removable partial dentures. Prior to the prosthetic treatment all patients were given oral hygiene instruction and periodontal therapy where indicated. The removable partial dentures were carefully planned and designed. During the follow‐up period the patients were examined at yearly intervals when remotivation, scalings, conservation and prosthetic adjustments were carried out as required. Patient cooperation was excellent and no significant deterioration of the periodontal status of the remaining teeth could be found, In addition the number of newly registered carious lesions was low. A certain degree of deterioration of occlusion, articulation, stability and clasp retention of the dentures fitted did occur, however.
Comparative clinical evaluation of freeze‐dried skin allografts and autogenous gingival grafts in humans*
Authors: Yukna Raymond A. , Tow Herman D. , Carroll Peter B. , Vernino Arthur R. , Bright Robert W.
Published: December 2005

Abstract. Freeze‐dried skin (FDS) allografts and fresh autogenous free gingival grafts (FGG) were placed in five paired sites in four patients. Both types of grafts healed uneventfully. Evaluation over a 1‐year period demonstrated no statistically or clinically significant differences between the FDS and FGG when: a) increase in the width of keratinized gingiva, b) decrease in recession, c) decrease in sulcus depth, d) gain in attachment level, or e) percent shrinkage of the graft were compared. It was concluded that FDS performs essentially similar to FGG in the correction of mucogingival problems, and has the advantages of decreased patient morbidity (no donor site) and availability of abundant amounts of graft material when needed.
A clinical study of the relationship between crowding of teeth, plaque and gingival condition
Authors: Ingervall Bengt , Jacobsson Ulrika , Nyman Sture
Published: December 2005

Abstract. A clinical trial was undertaken to assess whether crowded teeth were more likely to accumulate plaque and develop gingivitis than non‐crowded teeth. A tooth was considered crowded if it was displaced by 2 mm and/or rotated 15 degrees or more from the normal position in the arch.

The material consisted of 50 dental students aged 21 to 32 years. An initial examination comprised assessment of Plaque Index, Gingival Index and pocket depths. After this examination the subjects refrained from using interdental cleaning aids but continued with their normal toothbrushing for 40 days. After re‐examination they were instructed in the effective use of dental floss. A final examination was carried out after 140 days.

At the start of the trial no difference was found in regard to the Plaque Index between crowded and non‐crowded teeth. The Gingival Index for crowded front teeth, but not for crowded premolars, was somewhat higher than for the corresponding controls. The cessation of interdental cleaning resulted in a similar increase in plaque accumulation and gingival inflammation in both non‐crowded and crowded teeth. The use of denial floss for approximal tooth cleaning resulted in a similar decrease in the Plaque‐ and Gingival Indices for both types of teeth.

The results demonstrate that in a group of young adults, crowding of teeth (1) did not favour plaque accumulation on approximal tooth surfaces and (2) influenced the degree of gingival inflammation only to a minor extent.
Effect of the Water Pik® device on plaque accumulation and development of gingivitis
Authors: Hugoson Anders
Published: December 2005

Abstract The influence of the water irrigating device. Water Pik®, on the accumulation of plaque and development of gingivitis has been studied using the model, “experimental gingivitis in man”. The investigation was carried out on 41 patient volunteers whose teeth were thoroughly scaled and polished during a 4‐week period of intensive oral hygiene preceding each experimental period. Gingival exudation. Plaque Index and Gingival Index were registered at the beginning of the experimental periods. The participants were then divided into four groups. Groups A and B abandoned all forms of active oral hygiene. Group A, however, were given Water Pik devices as the only oral hygiene aid. Groups C and D continued to clean their teeth using a toothbrush and Group C were given Water Pik devices as a supplementary aid. After 14 days, gingival exudation. Plaque Index, Gingival Index and soft tissue injuries were registered. The results showed that, while both groups A and B demonstrated extensive plaqtie deposits and gingivitis, these were present to a significantly lesser degree in Water Pik users. The toothbrushing groups (C and D) failed to demonstrate any further reduction of plaque or gingivitis when Water Pik was introduced as an additional measure. No soft tissue injuries were found.
Relative distribution of bacteria at clinically healthy and periodontally diseased sites in humans*
Authors: Listgarten M. A. , Helldén L.
Published: December 2005

