bluuebunny/crossref_metadata_2025 huggingface dataset:
Untreated periodontal disease in Indonesian adolescents
Authors: Timmerman M.F. , Van der Weijden G.A. , Armand S. , Abbas F. , Winkel E.G. , Van Winkelhoff A.J. , Van der Velden U.
Published: December 2005

Abstract. At present, several risk factors for the initiation and progression of periodontitis have been identified. In order to investigate the role of various potential clinical and microbiological risk factors and indicators, a longitudinal study was initiated in a young population deprived from regular dental care. The present communication describes the baseline cross‐sectional data obtained in 1987 in terms of the clinical periodontal condition and prevalence of periodontal bacteria in the oral cavity. All inhabitants in the age range 15 25 years of a village with approximately 2000 inhabitants at a tea estate on Western Java, Indonesia, were examined clinically and microbiologically. In total, 255 adolescents, comprising 130 males and 125 females participated in the study. Samples for bacteriological examination were taken from the gingiva, the dorsum of the tongue, and the saliva. Plaque index, bleeding upon probing, pocket depth, and attachment loss (AL) were scored on the approximal surfaces from the vestibular aspect of all teeth as well as the mid‐vestibular and mid‐lingual aspects of the Ramfjord teeth. Calculus was scored only on the 4 surfaces of the Ramtjord teeth. Following the clinical measurements, the deepest bleeding pocket with no clinical loss of attachment was sampled for microbiological examination. In addition, in 37 subjects a deep bleeding (≥4 mm) with at least 4 mm of attachment loss was sampled. Moderate periodontitis (max. AL 3–4 mm) was found in 26% of the population, advanced periodontitis (max. AL ≥ 5 mm) in 8%, whereas 66% of the population showed no or minor periodontitis (max. AL 0–2 mm), Actinobacillus actinomycetetmcomitans was found in 57% of the population. Porphyromonas gingivalis in 87%. Prevotella intermedia and motile rods in all cases and spirochetes in 89%. P. gingivalis (66%), A. actinomycetemcomitans (37%) and spirochetes (63%) were, of all the sampled sites of the oral cavity, most frequently detected in pockets without attachment loss. Motile rods were most prevalent on the tongue and in the saliva (92% and 89%. respectively). A high prevalence of the investigated periodontal bacteria was detected both in the pockets without and with attachment loss. No significant association between the clinical periodontal parameters and the prevalence of the microorganisms was observed at a patient level. At a site level, both P. gingivalis and spirochetes were more prevalent in sites with attachment loss. The actual role of these putative periodontal pathogens may be elucidated more extensively, when longitudinal data on the present population become available.
Pre‐transplant gingival hyperplasia predicts severe cyclosporin‐induced gingival overgrowth in renal transplant patients
Authors: Varga E. , Lennon M. A. , Mair L.H.
Published: December 2005

Abstract. The relationship between the pre‐transplant periodontal status and the development of post‐transplant gingival overgrowth was investigated in a longitudinal study. The periodontal condition of 35 patients was examined on 2 occasions while they were on the transplant waiting list and then at 4–6, 10–12, 16 and 20 weeks post‐transplant. At each visit the plaque index, the bleeding index and a pocket index (CPITN) were measured. Dental impressions were taken of the pre‐ and post‐transplant gingival condition and used to make stone models which were used to score the gingival overgrowth index (GOI). The patients divided into 3 distinct groups having severe (n= 13), mild (n= 16) or no post‐transplant gingival overgrowth (n=6). Only 1 of the patients had taken cyclosporin prior to inclusion into the study. All the patients who developed severe overgrowth had evidence of gingival hyperplasia before the transplant. There was no difference in the serum cyclosporin levels between the three groups (χ2<2.28, p>0.319). Furthermore, there was no statistical difference for any of the periodontal indices. This study indicates that the hyperplastic gingival inflammatory response of some individuals appears to be potentiated by cyclosporin resulting in severe post‐transplant overgrowth. In other patients the same reaction may allow the fibroblastic activity to occur to an extent where it produces a mild clinically apparent overgrowth.
Healing patterns in recession defects treated with ePTFE membranes and with free connective tissue grafts
Authors: Weng Dietmar , Hürzeler Markus B. , Quiñones Carlos R. , Pechstädt Bettina , Mota Luis , Caffesse Raul G.
Published: December 2005

Abstract. This study focussed on the biologic success of 2 different procedures for root coverage. In the maxillary canines of 7 beagle dogs, buccal recessions were created and treated on one side with an ePTFE membrane (GTR‐group) and on the contralateral side with a free connective tissue graft from the palate (CT‐group). 2 areas served as negative controls. After 4 months of healing, histologic sections were processed and histologically analyzed. The evaluated parameters were coverage height, bone, cementum and connective tissue attachment regeneration, length of the epithelium, resorption, and ankylosis. Histologically, both GTR‐group and CT‐group produced more new bone, new cementum and new connective tissue attachment than the two control teeth. When histologically evaluated, the amount of new bone was more pronounced in the GTR‐group than in the CT‐group, however, no statistical differences in any of the evaluated parameters could be deteced between the 2 procedures tested. Frequency and distribution of resorption and ankylosis were similar in the GTR‐group and in the CT‐group, Within the limits of this study, no differences in terms of the biologic rehabilitation between those recessions treated with ePTFE membranes and those treated with a free connective tissue graft could be found.
Nicotine and smokeless tobacco effects on gingival and peripheral blood mononuclear cells
Authors: Bernzweig Eric , Payne Jeffrey B. , Reinhardt Richard A. , Dyer John K. , Patil Kashinath D.
Published: December 2005

