bluuebunny/crossref_metadata_2025 huggingface dataset:
Histopathology of initial gingivitis in humans
Authors: Klinge Björn , Matsson Lars , Attström Rolf
Published: December 2005

Abstract The present study concerns the inflammatory alterations in the gingival margin during initial gingivitis in 11–13 year old human subjects.

At day 0 of the experiment, all participants had clean teeth and healthy gingiva. All active oral hygiene measures were excluded for 4 days. From upper and lower premolars, which were extracted for orthodontic reasons, contralateral gingival biopsies, including the tooth and the adjacent gingiva, were obtained on days 0 and 4. The presence of inflammatory cells in the junctional epithelium and the adjacent connective tissue was determined quantitatively in semi‐thin sections. The collagen content of the gingival margin was also determined.

From day 0 to day 4 there was only a slight increase in the number of neutrophilic granulocytes in the junctional epithelium and adjacent connective tissue, while a more pronounced increase was found in the number of mononuclear leukocytes. A loss of collagen was noticed in 4 of the subjects, while 2 did not show any changes in collagen content.

The inflammatory reaction seen in the present study differs somewhat from that observed in adult humans and adult dogs. The results correspond more to the reaction seen in juvenile dogs.
Longitudinal evaluation of a system for self‐monitoring plaque control effectiveness in orthodontic patients
Authors: Boyd Robert L.
Published: December 2005

Abstract This study was undertaken to determine the effectiveness of the Plaklite® as an adjunct to plaque control instruction in orthodontic patients. 24 subjects, aged 9–14, who were to receive full banded Edgewise orthodontic appliances, were divided randomly into 3 groups. The first group was a control and did not receive structured plaque control instructions. The second group received plaque control instructions using the modified Bass brushing technique with no disclosant. The third group received a similar type of plaque control instructions supplemented with instructions in the use of a Plaklite to self‐assess the effectiveness of plaque control. Both plaque control groups received monthly reinforcement of their initial instructions for the first 5 months of orthodontic treatment. The Plaque Index and Gingivitis Index were utilized to assess plaque and gingival inflammation before and after banding, and at 6‐week intervals for the first 9 months of treatment. These indices were recorded single blind. The results indicated that plaque and gingivitis scores progressively increased during the test period for the control group. Also those subjects who received a plaque control program which included the Plaklite had a more sustained improvement in plaque and gingivitis scores for the test period than the group receiving plaque control instructions only.
Clinical and histological characteristics of lyophilized allogenic dura mater in periodontal bony defects in humans
Authors: Busschop J. , De Boever J.
Published: December 2005

Abstract This clinical and histological study investigated the use of lyophilized, allogenic dura mater (Lyodura ®) as a periodontal implant material in interdental bony defects (2‐wall lesions) in humans.

For 23 defects in 8 subjects a modified Widman flap was raised, curettage performed and the defects bridged with the implant. The same procedure, without Lyodura implantation, was performed on 23 contralateral teeth.

By a standardized method, involving the use of a removable stent, the following clinical measurements were recorded after 24 and 48 weeks: the probing attachment level, the probing bone level, the probing pocket depth and the labial and interdental gingival recession.

For the histological study 5 additional, interdental craters arid 5 control defects were treated as in the clinical study. They were block‐sectioned after 1,2,6,12 and 24 weeks and processed in the usual manner for routine examination by light and polarization microscopy.

From the clinical study it could be concluded that, in absolute values, only the experimental side showed a significant gain in probing attachment level and a greater reduction of the probing pocket depth. In percentage values the labial gingival recession was significantly lower and the bone formation significantly more pronounced on the experimental side.

The histological examination showed that the implant remodelled completely without rejection phenomena. It was replaced gradually, after enzymatic breakdown, by the host's own collagen through the action of invading fibroblasts.

Bone formation occurred along but never in the implant. The implant material seems to act as a barrier against epithelial downgrowth and infiltration of inflammatory cells.
Antibiotic susceptibility testing of subgingival plaque samples
Authors: Walker Clay B. , Gordon Jeffrey M. , Socransky Sigmund S.
Published: December 2005

