bluuebunny/crossref_metadata_2025 huggingface dataset:
Bone mineral density in mandibles of ovariectomized rabbits
Authors: Cao Tong , Cao Tong , Shirota Tatsuo , Yamazaki Masataka , Ohno Kohsuke , Michi Ken‐ichi
Published: March 2003

Abstract: The purpose of this study was to evaluate the association between loss of ovarian function and bone mineral density changes in the mandibles of ovariectomized rabbits using peripheral quantitative computed tomography. Twenty‐four adult female Japanese white rabbits were used in this experiment. The mandibular incisors were initially extracted to create implant bone. Twelve animals were bilaterally ovariectomized and the other twelve sham‐ovariectomized 12 weeks after tooth extraction. All rabbits were sacrificed at 4 and 12 weeks after ovariectomy and sham‐ovariectomy, with 6 rabbits in each of the four resultant groups. The edentulous parts of distal mandibular bodies were measured by peripheral quantitative computed tomography. There were significant decreases in total bone mineral density and trabecular bone mineral density in the mandibles of rabbits at 12 weeks post‐ovariectomy. The results demonstrate the mineralized bone loss in the mandibles of ovariectomized rabbits.
Long‐term clinical effectiveness of oral implants in the treatment of partial edentulism
Authors: Romeo Eugenio , Chiapasco M. , Ghisolfi M. , Vogel G.
Published: March 2003

Abstract: One hundred and eight‐seven ITI® implants were prospectively followed from November 1992 to July 2000, in order to evaluate the clinical efficiency and the long‐term prognosis in 109 partially edentulous patients (69 women and 40 men; average age 41.3 years). Of these 187 implants, 69.5% were placed in the mandible and 30.5% in the maxilla. After a healing period that ranged from three to six months, the osseointegrated implants (n = 184) were restored with single crowns. Three implants were extracted prior to loading the fixture and were considered early failures. Each implant was reassessed on a yearly basis, both clinically and radiographically. The results of the investigation, which were evaluated according to predefined success criteria, were reviewed in accordance with a life table method. During the follow‐up, six cases were deemed to be late failures. In each of these cases, a suppurative infection of the peri‐implant tissue was diagnosed: in one implant, the infection could not be eradicated and the implant was removed. When 11 drop‐outs were included in the analysis, the cumulative survival and success rates for the whole sample group were 96.77% and 93.6%, respectively. When only prosthetically loaded implants were considered, the results increased to 99.35% for the cumulative survival rate and 96.18% for the cumulative success rate. The analysis on disaggregated data showed better results for maxillary restorations (survival rate 100%) in comparison to mandible restorations (survival rate 95.11%). It was concluded that, under standard anatomic conditions (bone site height > 8 mm, thickness > 6 mm), prosthetic restoration of partially edentulous patients with the ITI system can be described as a reliable and efficient therapy in the long term.
A long‐term follow‐up study of non‐submerged ITI implants in the treatment of totally edentulous jaws
Authors: Ferrigno Nicola , Laureti Mauro , Fanali Stefano , Grippaudo Guido
Published: March 2003

Abstract: In this prospective multicenter study, non‐submerged ITI implants were followed in order to evaluate their long‐term prognosis in fully edentulous jaws. A total of 1286 implants were inserted in 233 consecutive patients and, after a healing period of three to six months, the successfully integrated implants were restored with 163 overdentures and 95 fixed full‐arch bridges. This prospective study not only calculated the 10‐year cumulative survival and success rates for the 1286 implants by life table analysis, but also evaluated the actual survival and success rates for 498 implants after at least five years of functional loading. In addition, cumulative success rates were calculated for implant subgroups according to implant length and location. Additional analyses were performed to evaluate the estimated and actual survival and success rates of the implants in relation to various prosthetic rehabilitation techniques. The 10‐year cumulative survival and success rates were 95.9% and 92.7%, respectively. The actual 5‐year survival and success rates of the first 498 implants that were inserted were 97.7% and 95.0%, respectively. The analysis of implant subgroups showed slightly more favourable cumulative success rates for 12 mm long implants (93%), in comparison to 10 mm and 8 mm long implants (91.6% and 89.6%, respectively). The cumulative success rate for mandibular implants (approximately 94%) was also more favourable than that for maxillary implants (approximately 91%). Patients who were loaded with both maxillary and mandibular prostheses maintained success rates well above 90%; while only implants that were inserted to support maxillary overdentures that were retained by Dolder bars showed a success rate below 90%.
Immediate loading of single‐tooth ITI implants in the anterior maxilla: a prospective 5‐year pilot study
Authors: Andersen Eivind , Haanæs Hans Reidar , Knutsen Bjørn Mork
Published: March 2003

Abstract: The aim of the present study was to evaluate the success rate of immediately loaded single‐tooth ITI solid plasma‐sprayed (TPS) implants in the maxilla. Eight implants were loaded immediately after placement in eight different patients, and were followed for five years. Temporary acrylic resin restorations, which were fabricated from impressions that were taken immediately after implant placement, were connected one week later. These temporary restorations were adjusted in order to avoid any direct occlusive contacts. After six months, the provisional crowns were replaced by definitive ceramic crowns. Regular follow‐ups were performed during the investigation period. No implants were lost, and the mean marginal bone level for the eight implants increased by 0.53 mm (range − 0.83 to + 1.54 mm) from placement to the final examination. Only minor complications were noted, and overall patient satisfaction was high.
Curasan PRP kit vs. PCCS PRP system
Authors: Weibrich Gernot , Kleis Wilfried K. G.
Published: March 2003