Abstract. The pathogenesis of tobacco‐related periodontal diseases is not well understood. The purpose of this study was therefore to investigate smokeless tobacco extract (ST) and nicotine effects on prostaglandin E2 (PGE2) and interleukin‐1β (IL‐1β) secretion by peripheral blood mononuclear cells (PBMC, consisting of monocytes and lymphocytes) and gingival mononuclear cells (GMC). Both peripheral blood and gingival tissue adjacent to the alveolar crest were taken from non‐smoking adult periodontitis patients. Gingival tissue was treated with collagenase and deoxyribonuclease and GMC and PBMC were isolated by Ficoll‐Hypaque centrifugation. GMC and PBMC (100,000 cells/200 μl) were cultured for 24 hours in supplemented RPMI 1640 alone (control), or in supplemented RPMI 1640 containing 1% ST, 100μg/ml nicotine, 1 μg/ml Porphyromonas gingivalis LPS, or 1 μg/ml P. gingivalis LPS and either 100 μg/ml nicotine or 1% ST. Enzyme immunoassays were used to quantity PGE2 and IL‐1β. Treatments were compared by repeated measures ANOVA. 100 μg/ml nicotine (7‐fold, p<0.02) and 1% ST (3.5‐fold, p<0.004) significantly increased secretion of PGE2 by PBMC relative to control cultures. 100 μg/ml nicotine and 1% ST, however, had no effect on IL‐1β secretion by PBMC. Enhanced PGET secretion also was seen when PBMC were treated with P. gingivalis LPS+100 μg/ml nicotine relative to P. gingivalis LPS alone (p<0.007). In contrast, 100 μg/ml nicotine significantly downregulated IL‐1β secretion by GMC relative to medium alone (p<0.008) and had no effect on PGE2 secretion by GMC, These data indicate that while nicotine and ST can stimulate PBMC to secrete PGE2, they cannot activate further mononuclear cells extracted from gingiva, possibly due to maximal previous stimulation in the periodontitis lesion.
GTR treatment of degree III furcation defects with 2 different resorbable barriers An experimental study in dogs
Authors: Araújo M. G. , Berglundh T. , Lindhe J.
Published: December 2005

Abstract. The aim of the present study was to describe the periodontal tissue that formed after GTR when different resorbable barriers were applied to degree III furcation defects. The study was performed in 5 foxhound dogs. The 2nd and 4th premolars in both sides of the mandible were extracted. Degree III furcation defects were produced in the 3rd mandibular premolars. 5 weeks later. GTR therapy using a barrier composed by a polylactide‐glycolide copolymer was performed on one quadrant (group A). In the contralateral quadrant, a barrier made of polylactide and citric acid ester (group B) was used. The dogs were sacrificed 6 months after reconstructive therapy. Tissue blocks containing the experimental teeth were excised, demineralised in EDTA and embedded in paraffin. Serial sections were cut in the mesio‐distal plane and parallel with the long axis of the roots. The microtome was set at 7 μm. The sections were stained in hematoxyline and eosin. From each biopsy, 3 sections representing the central part of the furcation were selected for light microscopic examination. In the healed furcation sites, descriptive histological analysis and histomorphometric measurements of the newly formed tissues were performed. In both groups the root surface of the healed furcation defects was covered by a cellular, extrinsic‐intrinsic fibers type cementum. The composition of the newly formed periodontal ligament was similar in both groups. The proportions of bone, bone marrow and periodontal ligament, however, were substantially larger in group A than in group B. In Group B, an area in the previous furcation defect was consistently occupied by a granuloma. It is suggested that the presence of the granuloma in the healed furcation defect prevented bone regrowth.
Gingival ulceration in HIV infection
Authors: Robinson Peter G. , Sheiham Aubrey , Challacombe Stephen J. , Wren Michael W. D. , Zakrzewska Joanna M.
Published: December 2005

Abstract. All cases of HIV‐associated gingival ulceration seen at a dedicated dental clinic in a 5‐ycar period were reviewed and compared against other patients attending the clinic. 94 (7.1%) of 1308 patients had 146 episodes of gingival ulceration. 89 patients had 140 episodes similar to acute necrotising ulcerative gingivitis (ANUG) and responded well to conventional treatment for ANUG. The cases were compared with 269 controls in logistic regression. Gingival ulceration was associated with oral candidiasis, lower age and lack of AIDS diagnosis possibly due to a protective effect of co‐trimoxazole medication. 5 patients with neutropenia had extensive ulceration without the microflora of ANUG. Histopathology, viral and bacterial culture revealed non‐specific changes. The ulcers did not respond to the treatment regimen for ANUG but responded to treatment of their neutropenia. Gingival ulceration is not common in HIV infection. Most cases resemble severe ANUG. It is more frequent in younger people, those with oral candidiasis and without AIDS. Co‐trimoxazole may be protective. A minority of cases with ulceration and associated neutropenia resembled the non‐specific oral ulceration associated with HIV.
Interrelationship between periodontics and adult orthodontics
Authors: Ong Marianne A. , Wang Hom‐Lay , Smith Frederic N.
Published: December 2005