Abstract The in vitro inhibitory effect of several antimicrobial agents was determined against dispensed dental plaque samples taken from periodontally diseased sites as an aid in the selection of antibiotics for adjunctive use in periodontal therapy. 2 groups of patients were sampled. 1 group of 10 patients with severely advanced disease had received periodontal treatment which included the frequent adjunctive use of an antibiotic. The second group consisted of 15 individuals with less severe periodontal disease; only 4 individuals had been previously treated with antibiotics for their periodontal disease. Bacterial samples of subgingival plaque were taken from each patient and tested against a battery of antibiotics to determine which agent was the most effective in suppressing bacterial growth. Each antibiotic was incorporated into Trypticasesoy blood agar at a concentration equivalent to that achieved in either gingival fluid or blood following recommended oral dosages. The inhibitory effect was determined by comparing the number of bacteria recovered on the antibiotic‐containing medium to the total number of bacteria recovered on the basal medium. Penicillins, with the exception of cloxacillin, were the most effective in inhibiting bacterial growth. Benzylpenicillin consistently inhibited the growth of 90% of the isolates recovered on‐media free of antibiotics while ampicillin and amoxicillin frequently inhibited 99% or more of the bacteria recovered. Tetracycline was generally inhibitory for at least 90% of the isolates if the patients had not been previously treated with this agent. However, resistance to this drug was common in samples taken from patients previously treated with tetracycline. Doxycycline, a tetracycline derivative, did not inhibit significantly more isolates than tetracycline. Clindamycin was inhibitory for 90% or more of the organisms in most of the samples; and. was usually effective in inhibiting isolates in samples which exhibited large numbers of isolates resistant to tetracycline. Erythromycin was relatively ineffective against the isolates recovered from samples from the severely diseased group but was inhibitory to isolates in some samples taken from the more moderately diseased group. Metronidazole, at the concentration tested, was largely ineffective against the isolates in bacterial samples from both groups. No single antimicrobial agent was found to be inhibitory for greater than 90% of the bacteria recovered from all of the subgingival plaque samples with the possible exception of some penicillins.
Clinical and microbiological effects of subgingival restorations with overhanging or clinically perfect margins
Authors: Lang Niklaus P. , Kiel Robert A. , Anderhalden Katharina
Published: December 2005

Abstract The close association between restorations with overhanging margins and chronic destructive periodontitis has been known for many years. However, the mechanisms by which overhanging restorations will interact in the pathogenesis of periodontal disease are still unknown. Generally it is accepted that overhanging restorations contribute to the promotion of the disease process by virtue of their capacity to retain bacterial plaque. The purpose of the present study was to determine if the placement of subgingival restorations with overhanging margins results in changes in the subgingival microflora.

9 dental students with clean teeth and clinically healthy gingivae (GI < 0.1) gave their consent to participate in the study. 5 MOD cast gold onlays with 1 mm proximal overhanging margins were placed in mandibular molars for 19–27 weeks. They were replaced in a cross‐over design by 5 similar onlays with clinically perfect margins which served as controls. Another 5 onlays were placed in reverse order in the remaining patients.

Prior to and every 2–3 weeks after insertion, subgingival microbiological samples were obtained by inserting a fine sterile paper point for 30 sec into the gingival sulcus subjacent to the restoration. The predominant cultivable flora was determined using continuous anaerobic culturing techniques. Following the placement of restorations with overhanging margins, a subgingival flora was detected which closely resembled that of chronic periodontitis. Increased proportions of Gram‐negative anaerobic bacteria black‐pigmented Bacteroides and an increased anaerobe: facultative ratio were noted. Following the placement of the restorations with clinically perfect margins, a microflora characteristic for gingival health or initial gingivitis was observed.

Black‐pigmented Bacteroides were detected in very low proportions (1.6–3.8%). These changes in the subgingival microflora were obvious irrespective of whether the restorations with the overhanging margins were placed in the first period of the experiment or following the cross‐over. Clinically, increasing gingival indices were detected at the sites where overhanging margins were placed. Bleeding on gentle probing always preceded the peak level of black‐pigmented Bacteroides, Loss of attachment was not detected in any site. Changes in the subgingival microflora after the placement of restorations with overhanging margins document a potential mechanism for the initiation of periodontal disease associated with iatrogenic factors.
Observations on gingival health in communities with and without school‐based preventive programs
Authors: Marthaler T. M. , Moos B.
Published: December 2005

Abstract The effect of school‐based preventive programs was studied in 13–15 year old children living in 2 regions.

In one region, those children who had tooth brushing exercises showed less plaque and gingivitis than control children, while in the other region the respective findings were equivocal.

In general relatively low levels of caries prevalence were found. In the discussion part of the unexpected results are explained.
Behavior of neutrophilic granulocytes in a case of Papillon‐Lefèvre syndrome
Authors: Schroeder H. E. , Seger R. A. , Keller H. U. , Rateitschak‐Plüss E. M.
Published: December 2005

Abstract Recently we had the opportunity 10 examine and follow up over a period of 2 years an unusual case of Papillon‐Lefèvre syndrome (PLS). A 10 year old boy exhibited all symptoms typical of PLS except periodontitis and premature loss of deciduous teeth. The present report aimed at studying the functional capacity of his neutiophilic granulocytes. It integrates clinical observations, histopathological findings and results of in vitro tests, The bioptic material examined included one gingival biopsy, extracted teeth, suppurative material discharged from periodontal pockets, pus emanating from a mucosal abscess, and peripheral blood leucocytes. The neutrophils were sampled on two separate occasions in two independent laboratories and tested for a variety of functions, i.e. motility, random and directional locomotion (chemotaxis), phagocytosis, membrane potential depolarization, oxygen consumption, NBT reduction, and intracellular killing of bacteria and fungi. Findings and test data indicated that in this case of PLS, neutrophilic granulocytes behaved normally with respect to all these functions including margination in blood vessels, emigration, phagocytosis of a broad range of bacteria, degranulation of lysosomes, and intracellular destruction. The data imply that factors other than neutrophil defects may be responsible for rapidly destructive periodontitis in cases where PLS is not associated with an increased susceptibility to infection.
Potential cariogenicity of low and high sucrose dietary patterns
Authors: Graf Hans
Published: December 2005