Abstract Samples of subgingival bacteria were collected with a clean curette from two relatively normal and two periodontally diseased sites in each of 12 patients with advanced periodontal disease. The samples were suspended in physiologic saline containing 1 % gelatin and examined within 1 hour by darkfield microscopy. From 100‐200 bacteria were classified on a percentage basis into one of the following categories: (1) coccoid cells, (2) straight rods, (3) filaments, (4) fusiforms, (5) curved rods, (6) small spirochetes, (7) medium‐sized spirochetes, (8) large spirochetes, and (9) motile rods. For each area sampled the following clinical criteria were also recorded: (1) Gingival Index, (2) Plaque Index, (3) probing depth and (4) gingival fluid flow. For each patient separate mean values were calculated for the normal and the diseased sites. The results indicated that significant differences existed in the microbial flora of clinically normal and diseased sites using a paired t‐test comparison (2α= 0.001), with coccoid cells more predominant at normal sites (74.3 % vs. 22.3 %), while at diseased sites motile rods were more frequent (12.7 % vs. 0.3 %), as well as curved rods (1.7 % vs. 0 %), small spirochetes (12.6 % vs. 1.1 %), medium‐sized spirochetes (18.5 % vs. 0.5 %) and large spirochetes (6.7 % vs. 0.2 %). The ratio of motile to non‐motile cells in the normal was 1:49, whereas at diseased sites the ratio was in the vicinity of 1:1. These results clearly show that a different flora is associated with healthy and periodontally diseased sites in the same patient population and that these differences can be detected by means of a technique which is simple and readily adaptable to a clinical setting. The data obtained in this fashion may be useful in monitoring the effect of various treatment modalities on the periodontal flora and possibly in determining the presence or absence of active disease.
Autologous tooth transplantation to replace molars lost in patients with juvenile periodontitis
Authors: Borring‐Møller Gert , Frandsen Asger
Published: December 2005

Abstract A method is described to replace periodontaily destroyed first molars in patients with juvenile periodontitis by auto‐transplantation of third molars.

Fifteen molars which had been extracted due to periodontal destruction were replaced by autologous third molars with incomplete root formation. The patients were then observed for a period up to 7 years.

In ail cases complete regeneration of the alveolar bone took place and radiographically a normal periodontal membrane was established. All of the transplanted teeth continued their root formation and there was no radiographic evidence for root resorption, ankylosis or necrosis of the pulp. None of the transplanted teeth displayed pocket depths over 3 mm and no abnormal mobility was detectable.
Use of chlorhexidine gluconate and povidone iodine mouthwashes in the treatment of acute ulcerative gingivitis
Authors: Addy M. , Llewelyn J.
Published: December 2005

Abstract A trial was conducted to compare the effectiveness of povidone iodine and chlorhexidine gluconate with buffered peroxyborate in the treatment of acute ulcerative gingivitis. After 20 patients had entered the trial and 11 had required additional therapy with metronidazole to control their symptoms, the study was terminated. Those patients receiving peroxyborate all showed a satisfactory improvement in clinical signs and symptoms. One patient each receiving povidone iodine or chlorhexidine reported a symptomatic improvement, although gingival ulceration was still apparent at 1 week. The remaining patients all required metronidazole therapy to control their symptoms. Povidone iodine and cblorhexidine gluconate therefore cannot be recommended for the treatment of acute ulcerative gingivitis.
Errors in the assessment of pocket depth in vitro
Authors: van der Velden U.
Published: December 2005

Abstract. The inaccuracy of the calibration of two Merritt‐B probes, old and new style, was investigated. It appeared that the calibration of the Merritt‐B “new style” probe was better than the calibration of the old one. The influence of the mode of calibration and the reading of the calibration on pocket depth assessment with a Merritt‐B “old style” probe was studied in an in vitro model. The model consisted of 32 aluminium cubes each with a hole in the centre. The holes were 1 mm in cross‐section and the depth varied from 0.25 mm to 8 mm in 0.25‐mm increments. Results show that pocket depths of 1 mm to 8 mm ±0.25 mm generally were read correctly about 90 % of the lime. This was not true for the 4‐ and 6‐mm areas. When a probe was used where the 4‐ and 6‐mm marks were omitted, pocket depths in that area were read correctly only in about 60 % of instances. This difference disappeared when the 4‐ and 6‐mm marks were added. Results of measuring the half millimeter values showed that generally 80 % were recorded as the lower whole millimeter.
Introduction of a new periodontal probe: the pressure probe
Authors: van der Velden U. , de Vries J. H.
Published: December 2005