Abstract. The purpose of this review article is to provide the dental practitioner with an understanding of the interrelationship between periodontics and orthodontics in adults. Specific areas reviewed are how periodontal tissue reacts to orthodontic forces, influence of tooth movement on the periodontium, effect of circumferential supracrestal fiberotomy in preventing orthodontic relapse, effect of orthodontic bands on the periodontium, specific microbiology associated with orthodontic bands, mucogingival considerations and time relationship between orthodontic and periodontal therapy. In addition, the relationship between orthodontics and implant restorations (e.g., using dental implants as orthodontic anchorage) will be discussed.
Which periodontal changes are associated with HIV infection?
Authors: Robinson Peter G.
Published: December 2005

Abstract. To assess the validity of diagnostic criteria for HIV‐associated periodontal diseases, existing sets of criteria were applied post‐hoc to cross‐sectional data of the periodontal health of men with and without HIV and their ability to predict HIV infection was compared. Criteria for gingival or periodontal ulceration predicted HIV infection to a similar level. Criteria sensitive to erythema of the attached gingiva and interdental craters had high positive predictive values. Distinct gingival red bands did not predict HIV. 3 HIV‐associated periodontal changes were recognised: erythema of the attached gingiva; necrotizing periodontal disease and interdental craters. Epidemiological research should also consider conventional gingivitis and lost periodontal attachment. The presence or absence of all 5 conditions should be recorded at each site. Hierarchies of diagnoses with only the most severe condition assigned to each individual swamp valuable information.
Porphyromonas gingivalis, Prevotella intermedia and Bacteroides forsythus in plaque subjacent to bridge pontics
Authors: Wang Jen‐Chyan , Lai Chern‐Hsiung , Listgarten Max A.
Published: December 2005

Abstract. This study examined the distribution of P. gingivalis, P. intermedia and B. forsythus in plaque on metallic and porcelain pontics adjacent to healthy and inflamed mucosa. Subpontic plaque was collected from 33 inflamed and 31 healthy sites. Plaque suspension was incubated with specific rabbit antisera to P. gingivalis (FDC 381), P. intermedia (ATCC 25261) and B. forsythus (FDC 335), and the labelled cells disclosed with fluorescein‐labelled goat‐anti‐rabbit IgG by indirect immunofluorescence microscopy. Mean proportions of P. gingivalis, P. intermedia, and B. forsythus at inflamed sites were 0.60±0.75, 2.48±2.28, and 0.44±0.64% respectively, and at healthy sites 0.21±0.43, 1.27±1.05, and 0.15±0.18% respectively. These differences were statistically significant. Almost all sites were positive for P. intermedia, whereas only 12/31 healthy and 21/33 inflamed sites were positive for P. gingivalis.18/31 healthy and 28/33 inflamed sites were positive for B. forsythus. P. intermedia was recovered in higher proportions from metallic pontics adjacent to inflamed sites (MI) than healthy sites (MH) or porcelain pontics next to inflamed (PI) or healthy sites (PH), P. gingivalis is was recovered in higher proportions from MI than PH. We conclude that both the nature of the pontic material and the health status of the mucosa affect the composition of the associated microbiota.
Microbial factors and gingival crevicular fluid aspartate aminotransferase levels
Authors: Smith A. J. , Alexander M. , Mackenzie D. , Lennon A. , Riggio M. P. , MacFarlane T. W.
Published: December 2005

Abstract. The aim of this cross‐sectional study was to investigate the clinical application of chairside tests for gingival crevicular fluid (GCF) aspartale amino‐transferase (AST) levels and plaque BANA hydrolysis activity with the presence of the periodontal pathogens Porphyromonas gingivalis and Actinohacillus action‐mycetemcomitans. The study comprised 100 periodontitis sites (pocket depths≥4 mm. GI = 3) from 10 patients with chronic adult periodontitis and 100 control sites (pocket depths <4 mm. GI<3) from 10 periodontally healthy patients comprising 55 healthy sites (pocket depths <4 mm. GI=0) and 45 gingivitis sites (pocket depths <4 mm, GI=1 or 2). The values for both BANA hydrolysis and AST levels were significantly higher in samples from periodontitis compared with gingivitis and healthy sites (p<0.001), A. actinomycetemcomitans was identified in 45% and P. gingivalis in 17% of periodontitis sites but neither pathogen was recovered from control sites and there was no significant correlation with (he clinical parameters measured. There was no significant relationship between the presence of P. gingivalis and/or A. actinmycetemcomitans with BANA hydrolysis or AST levels. A significant correlation (p=0.0017) was observed between BANA hydrolysis and pocket depth and between AST hydrolysis and the GI (p=0.01). This study failed to demonstrate a positive association between chairside analysis of GCF metabolites for AST levels and/or BANA hydrolysis with P. gingivalis and A. actinomycetemcomitans. However, the GCF metabolites had a significant correlation with periodontally diseased sites in patients with chronic adult periodontitis and may help confirm clinical observations.
The use of metronidazole and amoxicillin in the treatment of advanced periodontal disease
Authors: Berglundh T. , Krok L. , Liljenberg B. , Westfelt E. , Serino G. , Lindhe J.
Published: December 2005