Abstract In vivo daytime plaque pH telemetry during 2 week periods was combined with measurement of changes in enamel microhardness and analysis of microbial plaque composition in 2 human subjects. Well defined sucrose rich and sucrose poor diets were used as variables. During the 2 weeks of the high sucrose diet (50–80 g/day), a high cariogenic add attack calculated from pH changes in “Proton hours” was associated with a marked progressive decrease in enamel microhardness. The low sucrose diet (2–6 g/day) showed a low “Proton hour” acid attack during the entire 2 weeks. The decrease in enamel microhardness, however, was low only during the first week. After day 7 a marked decrease could be observed. It could not be explained by the glycolytic activity of the plaque, which was low. Streptococcus mutans was present in all microbial samples.
Microbiological and clinical effects of topical subgingival antimicrobial treatment on human periodontal disease
Authors: Rosling Bengt G. , Slots Jbroen , Webber Richard L. , Christersson Lars A. , Genco Robert J.
Published: December 2005

Abstract. This study was undertaken to evaluate the microbiological and clinical effects of a subgingivally applied mixture of H2O2‐NaCl and NaHCO3 followed by subgingival irrigation with 1% Betadine® in the treatment of periodontal disease. 20 adults with moderate to severe periodontal disease were included in a split mouth design study. All patients were given oral hygiene instructions and were subjected to supragingival scaling in all 4 quadrants, and subgingival scaling and root planing of half the dentition. 10 patients were instructed to use the chemical antimicrobial mixture twice a day instead of dentifrice, and also received professional application of the mixture once every 14 days for 3 months in connection with reinstruction in oral hygiene procedures. The remaining 10 patients received oral hygiene instructions combined with professional tooth cleaning without use of chemicals once every 14 days during a 3–month period.

The effect of treatment was evaluated by monitoring the subgingival microflora, clinical periodontal parameters, and by computer assisted subtraction analysis of serial standardized radiographs to determine changes in mass of the supporting alveolar bone.

The present study revealed that subgingival debridement combined with mechanical plaque control resulted in decreased numbers of subgingival microorganisms including spirochetes and motile rods, and arrested the progressive breakdown of the periodontal tissues. Topical antimicrobial agents used in combination with subgingival scaling further reduced the subgingival microflora and substantially improved early periodontal healing including gain of probing attachment level and gain in radiographic alveolar bone mass during the 12 months of observation. No clinical improvement but a tendency to further periodontal breakdown was found in the unsealed quadrants, even in those which were subjected to a personal application of the topical antimicrobial mixture.

This study indicates that professional and personal subgingival application of a mixture of H2O3‐NaCl and NaHCO3 will significantly enhance the microbiological and clinical effects of peridontal scaling and root planing. These agents, and the topical mode of antimicrobial therapy seem promising in the management of human periodontal diseases.
Effects of nonsurgical periodontal therapy on periodontitis in humans
Authors: Garrett. J. Steven
Published: December 2005

Abstract. Root planing is an effective method of treating both moderate and severe periodontitis. Predictable and significant improvements in bleeding scores, probing pocket depths and probing attachment levels have been demonstrated by a number of different research groups. Significant positive changes in the subgingival microflora are induced. These improvements can be sustained for longer periods of time if adequate supragingival plaque control is achieved.

It is important to realize that the research to date excludes the effects of therapy on furcation pockets. Results of conservative therapy in this critical area remain to be studied.
Plaque‐host imbalance in severe periodontitis
Authors: Newman H. N. , Rule D. C.
Published: December 2005

Abstract. One child and one adult with severe periodontitis were investigated for relevant systemic factors and predominant periodontal pocket bacteria. The child had a chronic neutropenia, the adult late yaws, a chronic iron deficiency and possibly rheumatoid arthritis. The predominant organisms in both pocket floras were gram‐negative cocci showing occasional filament formation and resembling strains of Bacteroides asaccharolylicus and possibly Actinobacillus actinomyceiemcomitcins described by others. There were indications that the flora was determined by the host response rather than vice versa and that thorough systemic investigation may aid the efficient diagnosis and treatment of patients with severe periodontitis.
Significance of frequency of professional tooth cleaning for healing following periodontal surgery
Authors: Westeelt Elisabeth , Nyman Sture , Socransky Sigmund , Lindhe Jan
Published: December 2005