Abstract. A new periodontal probe has been developed: the pressure probe. The probe consists of a cylinder and piston assembly connected to a variable air pressure system. The working end is a metal tube in which a plunger can move freely. By means of air pressure the plunger is constantly fully extruded. During probing the plunger will intrude from the position of maximum extrusion only as the probing force exceeds the predetemined force acting on the plunger. The difference by which the plunger is intruded can be read on a millimeter scale within the handle of the probe. The purpose of the present investigation was to determine whether probing force is constant during probing, to study the reliability of reading pocket depth measurements in vitro, and to investigate the relationship between pocket depth and applied force in man. In order to evaluate whether the probing force is constant during probing, measurements were performed on a force transducer. Results show that the device makes probing possible with a constant and adjustable pressure. The influence of the reading of the calibration on pocket depth assessment in vitro was studied in an in vitro model. Results show that pocket depths of 1 mm to 8 mm ± 0.25 mm were read correctly in about 90 % of instances. Generally about 45 % of the half millimeter values were recorded as the lower whole millimeter. To investigate the relationship between pocket depth and applied force, 173 pocket depth measurements were performed in eight patients. Patients selected for this study had, in some part of the upper anterior segment, loss of alveolar bone support up to two‐thirds of the root length, visible on periapical radiographs. All patients received preliminary treatment consisting of plaque control and removal of subgingival deposits. The mean Sulcus Bleeding index score was 0.2. Pocket depth measurements were carried out with forces of 0.15, 0.25, 0.50 and 0.75 N. Both approximal and vestibular pocket depths were recorded. In this study 0.75 N was chosen as the maximal force since in a pilot study a force of 1.0 N appeared too painful for patients. Results show an increasing pocket depth with increasing probing force. The mean pocket depths increased from 2.08 mm at 0.15 N to 3.71 mm at 0.75 N. Testing showed it to be statistically significant. At 0.75 N, 72 out of the 173 pockets examined were equal to or deeper than 4 mm. The percentages were calculated of differences equal to or more than 2 mm between pocket depth measurements carried out with 0.75 N and lower forces. It was found that 63.3 % of pocket depths measured with 0.15 N were, when measured with 0.75 N, 2 mm or more deeper. This was 43.1 % when 0.25 N and 0.75 N were compared and 9.7 % when 0.50 N and 0.75 N were compared. The maximal differences varied from 5 mm to 7 mm.
The effect of metronidazole on the development of plaque and gingivitis in the beagle dog
Authors: Heijl L. , Lindhe J.
Published: December 2005

Abstract The present investigation was performed in order to assess if the administration of metronidazole changed the composition of developing plaque in dogs, which at the start of the study were free from signs of gingivitis. Five beagle dogs were used. Throughout the observation period the animals were fed a diet which favored plaque accumulation. A baseline examination involved assessments of plaque, gingivitis and gingival exudate. Gingival biopsies were sampled and the tissue examined by a point counting procedure. The composition of the subgingival bacterial flora was assessed by dark‐field microscopy. The bacteria were characterized into the following types: coccoid cells, straight rods, filaments, fusiforms, motile and curved rods and spirochetes.

Following the baseline examination the teeth of the right jaws were allowed to accumulate plaque. A careful tooth cleaning program was maintained in the left jaw quadrants. Plaque and gingivitis assessments were repeated and biopsies sampled in the right jaws after 7, 14 and 28 days of no tooth cleaning. On experimental day 28 the second part of the study was initiated. A new baseline examination was performed in the left jaws, after which the tooth cleaning program also in this part of the dentition was terminated. During the subsequent 28‐day period each animal was given a dosage of 20 mg metronidazole/kilogram bodyweight/day. Clinical examinations and biopsies were repeated after 7, 14 and 28 days.