Abstract: An important reason to improve methods of isolating platelet‐rich plasma (PRP) is the potential use of autologous thrombocyte growth factors. In addition to discontinuous cell separation, two methods for extracting PRP that can be performed directly by the surgeon are now available. This study compared the suitability of these two methods for the preparation of PRP. Whole blood was drawn from 47 healthy donors (18 men, 29 women) aged 20–59 years (mean 29.9, SD 7.7). For each donor, PRP was separated by the PCCS method (PCCS Kit, 3i Implant Innovations, Palm Beach Gardens, FL, USA) and by the Curasan method (analogous to the PRP kit, Curasan, Kleinostheim, Germany). Thrombocyte counts differed significantly (sign test P = 0.001) between the donor blood (mean 290,000/µl, SD 86,000/µl), the PCCS PRP preparation (mean 2,209,000/µl, SD 901,000/µl), and the Curasan PRP (mean 1,075,000/µl, SD 636,000/µl). The correlation between the thrombocyte count in the PRP and the thrombocyte count in the donor whole blood was greater for the PCCS PRP (Spearman's correlation coefficient rS = 0.60) than for the Curasan PRP (rS = 0.34). A slight, clinically irrelevant, influence of gender on thrombocyte concentration in whole blood was found, but no influence of age was detected.
Precision of transfer of preoperative planning for oral implants based on cone‐beam CT‐scan images through a robotic drilling machine
Authors: Fortin Thomas , Champleboux Guillaume , Bianchi Silvio , Buatois Hervé , Coudert Jean‐Loup
Published: March 2003

Abstract: In this study, an image‐guided system for oral implant placement was assessed. A specially designed mechanical tool has been elaborated to transfer the preoperative implant axis planned on 3‐dimensional imagery into a surgical template by a numerically controlled drilling machine. The main drawback of image‐guiding systems is the use of preoperative computed tomography, which is expensive and delivers high radiation doses. Therefore, in this study the image‐guiding system was coupled with a cone‐beam tomograph that significantly decreased both cost and radiation doses. Three edentulous models were used. To determine the accuracy of the system, the ability of a 1.8‐mm diameter drill to enter a 2.0‐mm diameter, 10‐mm‐long titanium tube inserted on the model with no contact was verified. Because the drill entered the tubes with no contact and went beyond the end of the tube, the transfer error was less than 0.2 mm for translation and less than 1.1° for rotation. The method presented here is low cost and high precision compared to other technological solutions such as tracking. Further assessment in the surgical field should lead to daily use of this system for flapless surgery, to prepare a prosthesis prior to surgery for immediate loading, to reduce risk of injuring critical anatomical structures and to eliminate manual placement error.
Bone augmentation by means of a stiff occlusive titanium barrier
Authors: Van Steenberghe Daniel , Johansson Carina , Quirynen Marc , Molly Liene , Albrektsson Tomas , Naert Ignace
Published: March 2003

Abstract: It has already been shown that occlusive titanium barriers have osteoconductive properties. These barriers, however, cover only a limited surface area and have only been used in animal experiments. The aim of this study was to evaluate bone neogenesis under a pre‐shaped titanium barrier placed over the top of the rabbit skull and the top of highly resorbed edentulous upper‐jaw bone in patients. Computed tomography (CT) scans made it possible to pre‐shape the titanium barrier according to individual bone shape in human experiments. On the rabbit skull, tissue augmentation of up to 6 mm 1 year after barrier placement was observed, while the original thickness of skull bone was on average between 1.5 and 2.5 mm. The bone, which remained histologically immature for 1 year, grew systematically along the titanium surface, illustrating its osteoconductivity. Even after removal of the barrier, on average, 75.3 and 59.4% of the newly created tissue volume was maintained after 3 and 9 months, respectively. Clinical observations on 10 consecutive patients showed that, in those (5/10) in which the barrier remained unexposed for several months, an increase of the jawbone height and width of up to 16 mm could be observed when the barrier was removed after 12–18 months. As in the rabbits at barrier removal, the bone demonstrated a limited degree of mineralization as ascertained from biopsies. This newly formed osteoid tissue allowed the insertion of 33 screw‐shaped titanium implants which in most cases (30/33) successfully osseointegrated to support a fixed prosthesis. The surrounding marginal bone level remained stable even up to 5 years after implant placement. Both animal and clinical data demonstrate that guided bone neogenesis under a subperiosteally placed titanium barrier can reach large volumes.
Stain, plaque and gingivitis reduction by combining chlorhexidine and peroxyborate
Authors: Gründemann L. J. M. M. , Timmerman M. F. , Ijzerman Y. , Van Der Velden U. , Van Der Weijden G. A.
Published: March 2003

Background: Previous studies have shown that using an oxidising agent in addition to chlorhexidine reduces staining.

Aim:

The purpose of the present study was to investigate whether, compared to chlorhexidine alone, the use of an oxidising mouthrinse as an adjunct to chlorhexidine is efficacious in reducing stain, plaque and gingivitis.

Method: This study had a single‐blind, 2‐group parallel design, including a 14‐day experimental non‐brushing period during which 1 group (n=14) used chlorhexidine alone (CHX) (chlorhexidine mouthrinse, 0.12% Oral‐B® laboratories, Ireland), and the other (n=14) used chlorhexidine in combination with an oxidising agent (sodiumperborate‐monohydrate‐Bocasan®, Oral‐B laboratories, Ireland). Patients were randomly assigned to either group. All participants received a scaling and polishing before the start of the trial. No oral hygiene instructions were given. Since, at the start of the experiment, all stain and plaque were removed, only the gingival condition was evaluated at baseline by means of bleeding on marginal probing. The examination after 14 days of rinsing included the evaluation of plaque, bleeding on marginal probing and stain (GMSI: gingival modification of the stain index).