Abstract. The present investigation was undertaken to study the significance of frequently repeated professional tooth cleaning for healing results following periodontal surgery. 24 patients suffering from moderately advanced periodontal disease were selected for the study. Following a Baseline examination comprising assessment of oral hygiene status, gingival conditions, probing depths and attachment levels, all patients were given detailed instruction in proper oral hygiene measures. They were then subjected to periodontal surgery using the modified Widman flap procedure. During the initial 6 months after surgery all patients were enrolled in a maintenance care program which included measures such as scaling and professional tooth cleaning. The patients were randomly distributed into 3 different maintenance care groups. 8 patients (Group 1) received maintenance care once every 2 weeks, another 8 patients (Group 2) received a similar treatment once every 4 weeks while the remaining 8 patients (Group 3) were recalled once every 12 weeks. Following a reexamination at the termination of this 6month period the recall program was changed. Thus, during the subsequent 18 months of maintenance (the maintenance phase) all 24 patients were recalled for prophylaxis once every 3 months. A final reexamination was performed 24 months after completion of active therapy.

The reexamination performed 6 months after surgery revealed that while patients who had been recalled for professional tooth cleaning once every 2 weeks had low numbers of inflamed gingival units and deep (>3 mm) periodontal pockets, test subjects recalled less frequently exhibited an increasing number of inflamed gingival units and deep pockets. In addition, the frequency of sites exhibiting attachment loss of > 1 mm was closely related to the frequency of maintenance care. Patients recalled once every 12 weeks for maintenance therapy had 3 times the number of sites with attachment loss (>1 mm) as compared to those who were recalled once every 2 weeks. With the use of regression analysis critical probing depth values were calculated. This analysis showed that while the critical probing depth value was Sow in patients frequently recalled during the healing phase, this parameter adopted gradually increasing values in patients recalled with less frequent intervals. Between the 6‐ and 24‐month reexaminations there were no significant alterations of the oral hygiene status, the gingival condition or the probing depth and attachment level data in any of the 3 groups of patients.
Stannous fluoride and subgingival chlorhexidine irrigation in the control of plaque and chronic periodontitis
Authors: Wieder S. G. , Newman H. N. , Strahan J. D.
Published: December 2005

Abstract. The purpose of this study was to investigate the possible benefits of stannous fluoride dentifrice (SnF2) and once daily chlorhexidine (CH) in the control of chronic periodontitis, following a single course of scaling and root planing. 14 adult patients with pockets 4 mm or deeper received a thorough scaling and root planing, followed by instruction in the irrigation of those pockets with CH. They were given either SnF2:‐containing or a placebo dentifrice, and a new multituft toothbrush, but no instruction in routine oral hygiene.

Plaque Index (PII), Sulcus Bleeding Index (SBI) and pocket depth were recorded prior to scaling on day 0. The same parameters and gingival shrinkage were recorded at weeks .1, 2, 4, 8 and 12. CH irrigation was discontinued at day 28.

Both groups showed highly significant improvements in all parameters except gingival shrinkage after 28 days. PII was significantly less at all stages in the SnF2 group. It reached baseline values by day 56 in the placebo and day 84 in the SnF2 group. Periodontitis as assessed by SBI remained reduced significantly below baseline values in both groups at the end of the study. At this time there was no significant difference between the groups as regards SBI.

It was concluded that a single course of thorough scaling and root planing followed by once daily subgingival irrigation with CH for 1 month, produced a reduction in periodontitis still apparent 2 months after cessation of irrigation. This regime allows a 3‐month interval between oral hygiene visits. SnF2‐containing dentifrice had a plaque control effect additional to that produced by the regime but had no effect on periodontitis as assessed by SBI.
Effect of citric acid on soft tissue healing in the rat palate
Authors: Seymour G. J. , Romaniuk K. , Newcomb G. M.
Published: December 2005

Abstract. The present study was carried out to determine the effects of citric acid (pH I) on soft tissue healing. Standardised circular wounds were created in the palates of 24 rats using a modified trephine. Test animals had citric acid (pH I) applied to the wounds for 3 min followed by rinsing with saline. In the control animals saline alone was applied for a similar time which was again followed by rinsing. Animals were sacrificed at 0. 1, 4 and 24 h, the palates dissected out and fixed in either neutral formalin, formol‐sucrose for histochemical analysis or had epithelial sheets prepared for ATPase staining of Langerhans cells. At O. 1 and 4 h less enzyme activity (non‐specific esterase and acid phosphatase) was observed in the epithelium in the edge of the citric acid treated wounds compared to the controls. This was not seen at 24 h. No morphological difference was noted between the citric acid treated wounds and the controls at any of the time intervals. The morphology and distribution of ATPase positive Langerhans cells did not differ between the test and control wounds.