The results demonstrated that metronidazole administered via the systemic route during a 28‐day period can effectively decrease plaque and gingivitis development in dogs. The bacterial flora from subgingival sites of healthy gingiva was dominated by coccoid cells and straight rods. During the phase of developing gingivitis the percentage of coccoid cells and rods tended to decrease, while motile rods and spirochetes increased. During the 28 days of metronidazole treatment the subgingival plaque flora maintained its “healthy” composition, i.e. a gradual influx of motile rods and spirochetes was prevented.
Subgingival microflora of periodontal patients on tetracycline therapy
Authors: Williams B. L. , Osterberg S. K.‐Å. , Jorgensen J.
Published: December 2005

Abstract Samples of snbgingival plaque were collected from periodontal patients receiving two different tetracycline treatment regimens following conventional periodontal therapy. Four patients had received an oral dose of 1000 mg/day for 2 weeks and nine had received 1000 mg/day for 1 week followed by 250 mg/day for extended time periods. The latter regimen is similar so that commonly prescribed for the chronic skin disease, acne vulgaris. Taxonomic characterization of plaque isolates indicated that the predominant organisms cultured from both treatment groups were species of Streptococcus and the branching, filamentous Gram‐positive rods, Actinomyces and Rothia. A much greater microbial complexity was observed among the flora isolated from patients taking 250 mg/day. The latter group harbored many of the fastidious Gram‐negative organisms presently implicated in the etiology of periodontal disease. All bacterial strains isolated were tested for resistance to tetracycline by replica‐plating cultures on an agar medium containing two‐fold dilutions of the antibiotic. Streptococcus, Veillonella and Neisseria were the bacterial genera found to be consistently resistant to tetracycline, with minimum inhibitory concentrations as high as 128 μg/ml. Among the Actinomyces selection for antibiotic resistance was common only within a single species, A. odontolyticus. However, A. viscosus strains isolated as 54% of the subgingival flora from one patient did demonstrate an intermediate resistance level, growing on concentrations up to 8 μg/ml. Tetracycline resistance was shown by a variety of Gram‐negative rods isolated from the low dosage group. Although a minimum number of patients were studied, extensive microbial analyses of the predominating subgingival bacteria indicated that the goal of tetracycline therapy was achieved during the 2‐week therapy period at 1000 mg/day.
A 3‐year longitudinal study of the position of the gingival margin in man
Authors: Volchansky A. , Cleaton‐Jones P. , Fatti L. P.
Published: December 2005

Abstract The position of the gingival margin of the incisor and canine teeth, indicated by clinical crown height, was measured using a standardised photographic technique, in 30 dental students over a 3‐year period. There was a progressive increase in mean clinical crown height during this period, suggesting that continual passive eruption of the teeth was occurring. There was a significant slowing in the rate of change over the period 1975–1977 for tooth 33, the reason for which is unknown.
Periodontal self‐examination A motivational tool in periodontics
Authors: Glavind Leif , Attström Rolf
Published: December 2005

Abstract The institution of proper oral hygiene procedures and habits is a learning process. This paper describes a self‐instructing periodontal self‐examination program to be used in the initial phase of periodontal treatment. The program was designed in an effort to facilitate learning by taking the teaching conditions into consideration. The program tries to utilize the patient's curiosity and need for activity and to involve the patient himself in an effort to make the patient apprehend the relevance of subject matter. The program also allows for an individualized learning speed of the patient.

The self‐examination program was tested on 108 periodontal patients (19–75 years of age) and the patients' findings were compared to those made by a dentist. Questionnaires before and after the self‐examination were used in the evaluation of opinions of the patient. The present study showed that the patients were able to perform the self‐examination without individual professional guidance. A rather close correlation was noted between findings made by the patient and the dentist. Furthermore, the program was well accepted and appreciated by the patients according to their answers on the questionnaires.
Establishing and maintaining clinically healthy gingivae in Rhesus monkeys
Authors: Caton Jack
Published: December 2005

Abstract The aim of the present investigation was to determine a method and a minimal frequency of plaque removal for the establishment and maintenance of clinically healthy gingivae in Rhesus monkeys. Six adult, male monkeys were used and divided into three groups. In each group different methods were used for plaque removal. Frequencies of plaque removal of one, two and three times per week for consecutive weeks were tested. The results showed that gingival health could be established and maintained with any of the methods used (toothbrushing and interdental flossing: toothbrushing and a 3‐min application of 2% chlorhexidine gluconate) but only when plaque was removed 3 times a week. This frequency of plaque removal sessions is discussed in relation to the necessity for sedation of the animals with possible adverse side effects.
Clinical evaluation of Spiramycin and Erythromycin in control of periodontal disease
Authors: Mills W. H. , Thompson G. W. , Beagrie G. S.
Published: December 2005

Abstract Two studies are reported. Each was double‐blind in which Spiramycin was compared to Erythromycin and a placebo, to determine the value of Spiramycin as a therapeutic agent in the control of periodontal disease. In Study 1, 48 adults with varying degrees of periodontal disease were randomly assigned to treatment and control groups. Assessments of gingival index, plaque height, pocket depth, crevicular fluid volume and wet plaque weight were made. During this 4‐week clinical trial, the patients maintained their usual oral hygiene. The medication was administered systemically for 5 days, starting at the conclusion of week 2.