Results: The results showed at day 14, a significant difference between the 2 groups for plaque (CHX: 0.18, CHX+PER: 0.08, p=0.03) and gingival bleeding (CHX: 0.38, CHX+PER: 0.21, p<0.001). The proportion of stained surfaces was less in the CHX+PER group (28%), than in the chlorhexidine group (48%) (p=0.04).

Conclusions: In conclusion, the adjunctive use of an oxidising agent peroxyborate to chlorhexidine, proved to be superior to chlorhexidine alone with regard to the inhibition of plaque and development of gingivitis. In addition, the proportion of stained surfaces was significantly less when adding the oxidising mouthrinse to chlorhexidine.
Antimicrobial resistance in the subgingival microflora in patients with adult periodontitis
Authors: Van Winkelhoff A. J. , Gonzales D. Herrera , Winkel E. G. , Dellemijn‐Kippuw N. , Vandenbroucke‐Grauls C. M. J. E. , Sanz M.
Published: March 2003

Background: The widespread use of antibiotics for prophylaxis and treatment of bacterial infections has lead to the emergence of resistant human pathogens. Great differences have been documented between European countries in the use of systemic antibiotics. In parallel, significant differences in levels of resistant pathogens have been documented.

Aim:

To investigate whether differences in antibiotic use influence the level of antimicrobial resistance of the subgingival microflora of untreated patients with adult periodontitis in The Netherlands and Spain.

Method: Blood agar plates containing breakpoint concentrations of penicillin, amoxicillin, amoxicillin and clavunalate, metronidazole, erythromycin, azithromycin, clindamycin and tetracycline were used to determine the proportion of bacteria from the subgingival plaque that was resistant to these antibiotics. In the Spanish patients, statistically significant higher mean levels of resistance were found for penicillin, amoxicillin, metronidazole, clindamycin and tetracycline. The mean number of different bacterial species growing on the selective plates was higher in the Spanish patients, as was the % of resistant strains of most periodontal pathogens. A striking difference was observed in the frequency of occurrence of tetracycline‐resistant periodontal pathogens. In Spain, 5 patients had 3 tetracycline resistant periodontal pathogens, whereas this was not observed in any of the Dutch patients.

Conclusions: The widespread use of antibiotics in Spain is reflected in the level of resistance of the subgingival microflora of adult patients with periodontitis.
Regenerative periodontal surgery in interproximal intrabony defects with biodegradable barriers
Authors: Dörfer Christof E. , Kim Ti‐Sun , Steinbrenner Harald , Holle Rolf , Eickholz Peter
Published: March 2003

Aim:

The comparison of the effects of guided‐tissue regeneration (GTR) using 2 different biodegradable barriers (polylactide acetyltributyl citrate; polydioxanon) in 3‐ and 2‐wall intrabony defects.

Method: The polydioxanon barrier is an experimental membrane for GTR therapy that consists of an continuous occlusive barrier that has a layer of slings on the side that is meant to face the mucoperiosteal flap. 15 patients provided 15 pairs of similar contralateral periodontal defects: 12 predominantly 2‐wall and 18 predominantly 3‐wall intrabony defects. Each defect was randomly assigned to treatment with either polylactide acetyltributyl citrate (control [c]) or polydioxanon (test [t]) devices. At baseline and 6 months after surgery, clinical measurements (PlI, GI, PPD, PAL‐V) were performed.

Results: Barrier exposure was commonly observed in both groups (control/test): 5/4 after 7 days, 9/11 after 14 days and 11/12 after 28 days postsurgically. 4 weeks after surgery, 77% of all barriers were exposed to some extent. However, both treatments revealed a significant GI reduction (p<0.05), PPD reduction [−4.63±1.85 mm (t), −4.17±1.89 mm (c); p<0.001] and PAL‐V gain [3.97±1.17 mm (t), 3.40 mm±1.40 (c); p<0.001] 6 months after surgery. Regarding GI and PPD reduction as well as PAL‐V gain, there were neither statistically significant nor clinically relevant differences between test and control: similar clinical results were found 6 months after surgical treatment using both biodegradable barriers.

Conclusions: Based on the results of the present study, the use of both biodegradable barriers in GTR therapy may be recommended.
Radiographic detection and assessment of the periodontal endosseous defects
Authors: Pepelassi Eudoxie A. , Tsiklakis Kostas , Diamanti‐Kipioti Anthi
Published: March 2003

Aims: The aim of the present study was to investigate the potential of conventional radiography in detecting and accurately imaging periodontal endosseous (or osseous) defects when compared to surgical measurements. A further objective of the study was the selection of the most successful radiographic method for the assessment of endosseous defects.

Method: Surgical measurements, during periodontal flap surgery, and radiographic measurements, from periapical and panoramic radiographs, were obtained from 5072 proximal surfaces of 100 patients presenting with periodontitis.