These results indicate that the application of citric acid (pH 1) has little effect on the short‐term healing of soft tissue wounds in the rat palate.
Periodontal status associated with chronic neutropenia
Authors: Baehni Pierre C. , Payot Pierre , Tsai Chi‐Cheng , Cimasoni Giorgio
Published: December 2005

Abstract. A case of chronic neutropenia in a 12‐year‐old boy is reported. The patient presented with severe gingival inflammation and alveolar bone loss, Immunologic analysis of the patient's serum revealed the presence of precipitating antibodies against antigenic components of Actinobacillus actinamycetemcomitans Y4 and 652. It was also found that the serum neutralized the leukotoxicactivity of Actinobacillus actinomycetemcomtians Y4. The etiology and the pathogenesis of periociontal disease in neutropenic patients are discussed in view of these findings.
Gingival bleeding after chlorhexidine rinses with or without mechanical oral hygiene
Authors: Asikainen Sirkka , Sandholm Leena , Sandman Sanna , Ainamo Jukka
Published: December 2005

Abstract In a previous paper a slight increase in gingival bleeding tendency was reported after the use of chlorhexidine rinses in dental students with clinically healthy gingivae. For further clarification of this finding the study was repeated using a split mouth approach. 30 dental students brushed the teeth in either the left or the right side of their mouth twice daily during a 7‐day period. After each brushing, they rinsed for 1 min with 10 ml of a 0.2% chlorhexidine digluconate solution. Both the Plaque Index (PII) scores and the bleeding tendency after massage of the gingival margin were low at the initial examination. The low PII scores at baseline were further reduced on both sides of the jaws. On the side which was only rinsed the PII scores were higher than on the side of combined mechanical and chemical cleaning. The gingival bleeding tendency was found to decrease on the brushed side and to increase on the side which was only rinsed. An increased bleeding tendency was most often observed in those individuals whose gingivae were the healthiest at baseline. A SEM analysis of the 2 sides of the dentition indicated that bleeding after chlorhexidine rinses may be associated with irritation from debris which, after the 7‐day period of no mechanical oral hygiene measures, seemed to obliterate the gingival sulcus.
Gingival IgE and histamine concentrations in patients with asthma and in patients with periodontitis
Authors: Hyyppä Tuula
Published: December 2005

AbstractIn the present study the concentrations of IgE and histamine were determined in gingival tissue of patients with asthma (N= 15), patients with periodontitis (N = 21) and healthy controls (N= 18).

Gingival IgE concentrations in the asthma group were markedly elevated confirming the results obtained in previous studies on salivary IgE concentrations. An increase of IgE was also observed in the periodontitis group.

Histamine concentrations in the asthma group did not differ from the healthy controls, while in the periodontitis group a significant decrease in gingival histamine concentrations was found.
Long‐term maintenance of patients treated for advanced periodontal disease*
Authors: Lindhe Jan , Nyman Sture
Published: December 2005

Abstract The aim of the present investigation was to evaluate the periodontal conditions of a group of patients who, following active treatment of extremely advanced periodontal disease, had been maintained for 14 years in a well‐supervised maintenance care program. The present sample included 61 subjects out of an initial group of 75 individuals who in 1969 were referred to and treated by the authors. Following an initial examination, the patients were given detailed instructions in proper plaque control measures and were subjected to scaling and root planing and surgical elimination of pathologically deepened pockets. After the termination of the active treatment phase, the patients were placed in a maintenance care program including recall appointments every 3–6 months. At the initial examination, immediately after the completion of the active treatment phase and then once a year, all patients were examined regarding oral hygiene, gingival conditions, probing depths and clinical attachment levels. In addition, the interproximal alveolar bone height was determined from full mouth radiographs obtained before active treatment, at the completion of active therapy and 1, 3, 5, 8, 10, 12 and 14 years after treatment.

The results from the repeated examinations demonstrated that treatment of advanced forms of periodontal disease resulted in clinically healthy periodontal conditions and that this state of “periodontal health” could be maintained in most patients and sites over a period of 14 years. It was also demonstrated that the treatment and maintenance programs described were equally effective in young and older patients.

The individual mean values describing probing depths, attachment levels, and bone heights did not vary significantly over the 14 years of observation. A more detailed analysis of the data revealed, however, that a small number of sites in a few patients lost a substantial amount of attachment. This attachment loss occurred at different time intervals during the course of the maintenance period. Thus, 43 surfaces in 15 different patients were exposed to recurrent periodontal disease of a significant magnitude. This recurrent inflammatory periodontal disease caused the loss of 16 teeth in 7 different patients during the maintenance period. The data reported question the validity of using individual mean values to describe alterations of the periodontal conditions during maintenance following active periodontal therapy.
Corticosteroid therapy and periodontal disease
Authors: Safkan B. , Knuuttila M.
Published: December 2005

Abstract In the present investigation, the frequency and severity of periodontal disease was assessed in a group of patients with multiple sclerosis receiving corticosteroid hormone therapy for neurological disease. Age‐matched patients with multiple sclerosis but without hormone therapy as well as healthy subjects served as controls. Individuals suffering from multiple sclerosis or polyneuropathies were selected from a pool of patients who were under treatment at the Department of Neurology, The Central Hospital of Kuopio, Finland. 27 individuals were identified who had received more than 1.5 g prednisonc over a 1–4 year period. The average amount of steroid given to these patients was 3.5 g. 26 individuals also suffering from neurologic disease had received no or only negligable amounts of hormone therapy and were used as diseased controls. Another control group comprised age‐ and sex‐matched healthy individuals from the city of Kuopio.