Abstract. The present clinical trial was performed to study the effect of systemic administration of metronidazole and amoxicillin as an adjunct to mechanical therapy in patients with advanced periodontal disease. 16 individuals, 10 female and 6 male, aged 35–58 years, with advanced periodontal disease were recruited. A baseline examination included assessment of clinical. radiographical, microbiological and histopathological characteristics of periodontal disease. The 16 patients were randomly distributed into 2 different samples of 8 subjects each. One sample of subjects received during the first 2 weeks of active periodontal therapy, antibiotics administered via the systemic route (metronidazole and amoxicillin). During the corresponding period, the 2nd sample of subjects received a placebo drug (placebo sample). In each of the 16 patients, 2 quadrants (1 in the maxilla and 1 in the mandible) were exposed to non‐surgical subgingival scaling and root planing. The contralateral quadrants were left without subgingival instrumentation. Thus, 4 different treatment groups were formed; group 1: antibiotic therapy but no scaling, group 2: antibiotic therapy plus scaling, group 3: placebo therapy but no scaling, group 4: placebo therapy plus scaling. Re‐examinations regarding the clinical parameters were performed, samples of the subgingival microbiota harvested and 1 soft tissue biopsy from 1 scaled and 1 non‐scaled quadrant obtained 2 months and 12 months after the completion of active therapy. The teeth included in groups 1 and 3 were following the 12‐month examination exposed to non‐surgical periodontal therapy, and subsequently exited from the study. Groups 2 and 4 were also re‐examined 24 months after baseline. The findings demonstrated that in patients with advanced periodontal disease, systemic administration of metronidazole plus amoxicillin resulted in (i) an improvement of the periodontal conditions, (ii) elimination/suppression of putative periodontal pathogens such as A. actinomycetemcomitans, P. gingivalis, P. intermedia and (iii) reduction of the size of the inflammatory lesion. The antibiotic regimen alone, however, was less effective than mechanical therapy with respect to reduction of BoP—positive sites, probing pocket depth reduction, probing attachment gain. The combined mechanical and systemic antibiotic therapy (group 2) was more effective than mechanical therapy alone in terms of improvement of clinical and microbiological features of periodontal disease.
Effect of a triclosan/copolymer dentifrice on the incidence of periodontal attachment loss in adolescents
Authors: Ellwood R. P. , Worthington H. V. , Blinkhorn A. S. B. , Volpe A. R. , Davles R. M.
Published: December 2005

Abstract. The aim of this study was to assess the effectiveness of a dentifrice containing 0.3% triclosan, 2.0% copolymer and 0.243% sodium fluoride (Colgate Total®) in the prevention of periodontal attachment loss in adolescents. A 3‐year, double‐blind, randomised, controlled, clinical trial was conducted on 641 adolescents, initially aged 11–13 years. The participants were enrolled from schools in economically deprived areas of Manchester, England, which had a high % of Asian pupils originating from India, Pakistan and Bangladesh. After the baseline examination, which included assessments of pocket depth, attachment loss and subgingival calculus, the adolescents were randomly allocated to use either a triclosan/copolymer or control dentifrice. The control was identical to the test dentifrice with the exception that it did not contain triclosan/copolymer. Participants were re‐examined after 18 and 36 months. After 3 years, a total of 239 adolescents remained in the test and 241 in the control group. The prevalence of attachment loss increased from 2% at baseline to 24% after 3 years. The mean increment of attachment loss during the study was 0.025 mm per site in the control group and 0.018 mm per site in the test group. A linear regression model showed a statistically significant difference in attachment loss between the test and control group, in adolescents with high mean pocket depths at baseline. No adverse effects attributable to the test or control dentifrices were observed during the study. This study has demonstrated that unsupervised use of a triclosan/copolymer dentifrice can significantly reduce periodontal attachment loss, particularly in adolescents with high mean pocket depths.
Association of crevicular fluid elastase‐like activity with histologically‐confirmed attachment loss in ligature‐induced periodontitis in beagle dogs
Authors: Renvert S. , Wikström M. , Mugrabi M. , Kelly A. , Claffey N.
Published: December 2005

Abstract. Experimental periodontitis was induced using ligatures in 6 beagle dogs over 57 days. Levels of elastase like activity in healthy sites, gingivitis sites, and in sites ligated for different time points were analyzed with respect to levels of histologically confirmed attachment loss. Attachment loss increased with increasing periods of ligation and reached a maximum of 0.15 mm at 57 days. Maximum loss of histological attachment was found to coincide with the period of maximum enzyme activity; during the first 7 days of ligature. Spearman correlation analysis of enzyme activity with attachment loss yielded a significant correlation (0.73, p=0.0396). The healthy and gingivitis sites were found to have minimal levels of enzyme activity throughout. Thus, this prospective study in beagle dogs found a relationship between histologically confirmed attachment loss and increased levels of elastase like activity indicating the probable usefulness of this parameter, either alone or in conjunction with other markers, for disclosing active periodontitis.
The effects of an ultrasonic toothbrush on plaque accumulation and gingival inflammation
Authors: Forgas‐Brockmann Lorraine B. , Carter‐Hanson Carrie , Killoy William J.
Published: December 2005