Spiramycin significantly reduced the scores for the five parameters recorded. When comparisons were made, the greatest recorded effect with Spiramycin treatment was found in patients with advanced periodontal disease. The indication of this trend favouring Spiramycin led to art extension of this clinical trial involving only patients with advanced periodontal lesions.

This second study comprised 54 adults. The same parameters, were measured over the same time period as in Study 1. Spiramycin again was responsible for the greatest reduction in the recorded scores. For example, average pocket depth was decreased by approximately 30%, whereas Erythromycin produced a reduction of 15%. It would appear that Spiramycin is of definite benefit in the management of periodontal disease, especially in the more advanced cases.
The effect of splinting on tooth mobility (2) After osseous surgery
Authors: Galler Cary , Selipsky Herbert , Phillips Ceib , Ammons WilliamF.
Published: December 2005

Abstract The purpose of this study was to determine if fixed splinting of teeth with intraoral wire and acrylic splints had advantages with respect to tooth mobility, bone level and attachment level over unsplinted teeth following osseous surgery. Ten patients were chosen who exhibited bilaterally similar chronic destructive periodontitis and mobile teeth. One maxillary sextant was splinted, while the other was unsplinted. Both sextants functioned against an unsplinted mandibular arch. Following initial therapy, osseous surgery was performed in both maxillary sextants on the same day. Tooth mobility data was collected 1 week before and at 3, 6, 12, and 24 weeks following surgery. Levels of gingival attachment and bone were recorded before and 24 weeks after surgery. Splints were removed before measurements, then replaced, and the occlusion refined. Prophylaxes and oral hygiene instruction were repeated every 3 weeks throughout the study.

For all categories of teeth and mobility examined, tooth mobility increased initially after surgery and subsequently decreased by 24 weeks to about presurgical values. The splinted and unsplinted segments reacted similarly throughout the study; splinting did not significantly reduce the mobility of individual teeth. Pre‐ and postsurgical bone and ginuival attachment levels were also similar for the splinted and unsplinted segments.
Subgingival microflora and periodontal disease
Authors: Slots Jørgen
Published: December 2005

Abstract This article describes the subgingival microflora of the healthy periodontium, gingivitis, advanced adult periodontitis, and juvenile periodontitis. A total of seven to nine subjects were examined in each of the four periodontal clinical entities listed. The individual bacteriological samples included material from the base of a single periodontal pocket. The sampling, the treatment of the samples, and the bacteriological cultivations were carried out using continuous anaerobic techniques.

Briefly, the healthy gingival sulcus harbored a scant microflora dominated by Gram‐positive organisms (85%), usually Streptococcus and facultative Actinomyces species. The development of gingivitis was accompanied by a marked increase in the total number of Gram‐negative organisms. Fusobacterium nucleatum, Bacteroides melaninogenicus ss. intermedius, Haemophilus species, and other Gram‐negative organisms comprised about 45% of the total gingivitis isolates. Streptococcus and facultative and anaerobic Actinomyces species constituted the majority of the Gram‐positive gingivitis isolates. The micro‐flora of advanced adult periodontitis was comprised mainly of Gram‐negative anaerobic rods (about 75%), B. melaninogenicus ss. asaccharolyticus and F. nucleatum being the most predominant isolates. The deep pocket microflora in juvenile periodontitis was also made up mainly of Gram‐negative organisms (about 65%), but was of a nature different from that of adult periodontitis, being predominated by isolates of Bacteroides species and other organisms of unknown species.

The present article also concerns factors of importance for the colonization of Gram‐negative anaerobic rods in the oral cavity and periodontal pockets. In vitro experiments showed that cells of B. melaninogenicus ss. asaccharolyticus and other Gram‐negative organisms attached in high numbers to epithelial cells, hydrosyapatite (HA) surface, and Gram‐positive bacteria when suspended in phosphate‐buffered saline; however, the bacterial attachment to epithelial cells and HA was strongly inhibited in the presence of human saliva and serum. In contrast, saliva and serum had little effect upon the attachment of Gram‐negative bacteria to Gram‐positive bacterial cells. These findings agreed well with data from an in vivo study, in which streptomycin‐labeled cells of B. melaninogenicus ss. asaccharolyticus were introduced into the mouth of two volunteers. A significantly higher number of B. melaninogenicus cells was recovered from dental plaque than from the other oral surfaces studied.