The dental examination which was performed by one dentist comprised assessments of the following parameters: oral hygiene status, gingival conditions, probing depth, gingival recession and height of the alveolar bone. The findings clearly demonstrated that patients with neurological disease who received corticosteroid therapy had the same frequency of gingivitis as non‐treated diseased controls. Furthermore, data describing probing depth, gingival recession and height of the alveolar bone revealed that there was no difference regarding the frequency and severity of periodontal disease between the 2 groups of neurological diseased patients. It was concluded that corticosteroid therapy maintained over 1‐4 years had no obvious influence on clinical parameters of periodontal disease in patients suffering from neurological disease.
A longitudinal study of untreated periodontal disease
Authors: Buckley Louis A. , Growley Michael J.
Published: December 2005

Abstract 1016 textile workers were examined during a baseline study in 1969/70. A follow‐up examination in 1979/80 identified 82 subjects who had not been treated for periodontal disease in the intervening period. There were 39 male and 43 female subjects; the average age at the initial examination was 27.0 years. There was an average tooth loss of 2.5 (SEM 0.6) teeth per subject over the 10‐year period. While periodontal disease was significantly related to oral hygiene at the outset, neither factor was significantly related to the degree of tooth loss.

A detailed analysis of the dynamics of the periodontal condition was undertaken. The subsequent results are presented in the form of transition matrices and clearly illustrate both the progression of periodontal disease and the degree of tooth loss associated with each level of periodontal disease at the initial examination.

The main findings are as follows.

(a) Overall 6% of teeth initially free of periodontal disease (P.I.O.) were lost compared to 14% with destructive periodontal disease (P.I.6).

(b) Progression of periodontal disease was slow for teeth initially free of periodontal disease and with mild gingivitis (P.1.0 and P.I.1) for all age groups. However severe gingivitis (P.1.2), resulted in more rapid deterioration of the supporting tissues in subjects over 35 years old at the final examination; 35% of such teeth changed to destructive periodontal disease (P. 1.6) compared to 17% of corresponding teeth for the under 35‐year age group. In contrast, a poorer prognosis was found for the teeth with destructive periodontal disease (P.1.6) in the younger age group.

(c) While the rate of progression of established periodontal disease was similar for anterior and posterior teeth, the onset of gingivitis was more pronounced in the latter.
Effect of chlorhexidine rinses on the morphology of early dental plaque formed on plastic film
Authors: Brecx Michel , Theilade Jorgan
Published: December 2005

Abstract The effect of chlorhexidine on early plaque formation was studied in vivo in order to assess potential structural and quantitative changes. 3 subjects with healthy gingiva were used. Plastic films were applied to the buccal surfaces of the maxillary right first premolars and plaque was allowed to form for either 4 or 24 h. A single 1‐min rinse with 0.2% chlorhexidine digluconate was used for the 4‐h experiments, 1 min after film placement, whereas, for the 24‐h experiments, an additional 1 min rinse was used at 12 h. In total, 62 films were obtained, half treated and half controls. These were processed for light and transmission electron microscopy, using standardized techniques for area sampling and cell counting.

All plastic films were covered by a surface coating of a cellular material in or on which bacteria, epithelial cells and leukocytes were observed. In the controls, an important increase in bacterial count was seen between 4 and 24 h, whereas the increase with chlorhexidine was slight. There were fewer bacteria in the chlorhexidine as compared to the water specimens, for both time periods. Many microorganisms in the chlorhexidine. Samples appeared to be undergoing degeneration with coagulated cytoplasm and disrupted cell walls.
Slow release metronidazole and a simplified mechanical oral hygiene regimen in the control of chronic periodontitis
Authors: Newman H. N. , Yeung F. I. S. , wan Yusof W. Z. A. B. , Addy M.
Published: December 2005

Abstract The present study is one of a series aimed at devising practical methods of control of chronic periodontitis that do not depend upon stringent interdental cleaning by the patient. The regime consists of professional and home care components thought to be realistic for general practice. Patients with chronic periodontitis, but without any complicating factor, such as systemic disease, recent antimicrobial therapy or occlusal traumatism were selected. They received an initial thorough scaling, root planing and an instruction in Bass brushing, using a multituft brush and a sodium fluoride toothpaste, but without emphasis on inter‐dental cleaning. They were then assigned to one of two groups, one of which received, in addition to the above mechanical oral hygiene regime, low (0.5 %) and the other high (40 %) dose metronidazole locally in periodontal pockets once a week for 4 weeks. The low dose was supplied in the form of solution inside fine dialysis tubing. The high dose was in the form of metronidazole powder incorporated in acrylic resin. Plaque index, sulcus bleeding index, probeable pocket depth and gingival shrinkage were monitored during this period and for a further 8 weeks. Both groups showed highly significant reductions in (supragingival) plaque and periodontal inflammation, maintained at least 8 weeks after the end of the 4‐week chemotherapy period. Reductions in SBI were greatest for the 40% metronidazole group. It was concluded that local metronidazole, even in the form of 0.5% metronidazole in a small portion of dialysis tubing, has a positive role in the control of chronic periodontitis.
Clinical, microbiological and immunological features associated with the treatment of active periodontosis lesions
Authors: Haffajee A. D. , Socransky S. S. , Ebersole J. L. , Smith D. J.
Published: December 2005