Abstract. The purpose of this study was to evaluate the effectiveness of an ultrasonic toothbrush to reduce plaque and gingival inflammation when compared to a manual toothbrush. 62 healthy adult patients with a plaque index of at least 2.0, a 50% bleeding index and at least 16 natural teeth participated in this study. 31 patients were randomly assigned to the manual toothbrush group (group A) and 31 were assigned to an ultrasonic toothbrush group (group B). The Turesky et al. plaque index (PI), Eastman bleeding index, and Löe & Silness gingival index (GI) were performed at baseline, 15, and 30 days at the beginning of each appointment (pre‐brushing). Patients then brushed with their assigned toothbrush and a post‐brushing plaque index was recorded. Kruskal‐Wallis one‐way analysis of variance (ANOVA) was performed to determine between group differences on the parameters of all clinical indices. Results of the pre‐brushing plaque index in group B were significantly lower at 15 and 30 days compared to group A. The post‐brushing plaque index demonstrated no statistically significant between or within group differences. Both groups demonstrated significant within group reductions in GI and BI from baseline to 15 days and from 15 to 30 days, however, no between group differences were noted. The results of this study support the ability of an ultrasonic toothbrush to significantly remove plaque and reduce inflammation as well as a manual toothbrush over a 30 day period.
Differential clinical treatment outcome after systemic metronidazole and amoxicillin in patients harboring Actinobacillus actinomycetemcomitans and/or Porphyromonas gingivalis
Authors: Flemmig T. F. , Milián E. , Karch H. , Klaiber B.
Published: December 2005

Abstract. 48 adult patients with untreated periodontitis harboring subgingival Actinobacillus actinomycetemcomitans and/or Porphyromonas gingivalis as assessed by PCR were randomly assigned to receive full‐mouth sealing alone (control) or scaling with systemic metronidazole plus amoxicillin and supragingival irrigation with chlorhexidine digluconate (test). In patients harboring A. actinomycetemcomitans intraorally at baseline, the adjunctive antimicrobial therapy resulted in a significantly higher incidence of probing attachment level (PAL) gain of 2 mm or more compared to scaling alone over 12 months (P< 0.05). In addition, suppression of A. actinomycetemcomitans in subgingival plaque below delectable levels was associated with an increased incidence of PAL gain. In contrast, patients initially harboring P. gingivalis but not A. actinomycetemcomitans in the oral cavity showed a significantly higher incidence of PAL loss following adjunctive antimicrobial therapy compared to scaling alone (P<0.05). When the presence of pathogens at baseline was disregarded in the analysis, adjunctive antimicrobial therapy did not significantly enhance clinical treatment outcome. The results indicated that adults with untreated periodontitis harboring A. actinomycetemcomitans may benefit from the adjunctive antimicrobial therapy for a minimum of 12 months, whereas, the regimen may adversely affect the clinical treatment outcome of patients harboring P. gingivalis but not A. actinomycetemcomitans.
Hyper‐reactive peripheral neutrophils in adult periodontitis: generation of chemiluminescence and intracellular hydrogen peroxide after in vitro priming and FcγR‐stimulation
Authors: Fredriksson M. , Gustafsson A. , Åsman B. , Bergström K.
Published: December 2005

Abstract. We have earlier reported a higher Fcγ‐receptor (FcγR)‐mediated generation of reactive oxygen species, measured as luminol‐enhanced chemiluminescence (CL) from peripheral neutrophils in adult periodontitis patients. The aims of this study were to confirm our previous results and lo elucidate the mechanism of this phenomenon by measuring CL in parallel with the intracellular production of hydrogen peroxide, after stimulation with opsonized bacteria. To determine whether the higher CL was associated with altered responsiveness to priming, the cells were preincubated with tumor necrosis factor α (TNFα) and lipopolysaccharide (LPS). While CL was significantly higher in subjects with periodontitis, there was no difference in hydrogen peroxide production between the patients and the controls, indicating that the hyperreactivity is related to the generation of other oxygen species than H2O2 and/or to processes in the outer cell membrane. The responsiveness to priming with LPS on CL was slightly but not significantly higher in the periodontitis group, suggesting that priming could be of value for distinguishing subjects with periodontitis. When assaying intracellular production of H2O2, TNFα and LPS had both a priming and an activating effect. There were no significant differences between the two groups. In conclusion, this study shows a higher FcγR‐mediated CL of peripheral neutrophils from adult patients with periodontitis, thus confirming our earlier results. The hyperreactivity seems to be related to the outer cell membrane or to oxygen species other than H2O2.
The effect of herbal extracts in an experimental mouthrinse on established plaque and gingivitis
Authors: Van der Weijden G. A. , Timmer C. J. , Timmerman M. F. , Reijerse E. , Mantel M. S. , van der Velden U.
Published: December 2005