The present series of studies has pointed to certain Gram‐negative organisms as potential pathogens in rapidly progressing periodontal lesions. The available data on oral microbial ecology suggest that the presence of dental plaque containing Gram‐positive organisms may be essential for the attachment and colonization of several Gram‐negative species after their initial introduction into the mouth and the periodontal pocket area. The clinical relevance of these findings is discussed.
Plaque growth while chewing sorbitol and xylitol simultaneously with sucrose flavored gum
Authors: Ainamo Jukka , Asikainen Sirkka , Ainamo Anja , Lahtinen Aira , Sjöblom Monica
Published: December 2005

Abstract In a recent study, sorbitol flavored chewing gum was found neither to increase nor decrease the normal rate of plaque formation, whereas high plaque scores were obtained with sucrose gum during 4 days of no mechanical tooth cleaning. The aim of the present study was to see if chewing sorbitol or xylitol flavored gum together with sucrose gum would affect the growth rate of plaque and whether chewing of xylitol flavored gum could reduce the amount of already formed plaque. Twenty‐seven dental students refrained from mechanical oral hygiene measures from Monday to Friday morning for 3 weeks. The students were randomly divided into three groups. A three time crossed‐over double‐blind approach was used. During each test period one group chewed a combination of one piece sorbitol and one piece sucrose flavored gum five times per day, the second group correspondingly chewed xylitol and sucrose flavored gum, while the third group served as a no hygiene control group. After each test period the students in the control group chewed one piece of xylitol gum every 15 minutes for 2.5 hours. The participants started out each week with clean teeth and were at the end of each test period scored for visible plaque on the facial, mesial and lingual surfaces of their teeth. There was somewhat more plaque after 4 days of chewing sucrose‐sorbitol and sucrose‐xylitol gum combinations than after no oral hygiene alone. There was no difference between the two test treatments. The 2.5‐hour chewing of xylitol flavored gum after the no oral hygiene period did not result in a reduction, of the 4–day‐old plaque.
Juvenile periodontitis Localization of bone loss in relation to age, sex, and teeth
Authors: Høsrmand J. , Frandsen A.
Published: December 2005

Abstract The distribution of bone loss in 156 patients, 12–32 years old, with juvenile periodontitis was analyzed according to age, sex, and teeth affected. The criteria for bone loss were: vertical or horizontal bone loss involving more than one‐third of the root as judged by radiographs. Three age groups were established: 12–18, 19–25, and 26–32 years old. Three types of bone loss localization were defined: I. First molars and/or incisors. U. First molars, incisors and some additional teeth (total <14 teeth). III. General involvement. There was a dominance of female patients. The ratio females: males decreased from 5.3:1 in the youngest age group to 1.5:1 in the oldest. The mean number of involved teeth increased with age from 5.3 teeth in the youngest group to 11.6 in the oldest. The frequency of type I bone loss decreased from 55% in the youngest group to 7% in the oldest. Type 11 occurred with the same frequency (55–58%) in all three age groups. Type III was not seen in the youngest group whereas it increased from 17 % in the middle to 35 % in the oldest group. Of the total number of involved teeth, the first molars were most frequently affected, followed by the incisors. Maxillary teeth were involved to a slightly higher degree than mandibular teeth, and there was a strong “mirror effect” between involved teeth of right and left jaw halves.
Periodontal therapy by local delivery of tetracycline
Authors: Goodson J. M. , Haffajee A. , Socransky S. S.
Published: December 2005

Abstract. The present investigation assessed the feasibility of treating periodontal disease by controlled delivery of antibacterial agents from within periodontal pockets. Tetra‐cycline‐filled hollow fibers placed in the gingival sulcus were shown to have a dramatic effect both on the periodontal microflora and clinical manifestations of disease. Furthermore, it was found that drug‐filled cellulose acetate hollow fibers are biologically compatible with the environment and can be manipulated by dental personnel to provide drug therapy with less than 1/1000 the amount of tetracycline that would have been used for systemic therapy.