Abstract Clinical, microbiological and immunological factors were examined using data from a subject with periodontosis. The subject was monitored at bimonthly intervals for 26 months at 6 sites per tooth for redness, plaque, suppuration, bleeding on probing, pocket depth, and attachment level. Using attachment level measurements and the tolerance method of analysis, sites with active disease and control (inactive) sites of equal pocket depth were selected. Subgingival plaque samples were taken from these sites for predominant cultivable and dark field evaluation before, and 5 and 13 months after treatment by Widman flap surgery and systemic tetracycline. 50 isolates from each of 5 sites monitored before and after treatment were characterized and, if possible, identified. Active sites showed between 2 and 6 mm of attachment loss prior to therapy and “gained” between 2 and 9 mm of attachment after therapy. The control sites “gained” 0 to 1 mm of attachment after therapy. Bleeding on probing was significantly reduced after treatment, whereas plaque accumulation increased significantly in the sampled sites. Similar changes were seen in the remaining sites.

The proportions of Actinobacillus actinomycetemcomitans and Selenomonas sputigena were elevated in active sites, while proportions of Bacleroides intermedius were elevated in control sites. 5 months after treatment, proportions of A. actinomycetemcomitans, S. sputigena and Eikenella corrodens were significantly decreased in the previously active sites and proportions of B. intermedius and E. corrodens were significantly decreased in the control sites. 13 months after therapy, the proportions of Fusobacterium nucleatum and Capnocytophaga species had increased.

Multiple linear regression analysis was used to examine models which could “predict” the outcome, attachment level change in the previous monitoring period. The proportions of A. actinomycetemcomitans and S. sputigena, which were associated with destruction, coupled with the proportions of Streptococcus sanguis II and Campylobacter concisus which were associated with “gain” could predict prior attachment level change with an r2 of 0.93.

Humoral antibody response to A. actinomycetemcomitans and C. sputigena significantly increased in a period in which multiple actively breaking down sites were detected. Antibody responses to 20 other species tested did not significantly change during the course of monitoring. Crevicular fluid and tissue levels of antibody to A. actinomycetemcomitans were elevated in 5 of 6 active destructive lesions prior to therapy. Surgical and tetracycline therapy diminished the local antibody response to A. actinomycetemcomitans to levels found in serum.
Folate mouthwash: effects on established gingivitis in periodontal patients
Authors: Pack Angela R. C.
Published: December 2005

Abstract A double blind study was designed to determine the effects of folate mouthwash (MW) on established gingivitis in non‐pregnant adults. 60 subjects who had >20 teeth, visible gingival inflammation around >6 teeth, no complicated medical history, currently not receiving periodontal treatment or medication, and not wearing dentures, were randomly assigned to control or experimental groups. Full mouth assessment included plaque scores, gingival colour changes, bleeding tendency around every tooth and experience of disease and local factors. Subjects used 5 ml of MW twice daily for 4 weeks, rinsing for 1 min before expectorating. Experimental MW contained 5 mg folate per 5 ml. The control group used a placebo MW. A detailed 3‐day diet record was kept by each subject. The oral examination was repeated after 4 weeks. Initially, groups were similar except that the experimental group exhibited more bleeding sites at the outset, but after 4 weeks, the experimental group showed a significant decrease in mean number of colour change sites (from 70.17 ±12.89 to 56.62 ±17.42) and in bleeding sites (from 48.59 ±24.28 to 29.28 ±19.64) compared with control group (colour: from 66.93±15.27 to 66.20± 18.83; bleeding: from 36.93±16.96 to 39.47± 16.67)p<0.001. Dietary analysis showed that few subjects ate >200,μg folate daily. However, the level of dietary folate did not correlate with changes in inflammation in experimental subjects, r=0.097. Folate MW appears to have an influence on gingival health through local rather than systemic influence.
New concepts of destructive periodontal disease
Authors: Socransky S. S. , Haffajee A. D. , Goodson J. M. , Lindhe J.
Published: December 2005