Abstract. The purpose of the present study was to establish in vitro the inhibiting effect of a herbal extract mixture on a selected number of micro‐organisms and to test in vivo the effect of a mouthwash containing 6.3 mg/ml herbal extract mixture on plaque and gingivitis as compared to a minus active control mouthrinse. The herbal extract was a mixture of: Juniperus communis (juniper), Urtica dioca (nettle), Achillaea millefolium (yarrow); 1:1:1. In the study, in‐vitro, the effect of pure herbal extract mixture on acid production of Streptococcus mutans was tested and the minimum inhibitory concentrations (MIC) of the following micro‐organisms were tested: Streptococcus mutans, Streptococcus mitis, Actynomyces viscosus, Actynomyces naeslundii, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Campylobacter rectus, Fusobacterium nucleatum, Veillonella parvula. The MIC‐values for A. viscosus and P. gingivalis were 100 mg/ml. The MIC‐values for A. naeslundii and A. actinomycetemcomitans were considerably lower (10 mg/ml). S. mitis was the most susceptible of the tested organisms to the extract with a MIC value of 1 mg/ml. S. mutans, C. rectus, V. parvula, and F. nucleatum were not influenced by the extracts. No inhibitory effect of the 6.3 mg/ml herbal extract mixture was observed on the acid production of S. mutans. For the study in‐vivo, 45 volunteers were selected on the basis of having moderate gingival inflammation. As efficacy parameters the plaque index, modified gingival index and angulated bleeding index were assessed. The subjects were randomly divided among 3 experimental groups (2× test and 1‘minus active’control). The participants were requested to rinse with 10 ml of mouthwash twice a day for a period of three months. After 6 weeks and 3 months, the same clinical indices as at baseline were recorded. The results show no difference between the two test groups and the control group. In conclusion, the results of the present study have shown that the mixture of the 3 herbal extracts, Juniperus communis, Urtica dioca and Achillaea millefolium when used in a mouthrinse has no effect on plaque growth and gingival health.
Relationship between the plaque removal efficacy of a manual toothbrush and brushing force
Authors: Van der Weijden G. A. , Timmerman M. F. , Danser M. M. , Van der Velden U.
Published: December 2005

Abstract. This survey investigated the association between the efficacy of plaque removal and toothbrushing forces during a normal brushing regime. The 94 subjects participating in this study were requested not to brush 24 h prior to the experiment. Panellists brushed for 1 min with a manual toothbrush. Before and after brushing, plaque was assessed using the Turesky modification of the Quigley & Hein plaque index. A second 1‐min exercise of brushing was carried out to assess the toothbrushing force. The mean plaque reduction was 39%, with vestibular surfaces being cleaned most effective (69%) and the lingual surfaces the least (21%). The mean brushing force was 330 g. No correlation was observed between efficacy and brushing force (r=0.14, p=0.16). The relationship between pre‐ and post‐brushing plaque was stronger (r=0.68, p<0.001). Multiple regression analysis entering squared values of force as an independent variable into the equation, indicated that the relation between efficacy and force was not linear. A curve could be fitted to the plot (p=0.0004), demonstrating that up to a certain level of force, an increase of force is associated with an increase in efficacy (r=0.33, p<0.01). Beyond this point, application of higher forces resulted in reduced efficacy (r=‐0.49, p=0.03). As was calculated in this particular test this‘transition’level of force was 407.4 g. The absence of a correlation between brushing force and plaque removal efficacy suggests that in a‘user model’brushing situation, other factors than brushing force are of major influence on the amount of plaque removed.
Probe penetration in relation to the connective tissue attachment level: influence of tine shape and probing force
Authors: Bulthuis Hankie M. , Barendregt Dick S. , Timmerman Mark F. , Loos Bruno G. , van der Velden Ubele
Published: December 2005

Abstract. Previous research has shown that probing force and probe tine shape influence the clinically assessed probing depth. The purpose of the present study was to investigate the effect of tine shape and probing force on probe penetration, in relation to the microscopically assessed attachment level in untreated periodontal disease. In 22 patients, scheduled for partial or full mouth tooth extraction and no history of periodontal treatment, 135 teeth were selected. At mesial and distal sites of the teeth reference marks were cut. Three probe tines, mounted in a modified Florida Probe® handpiece, were tested: a tapered, a parallel and a bail‐ended; tip‐diameter 0.5 mm. The three tines were distributed at random over the sites. At each site increasing probing forces of 0.10 N, 0.15 N, 0.20 N, 0.25 N were used. After extraction, the teeth were cleaned and stained for connective tissue fiber attachment. The distance between the reference mark and the attachment level was determined using a stereomicroscope. The results showed that the parallel and ball‐ended tine measured significantly beyond the microscopically assessed attachment level at all force levels; with increasing forces, the parallel tine measured 0.96 to 1.38 mm and the ball‐ended tine 0.73 to 1.06 mm deeper. The tapered tine did not deviate significantly from the microscopic values at the forces of 0.15. 0.20 and 0.25 N. It can be concluded that for the optimal assessment of the attachment level in inflamed periodontal conditions, a tapered probe with a tip diameter of 0.5 mm and exerting a probing force of 0.25 N may be most suitable.
Gingival dimensions after root coverage with free connective tissue grafts
Authors: Müller Hans‐Peter , Eger Thomas , Schorb Andreas
Published: December 2005

Abstract. Traumatic injury in the presence of a thin and narrow zone of gingival tissue may lead to gingival recession. Especially in class I and II recessions, root coverage may be accomplished with connective tissue grafts. In order to prevent recurrent recession, altering gingival dimensions width and thickness might be of advantage. In the present study, dimensions of gingiva were followed for 1 year after root coverage with connective tissue grafts. The study population consisted of 18 patients with a total of 28 class I or II recessions. Gingival width and depth of the recession were measured with a caliper, and thickness of the marginal tissue with an ultrasonic device. Periodontal probing depth was determined with a pressure‐controlled electronic probe. Mean (±sd) recession depth at baseline was 3.l±l.4 mm. After 12 months, coverage amouted to 74±30%. Width of gingiva rose from 2.1±1.0 mm to 3.2±1.4 mm. whereas thickness was increased from 0.8±0.3 mm to 1.5±0.7 mm, on average. No significant alteration of periodontal probing depth was observed but a mean gain of clinical attachment of 1.7± 1.1 mm was ascertained. In a multiple regression analysis, recession depth and presence of the recession in the maxilla, but not tooth type significantly influenced relative root coverage (R2‐=0.34, p<0.01). Attachment gain after surgery depended on baseline attachment loss and was negatively influenced by smoking. The present results point to the possibility of doubling gingival thickness after root coverage with connective tissue crafts.
Home use oral hygiene product trials; timing of the last brushing before scoring; an assessment of variation
Authors: Renton‐Harper P. , Addy M. , Warren P. , Newcombe R. G.
Published: December 2005