Results: Statistical evaluation of the surgical and radiographic measurements revealed the following. (1) The ability of the radiographs to detect periodontal osseous defects was relatively low. (2) For periapical radiography, it depended, in descending order, on the depth and buccolingual width of the defect, the number of osseous walls and the jaw location. For panoramic radiography, it depended only on buccolingual width. (3) Osseous defects of small depth and/or small buccolingual width were the most difficult to detect radiographically. (4) Periapical radiography was more successful than panoramic in detecting osseous defects, and more accurate in assessing the defect dimensions (depth, mesiodistal width). (5) The difference in the defect detection ability between the 2 radiographic methods, the accuracy of the radiographic defect dimensions assessment as well as the degree of agreement between periapical and panoramic assessment depended on defect location and dimensions.

Conclusions: Periapical radiography is superior to panoramic in detecting and accurately imaging periodontal osseous destruction.
Is there a relationship between rheumatoid arthritis and periodontal disease?
Authors: Mercado F. , Marshall Roderick I. , Klestov Alexander C. , Bartold P. Mark
Published: March 2003

Aim: The aim of this study was to determine whether there is a relationship between disease experience of rheumatoid arthritis and periodontal disease.

Methods: 1412 individuals attending the University of Queensland's School of Dentistry were assessed for the prevalence of periodontal disease and rheumatoid arthritis. Analysis of data obtained from a self‐reported health questionnaire and dental records was carried out and included: number of individuals referred for advanced periodontal care (test group); number of individuals attending for routine dentistry; determination of rheumatoid arthritis, cardiovascular disease and diabetes mellitus through self‐reporting and assessment of prescription medications; assessment of periodontal disease through assessment of existing oral radiographs.

Results: In patients referred for periodontal treatment, the prevalence of self‐reported rheumatoid arthritis was 3.95% which is significantly higher than that seen in patients not referred for periodontal treatment (0.66%) and also that reported in the general population (1%). Of those referred patients with rheumatoid arthritis, 62.5% had advanced forms of periodontal disease. These results were mirrored in the results of the self‐reported prevalence of cardiovascular disease and diabetes mellitus which was consistent with the published higher prevalence in periodontal patients.

Conclusions: Based on data derived from self‐reported health conditions, and not withstanding the limitations of such a study, we conclude that there is good evidence to suggest that individuals with moderate to severe periodontal disease are at higher risk of suffering from rheumatoid arthritis and vice versa.
Matrix metalloproteinase‐8 levels and elastase activities in gingival crevicular fluid from chronic adult periodontitis patients
Authors: Chen H. Y. , Cox S. W. , Eley B. M. , Mäntylä P. , Rönkä H. , Sorsa T.
Published: March 2003

Aim: To make an initial assessment of the periodontal diagnostic potential of immunoreactive matrix metalloproteinase‐8 (MMP‐8) in gingival crevicular fluid (GCF) by comparison with elastase activity which has previously been associated with disease severity and progression.

Methods: GCF was collected from molar and premolar sites of 16 chronic adult periodontitis patients before treatment and 13 of this group 2 weeks after scaling and root planing. Samples were analysed for MMP‐8 by immunofluorometric assay and for elastase activity with a fluorogenic substrate.

Results: Mean patient clinical parameters and GCF enzyme totals both decreased significantly after treatment. Total MMP‐8 levels and elastase activities generally correlated significantly with gingival and bleeding indices. For GCF concentrations, only MMP‐8 showed a significant fall after treatment, and some significant correlations with clinical parameters. Amounts of the 2 enzymes correlated significantly with each other.

Conclusions: Similarities betdween MMP‐8 and elastase probably reflect the fact that both enzymes are associated mainly with neutrophils: MMP‐8 levels may have fallen more after treatment because the assay, unlike that for elastase, would most likely not have detected much enzyme bound to α2‐macroglobulin. The immunoassay for MMP‐8 is more specific and convenient than functional collagenase assays, and might be suitable for monitoring the periodontal condition.
β‐lactamase producing bacteria in the subgingival microflora of adult patients with periodontitis. A comparison between Spain and The Netherlands
Authors: Herrera D. , Van Winkelhoff A. J. , Dellemijn‐Kippuw N. , Winkel E. G. , Sanz M.
Published: March 2003

Background/aims: Countries with a high per capita antibiotic use frequently demonstrate a high level of drug resistance. The aim of this study was to compare the prevalence and levels of β‐lactamase producing bacteria in the subgingival microflora in adult patients with periodontitis in Spain and The Netherlands, and to characterise β‐lactamase producing bacteria in both patient samples.

Method: Patients with moderate to severe periodontitis were consecutively selected and asked to report on: current systemic disorders and medications, history of use of antibiotics, and smoking habits. Clinical variables included probing pocket depth, clinical attachment level, plaque, bleeding on probing, and suppuration. Pooled subgingival samples of 4 selected sites were anaerobically cultured in blood agar plates with and without amoxicillin, and amoxicillin/clavulanate. Bacterial colonies growing on amoxicillin plates but not on amoxicillin/clavulanate plates were tested for β‐lactamase production. β‐lactamase producing bacteria were isolated and identified.

Results: 31 patients were studied in the Spanish group and 30 in the Dutch group. Comparable mean gender and ages were found. Evaluation of previous antibiotic use revealed that, in the previous 12 months, 54.8% of patients in the Spanish group and 10% in the Dutch group reported antibiotic use (p<0.001). The prevalence of β‐lactamase producing bacteria was 87.1% in the Spanish group and 73.3% in the Dutch group. Total counts of β‐lactamase producing bacteria on amoxicillin plates (p<0.01), the mean number of different β‐lactamase producing colonies per patient (p<0.001), and the number of amoxicillin resistant colonies (p<0.001) were significantly higher in the Spanish group. 74 β‐lactamase producing strains in the Spanish group and 33 in the Dutch group were isolated for identification. 23 out of 35 identified strains in the Spanish group, and 32 out of 33 in the Dutch group belonged to Prevotella genus.