Abstract The most common forms of destructive periodontal disease have been thought to slowly and continuously progress until treatment or tooth loss. Recently, data have become available which are inconsistent with this “continuous disease” hypothesis. Data from longitudinal monitoring of periodontal attachment levels and alveolar bone in humans and in animals suggest that periodontal disease progresses by recurrent acute episodes. In addition, rates of attachment loss have been measured in individual sites which are faster than those consistent with the continuous disease hypothesis or slower than those expected from estimates of prior loss rates. To account for these observations, a model of destructive periodontal disease is described in which bursts of activity occur for short periods of time in individual sites. These bursts appear to occur randomly at periodontal sites throughout the mouth. Some sites demonstrate a brief active burst of destructive periodontal disease (which could take a few days to a few months) before going into a period of remission. Other sites appear to be free of destructive periodontal disease throughout the individual's life. The sites which demonstrate destructive periodontal activity may show no further activity or could be subject to one or more bursts of activity at later time periods. Comparison of monitored loss rates for a year with mean loss rates prior to monitoring suggested that there may be relatively short periods in an individual's life in which many sites undergo periodontal destruction followed by periods of extended remission. An extension of the random disease model is also suggested in which bursts of destructive periodontal disease activity occur with higher frequency during certain periods of an individual's life.
Effect of metronidazole on chronic periodontal disease in subjects using a topically applied chlorhexidine gel
Authors: Joyston‐Bechal S. , Smales F. C. , Duckworth R.
Published: December 2005

Abstract A double blind between subject comparison of the effect of metronidazole and placebo tablets was completed over 22 weeks in 45 subjects with chronic periodontal disease ranging in severity from moderate (PI = 2.0–3.9) to high (PI = 4.0–6.0). All subjects used a topically applied chlorhexidine gel for the first 10 weeks. Throughout the trial plaque, bleeding and calculus were assessed on the buccal, lingual, mesial and distal surfaces of teeth 16, 21, 24, 36, 41 and 44 and their supporting tissues. The pocket depths on the same 4 aspects of all teeth present were measured.

The regime employed consisted of oral hygiene instruction (OHI) at the initial visit followed by scaling and further OHI at visits 1 and 2 weeks later. After the third visit 16×200 mg metronidazole or placebo tablets were issued with instructions to take 1 that evening and 3 per day at 5‐h intervals for the next 5 days. 4 weeks later, scaling and OHI were carried out and the course of test or placebo tablets was repeated. The subjects returned for further scaling and OHI 4 weeks later and the chlorhexidine gel was withdrawn. Final assessments were made 12 weeks later.

The results showed that metronidazole had no effect on plaque levels and gingival bleeding beyond the effect of OHI, scaling and chlorhexidine gel. On the other hand, significantly greater reductions in pocket depths were achieved with the use of metronidazole. A surprising and interesting finding was that these reductions were apparent only in the subjects with severe periodontal disease (PI = 4.0–6.0).
Effect of topical application of citric acid in the treatment of furcation involvement in human lower molars
Authors: Parori Ricardo J. , Esper Maria E.
Published: December 2005

Abstract Improvement of new attachment procedures using topically applied citric acid was tested in human beings. Furcation involvement and the adjacent proximal area were surgically exposed. Saline was used as placebo drug. Baseline pocket depth and attachment levels were scored prior to surgery and bone level recorded at the time of surgery. After 1, 3 and 6 months, the clinical parameters were re‐scored and at that time, a re‐entry operation allowed a new measurement of the bone level. In the post‐operative experimental periods, there was an improvement of all clinical parameters in both the control and experimental groups. Pocket depth reduction was consistent; the gain in the attachment level compared to the baseline examination in the experimental group and the improvement in the bone height level were statistically significant within the 6‐month post‐operative interval; however, in both the furcation and proximal areas, no statistically significant differences could be detected on comparing experimental and control groups.
A comparison of 3 systems for quantifying gingival crevicular fluid with respect to linearity and the effects of qualitative differences in fluids
Authors: Hinrichs James E. , Bandt Carl L. , Smith Judith A. , Golub Lorne M.
Published: December 2005

Abstract This investigation compares the Periotron 6000, Periotron 600, and ninhydrin area systems for quantifying gingival fluid. All systems have highly significant (p<0.001) linear relationships between measurements and fluid volumes. Additional curvilinear components have virtually no clinically significant implications. Qualitative differences in fluid only have clinically significant implications for the Periotron 600. When both quantitative and qualitative properties of gingival crevicular fluid are being investigated, the Periotron 6000 is the system of choice.
Toothbrushing frequency in 4 consecutive studies of Finnish adolescents
Authors: Nyyssonen V. , Honkala E.
Published: December 2005

Abstract This study aimed at analyzing the pattern of toothbrushing frequency over a period of 2 years in a group of Finnish adolescents. Data for this study were collected from 4 questionnaires distributed to a sample of adolescents born in 1960, 1962, and 1964. Subjects were divided into 4 groups according to their reported toothbrushing frequencies. Half of the subjects remained in the same category of brushing frequency (in 3 categories) during the consecutive studies. Among those having changed the frequency (54%), changing to a better toothbrushing frequency was more common among girls than among boys.