Abstract. Home use studies to evaluate oral hygiene products often standardise the time lag between plaque scoring and the previous toothbrushing. Most protocols have favoured an evening before brushing regimen, but the rationale and even the validity of this approach has not been evaluated. In this study, a group of 30 adult subjects participated in a 4‐period randomised single‐blind crossover evaluation of within‐subjects and between‐subjects variation in plaque levels after two different brushing times. Thus, on 2 occasions, plaque was scored after an “evening before” brushing and on the other 2 occasions plaque was scored after a “morning before” brushing. As expected, mean plaque levels were lower after morning brushing, but only by 11%. There was little difference for lingual plaque (4%) but a greater difference for buccal plaque (18%), Comparisons for within‐subjects variation, which ideally should be low, favoured morning brushing but differences were small and not significant. Comparisons for between subjects variation, which ideally should be high to permit discrimination between high and low plaque formers, also favoured morning brushing but were only significant for lingual plaque. Intraclass correlation coefficients of reliability revealed that overall repeatability was high for both morning and evening regimens; marginally favouring morning brushing. Analyses using all four scores per subject disregarding timing of brushing increased within subjects variation and decreased repeatability, particularly for buccal plaque. In conclusion, the data support the concept of standardising the time between plaque scoring and the previous tooth‐brushing. There were no clear statistically significant grounds for preferring one brushing regimen to the other, however the data favoured the morning brushing.
Contribution of individual drugs to gingival overgrowth in adult and juvenile renal transplant patients treated with multiple therapy
Authors: Wilson R. F. , Morel A. , Smith D. , Koffman C. G. , Ogg C. S. , Rigden S. P. A. , Ashley F. P.
Published: December 2005

Abstract. Drug regimens for transplantation often consist of multiple therapeutic agents and may result in drug‐induced gingival overgrowth (DIGO). The aim of this study was to investigate the contribution of individual drugs in renal transplant patients. 147 adults (19–84 years) and 60 juveniles (3–18 years) were scored for DIGO and other clinical variables. Duration of treatment, dosage of drugs per kg body weight and serum cyclosporin levels were recorded. 44% of adults and 27% of children had DIGO. All patients were receiving prednisolone. More adults than children were administered cyclosporin, the reverse was true of azathioprine (P0.01), Explanatory models were evaluated by stepwise ordinal polynomial logistic regression. Statistically significant explanation (P0.05) of DIGO was afforded by prednisolone, nifedipine and azathioprine concentrations in adults and by cyclosporin, nifedipine and azathioprine concentrations in juveniles. Prednisolone and azathioprine were inversely related to the degree of DIGO. Plaque and irregularity scores, lip coverage and mouthbreathing status showed significant additional explanation in adults, replacing nifedipine and azathioprine in the final model. Irregularity was additionally explanatory in children, but no other clinical variables. A larger proportion of the variance of DIGO was explained by the available variables in children than in adults (pseudo r2=0.50 versus 0.25). The degree of DIGO in renal transplant patients is influenced by the dosage of a number of individual components of multiple drug therapy independently of the presence of local clinical factors.
Therapy‐resistant periodontitis. Psychosocial characteristics
Authors: Axtelius Björn , Söderfeldt Björn , Nilsson Alf , Edwardsson Stig , Attström Rolf
Published: December 2005

Abstract. This study investigated the perspective of a stress system disorder in the pathogenesis of therapy‐resistant periodontitis. The goal was to find indications that the stress‐behaviour‐immune system model holds as an explanatory model for the understanding of periodontal disease, 2 patient‐groups were compared: one group classified as responding well to periodontal treatment (responsive‐group. R‐group. n= 11); the other group was classified as responding less well to treatment (non‐responsive‐group. NR‐group, n=l I), Somatic and psychological factors were described as obtained by interviews and psychological testings. These findings were related to clinical data documented during the treatment of the patients. An exact logistic multivariate regression analysis was performed on a model based on variables selected by bivariate analysis (variable versus group). The results indicated that the NR‐group patients displayed indications of more psychosocial strain and a more passive‐dependent personality. The R‐group patients displayed a more rigid personality and possibly a less stressful psychosocial situation in the past. The report highlights the possible contribution of stress factors in the context of therapy resistant periodontal disease, and the results seem to be understandable within the context of a stress system disorder perspective.
GTR therapy of intrabony defects using 2 different bioresorbable membranes: 12‐month results
Authors: Christgau M. , Bader N. , Schmalz G. , Hiller K.‐A. , Wenzel A.
Published: December 2005