Conclusions: A high prevalence of β‐lactamase producing bacteria has been evaluated in two distinct populations, belonging to two European countries with clear differences in antibiotic usage policy. A higher prevalence and a more complex β‐lactamase producing microflora, were found in the Spanish group, associated with a higher antibiotic consumption. This study shows that a higher use of β‐lactam antibiotics is reflected in the % of β‐lactamase producing bacteria in the subgingival microflora of patients with periodontitis. This information may be important in the treatment of severe periodontitis.
A study to assess the plaque inhibitory activity of a new triclosan mouthrinse formulation
Authors: Moran J. , Addy M. , Newcombe R. G. , Marlow I.
Published: March 2003

Background/aims: Toothpastes and mouthrinses containing triclosan have been shown to be of some value at inhibiting both plaque and gingivitis. However much improved activity can be obtained by the addition of other chemicals which increase substantivity or antimicrobial activity. The present study was designed to determine whether a new mouthwash formulation containing a triglyceride oil was capable of reducing plaque reformation when compared to a control rinse containing neither triclosan or oil.

Methods: A total of 24 subjects took part in a double‐blind, single‐centre, cross‐over study in which rinses were used as the only form of oral hygiene over a 4‐day period. On the 1st day of each period, the subjects were given a prophylaxis to remove all plaque and calculus deposits. A single supervised rinse was taken and subsequent 2× daily rinses over the following 3 days. 24 and 96 h after the prophylaxis, the volunteers returned to the clinic, the plaque disclosed and assessed by plaque index and area. The test procedure and wash‐out phase were repeated until all of the subjects had used both rinses.

Results: After 24 h, a 12% reduction in plaque score and a 25% reduction in plaque area was noted for the triclosan/oil rinse compared to the control rinse; however, these reductions were not significant (p>0.05). After 96 h, the triclosan/oil rinse failed to produce a numerical or statistical reduction in plaque whether measured by plaque score or area.

Conclusions: These findings would suggest that the triclosan/oil rinse would be of little value at inhibiting dental plaque whether used alone or as an adjunct to conventional oral hygiene measures.
Altered chemotactic behavior of crevicular PMNs in different forms of periodontitis
Authors: Sigusch B. , Eick S. , Pfister W. , Klinger G. , Glockmann E.
Published: March 2003

Background, aims: Polymorphonuclear neutrophils (PMN) are the predominant host defence cells in the gingival sulcus. Previous work demonstrates that the in vitro phagocytosis of crevicular cells in localised early onset periodontitis (LEOP) and generalised early onset periodontitis (GEOP) lesions is diminished. The present study extends this work by characterizing the chemotaxis function of crevicular fluid (CF) PMNs in various forms of periodontitis.

Methods: We investigated 7 patients with LEOP, 11 patients with GEOP, 12 patients with adult periodontitis (AP) and 2 age‐ and sex‐matched healthy control groups. The two deepest sites of each quadrant in test and control subjects were selected for crevicular sampling. Chemotaxis was performed in a micro chamber (moist atmosphere, 5% CO2, 37 °C, 30 min) using N‐formyl‐methionyl‐leucyl‐phenylalanine (FMLP, 1×10−7 mol FMLP/l) as a chemoattractant. The total chemotaxis was defined as the difference between the number of cells migrating towards FMLP minus the number of cells migrating towards PBS, counted in 20 randomly selected fields. Membranes were examined microscopically at 400× magnification.

Results: The chemotactic activity in the adult periodontitis group was significantly higher compared to the age‐related control group. However, we found a statistically significant reduction of chemotactic activity in LEOP and GEOP patients compared to the controls.

Conclusions: These results indicate an increase of chemotactic activity from CF‐PMN in patients with adult periodontitis, but on the other hand, a significant reduction of chemotactic responsiveness of these cells in LEOP and GEOP lesions.
Effects of SCN−/H2O2 combinations in dentifrices on plaque and gingivitis
Authors: Rosin Michael , Kocher Thomas , Kramer Axel
Published: March 2003

Objectives: A 10‐week, double‐blind, placebo‐controlled clinical study on 140 male subjects was conducted to determine the effect on plaque and gingivitis of 5 dentifrices containing various thiocyanate (SCN−)/hydrogen peroxide (H2O2) combinations.

Materials and Methods: The dentifrices consisted of a gel base without any detergents or abrasives (placebo, group A) to which SCN− and/or H2O2 were added as follows: 0.1% SCN− (group B), 0.5% SCN− (group C), 0.1% SCN−/ 0.1% H2O2 (group D), 0.5% SCN−/0.1% H2O2 (group E) and 0.1% H2O2 (group F). A baseline examination was performed in which the Silness and Löe Plaque Index (PI), the Mühlemann and Son Sulcus Bleeding Index (SBI), and the amount of gingival crevicular fluid (GCF) were recorded using the Periotron 6000 on teeth 16, 12, 24, 36, 32, and 44. The subjects were randomly assigned to either the placebo group (n=40) or one of the test groups (n=20) and used their respective dentifrices over a period of 8 weeks. Finally, each group used the placebo for another 2 weeks (wash‐out). Re‐examinations were performed after 1, 4, and 8 weeks and the 2‐week wash‐out period employing the clinical parameters used at baseline. Intragroup changes were analyzed with the Wilcoxon signed‐ranks test, using the baseline and wash‐out points as references. The Mann‐Whitney U test was used for comparisons between the treatment groups and the placebo group.