Of theoretical importance is the observation that virtual elimination of spirochetes from the gingival sulcus is possible by a single placement of tetracycline‐filled hollow fibers, and spirochetes, ones eliminated from a site, do not rapidly recolonize despite the persistence of viable organisms elsewhere in the mouth.
Long‐term effects of tetracyline on the subgingival microflora
Authors: ÖSterberg S. K.‐Å. , Williams B. L. , Jorgensen J.
Published: December 2005

Abstract. The long‐term effect of tetracycline therapy on the subgingival microbiota was studied in a single patient, a 33‐year‐old female with advanced periodontal disease. Prior to antibiotic therapy, two initial plaque samples were collected to establish the baseline microbial data. These untreated samples contained high numbers of small and medium‐sized spirochetes together with anaerobic Gram‐negative rods including Bacteroides asac‐charolyticus, Fusobacterium nucleatum, anaerobic “corroding” rods resembling the species B. corrodens but lacking a positive urease reaction, and a group of unidentified, non‐fermenting anaerobic rods. The anaerobic asaccharolytic coccus, Peptostreptococcus micros, was also present as 7–10 % of the pretreatment flora. This complex, largely Gram‐negative flora was changed to a facultative, saccharolytic plaque of streptococci (5. mitis and S. mutans) and actinomyces (A. viscosus and A. naeslundit) within 2 weeks of tetracycline therapy at 1000 mg per day. Rothia dentocariosa was the dominant organism cultured after an additional 2 weeks of 500 mg tetracycline per day. Of the predominant pretreatment flora, Fusobacterium nucleatum and Peptostreptococcus micros returned 6–8 weeks following therapy. The known pathogenic associations of this pair of organisms are discussed. However, there were no clinical manifestations of the recolonization by these organisms. Small spirochetes were observed, but not numerous, beginning 16 weeks after therapy. Two groups of organisms currently considered important in periodontal destruction, B. asaccharolyticus and the anaerobic “corroding” bacilli, did not return during the period of observation. High levels of tetracycline resistance were common among the Gram‐positive cocci isolated during treatment.
Mucogingival surgery. The subperiosteal vestibule extension
Authors: Schmid Max O. , Mörmann Werner , Bachmann André
Published: December 2005

Abstract. A surgical technique to establish wide zones of attached mucosa was performed in 28 patients presenting with inadequate amounts of attached gingiva. The clinical results of the procedure were monitored over a period of 2 years. Biometric assessment of 112 mucogingival units immediately before and at 1, 3, 6, and 24 months after surgery revealed that the mean width of attached gingiva changed from 1.1 mm to 5.3 mm of attached tissue (gingiva plus vestibular mucosa). A surgically produced increase of 4.9 mm in width (P< 0.001) and subsequent shrinkage of 0.7 mm or 14 % (P< 0.01) resulted in a total average gain oj 4.2 mm of attached mucosa 2 years after surgery (P < 0.001). A begin/end analysis of the coronal level of clinical periodontal attachment and the extent of gingival recession showed no clinically significant changes. The mean width of keratinized gingiva increased 0.8 mm during the 2‐year postoperative period. The subperiosteal vestibule extension is recommended as an alternative to the free autogenous mucosa graft for establishing wide bands of attached mucosa in areas where loss of attached gingiva is associated with mechanical or microbial irritation of the marginal periodontium.
Vascular morphology in noninflamed healed gingiva of dogs
Authors: Hock J.
Published: December 2005

Abstract. The objective of this study was to determine if the regular vascular network previously reported as occurring in noninflamed marginal gingiva would become re‐established following plaque control and treatment of gingiva by gingivectomy and scaling.

Gingivectomies were performed on dogs with and without pre‐experimental gingivitis in order to obtain gingival specimens healed for 4, 8 and 12 weeks. Plaque was controlled using toothbrushing and topical applications of 0.2 % chlorhexidine gluconate. After 12 weeks, the animals were perfused via the carotid arteries with glutaraldehyde and Microfil® latex compound. Specimens were processed for either routine histology or examination of vascular morphology in methyl salicylate cleared tissues. The absence of inflammation in healed gingiva was evaluated clinically, using the Gingival and Plaque Indices, and histologically.

Results showed that in healed clinically and histologically noninflamed gingiva, the vascular morphology was established as a series of looped vessels which could readily be distinguished from the regular network of vessels described by Hock (1975) in marginal gingiva that had neither been inflamed nor resected.