Abstract. This prospective split‐mouth study was designed to compare the clinical and radiographic healing results in intrabony periodontal defects 12 months after GTR therapy with 2 different bioresorbable barriers. The study comprised 25 healthy patients with one pair of contralaterally located intrabony defects with a probing pocket depth of ≥6 mm and radiographic evidence of angular bone loss of ≥4 mm. The 2 defects of each patient were randomized for treatment either with polylactic acid (PLA) membranes or with polyglactin‐910 (PG‐910) membranes. The patients received systemic doxycycline (100 mg/d) for 11 days post‐operatively. One blinded examiner recorded the following clinical parameters using a pressure calibrated probe at baseline and after 12 months: papillary bleeding index (PBI), gingival recession (REC), probing pocket depth (PPD), and probing attachment level (PAL). The vertical relative attachment gain (V‐rAG) was calculated as a % of the PAL gain related to the maximum possible attachment gain (expressed by the intrraoperatively measured depth of the osseous defect). Geometrically standardized intraoral radiographs were quantitatively evaluated for bone changes (density, area) in the defect region using digital subtraction radiography (DSR). Clinical and radiographic data were statistically analyzed using the Wilcoxon‐signed‐rank test (α=0.05). Postoperative membrane exposures occurred in 9 PLA and 13 PG‐910 treated sites. After 12 months of healing, both barrier types provided significant PPD reductions and PAL gain [median (25/75 percentile)]: ΔPPD (PLA: 3.0 (2.0/4.0) mm: PG‐910: 3.0 (2.0/4.5) mm]; ΔPAL [PLA: 3.0 (2.5/4.0) mm: PG‐910: 2.0 (1.0/4.0) mm]. V‐rAG amounted to 60% in PLA sites and 54% in PG‐910 sites. DSR revealed significant bone density gain after 12 months. 58.3% of she initial defect area in PLA sites and 54.0% of the initial defect area in PG‐910 sites showed bone density gain. Neither clinical nor radiographic data revealed any significant difference between the 2 barrier types after 12 months. In conclusion, this 12‐month study demonstrated that PLA and PG‐910 membranes provided similar favorable regeneration results in deep intrabony periodontal defects.
Serum IgG antibody response to Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis: implications for periodontal diagnosis
Authors: Lamster Ira B. , Kaluszhner‐Shapira Irina , Herrera‐Abreu Miriam , Sinha Rakhi , Grbic John T.
Published: December 2005

Abstract. The relationship of the serum antibody titer and avidity to the putative periodontal pathogens Actinobacillus actinomycetemcomitans (Aa) strains Y4 and 29523 and Porphyromonas gingivalis (Pg) strain 381 were examined in relation to clinical parameters in 26 gingivitis and 28 periodontitis patients. The relationship of antibody titer and avidity to infection with the homologous organism was also examined in a subset of 30 patients. Antibody titer was determined by an enzyme‐linked immunosorbent assay, and antibody avidity was assessed using a dissociation assay. Considering all patients, there was a significant negative correlation between mean probing depth and antibody titer (r=‐0.28) and avidity (r=‐0.28) to Aa Y4. There was a significant positive correlation of probing depth and antibody titer (r=0.46) and avidity (r=0.46) to Pg. The correlation of antibody titer and avidity to Aa and infection with Aa Y4 (r=‐0.32, r=‐0.21) and Aa 29523 (r=‐0.35, r=‐0.39) was negative, while the correlations of titer and avidity to Pg and presence of the organisms was strongly positive (r=0.40, r=0.35). These data indicate that the relationship of serum antibody titer and avidity to clinical parameters of periodontal disease severity and the level of infection with the homologous organism appears to be different for Aa and Pg. The development of an antibody response to Aa appears to protect the individual from infection with the organism. In contrast, the development of an antibody response to Pg was not able to eliminate the infection. These results should be considered when developing a diagnostic strategy for periodontal disease utilizing the humoral immune response.
Psychosocial factors, dental plaque levels and smoking in periodontitis patients
Authors: da Silva A. M. Monteiro , Newman H. N. , Oakley D. A. , O'Leary R.
Published: December 2005

Abstract. Psychological disturbances may lead patients to neglect oral hygiene. This study investigated whether a number of psychosocial factors (depression, state and trait anxiety, total and average perceived stress, and loneliness) could predict dental plaque levels in patients with adult onset rapidly progressive periodontitis (RPP) and routine chronic adult periodontitis (RCAP), before periodontal treatment. It was also examined whether RPP and RCAP patients differed on plaque and smoking. Plaque was scored in a sample of 6 teeth in each of 80 subjects, 40 with RPP, 40 with RCAP, before psychosocial questionnaire completion. Multiple regression was performed between plaque as the dependent and psychosocial factors, gender, education, form of periodontitis and smoking as independent variables. Only gender contributed significantly to prediction of plaque, t=‐2.70, p=0.01, partial regression coefficient ‐0.37, 95% CI; ‐0.64 to ‐0.10, indicating that plaque was on average 0.37 lower for females than males, after adjusting for the other predictor variables. It was confirmed that RPP and RCAP patients did not differ significantly on plaque, univariate r‐test(69.99)= 0.65, p=0.13. However, RPP patients smoked significantly more than RCAP patients t(69.72)=2.36, p=0.02. There was also a marginally significant correlation between depression and smoking, r=0.l6, p=0.01. One possible reason advanced for the lack of an association between psychosocial factors and plaque, and the absence of a difference in plaque between RPP and RCAP patients is the fact that the patients involved in the present study were seen as secondary referrals. The gender difference in plaque levels and the greater incidence of smoking in RPP patients may be of significance in planning interventions with patients with periodontitis.