Results: At the 8‐week examination, the plaque index in group E (p=0.017) and group F (p=0.032) was lower than in the placebo group. The Sulcus Bleeding Index in group F after 1 week was increased (p=0.023) and the SBI in group E after 8 weeks was reduced (p=0.047) as compared to the placebo group.

Conclusion: The results demonstrated that a dentifrice containing 0.5% SCN− and 0.1% H2O2 but no detergents or abrasives inhibited plaque and decreased gingivitis.
Toothbrush filaments end‐rounding: stereomicroscope analysis
Authors: Checchi L. , Minguzzi S. , Franchi M. , Forteleoni G.
Published: March 2003

Abstract Background, aims: Toothbrush filaments with rounded ends allow for efficient removal of bacterial plaque and are less harmful to periodontal tissues than non‐rounded bristles. The aim of this research was to evaluate the % of rounded filaments considered to be of acceptable quality in different toothbrush brands and to determine whether there is a standardization of quality, as manufacturers claim.

Method: Brushes tested included 2 samples of medium‐hard nylon or tynex toothbrushes from 31 various types found on the retail market in Italy. Tufts from the same position on the toothbrush head were removed and examined under a stereomicroscope, utilizing methods which did not alter the physical properties of the filaments. In 4 of the 31 toothbrush brands tested, more than 50% of the filaments appeared rounded, in 19 of them, between 11.9% and 40.5% and in 8 brands between 0% and 7%.

Results: Differences were found in the number and disposition of filaments among different brands and even within the same toothbrush brand.

Conclusion: The results appear to indicate that a large % of toothbrushes on the retail market do not meet acceptable quality criteria.
The effect of systemic antibiotics in the treatment of patients with recurrent periodontitis
Authors: Serino G. , Rosling B. , Ramberg P. , Hellström M.‐K. , Socransky S. S. , Lindhe J.
Published: March 2003

Background: Subjects with periodontal disease exist who either (i) respond poorly to initial mechanical therapy (“refractory” periodontitis) or (ii) fail to adopt adequate self‐performed plaque control techniques and hence develop recurrent disease (“recurrent” periodontitis) at multiple sites during the supportive treatment phase (SPT). Various systemic antibiotic regimens have been tried as adjuncts to the mechanical (re‐) treatment of such “difficult to treat”‐patients. While most studies indicated a positive outcome of the adjunctive therapy, some clinical investigators reported that this additional measure provided little or no benefit.

Aim: The aim of the present investigation was to study the more long term effect of adjunctive antibiotic therapy in the re‐treatment of patients with a well defined history of recurrent periodontitis.

Material and Methods: 17 subjects with recurrent advanced periodontal disease were, following a baseline examination, subjected to non‐surgical therapy including the use of systemic antibiotics (amoxicillin and metronidazole). They were placed in a careful SPT program and re‐examined after 1, 3 and 5 years. The examinations included both clinical and microbiological assessments.

Results: It was demonstrated that in subjects with advanced and recurrent periodontitis, re‐treatment including (i) comprehensive scaling and root planing (SRP), (ii) systemic administration of antibiotics and (iii) meticulous supragingival plaque control by both mechanical and chemical means established periodontal conditions that in the short term (3 years) and in the majority of subjects could be properly maintained by traditional SPT measures. Between 3 and 5 years, however, only 5 of the 17 subjects exhibited stable periodontal attachment levels.

Conclusions: Some deep pockets and furcations were most likely inadequately instrumented during the active treatment phase. Microorganisms residing in biofilms left in such locations were probably not sufficiently affected by the 2 weeks of adjunctive antibiotic therapy. It is suggested that removal of certain subgingival deposits, therefore, may require surgical intervention.
Flow‐cytometric analysis of lymphocyte subsets and mCD14 expression in patients with various periodontitis categories
Authors: Buduneli Nurcan , Bıçakçı Nurgün , Keskinogˇlu Ahmet
Published: March 2003

Background: Membrane‐bound CD14 (mCD14) is expressed mainly on circulating monocytes and tissue macrophages. It is one of the receptors, which act at the recognition of lipopolysaccharides by host cells. Periodontopathic bacteria result in activation of cellular and humoral immune responses.

Aim: The aim of the present study was to analyze the peripheral blood mCD14 concentrations as well as cell surface markers of lymphocyte subsets in periodontitis patients of various categories.

Materials and Methods: Peripheral blood samples were obtained from 22 early onset periodontitis (EOP), 10 adult periodontitis (AP) patients and 13 systemically and periodontally healthy control subjects. Three‐color flow cytometry and a panel of relevant monoclonal antibodies were used to determine the percent expression of various cell surface markers on peripheral blood mononuclear cells (PBMCs). The results were tested statistically by one‐way variance analysis and Newman Keuls test.

Results: No significant difference was observed between the study groups with regard to the relative counts of B‐cells, T‐cells, T‐helper, T‐cytotoxic/suppressor, activated T‐cells and natural killer cells. EOP patients expressed significantly lower level of interleukin‐2 receptor (IL‐2R) when compared with AP patients (6.08% and 19.3% respectively) (p<0.05). The level of mCD14 in EOP patients (7.18%) was lower than that of AP patients (9.3%) and the control subjects (9.2%), but the differences were not statistically significant.

Conclusions: The low level of IL‐2R in the EOP group may be interpreted as an insufficient responsiveness to the periodontopathogens, which may be ultimately related with the more severe tissue destruction. Though not significant, the reduced expression of mCD14 in EOP group may also be related with the immune system deficiencies in these patients.
Clinical features of gingival pemphigus vulgaris
Authors: Mignogna Michele D. , Lo Muzio Lorenzo , Bucci Eduardo
Published: March 2003

Background: Pemphigus vulgaris (PV) is a rare, chronic, intraepithelial bullous disease with a potentially fatal outcome. Oral lesions are a hallmark of PV and occur in almost all cases, and represent the preliminary symptom in more than half of the patients. Gingival lesions are very common and, when solitary, often first recognized by periodontist.

Method: In the literature, gingival localization of PV are usually described as desquamative gingivitis (DG) and/or as vesiculobullous lesions of the free and attached gingiva; in our experience, early lesions only rarely appears as extensive erythema and erosions.

Conclusions: PV at the onset may frequently appear on gingiva as isolated blisters and/or erosions mainly located to the free gingiva, very little in extension and hardly to recognize as bullous lesions.
Comparative antimicrobial activities of antiseptic mouthrinses against isogenic planktonic and biofilm forms of Actinobacillus actinomycetemcomitans
Authors: Fine D. H. , Furgang D. , Barnett M. L.
Published: March 2003

Background: Bacteria contained in biofilms have been shown to have a decreased susceptibility to antimicrobial agents compared to those in planktonic form. Thus, in vitro biofilm models have been developed for screening oral antimicrobial formulations in an effort to produce findings more predictive of clinical activity. This study compared the antimicrobial activity of three mouthrinse formulations when tested against isogenic strains of Actinobacillus actinomycetemcomitans (Aa), one of which was a clinical isolate which forms tenacious biofilms in vitro and the other of which was a spontaneous variant which always grows planktonically.

Method: Biofilm‐forming Aa strains CU1000 and NJ4300, obtained as clinical isolates, and their respective spontaneous planktonic variants, CU1060 and NJ4350, were grown under standard laboratory conditions and exposed for 15 s to either a negative control (phosphate buffered saline [PBS]), an essential‐oil containing mouthrinse (Listerine® Antiseptic [LA]), an amine fluoride/stannous fluoride‐containing mouthrinse (Meridol®[M]), or a triclosan and PVM/MA copolymer‐containing mouthrinse (Plax®[P]). The cells were then washed, serially diluted, plated, and incubated for enumeration of viable bacteria. Colony‐forming units (CFU)/ml were log10 transformed and the mouthrinse groups were compared to the PBS group using analysis of variance.

Results: All 3 mouthrinses produced statisically significant 99.99% reductions (p0.0001) in both planktonic strains compared to the PBS control. Effects on the biofilm forms of the organisms were more variable. Exposure to LA produced statistically significant (p0.0001) reductions in strains CU1000 and NJ4300 of 98.20% and 96.47%, respectively, compared to PBS. M and P produced much smaller reductions which were not statistically significant.

Conclusions: The results of this study, in which antimicrobial mouthrinses were tested against biofilm‐forming and planktonic strains of the same organism, provide a clear demonstration of the resistance to antimicrobial agents conferred by biofilm formation and provide additional support for employing tests using biofilms to more accurately assess the relative activities of antiplaque agents in vitro.
Exostosis following a free gingival graft
Authors: Echeverria José J. , Montero Mauricio , Abad Daniel , Gay Cosme
Published: March 2003

Background: There have been few cases reported of exostoses following a free gingival graft. In 1980, a free gingival graft was placed on the facial level of 33–34, developing over the years a significant enlargement. In 1999, since the patient felt progressively uncomfortable with the enlarged area, its surgical reduction was proposed.

Method: Under local anesthesia, the hard tissue developed under the previously‐grafted area, was significantly reduced. The specimen, together with a fragment of the covering soft tissue, was sent for histological analysis.

Results: The surgical wound healed uneventfully, and the patient was satisfied with the results. The histology showed the presence of mature bone surrounded by a dense connective tissue, whereas the gingival tissue showed acanthosis and fibrosis.

Conclusion: The development of exostoses following a free gingival graft can be considered an unpredictable, albeit infrequent side‐effect of this procedure. The fact that most of these exostoses appear in the cuspid‐premolar area, deserves further consideration.
Dental biofilms at healthy and inflamed gingival margins
Authors: Rüdiger S. G. , Carlén A. , Meurman J. H. , Kari K. , Olsson J.
Published: March 2003

Objectives: The increased plaque formation observed in gingival inflammation is not fully understood. Receptor proteins in the dental pellicle might influence bacterial adhesion and subsequent plaque formation. The purpose of the present study was to examine proteins and microorganisms in dental biofilms, at healthy and inflamed gingival margins.

Material and methods: To see whether marginal inflammation affects the composition of the pellicle and the early dental plaque, samples were taken from the gingival and incisal parts of teeth in periodontally healthy subjects, both in gingival health and during experimental gingivitis. Pellicle proteins were analysed using gel‐electrophoresis, immunoblotting and image analysis. Bacteria were analysed by culturing and the PCR technique.

Results: During gingivitis, the rate of plaque formation increased significantly. The semiquantitative amounts of proteins and the numbers of bacteria varied considerably between individuals and surfaces. The amount of total and individual pellicle proteins and the total numbers of bacteria were, however, increased during gingivitis and the increase in proteins was statistically significant on the incisal parts of tooth surfaces. Compared to a healthy gingiva, reduced numbers for Actinomyces spp. (incisal parts only) and streptococci and increased numbers of periodontopathogens in the 4 h dental biofilms were seen at the inflamed gingiva.

Conclusion: Increased gingival crevicular fluid flow during gingivitis affects pellicle formation and increased plasma proteins in the pellicle may modify bacterial attachment and early dental plaque composition.
Root surface roughness following Er:YAG laser irradiation at different radiation energies and working tip angulations
Authors: Folwaczny Matthias , George Gelu , Thiele Lidka , Mehl Albert , Hickel Reinhard
Published: March 2003

Objectives: The determination of roughness of root surfaces following treatment with 2.94 µm Er:YAG laser radiation at different radiation energies and working tip angulations.

Materials and methods: The study sample comprised 85 extracted human molars, premolars, canines and incisors (n = 85). The source of laser radiation was an Er:YAG laser device (KAVO‐Key II, System Aesculap Meditec) emitting pulsed infrared radiation at a wavelength of 2.94 µm, with a pulse duration of 250 µs, and a pulse repetition rate of 10 pps. The samples were randomly divided into three experimental units, for treatment with a constant amount of 380 laser pulses at a radiation energy of 60 mJ, 100 mJ, and 180 mJ. Each experimental unit was divided into five subgroups of five samples, which were irradiated at a working tip angulations of 15°, 30°, 45°, 60°, and 90°. Five samples were treated mechanically using curettes. Five samples were left untreated as control. The mean (Ra) and maximum (Rmax) surface roughness of each sample was measured using a profilometer. The statistical analysis was undertaken using anova and Scheffé‐test at a level of significance of 5% (p < 0.05).

Results: Er:YAG laser radiation led to an Ra which ranged from 0.52 µm (± 0.10) to 0.81 µm (± 0.26) and to an Rmax between 3.4 µm (± 0.48) and 9.26 µm (± 3.08). The Ra and Rmax for samples treated with curettes was 0.51 µm (± 0.11) and 5.08 µm (± 4.98), respectively. That for the untreated control samples were 0.53 µm (± 0.15) and 7.07 µm (± 5.48), respectively.

Conclusions: The mean and maximum surface roughness of root surfaces following irradiation with Er:YAG laser was not significantly different to that obtained on samples treated with conventional hand instruments or left untreated. Furthermore, the surface roughness does not depend on the radiation energy and the angulation of the working tip.
Comparison of microbial cultivation and a commercial PCR based method fordetection of periodontopathogenic species in subgingival plaque samples
Authors: Eick Sigrun , Pfister Wolfgang
Published: March 2003

Objectives: Microbiological laboratory procedures are involved in diagnosis and therapy control of progressive and refractory forms of periodontitis. In recent years techniques have been developed based on the detection of nucleic acids. The purpose of this study was to validate the commercially available micro‐Dent® test which employs probes for A. actinomycetemcomitans, P. gingivalis, P. intermedia, B. forsythus and T. denticola.

Methods: 122 plaque samples obtained from periodontal pockets with various depths from 33 early onset periodontitis (EOP) patients and 15 periodontally healthy subjects were analysed by cultivation and the microDent® kit.

Results: Both cultivation and the nucleic acid based assay showed a positive correlation of pocket depth with the frequency and quantity of periodontopathogenic species. T. denticola was found only in pockets > 4 mm in EOP patients. Comparison of the two methods revealed that the microDent® kit identified both P. gingivalis and B. forsythus more often than did the cultivation method.

Conclusions: Nucleic acid techniques should replace cultivation methods as gold standard in microbiological diagnosis of progressive periodontitis. The micro‐Dent® kit can be recommended for microbiological laboratories analysing subgingival plaque samples.
Sister chromatid exchange (SCE) analysis in periodontitis
Authors: Emingil Gülnur , Sapmaz Gül , Biçakçi Nurgün , Özkinay Ferda
Published: March 2003

Background: Emerging data indicate that genetic factors may be associated with the etiopathogenesis of aggressive periodontitis. Sister chromatid exchange (SCE) is a sensitive method that might reflect an instability of DNA or a deficiency of DNA repair. The aim of the present study was to investigate SCE frequency of patients with different forms of periodontal disease and to determine whether this cytogenetic marker in patients with aggressive periodontitis can be differential compared to patients with chronic periodontitis and control subjects.

Methods: SCE was analysed in peripheral blood lymphocyte chromosomes of 13 patients with generalised aggressive periodontitis (G‐AP), 10 patients with chronic periodontitis (CP) and 10 control subjects. The periodontal parameters of probing depth, clinical attachment level, the presence of bleeding on probing and plaque were recorded. Peripheral blood lymphocytes obtained from both patient groups and control subjects were cultured in the presence of 5‐Bromo‐2‐deoxyuridine in complete darkness for 72 h. For scoring SCE frequency, 20 metaphases were studied from each donor.

Results: The frequency of SCE was found to be 6.7 ± 0.9 per cell in patients with G‐AP, 6.5 ± 1.5 per cell in CP patients and 6.9 ± 1.1 in control subjects. No statistically significant differences were found between groups (p > 0.05).

Conclusions: The data indicate that there the cyotogenetic damage in the aggressive type of periodontal disease is not greater than in chronic periodontitis and control subjects. Although no aberrant cytogenetic damage was observed in different forms of periodontitis compared to control, this does not discount the importance of other genetic factors in the pathogenesis of periodontal disease.